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Vomiting is among the most common clinical signs in companion animals. Although a protective mechanism associated with removal of noxious ingested substances, it is also associated with many diseases. Due to the multitude of causes it can be a challenge for veterinarians to diagnose and manage vomiting.

The volume and tonicity of body fluids are maintained within a narrow normal range by regulation of sodium and water balance. The volume of extracellular fluid (ECF) is determined by the total body sodium content, whereas the osmolality and sodium concentration of ECF are determined by water balance.

There is no question that glucocorticoids (GCs) remain the mainstay of immunosuppressive therapy in small animal medicine. However other drugs are available that can be used in conjunction with GCs in order to provide synergistic immunosuppression and thus allow lower GC dosage, more specifically target certain arms of the immune system, and provide proven superior immunosuppression to GCs in a few diseases.