title: Incidence of and risk factors for postoperative regurgitation and vomiting in dogs: 244 cases (2000-2012).
abstract: OBJECTIVE
  To determine the incidence of and risk factors for postoperative regurgitation and vomiting (PORV) in dogs.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  244 client-owned dogs.
  
  
  METHODS
  Dogs referred for nonelective surgery in the first 3 months of 2000 and 2012 were included. Breed; sex; age; weight; body condition score; emergency status; food withholding status; history of vomiting or regurgitation; American Society of Anesthesiologists score; presence of diabetes or hypothyroidism; preoperative PCV and total solids concentration; anesthesia protocol; corticosteroid, opioid, neuromuscular blocking agent, and nitrous oxide usage; anesthesia time; surgery time; type of surgery; and occurrence of vomiting or regurgitation within 24 hours after recovery from anesthesia were recorded. Data were analyzed by means of the Fisher exact test, Wilcoxon rank sum test, and logistic regression.
  
  
  RESULTS
  30 of 244 (12.3%) dogs meeting study inclusion criteria developed PORV. There was no significant difference in the incidence of PORV between the 2000 (12/111 [10.8%]) and 2012 (18/133 [13.5%]) cohorts, although the incidence of regurgitation was higher in 2012. Univariate logistic regression identified the most significant risk factors as gastrointestinal surgery (OR, 11.15; 95% confidence interval [CI], 3.11 to 40.03), premedication without strong sedatives including either an α2-adrenoceptor agonist or acepromazine (OR, 5.36; 95% CI, 1.89 to 15.17), American Society of Anesthesiologists score of 4 (OR, 5.25; 95% CI, 1.05 to 26.15), history of vomiting or regurgitation (OR, 5.12; 95% CI, 1.83 to 14.31), emergency surgery (OR, 4.08; 95% CI, 1.29 to 12.90), neurologic surgery (OR, 3.18; 95% CI, 1.02 to 9.92), sevoflurane inhalation anesthesia (OR, 2.78; 95% CI, 1.25 to 6.13), and being sexually intact (OR, 2.37; 95% CI, 1.07 to 5.27). Multivariate analysis was not clinically useful owing to the low sensitivity and specificity of the model.
  
  
  CONCLUSIONS
  Between 2000 and 2012, there was no change in the incidence of PORV for dogs undergoing neurologic, orthopedic, and soft tissue surgical procedures; however, the proportion of dogs that regurgitated increased significantly in 2012. Preoperative antiemetic prophylaxis should be considered in dogs undergoing gastrointestinal surgery and in those in which other risk factors are present.
authors.affiliation: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
authors.forename: John A
authors.initials: JA
authors.lastname: Davies
authors.forename: Boel A
authors.initials: BA
authors.lastname: Fransson
authors.forename: Anastacia M
authors.initials: AM
authors.lastname: Davis
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Gilbertsen
authors.forename: John M
authors.initials: JM
authors.lastname: Gay
mesh_terms: D000777:Anesthetics / Q000009:adverse effects; D000818:Animals; D004283:Dog Diseases / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D004285:Dogs; D005260:Female; D008297:Male; D016017:Odds Ratio; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000473:pathology / Q000662:veterinary*; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000662:veterinary*
chemical_list: D000777:Anesthetics