5 Phenobarbitone responsive retching in a dog
Initial presentation
Gagging, retching and vomiting for 10 days
Signalment: 6-year-old neutered male Jack Russell terrier x poodle, body weight 6.6 kg
Case history
This dog had been referred for a suspected upper respiratory disorder or oesophageal foreign body based on his clinical signs and diet. He had been keen to eat, although according to the owner it appeared painful for him to eat and his food intake was decreasing. He was able to prehend and swallow food, but vomited 5 to 30 minutes after eating. Active abdominal contractions were present prior to and during the vomiting; the vomitus contained bile, digested and undigested food. The frequency of the episodes was increasing to several times per day.
His faeces were normal and he was defecating, drinking and urinating normally. He was fed dry food mixed with some canned food, plus table scraps including pork bones and chews. His vaccinations and de-worming programme were up to date.
He had lost weight and was becoming tired more quickly on his walks.
Physical examination
The dog was dull but responsive and his body condition score was 4/9. Mucus membranes were pink but tacky and he was estimated to be about 6% dehydrated. His capillary refill time was less than 2 seconds. Oral examination revealed hypersalivation, halitosis and mild gingival tartar.
He was trembling and palpation of the ventral neck resulted in a marked pain reaction, with spasms of the neck, bruxism and vocalization. The submandibular salivary glands were mildly enlarged and very firm.
Thoracic auscultation revealed normal heart and lung sounds, with a heart rate of 80 beats per minute (bpm) and a respiratory rate of 24 breaths per minute. Rectal temperature was 36.7° C.
Problem list and discussion of problems
Differential diagnosis
Differential diagnoses for the vomiting with gagging and retching may include some of the following categories of disorders.
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