Vomiting-- vet stumped

[...]

I'm just hoping the collective wisdom of the group has a few thoughts.
This is long, but I'm basically looking for whether anyone has any
thoughts for what's going on, and if there's anything that occurs to
you to raise with my vet before we get into seriously pricey testing.

My 8-year-old cat, Tristan, has had vomiting issues for a few months
now. I first saw the vet about it mid-December, when he was vomiting
daily. Did basic bloodwork, which was all normal. We switched to a
hypoallergenic food at that point, and the vet said to give it a few
weeks. We did, but he did not improve and on New Year's Day his
vomiting was out of control (by mid-afternoon it was hourly, and it
was obvious it couldn't wait until morning), and we ended up taking
him to the emergency vet. They did an x-ray (normal), and gave him a
shot of cimetadine (Tagamet). He went about a week without vomiting,
then it picked up again, so back to the vet. Got a prescription for
cimetadine, and he again stopped for a while, then started up again.
Increased the dosage, same result. On Friday, we started him on
metoclopramide, which the vet really expected to help. It didn't make
any difference. He's vomiting daily still, usually with blood in the
vomit. More bloodwork was still normal.

The vet is now talking about doing a barium series of x-rays and then
sending us to a vet college for endoscopy and/or whatever else the
clinic thinks is necessary. The nearest vet college is a couple of
hours away.

Aside from the vomiting and nausea, Tristan seems healthy and happy.
He's lost just a couple of ounces through all this, has a good
appetite, is well-hydrated, and seems to feel good when he's not
feeling queasy. Unfortunately, he feels queasy a lot.

So, has anyone else had a serious experience. Did you try any other
meds or anything before heading to the serious tests? Particularly,
has anyone tried any of the acid reducers that are newer than Tagamet?
I know that for humans, at least, the quality of acid reducers has
improved dramatically since Tagamet came out. Are any of these
(Prilosec, Prevacid, or any of the others) used in cats at all? Since
the Tagamet has slowed him down somewhat, I'd be really interested in
trying a more effective drug.

Any thoughts anyone has are most welcome.

Thanks,
Kendra

[Rascalsmom]

Well, I know it seems like a pain, but if it were me, I would go ahead
and do the tests. Right now Tristan feels reasonably well so he can
have the procedures done without an unusual amount of risk. If you let
this persist, chances are he will not hold up forever and may still
need the tests when he will be less able to tolerate it. Why mess
around with just trying this and that and the other thing? My opinion
is that it would be better to try to define what's causing the problem
instead of guessing. Just my two cents - someone else may have other
advice. Whatever you do, I wish you and Tristan good luck and positive
results. Laura

chil...@yahoo.com (...) wrote in message news:<208243ba.02021...@posting.google.com>...

[JaKe - Seattle]

Make sure a vet checks your cat's thyroid too.

JaKe

[CatProtectionSoc]

When I hear about vomiting like this i think about problems with the liver or
pancreas.

Maybe you know it already but don't feed him milk. Also, check for chemicals
around the house which can cause this problem such as whatever you use for
cleaning floors or rugs or chairs. What kind of house plants does he have
access to? Is he licking the tops of Clorox bottles when no one is looking.
All that sort of stuff.

CPS.

[Phil P.]

... <chil...@yahoo.com> wrote in message
news:208243ba.02021...@posting.google.com...

Is there any pattern to the vomiting? IOW, does it begin immediately after
eating, a few hours after eating, early morning before eating or at various
times with no particular pattern?

What does the vomit contain? Bile, undigested food? You mentioned blood;
was it flecks of blood, or digested blood (digested blood looks like "coffee
grounds"). Has the vet seen the actual vomit? Sometimes, its difficult to
distinguish chronic vomiting from chronic regurgitation.

You may want to have your vet examine the vomit for parasites.. especially
Ollulanus tricuspis - its a tiny nematode in the stomach that causes chronic
vomiting. If your vet doesn't have a dissecting or compounding microscope,
he doesn't have to send out the test - he can use a standard flotation
procedure (just like with feces) for parasites in vomit - its a rapid and
inexpensive test.

Do you have any plants in your home? If so, do the pots contain fertilizers
or insecticides? Also, have you done a ground-level search for toxins, such
as cleaning products, floor wax, rug shampoo, etc., that your cat may have
access to?

Since you've already tried dietary management without success, you may want
to suggest glucocorticoids (prednisone) to your vet - not for treatment, but
for diagnosis. If there's clinical response to steroid therapy, the
problem may be chronic gastritis secondary to immune-mediated mechanisms.
However, make *sure* your vet rules out gastric ulcer/erosion *before*
trying steroids. Also, you might want to ask your vet about withholding
food for 12-24 hours - sometimes, vomiting may be
stimulated by eating or drinking.

The problem may be gastritis - which has numerous causes - or idiopathic
gastritis - which is a diagnosis of exclusion (reached after everything else
has been ruled out). However, the problem may also be a gastrointestinal
foreign object that may not be radiodense and does not show up on x-rays.
Obstructions of the stomach and upper part of the intestines will cause
repeated vomiting whereas obstructions farther down the intestine may not
cause any vomiting. Ultrasounds are much more revealing than x-rays because
they can detect objects and disease processes that x-rays cannot. However,
sometimes, to find the cause of chronic vomiting, the diagnostic workup may
be extensive because there are many possible causes. In some cases a
definitive diagnosis requires a biopsy.

I know you're trying as hard as you can to solve the problem, however, I
wouldn't delay further diagnostics. Chronic vomiting can cause esophagitis
as well as aspiration pneumonia (from inhaling vomit into the lungs).

Sorry I can't be more helpful - vomiting has many causes - sometimes, the
cause is never found.

Good luck.

Phil.

PS: Speak to your vet about Zantac.

[Mccloudck]

Hello,
I saw a T.V. show the other day where a dog had similar symptoms. The dog
was miraculously cured when his person cleared her home of toxic household
cleaning suppliessuch as bleach, pine cleaners, air fresheners, etc. She was
also advised to clean everything thoroughly with natural cleaning agents like
vinegar, hydrogen pyroxide, lemon, baking soda.It's worth a try. Also with
tummy problems (just like people), acidophilus, enzymes and other friendly
bacterias helps all animals immensely. If posssible, take kitty to holistic
vet.

[...]

Just a quick update:

We're going to try one more drug regimen for a few days (give or take,
depending on how Tristan's doing), and then if that doesn't work I'll
be getting a referrel to the vet school 2 1/2 hours from here, where
they'll probably scope him. We'll be trying a combination of Prilosec
(omeprazole, a very good acid reducer) and an antibiotic. If we're
dealing with ulcers or some weird idiopathic gastritis, this should be
effective.

According to the vet, thyroid, pancreas, or liver problems all should
have shown up in the bloodwork that has been done, so those were all
good suggestions, but don't look too likely right now.

In response to questions about my boy's vomiting habits: it seems to
be entirely independent of when he eats/drinks. Occasionally, he
happens to vomit shortly after eating, but not usually. It seems
random. The vomit is yellowish-brown, frequently tinged with
bright-red blood.

I thought some more about possible toxins, and I'm starting to wonder
if this all started around the time we moved the litter box. I don't
remember quite when the move was, but it could've been in the right
ballpark. We pulled up some carpet in the new spot, so it seems
possible there are some chemicals from old carpet glue or something on
the floor there. Cat #2 is unaffected, but there's no harm in moving
the box and shutting the closet, so I'll give that a shot. The
stronger correlation is that this all started not long after I started
work full-time, so stress could definitely be a factor.

Thanks to everyone for their input. Further updates as events
warrant. :) Hopefully, whatever ends up happening will be useful info
for someone else.
-Kendra