18 Gastric adenocarcinoma in a dog
The dog had been vomiting intermittently for about 8 months. For the previous 2 months the frequency of vomiting had increased to at least once a day, usually in the morning. The vomiting occurred either before or after eating. The vomitus usually contained food and bile, but no blood. He was also reported to recently be gulping, retching and drooling. His appetite was still fair, although he was sometimes less interested in food than previously. His faeces were normal in appearance and frequency. He had lost some weight over the past 2 months.
He had previously been diagnosed with early congestive heart failure and was on treatment with furosemide (2 mg/kg po q 12 hours) and enalapril (0.45 mg/kg po q 12 hours). His urination and drinking were increased due to the diuretic treatment. His previous signs of weakness, coughing and tachypnoea appeared to be well controlled by the medication.
He was vaccinated yearly, but had not been treated for endoparasites for a couple of years. He was fed three times a day on a diet which included dry dog food as well as fried chicken, pasta, tuna and rice.
The dog was bright, alert and responsive. His body condition score was 4/9. Thoracic auscultation revealed a IV/VI left apex parasystolic heart murmur, with normal lung sounds. Heart rate was 132 beats per minute and he was intermittently panting. His pulse quality was good. The mucous membranes were pink and slightly tacky with a capillary refill time of <2 seconds. He was estimated to be about 6% dehydrated. Abdominal palpation revealed no abnormalities, although the dog swallowed several times during palpation. Rectal temperature was 38.5° C.
Clinical tip on abdominal palpation
In some cases, dogs with abdominal discomfort will not tense their abdomen during palpation, but careful observation of the head and face may show swallowing, a sharp intake of breath (catching breath) or turning of the head. This should be gently repeated to check that it is a consistent finding. It is also valuable to observe the dog’s head during palpation as an otherwise gentle dog may nip if a sensitive area is palpated!