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SAM_UK_03_CDSC_02_“Vomiting” After Meals: Regurgitation,

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Created on December 18, 2025

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Transcript

Owner
Veterinarian

Managing the Vomiting Patient in Real-World Clinical Practice

Start

“Vomiting” After Meals: Regurgitation, Megaoesophagus, or Oesophagitis?

A 6-year-old dog is presented for “vomiting” shortly after eating. The owner has not always witnessed episodes.

The owner requests antiemetics and a diet change and is reluctant to pay for thoracic imaging because “this is a stomach problem”.

The dog has started losing weight and occasionally coughs after meals. On auscultation, there are slightly increased thoracic sounds.

Next

Veterinarian

Clinical objections

Next

Veterinarian

Differentials (likelihood vs risk)

List your top differentials, ranked by likelihood and by danger if missed.

Veterinarian

Uncertainties/limitations

What are the biggest uncertainties in the history/exam that could mislead your reasoning?

Veterinarian

Stepwise clinical approach

Outline your next steps in order (including what you must confirm first). Justify each step in one line.

Veterinarian

Escalation triggers

Give escalation triggers (e.g., signs suggesting aspiration pneumonia, severe oesophageal disease, or obstruction).

Owner

What would you do if it were your pet?

Next

Owner

Empathy

Write one sentence for an owner who believes this is ‘just vomiting’ and wants quick meds.

Owner

Value framing

Explain, in plain language, why distinguishing vomiting vs regurgitation changes the plan.

Owner

Options scaled to budget & urgency

Offer options that scale with budget, clearly explaining what each option rules in/out.

Owner

If it were your pet?

Answer in 2–3 sentences without overpromising; emphasise why you would (or wouldn’t) image the chest first.

Well done

You successfully completed the challenge and addressed all of our questions, both from a professional perspective and as a pet owner