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THERAPEUTIC FAILURE The reason we are here today

THERAPEUTIC FAILURE The reason we are here today. DEFINING THE PROBLEM. VOMIT REGURG Prodromal signs usually no Retching usually no Bile sometimes no Digested blood sometimes no. If it looks like vomiting , it is probably vomiting

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THERAPEUTIC FAILURE The reason we are here today

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  1. THERAPEUTIC FAILUREThe reason we are here today

  2. DEFINING THE PROBLEM VOMITREGURG Prodromal signs usuallyno Retching usuallyno Bile sometimesno Digested blood sometimesno

  3. If it looks like vomiting, it is probably vomiting If it looks like regurgitation, then you don’t know for sure

  4. If it looks like vomiting, it is probably vomiting If it looks like regurgitation, then you don’t know for sure But it is still more efficient to look for causes of regurgitation first

  5. TAMU #79877

  6. TAMU #151587

  7. TAMU #151587

  8. TAMU #117587-9/09

  9. TAMU #117587-12/09

  10. TAMU #156420

  11. TAMU #156420

  12. TAMU #159116 Sig: 4 month F German shepherd CC: Febrile HPI: 1 month ago: dog febrile with soft cough – cured with antibiotics 3 days ago had same signs PE: T = 39.5 C No other abnormalities

  13. MSU #167884 Sig: 10 yr M(c) Mixed breed dog CC: Coughing HPI: Coughing began 2 years ago and is not controlled with any medications Dog now vomiting for 2 months

  14. Causes of Congenital Esophageal Weakness • Idiopathic

  15. Causes of Acquired Esophageal Weakness • Idiopathic • Myasthenia gravis (localized) • Hypoadrenocorticism (usually atypical) • Various Myopathies/Neuropathies • Spirocerca lupi • Tetanus/Botulism • Distemper • Hypothyroidism (?) • Trypanosomiasis (??)

  16. THERAPY FOR CONGENITAL MEGAESOPHAGUS • Dietary modification • Gruel from an elevated platform

  17. THERAPY FOR CONGENITAL MEGAESOPHAGUS • Dietary modification • Gruel • Meatballs (esp with partial motility) • Canned food • Dry food

  18. TAMU #124375 Sig: 2 yr M(c) Dalmatian CC: Vomiting HPI: Present since obtained dog 1 month ago. Dog “inhales” food & immediately vomits food without bile or blood Dog drools constantly Recently has trouble swallowing PE: Not remarkable

  19. TAMU #118002 Sig: 5 month F German shorthaired pointer CC: Vomiting HPI: 8 days ago: vomiting clear liquid Next day vomited blood and sticks Laparotomy: inflamed duodenum & blood in stomach Still vomits fluid & blood PE: No significant findings

  20. TAMU #118002 CBC: PCV = 20% (35-55) Profile: Albumin = 1.9 gm/dl (2.5-4.4)

  21. TAMU #99514 2/3 Sig: 10 yr F(s) Bichon CC: Vomiting HPI: Started vomiting bile on 1/12 Removed linear foreign object Vomiting continues: surgical pyloromyotomy 3 days later PE: Depressed, tight abdomen

  22. ESOPHAGITIS: CAUSES Organisms (especially fungal)

  23. ESOPHAGITIS: CAUSES Organisms (fungal) Foreign objects

  24. ESOPHAGITIS: CAUSES Organisms (fungal) Foreign objects Caustic agents

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