Dietary history

A complete dietary history can be very important in the diag­nosis of gastrointestinal disease and should include specific commercial foods that are being fed, commercial snacks or treats, supplements and chewable medications, chewable toys, human foods (especially leftover foods from human meals), access to other sources of food (ask about other pets in the household or about people who may give extra food to the pet).⁹ Many medical supplements or certain drugs contain proteins or additives that may elicit allergic or other adverse reactions (especially vitamins, fatty acids, or dermatological supplements).

Abnormal feeding patterns should be documented. Co- prophagia can be observed in any disorders causing polyphagia such as exocrine pancreatic insufficiency or high-dose corti­costeroid treatment. Also, coprophagia or pica can be observed in patients with nutritional deficiencies or those with behav­ioral problems. Eating grass is frequently reported in dogs and cats, and is of concern when it is followed by nausea or vom- iting.5 Eating grass could either be the cause or more com­monly a consequence of a gastrointestinal problem.

??9 Key Facts

■ Acquiring an accurate history is essential to further characterize the clinical signs related to digestive diseases.

■ Differentiation between regurgitation and vomiting is necessary to determine an optimal workup for each patient.

■ In cats constipation must not be mistaken for urinary straining.

■ Dietary history is a cornerstone in the diagnosis and management of digestive diseases.

References

1. Rothuizen J, Meyer HP. History, physical examination and signs of liver disease. In: Ettinger SJ, Feldman EC (eds.), Textbook of veterinary internal medicine, 5th ed.

2. Peeters ME, Venker van Haagen AJ, Wolvekamp WThC. Evaluation of a standardised questionnaire for the detection of dysphagia in 69 dogs. Vet Rec 1993; 132: 211-213.

3. Guilford WG. Approach to clinical problems in gastroenterology. In: Guilford WG et al (eds.), Strombeck' small animal gastroenterology, 3rd ed. Philadelphia, WB Saunders, USA, 1996; 50-76.

4. Elwood C. Investigations and differential diagnosis of vomiting in the dog. In Practice, 2003; 25: 374-386.

5. Tams TR. Gastrointestinal symptoms. In:Tams TR (ed.), Handbook of small animal gastroenterology, 2nd ed. Philadelphia,WB Saunders,2003; 1-50.

6. Hall E. Introduction to investigating gastrointestinal diseases. In: Thomas D et al (eds.), BSAVA Manual of Canine and Feline Gastroen­terology, 1st ed. Shurdington, UK, BSAVA, 1996; 9-19.

7. Jergens AE et al. A scoring index for disease activity in canine in­flammatory bowel disease.J Vet Intern Med, 2003; 17: 291-297.

8. Houston DM. Clinical examination of the alimentary system - dogs and cats. In: Radositits OM, Mayhew IGJ, Houston DM (eds.), Vet­erinary Clinical Examination and Diagnosis. Philadelphia, WB Saun­ders, 2000; 349-369.

9. Roudebush P, Guilford WG, Shanley KJ. Adverse reactions to food. In: Hand MS et al. (eds.), Small Animal Clinical Nutrition, 4th ed. To­peka, USA, Mark Morris Institute, 2000; 431-453.

10. Drosman DA, Chang L. Psychosocial factors in the care of patients with gastrointestinal disorders. In: Yamada T (ed.), Textbook of Gastro­enterology, 4th ed. Philadelphia, Lippincott Williams and Wilkins, 2003; 636-654.

11. Rijnberk A. The History. In: Rijnbberk A, de Vries HW (eds.), Me­dical History and Physical Examination in Companion Animals. Dor­drecht, Netherlands, Kluwer Academic Publishers, 1995; 49-56.

12. Hoskins JD. Congenital defects of the dog. In: Ettinger SJ, Feldman EC (eds.), Textbook of Veterinary Internal Medicine, 5th ed. Philadelphia, WB Saunders, 2000; 1983-1996.

13. Hoskins JD. Congenital defects of the cat. In: Ettinger SJ, Feldman EC (eds.), Textbook of Veterinary Internal Medicine, 5th ed. Philadelphia, WB Saunders, 2000; 1975-1982.

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