Suggestions to help with cat vomiting- UPDATE He's gone

[CleverUserName]

To preface: Said cat has been to the vet multiple times in the last few weeks. I’m at a loss as to what to try while at home.

He is an older cat (12), indoor only, and has a history of vomiting. He recently had a scare where I noticed he dropped a LOT of weight really fast. His bloodwork showed extremely high levels in his liver, and the vet suggested taking him to a clinic where they could do a liver biopsy and ultrasound. Those results showed his liver basically thought he was starving, and so his body began consuming his fat reserves (he was 6.2 kg… always was a big boy). He was given a few shots, and I had to give him Hills Emergency Recovery food in order to pack weight back on fast. He instantly began eating like he missed it, and I could see him filling out.

His two week checkup was normal.The vet didn’t want to give him more antibiotics, because of that, and he was (and is) acting completely normal.

The vomiting started again in earnest 8 days ago, and I took him back to the vet last Thursday. They gave him another two shots, and he was fine until Monday when he stated vomiting again. The vomit is mostly brown, digested food, in liquid form.

He has been taking Hepatiale Forte since the first vet visit. Then, last week they gave me Famosan to give him twice a day, but if it didn’t help I could stop giving it to him.

I initially changed food from Hill’s Prescription Digestive Formula to Concept for Life Digestive. I thought I switched too fast and that caused the vomiting. So I started mixing the two. I pulled his dry food away yesterday, since historically when he vomited it was mostly from eating too fast (I also kept ping pong balls in the dry food bowl to try and slow him down. He always had dry food available throughout the day).

I’ve now started to give him exclusively wet food, in smaller serving sizes throughout the day. I was hoping to see instant results, but that hasn’t happened. I also stopped with the Famosan and Hepatiale Forte pills today, as the vet said they could cause an upset tummy.

I really don’t know what else to try. I will take him back to the vet Thursday if the vomiting continues. He is absolutely acting normal, is drinking, peeing and pooping as normal. I was told a couple years ago he may just be ‘a cat who vomits’, but I do think this is different.

Is a can diet a good idea? Is one 150g can a day sufficient? Any suggestions welcome!

[Simkie]

Cats vomit for a reason. I’d get this one on pepcid ASAP and talk with your vet about an anti emetic. I prefer Zofran, but if the vet will only rx Cerenia, try that first.

Depending on his size, yes, 150g a day may be fine.

Oh, it looks like famosan is famotidine. Get him back on that. It will not cause nausea–it treats it.

[CleverUserName]

Thank you so much for your reply! He’s on 10 mg of Famosan (half pill 2x day). He’s been on that for 4 and a half days, but it hasn’t stopped his vomiting yet. I didn’t give it to him this morning, but I will do it now.

It looks like Zofran isn’t available here, but Cerenia is. I’ll ask his vet.

He’s a big boy, and seems to like eating many smaller meals a day. It’s just confusing because he is acting absolutely normal, and even wants to eat right after vomiting.

[OnAMission]

Hairball?

[4horses]

Rapid weight loss suggests either hyperthyroidism or cancer. Small cell lymphoma comes to mind. Any constipation? He could have IBD and or pancreatitis as well. Did they ultrasound his intestines and entire abdomen?

Unfortunately that is the age where things tend to go wrong. I lost my cat Pounce to lymphoma at age 12. I lost his brother at age 14 to hyperthyroidism and kidney disease. He possibly had cancer as well as he dropped a bunch of weight towards the end and the thyroid meds weren’t helping.

Any time I start seeing rapid weight loss, I start thinking end of life issues, unfortunately. Sometimes you get lucky and they bounce back and sometimes not. I would also check kidneys and get a urinalysis done to check urine specific gravity.

[OzarksRider]

@4horses

Rapid weight loss suggests either hyperthyroidism or cancer.

I agree with @4horses. Did the blood work include a test for thyroid function? If not, ask for it. I’m guessing that the blood work was a general chemistry panel, and if these results were all within the reference ranges that should rule out diabetes and kidney disease. The elevated liver enzymes and biopsy results suggest hepatic lipidosis, but this is usually caused by some other disease such as diabetes, pancreatitis, or cancer.

Hyperthyroidism can be cured with radioactive iodine or managed with methimazole, so it’s worth checking for that. Hyperthyroid cats sometimes present with anorexia, and that has a worse prognosis. I once had an anorexic hyperthyroid cat, and he had underlying heart disease that ultimately killed him.

Did your vet x-ray his abdomen to look for tumors or blocked up stool or hairballs? A big hairball could sure cause vomiting.

[CleverUserName]

Thank you all! We are just back from another vet visit. They did X-rays and didn’t see anything abnormal, but the X-rays won’t show something like string or wood…he’s not the type of cat who would eat something like that, but in order to rule anything out I have to give him (forgive me for forgetting the term) a paste-like substance tomorrow morning and take him back in the afternoon so they can see what passes through.

His blood work today was even better than his blood work a couple weeks ago. And, he’s gained .1 kilogram. They’re stumped because as much as he’s vomiting, he’s still going to the toilet, gaining weight and acting like a happy cat.

He got another round of five injections, including another antibiotic. Previously that set of meds did him well for two weeks, before the vomit started. If his X-rays tomorrow don’t show anything we will see the gastroenterologist.

[4horses]

He might need an abdominal ultrasound which would require a referral elsewhere. Very few people are skilled in performing an abdominal ultrasound so it almost always requires a referral to a vet school or specialty clinic.

[CleverUserName]

They did mention an abdominal ultrasound as a next step. Luckily there are two internal specialists at this clinic…one is on holiday but the other is available.

He slept thru the night (sleeping beside me at the moment), and hasn’t vomited, even after eating dinner last night and breakfast this morning. I’ll give him his paste and then take him back this afternoon to see the results.

[danacat]

Check out Kittybiome.com – I have a cat with somewhat similar vomiting issues to yours = no weight loss issues. Anyway, my vets are stumped so I found the kitty biome site, and apparently their ‘gut health test kit’ seems pretty great – might be benificial to you. I have my cat on their pro/prebiotics and also gave him their fecal transplant capsules. I also switched my cat to a novel protein diet; prescription Royal Canin as well as Hound&Gatos pork.
So far so good!

[CleverUserName]

Thanks for the suggestions!

Just back from the vet (again), and the paste showed no blockages in his digestion. He got another anti-nausea injection, and we will go back in a week to see the internist. Of course, if he starts vomiting again we’ll go back immediately.

He’s not too happy with me at the moment, but he just had some food so hopefully he’ll forgive me!

[CleverUserName]

Well, an inconclusive update.

He was perfectly fine from the last vet visit five days ago to Sunday, when he didn’t eat very much. I noticed when he jumped on the sofa with me he sort of lost his balance when he landed. But he jumped down with no issues and was walking normal. Sunday night he didn’t want much dinner, but neither did the other cat. It’s hot here.

Yesterday I noticed he was walking funny, and he didn’t want more than a bite or two of breakfast. I was able to work from home, and by mid afternoon he had vomited what little food he ate and then some water. He was also having drastically more trouble walking and balancing. I took him to his neighbourhood vet down the street, because I thought his little body was shutting down and it was time to think about his quality of life (the other vet requires a car ride, and if it was time to put him to sleep, I didn’t want to add extra stress). They were great, and gave him some medicine and asked me to come back this morning because the vet working spoke better English.

This morning they advised me to get an MRI or CT scan, and called a different clinic to set it up immediately. (So much for no car rides… off we went). We get to that clinic and upon hearing his symptoms, that neurologist suggested an MRI, which their machine wasn’t working, only the CT. He said an MRI was better, so then he called another clinic and off we went again.

The neurologist at this last clinic did a great job assessing him. He has lost feeling on the right side of his face, and the legs on his right are slow to react. He spent about 45 minutes with him, asking all sorts of questions. He then went for an MRI.

The results of the MRI are completely clean. No cancer, thank god. They also pulled some spinal fluid and will test that for infections, even though he thinks that is a low probability. He, like the others, are stumped at his symptoms. A clean MRI is great, but it doesn’t help in trying to figure out what’s happening to my little guy.

So he will stay at that clinic til Friday. They’re going to try corticosteroids to get him to eat, even though there was a slim chance he had a reaction to them (they were given so many days ago it seems unlikely). I feel confident with what he talked about doing, and I know he will be under constant monitoring and good care.

He has been so brave thru all this… even when he wasn’t able to balance well he wanted to jump up beside me and be petted. I know he’s a middle age/ older cat, but if there’s a chance he will be himself again, I have to try everything.

[rubygirl1968]

I’m sorry he’s not doing better. I hope the stay at the clinic helps him and he feels better.

Do they think he’s had a stroke? Poor guy.

Jingles for him and you!!

[Alex_and_Bodie_s_Mom]

Poor guy! Jingles for you both.

This is going to sound really random - but did they check his ears? I had a cat who ruptured her ear drum (we have no idea how); I’ve had other cats who had head tilts and were off-balance have a tick in the ear, or bad ear mites.

And a friend of mine has a son with Meniere’s disease - his main symptom was vomiting (to the point that he could only keep down protein shakes, and not even those sometimes). The Meniere’s affected his inner ear, which caused constant low-grade nausea (hence, the vomiting).

And I had a cat who had a small stroke one night (we think now); she had always had some wobbliness due to an early infection when she was young, but the stroke significantly increased that. (Before I could get her to the vet, she had a second stroke that incapacitated her, though.)

[CleverUserName]

Thank you both!
I will ask about a stroke when he calls tomorrow. He didn’t mention it, but I know ‘stroke’ isn’t the term they use here (non-English speaking county). It does seem possible, doesn’t it?

Yes, two vets checked his ears, but nothing unusual. The Meniere’s actually sounds similar to what he has.

They’re ruling out something in the food or environment, since my other cat is fine.

I also asked about West Nile, just reaching for anything. (My horse had West Nile and had neurological symptoms. He completely recovered, luckily). Turns out West Nile isn’t here (I guess I should say ‘isn’t here yet’.).

[Zu_Zu]

Jingles & AO ~ Always Optimistic for a diagnosis and treatment plan for your cat ~ (( hugs)) laced with extra strength and patience for his worried mom ~

Please share his name, so we can make our Jingles more comforting ~

[CleverUserName]

I mean, don’t all our animals have numerous names?
When he needs to be tough, like when the other cat tries to eat more than his share of food, I call him by his ‘hip hop DJ/street name’, BiggieO.

He’s got to be tough now, so send jingles to BiggieO!

[shiloh]

I hope he is doing better. Still jingling.

[CleverUserName]

He’s home, but it’s going to be a long road. I rearranged so he doesn’t need to go up the steps to his kitty box. I’ve put cushions on the floor around the sofa and beside the bed because he’s so uncoordinated, I don’t want him to hurt himself in the night if tries to jump off and falls down.

He’s spending a lot of time sleeping, he’s had some food and water, and his morning prednisone.

We’re not sure if he will improve, but the vets don’t think he will lose more coordination. He will go back in a couple of weeks for a checkup.

Thanks for all his jingles!

[Zu_Zu]

Jingles & AO for your beloved boy ~ wrap him up him home love and comfort ~