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SAM_UK_03_CDSC_04_Haematemesis After NSAIDs: When Treatment Causes

Improve International

Created on December 18, 2025

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Transcript

Owner
Veterinarian

Managing the Vomiting Patient in Real-World Clinical Practice

Start

Haematemesis After NSAIDs: When Treatment Causes the Problem

A 9-year-old dog has been receiving an NSAID prescribed by your clinic for osteoarthritis. The dog now presents with vomiting, possible haematemesis, and dark stools consistent with melaena.

The dog appears weak and mildly dehydrated. The owner asks whether this could have been prevented and what you are going to do “right now”.

The owner is upset and implies the medication is to blame.

Next

Veterinarian

Clinical objections

Next

Veterinarian

Differentials (likelihood vs risk)

List your top 5 differentials (include iatrogenic causes), ranked by likelihood and risk if missed.

Veterinarian

Uncertainties/limitations

What are the biggest uncertainties at presentation that affect your immediate plan?

Veterinarian

Stepwise clinical approach

Outline your next steps in order (stabilisation + GI protection + diagnostics). Justify each step in one line.

Veterinarian

Escalation triggers

Give escalation triggers (e.g., when to hospitalise, transfuse, scope, or refer).

Owner

What would you do if it were your pet?

Next

Owner

Empathy

Write one sentence acknowledging concern and frustration in an owner who feels the clinic caused harm.

Owner

Value framing

Explain what you can say today about NSAID risk vs certainty, and what information you need to confirm ulceration.

Owner

Options scaled to budget & urgency

Offer 2 options scaled by cost and urgency (what we do immediately vs what can be staged safely).

Owner

If it were your pet?

Answer in 2–3 sentences focusing on safety, immediate priorities, and transparent reasoning.

Well done

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