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Define the system

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Does Muriel have primary or secondary GI disease?

Most indicators in this case suggest that the vomiting is due to secondary GI disease because:

 The vomiting was preceded by 1–2 weeks of depression and reduced appetite.

 The vomiting is usually intermittent and unrelated to feeding (although of

 increasing frequency latterly).

This does not preclude primary GI disease but is more typical of secondary GI disease. Primary GI disease is less likely (although it cannot be completely excluded just yet).

Clinical Reasoning in Veterinary Practice

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