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tvpjournal.com | November/December 2015 | ToDay's VeTeriNary PracTice symPTomaTic maNagemeNT of Primary acuTe gasTroeNTeriTis Peer reviewed 47 mild clinical signs may not require laboratory testing on initial presentation. However, laboratory testing may be indicated to rule out extra-gastrointestinal causes of acute gastrointestinal signs, such as acute kidney injury, acute hepatitis, and pancreatitis, and metabolic complications of acute gastroenteritis, such as electrolyte and acid base abnormalities. When performed, laboratory testing should include a complete blood count, serum biochemical profle, and urinalysis. Measurement of serum canine pancreas-specifc lipase concentration may also be indicated to diagnose pancreatitis, and baseline serum cortisol concentration may be measured in order to exclude hypoadrenocorticism. Additional laboratory testing for infectious disease should be considered based on geographic location and signalment. For example, serology assists in diagnosis of Salmon poisoning disease in the Pacifc Northwest. In dogs with diarrhea, fecal fotation and direct smear examination should be performed to screen for primary or concurrent parasitism (Figure 1). In patients with clinical fndings (Table 2) or laboratory results that suggest a serious underlying cause, or those that do not respond to therapy, further diagnostic evaluation is indicated. Early identifcation is especially important in patients requiring surgical intervention, such as those with an obstructive intestinal foreign body (Figure 2). Imaging Abdominal ultrasonography and/or abdominal radiography are strongly advised in patients presenting with abdominal pain to screen for diseases requiring surgical intervention. It is important to remember that pancreas-specifc lipase concentrations can be increased in dogs and cats with gastrointestinal foreign bodies. Therefore, it is essential to rule out gastrointestinal foreign bodies with abdominal radiographs and, possibly, abdominal ultrasound before pancreatitis is diagnosed. If there is high suspicion for a gastrointestinal foreign body that may have been obscured by fuid or gas, diagnostic imaging should be repeated. THERAPEUTIC APPROACH When acute gastroenteritis is the primary cause of vomiting and/or diarrhea, the symptomatic treatments discussed in this article are appropriate for therapy. However, if gastroenteritis occurs FIGURE 1. Gastric nematode presumed to be Physaloptera rara visualized during gastroscopy. The hemorrhage observed is associated with gastric biopsy. Table 2. Selected Clinical Findings That Indicate Further Diagnostic Evaluation in Dogs & Cats with Acute Vomiting and/or Diarrhea • Abdominal pain • Anorexia • Bradycardia • Chronic vomiting or diarrhea • Hematemesis • Hyperthermia or fever • Jaundice • Lack of current vaccinations • Lymphadenopathy • Masses or organomegaly on abdominal palpation • Melena • Polyuria/polydipsia • Tachycardia • Tachypnea, cough, or abnormal lung sounds • Weak pulses • Weakness • Weight loss learn More Turn to page 77 to read the article, Endoscopic Foreign Body Retrieval. FIGURE 2. Fabric gastric foreign body visualized during gastroscopy.