Rosé A, Neiger R
Small Animal Clinic, Department of Internal Medicine, Justus-Liebig-University, Geißen, Germany.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2013;41(1):16-22.
To find the most common diagnoses of dogs where vomiting was the main reason for referral and to determine the usefulness of various diagnostic investigations.
213 dogs referred for vomiting as main or one of the main causes were analysed retrospectively. Diagnosis was reassessed and categorized into six groups, namely gastrointestinal, systemic, non-gastrointestinal abdominal, neurological, miscellaneous or no diagnosis. All diagnostic investigations were reviewed to assess their usefulness to reach a diagnosis. The usefulness of a diagnostic investigation was scored into the following four groups: enabled a diagnosis; assisted a diagnosis; no assistance, diagnosis reached by another procedure; no assistance, no final diagnosis made.
In 203 dogs (95.3%) a diagnosis was reached and was categorised as gastrointestinal (43.7%), systemic (27.7%), non-gastrointestinal abdominal (16.4%), neurological (1.4%) and miscellaneous (6.1%). Laboratory tests enabling or assisting a diagnosis as blood tests in 12.2%; 26.8%, as faecal analysis in 6.6%; 1.4%, as ultrasound in 5.2%; 17%, as cytology in 3.3%; 4.2%, as urinalysis in 2.3%; 9.9% and as radiographs in 1.9%; 8.5% of all cases.
Overall, there was a high incidence of dogs referred for vomiting with non-gastrointestinal diseases. Amongst them, renal problems were most commonly seen, which emphasises the need to perform a urinalysis in most dogs with vomiting as major complaint. However, vomiting can be due to a large variety of underlying pathophysiological mechanisms and no single problem seems to be much more common compared to other problems in a referral institution.
Based on this investigation it is not possible to clearly state a most useful single diagnostic test in dogs with emesis, however, it could clearly been shown that more than one test is often needed to reach a final diagnosis. This is important for owners to understand but also for referring veterinarians.
找出以呕吐为主要转诊原因的犬类最常见诊断，并确定各种诊断检查的效用。
对213只因呕吐作为主要或主要原因之一而转诊的犬进行回顾性分析。重新评估诊断并分为六组，即胃肠道、全身性、非胃肠道腹部、神经、杂项或未诊断。回顾所有诊断检查以评估其对确诊的效用。诊断检查的效用分为以下四组：确诊；辅助诊断；无辅助，通过其他程序确诊；无辅助，未做出最终诊断。
203只犬（95.3%）确诊，分类为胃肠道（43.7%）、全身性（27.7%）、非胃肠道腹部（16.4%）、神经（1.4%）和杂项（6.1%）。能确诊或辅助诊断的实验室检查中，血液检查占12.2%；粪便分析占6.6%；超声占5.2%；细胞学检查占3.3%；尿液分析占2.3%；X光片占1.9%，分别占所有病例的26.8%、1.4%、17%、4.2%、9.9%和8.5%。
总体而言，因非胃肠道疾病而因呕吐转诊的犬发病率较高。其中，肾脏问题最为常见，这强调了在大多数以呕吐为主诉的犬中进行尿液分析的必要性。然而，呕吐可能由多种潜在病理生理机制引起，在转诊机构中，与其他问题相比，似乎没有一个单一问题更为常见。
基于这项调查，无法明确指出针对呕吐犬最有用的单一诊断测试，然而，可以清楚地表明，通常需要不止一项测试才能做出最终诊断。这对犬主理解很重要，对转诊兽医也很重要。
