Table 6.
History taking for the dog with emesis
| A thorough history should be obtained during the initial assessment, including the following: | Example demonstrating the importance of this information | Reference (LOE) | Overall evidence grade |
|---|---|---|---|
| Onset and progression of signs | Sudden onset can suggest ingestion of foreign body or dietary indiscretion | 29 (4a) | C |
| Emesis or regurgitation | Regurgitation is seen in oesophageal disease | 132 (4b) | C |
| Relationship to eating | Vomiting > 10‐12 hours after meal indicates delayed gastric emptying (outflow obstruction, motility disorder) | 30 (4c) | C |
| The frequency, volume and nature of vomitus, including the presence of any fresh or digested blood | Haematemesis is sometimes seen after use of NSAIDs or acute vomiting | 133 (4c) | C |
| 134 (4b) | |||
| 85 (4a) | |||
| 135 (4c) | |||
| 136 (4c) | |||
| 137 (4c) | |||
| 138 (4c) | |||
| Whether or not there is any diarrhoea | Diarrhoea may suggest concurrent intestinal disease, but can be seen with other conditions e.g. pancreatitis | 139 (4b) | C |
| 140 (2a) | |||
| 85 (4a) | |||
| 141 (4c) | |||
| 142 (4c) | |||
| 143 (4a) | |||
| Presence and progression of weight loss | Weight loss suggests chronic disease, e.g. gastro‐intestinal tumour | 144 (4a) | C |
| Appetite and ability to maintain nutritional status | Early enteral nutrition is important in recovery | 145 (3b) | B |
| Fluid intake (increased, decreased or normal) | Polydipsia is seen with pyometritis | 146 (4a) | C |
| Presence and nature of any abdominal pain | Abdominal pain can e.g. be seen in pancreatitis | 85 (4b) | C |
| Recent changes in diet or provocative changes, including recent or ongoing drug treatment and access to toxins or foreign bodies | Emesis can be seen as a side effect of many drugs. | 147 (4c) | A |
| 148 (4b) | |||
| 149 (4c) | |||
| 150 (1b) | |||
| 151 (4b) | |||
| Change in diet can cause vomiting | D | ||
| Severe exercise can cause gastritis. | 152 (4c) | C | |
| Intoxication can cause vomiting e.g. ethylene glycol, grapes, Bufo marinus | 108 (4b) | C | |
| 97 (4b) | |||
| 153 (4a) | |||
| Ingestion of foreign body is a cause of emesis | 29 (4a) | C | |
| Vaginal discharge can be seen in pyometritis | 146 (4a) | C | |
| 154 (4a) | |||
| Reproductive status including recent seasons and presence of any vaginal discharge | Information on the reproductive status can suggest mucometra or closed cervix pyometra | 155 (4b) | C |
| 156 (4c) | |||
| Co‐existing neurological signs suggest neurologic disease | 55 (4c) | C | |
| 53 (4a) | |||
| 157 (4c) | |||
| 126 (4b) | |||
| Presence of neurological signs e.g. head tilt, ataxia, nystagmus, altered behaviour or consciousness | Emesis associated with motion sickness | 128 (4c) | B |
| Urinary tract disorders can be associated with emesis | 158 (4b) | C | |
| 159 (4c) | |||
| Presence of other signs suggestive of a systemic disease e.g. urinary tract signs (dysuria etc) |