Kedilerde Kusmanın Yönetimi

Kusma mide içeriğinin ağız yoluyla dışarı atılmasına yol açan bir reflekstir. Kedilerde kusma yaygın görülen ve çeşitli nedenlere bağlı olarak meydana gelen bir durumdur. Kusma nedenleri başlıca gastrointestinal nedenler ve gastrointestinal olmayan nedenler olarak tanımlanabilir. Gastrointestinal nedenler arasında mide hastalıkları, bağırsak hastalıkları, enfeksiyöz hastalıklar, yabancı cisimler, diyet kaynaklı kusma gibi durumlar sayılabilir. Gastrointestinal olmayan nedenler arasında hepatobiliyer hastalıklar, pankreas hastalıkları, kronik böbrek yetmezliği, toksinler, metabolik hastalıklar sayılabilir. Kusma şikayeti olan kedilerde tanı oldukça önemlidir. Tanının ilk basamağını anamnez bilgisi oluşturur. Dikkatli ve tam bir anamnez alınarak kusmanın nedeni anlaşılmaya çalışılır. Genel muayene, labaratuvar muayenesi, serolojik testler ve görüntüleme yöntemleri tanı yöntemleri arasında yer alır. Tedavide esas olan altta yatan nedeni belirleyip ona yönelik tedavi protokolü hazırlamaktır. Bunun dışında sıvı sağaltımı, antiemetik ilaçlar, mide koruyucu ve prokinetik ilaçlar semptomatik tedavi olarak uygulanabilir.

Anahtar Kelimeler:

Kedi, Kusma, Neden, Tedavi

Management of Vomiting in Cats

Vomiting is a reflex that causes gastric contents to be expelled through the mouth. Vomiting in cats is a common condition that occurs due to various reasons. The causes of vomiting can be defined as mainly gastrointestinal and non-gastrointestinal causes. Gastrointestinal causes include; stomach diseases, intestinal diseases, infectious diseases, foreign bodies, and diet-induced vomiting can be counted. Non-gastrointestinal causes include; hepatobiliary diseases, pancreatic diseases, chronic kidney failure, toxins, and metabolic diseases can be counted. Diagnosis is crucial in cats with vomiting complaints. The first step of diagnosis is anamnesis. By taking a careful and complete anamnesis, the cause of vomiting is tried to be understood. General examination, laboratory examination, serological tests, and imaging methods are among the diagnostic methods. The main thing in treatment is to determine the underlying cause and prepare a treatment protocol. Besides, fluid therapy, antiemetic drugs, gastric protective, and prokinetic drugs can be applied as symptomatic treatment.

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Allenspach K. (2015). Diagnosis of Small Intestinal Disorders in Dogs and Cats. Clinics in laboratory medicine, 35(3), 521–534. https://doi.org/10.1016/j.cll.2015.05.003
Batchelor, D. J., Devauchelle, P., Elliott, J., Elwood, C. M., Freiche, V., Gualtieri, M., ... & German, A. J. (2013). Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review. Journal of feline medicine and surgery, 15(4), 237-265. https://doi.org/10.1177/1098612X12473466
Benson, K. K., Zajic, L. B., Morgan, P. K., Brown, S. R., Hansen, R. J., Lunghofer, P. J., ... & Quimby, J. M. (2017). Drug exposure and clinical effect of transdermal mirtazapine in healthy young cats: a pilot study. Journal of feline medicine and surgery, 19(10), 998-1006. https://doi.org/10.1177/1098612X16667168
Boothroyd, C. (2020, April). Vomiting-control medication: when, how and why. In BSAVA Congress Proceedings 2020 (pp. 185-186). BSAVA Library.
Boukaache, Y., Ferret, M., Delteil-Prevotat, V., Khoukh, K., Enache, A., Iwaszkiw, D., Bertin, S., Bruno, F. & (2022) Evaluation of the Efficacy of Transdermal Administration of Maropitant in Managing Vomiting in Cats. Open Veterinary Journal, 12 (5), 618-621. http://dx.doi.org/10.5455/OVJ.2022.v12.i5.4
Brown, A. J., & Otto, C. M. (2008). Fluid Therapy in Vomiting and Diarrhea. Veterinary Clinics of North America: Small Animal Practice, 38(3), 653–675.doi:10.1016/j.cvsm.2008.01.008
Chandler, M. (2010). Vomiting in dogs and cats—is it medical or surgical?. In Practice, 32(3), 82-89. https://doi.org/10.1136/inp.c746
De la Puente‐Redondo, V. A., Siedek, E. M., Benchaoui, H. A., Tilt, N., Rowan, T. G., & Clemence, R. G. (2007). The anti‐emetic efficacy of maropitant (Cerenia™) in the treatment of ongoing emesis caused by a wide range of underlying clinical aetiologies in canine patients in Europe. Journal of Small Animal Practice, 48(2), 93-98. https://doi.org/10.1111/j.1748-5827.2006.00321.x
Denholm, L., & Gallagher, G. (2018). Physiology and pharmacology of nausea and vomiting. Anaesthesia & Intensive Care Medicine, 19(9), 513-516. https://doi.org/10.1016/j.mpaic.2018.06.010
De Santis, F., Boari, A., Dondi, F., & Crisi, P. E. (2022). Drug-Dosing Adjustment in Dogs and Cats with Chronic Kidney Disease. Animals, 12(3), 262. https://doi.org/10.3390/ani12030262
Encarnacion, H. J., Parra, J., Mears, E., & Sadler, V. (2009). Vomiting. Compendium (Yardley, PA), 31(3), E8-E8.
Gaschen, F. (2015). Disorders of esophageal, gastric, and intestinal motility in cats. August's Consultations in Feline Internal Medicine, Volume 7-E-Book, 7, 117.
Gianella, P., Pietra, M., Crisi, P. E., Bergamini, P. F., Fracassi, F., Morini, M., & Boari, A. (2017). Evaluation of clinicopathological features in cats with chronic gastrointestinal signs.
Griffin, S. (2019). Feline abdominal ultrasonography: What’s normal? What’s abnormal? The diseased gastrointestinal tract. Journal of feline medicine and surgery, 21(11), 1047-1060. https://doi.org/10.1177/1098612X19880434
Hall JH, German AJ. Diseases of the Small Intestines. In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine. Vol 2. 7th ed. St. Louis: Saunders, 2010:1526–1572.
Hauck, S. R., Gisselman, K., Cordner, A., & Nicholson, A. G. (2016). Chronic vomiting in cats: etiology and diagnostic testing. Journal of the American Animal Hospital Association, 52(5), 269-276. https://doi.org/10.5326/JAAHA-MS-6290
Husnik, R., Gaschen, F. P., Fletcher, J. M., & Gaschen, L. (2020). Ultrasonographic assessment of the effect of metoclopramide, erythromycin, and exenatide on solid‐phase gastric emptying in healthy cats. Journal of Veterinary Internal Medicine, 34(4), 1440-1446. https://doi.org/10.1111/jvim.15787
Kenneth W. Simpson. (2020).Chronic Vomiting: What’s the Cause? 98, Cornell University, Ithaca, New York, Amerika Birleşik Devletleri. https://www.ovma.org/assets/1/6/OVMA_2020_Conference_Proceedings_v5.pdf
Lund, E. M., Armstrong, P. J., Kirk, C. A., Kolar, L. M., & Klausnor, J. S. (1999). Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. Journal-American Veterinary Medical Association, 214, 1336-1341.
Marks, S. L., Kook, P. H., Papich, M. G., Tolbert, M. K., & Willard, M. D. (2018). ACVIM consensus statement: support for rational administration of gastrointestinal protectants to dogs and cats. Journal of veterinary internal medicine, 32(6), 1823-1840. https://doi.org/10.1111/jvim.15337
McGrotty, Y. (2010). Medical management of acute and chronic vomiting in dogs and cats. In Practice, 32(10), 478-483. https://doi.org/10.1136/inp.c6670
Miller, A. D., & Ruggiero, D. A. (1994). Emetic reflex arc revealed by expression of the immediate-early gene c-fos in the cat. Journal of Neuroscience, 14(2), 871-888. DOI: https://doi.org/10.1523/JNEUROSCI.14-02-00871.1994
O'connor, N. R., & Corcoran, A. M. (2012). End-stage renal disease: symptom management and advance care planning. American family physician, 85(7), 705-710. doi: 10.1111/j.1533-2500.2008.00204.x.
Pleuvry, B. J. (2009). Physiology and pharmacology of nausea and vomiting. Anaesthesia & Intensive Care Medicine, 10(12), 597-601. https://doi.org/10.1016/j.mpaic.2009.08.012
Quimby, J. M., & Lunn, K. F. (2013). Mirtazapine as an appetite stimulant and anti-emetic in cats with chronic kidney disease: a masked placebo-controlled crossover clinical trial. The Veterinary Journal, 197(3), 651-655. https://doi.org/10.1016/j.tvjl.2013.05.048
Quimby, J. M., Benson, K. K., Summers, S. C., Saffire, A., Herndon, A. K., Bai, S., & Gustafson, D. L. (2020). Assessment of compounded transdermal mirtazapine as an appetite stimulant in cats with chronic kidney disease. Journal of feline medicine and surgery, 22(4), 376-383. https://doi.org/10.1177/1098612X19851303
Roudebush, P. (2013). Ingredients and foods associated with adverse reactions in dogs and cats. Veterinary dermatology, 24(2), 293-294. https://doi.org/10.1111/vde.12014
Schaer M. (2008). Therapeutic approach to electrolyte emergencies. The Veterinary clinics of North America. Small animal practice, 38(3), 513–x. https://doi.org/10.1016/j.cvsm.2008.01.012
SJ, F. E., Feldman, E., & Saunders, W. (2010). Vomiting. Twedt DC. In: Textbook of Veterinary Internal Medicine: dog and the cat. Vol 1. 7th ed. St. Louis: Saunders, 2010: 195–200.
Sorrell, S. (2021). Diagnosing and treating chronic vomiting in cats. In Practice, 43(7), 348-361. https://doi.org/10.1002/inpr.98
Šutalo, S., Ruetten, M., Hartnack, S., Reusch, C. E., & Kook, P. H. (2015). The effect of orally administered ranitidine and once‐daily or twice‐daily orally administered omeprazole on intragastric pH in cats. Journal of Veterinary Internal Medicine, 29(3), 840-846. https://doi.org/10.1111/jvim.12580
Tolbert, K., Bissett, S., King, A., Davidson, G., Papich, M., Peters, E., & Degernes, L. (2011). Efficacy of oral famotidine and 2 omeprazole formulations for the control of intragastric pH in dogs. Journal of Veterinary Internal Medicine, 25(1), 47-54. https://doi.org/10.1111/j.1939-1676.2010.0651.x
Tello, L., & Perez-Freytes, R. (2017). Fluid and electrolyte therapy during vomiting and diarrhea. Veterinary Clinics: Small Animal Practice, 47(2), 505-519. https://doi.org/10.1016/j.cvsm.2016.09.013
Washabau, R. J., & Day, M. J. (2012). Canine and Feline Gastroenterology. Elsevier Inc. https://doi.org/10.1016/C2009-0-34969-7
Washabau, R. J. (2003). Gastrointestinal motility disorders and gastrointestinal prokinetic therapy. Veterinary Clinics: Small Animal Practice, 33(5), 1007-1028. https://doi.org/10.1016/S0195-5616(03)00076-7
Zoran, D. L. (2015). Vomiting Cat Cases: You Can Figure Them Out. https://vetcentre.com/dokok/termek_cikkek/cikk/termek_cikk_6742_1514900181.pdf.