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How to Evaluate, Diagnose, Treat, and Monitor the Patient with Vomiting

Topic outline

  • Hero Banner

  • Welcome & Orientation

  • Learning Outcomes

    • On successful completion of this module, candidates will be able to:

      Vomiting Vs regurgitation

      • Differentiate vomiting from regurgitation in dogs and cats using targeted history-taking and observation of episode characteristics.
      • Select key physical examination priorities that help localise disease to the oesophagus, stomach, or extra-gastrointestinal systems.
      • Justify an initial diagnostic direction based on timing (post-prandial vs fasting), contents, frequency, and associated clinical signs.
      • Recognise red flags (e.g., projectile vomiting, haematemesis, collapse) that warrant urgent stabilisation and escalation of care.

      Diagnostic tools

      • Formulate a rational diagnostic plan for vomiting patients, selecting appropriate baseline and advanced tests.
      • Interpret haematological and biochemical abnormalities in the context of vomiting and use them to refine diagnostic hypotheses.
      • Evaluate the role of abdominal point-of-care ultrasound (POCUS) in vomiting cases, including indications, limitations, and common decision points.
      • Select appropriate diagnostics when toxicological exposure is suspected, and explain how test results influence clinical decision-making.

      Approach to the vomiting patient

      • Generate a prioritised differential diagnosis list for acute vomiting that integrates signalment, history, and clinical presentation.
      • Plan a structured triage and stabilisation approach for vomiting patients, including analgesia, antiemetic use, and fluid therapy principles.
      • Formulate a coherent outpatient vs hospital-based management plan, with clear criteria for admission, monitoring, and reassessment.
      • Identify when vomiting may represent systemic disease and adjust diagnostic priorities accordingly.
      • Communicate a stepwise plan to owners, including safety-netting, expected response to therapy, and escalation triggers.

      Gastric and intestinal foreign bodies

      • Recognise clinical patterns and risk factors that increase suspicion for gastric or intestinal foreign bodies in dogs and cats.
      • Integrate history, examination findings, and imaging results to prioritise mechanical obstruction within the differential diagnosis list.
      • Plan an evidence-informed management pathway, including criteria for conservative management versus endoscopic or surgical intervention.
      • Outline practical monitoring parameters and decision points for reassessment to prevent deterioration and delayed intervention.

      Gastric ulcerations in dogs and cats

      • Identify common causes of gastric ulceration in small animals and link them to case presentation and risk assessment.
      • Recognise clinical and laboratory features consistent with gastrointestinal bleeding and explain their implications for case severity.
      • Design an appropriate treatment protocol for suspected or confirmed gastric ulceration, including gastroprotectants and supportive care.
      • Plan monitoring strategies to evaluate response, identify complications, and guide safe step-down or discharge planning.

      Addison’s disease

      • Recognise when vomiting may be a manifestation of hypoadrenocorticism and prioritise it appropriately within differentials.
      • Interpret key clinicopathological abnormalities suggestive of Addisonian crisis and explain their relevance to immediate management.
      • Plan an urgent diagnostic and stabilisation approach for suspected Addisonian patients, including appropriate test selection.
      • Formulate an initial management and monitoring plan that supports clinical stabilisation and guides onward care.

  • SECTION: Diagnostic Tools

    • This section builds a structured approach to diagnostics in vomiting patients, integrating laboratory testing, imaging, and point-of-care ultrasound. Learners practise interpreting haematology and biochemistry in context, and explore how results refine differentials. The section also addresses when to consider toxicity and how diagnostic choices influence safe, timely management.

    • Lectures

      • Lecture

      • Completion
        Students must
        View
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        Laboratory Evaluation in the Vomiting Dog and Cat Page

        Review how haematology and biochemistry findings guide case prioritisation, refine differentials, and inform safe, targeted management plans.

        Duration: 23:59 minutes

      • Completion
        Students must
        View
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        Diagnostic Imaging in Vomiting and Regurgitation Page

        Compare imaging options—including radiography and ultrasound—and learn when each is indicated to localise disease and identify time-critical problems.

        Duration: 24:31 minutes

    • Active Learning Activity

      • Virtual Journal Club

      • Virtual Journal Club

        This Virtual Journal Club examines a cross-sectional study comparing abdominal radiography and ultrasonography for diagnosing small-intestinal mechanical obstruction in acutely vomiting dogs. The aim is not to memorise performance figures, but to practise critical reading: what the test results really mean in clinic, when uncertainty is acceptable, and when it should trigger escalation.

      • Clinical Visual Analysis

      • Clinical Visual Analysis

        In this activity, you will work with six real-world abdominal ultrasound images/clips from dogs and cats with suspected gastric or intestinal foreign material. The aim is not to teach you to “become an imager”, but to help you recognise high-impact patterns and artefacts that influence clinical decisions.

      • Completion
        Students must
        Student must submit this questionnaire to complete it
        Questionnaire icon
        The Sonographer’s Dilemma. Operate or Wait? Questionnaire

  • Clinical Debate & Strategic Communication

    • Clinical Debate & Strategic Communication

      In this activity you will work through several integrative clinical cases from Module 3, How to Evaluate, Diagnose, Treat, and Monitor the Patient with Vomiting. The aim is not to “do it right”, but to train how you think and how you justify your approach when there is uncertainty, limitations, and pressure (time, budget, and owner expectations). This will be followed by a live, interactive discussion with the module lead to debate and compare approaches in real clinical scenarios.

      Before the live session, prepare each case from two perspectives

      Clinical objections
      Prepare your technical reasoning as if discussing your approach with a colleague or supervisor who challenges you: differentials, a stepwise diagnostic–therapeutic plan, red flags, and escalation triggers.

      What would you do if it were your pet?
      Prepare your owner-facing explanation: the value and limitations of tests, how you manage uncertainty, and how you adapt the plan to the budget without compromising patient safety.

      In the live session, role plays will be carried out to compare approaches and refine decision-making.

      How it works

      1. Review the clinical cases presented below.
      2. Complete the questions related to each case; they are divided into a veterinary section and another focused on communication with the owner.
      3. Join the live session and take part. If you can’t attend, don’t worry — it will be recorded and made available afterwards.

      Interactive Clinical Session

      The date and time for this ALA will be communicated once the module is completed.

      During this activity, we will explore real clinical scenarios involving patients with vomiting or regurgitation. We look forward to seeing you there.

      Speaker: Silvia Funes, DVM, MS, Dip ACVIM

  • Vet Knowledge Centre

    • Welcome to the Vet Knowledge Centre

      In a world overflowing with information yet limited by time, the true challenge is not access to knowledge but knowing what truly matters.The Vet Knowledge Centre gathers the most valuable readings, podcasts, and learning tools selected by the Improve team to enrich your understanding of each module’s key themes.Whether you are revisiting core ideas on the move or exploring new concepts in a quiet moment, this space offers clarity, focus, and clinically relevant insight.

    • Completion
      Students must
      View
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      Reading Room Page

      A selection of key papers and articles to deepen your scientific and clinical understanding.

    • Completion
      Students must
      View
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      Listening Room Page

      Audio versions of key papers, relevant podcasts, and a spoken summary of the module, making it easier to learn on the go.

    • From Outer Space

    • Completion
      Students must
      View
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      From Outer Space! Page

      A unique collection of multimedia resources drawn from other professions and disciplines, offering new perspectives and transferable insights that can enrich your veterinary practice.

  • Completion

    • Well done!

      You’ve completed the “How to Evaluate, Diagnose, Treat, and Monitor the Patient with Vomiting” module.

      Thank you for your hard work. In recognition of your achievement, you’ve earned a badge.

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