CKD cat vomiting since Tuesday

angela638x

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My 11yo Lola with CKD has had some vomiting lately. Tuesday night I came home and found (on my brand new rug :bawling2:) that she had thrown up her food and two marble-sized hair balls - I have never seen hairballs so round before? The next morning she vomited up her treat which she is always excited for, with foam- then ate that, gross - and I dosed her with cerenia 1/4 tab in another treat. It stayed down. This is the first time I’ve used it as she’s been eating and drinking well (she eats Hill's k/d dry, some wet food, and drinks hydracare religiously). She didn’t eat or touch her hydracare all day while I was at work and then had only had a few licks of some food when I pulled out some tiki cat sticks, then lost interest.

Wednesday night I heard her crunching so was eating, and ate more on Thursday morning, although ignoring her hydracare. Thursday afternoon she vomited white foam. She did eat half a can of Weruva wet food and drank water. Then today she vomited white foam in the morning, but was meowing for treats and her hydracare. Treat stayed down and she drank half the hydracare. Not sure what I'll find when I get home today.

Of course I messaged my vet... hoping to get some thoughts from you all. <3
 

Jem

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With CKD, nausea is very common which affects their eating habits and can lead to vomiting. It happens when the toxins build up due to the ineffectiveness of the kidney's filtration. She's probably dehydrated as well. When you speak to your vet, perhaps ask if it's time (even if just temporary) to give her a few weeks of subcutaneous fluids. It can be administered at home. The fluids were the biggest thing that helped with my kitty's eating/nausea. Also, if she's starting to have issues with hairballs, perhaps give her a few days of hairball gel to help pass them.
When we were treating my kitty, we only had to administer the fluids for a couple weeks every few months, but eventually, as the CKD progressed, it had to be done everyday. But thankfully it's not super expensive either.
A lactated ringer (think IV bag) was only about $10 (Canadian) the line was also about 10 bucks and a box of 100 needles was about the same. The line can be reused for multiple bags so it does not need to be replaced when the bag is empty. A new needle needs to be used for every administration. We gave 100mls a day so a bag lasted 10 days.
I'm glad you contacted your vet as this could be a sign that she might be "crashing", but if you catch it soon enough, she can bounce right back.
Here is a link for a site to all things CKD, it really helped me when treating my kitty.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat
 
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angela638x

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With CKD, nausea is very common which affects their eating habits and can lead to vomiting. It happens when the toxins build up due to the ineffectiveness of the kidney's filtration. She's probably dehydrated as well. When you speak to your vet, perhaps ask if it's time (even if just temporary) to give her a few weeks of subcutaneous fluids. It can be administered at home. The fluids were the biggest thing that helped with my kitty's eating/nausea. Also, if she's starting to have issues with hairballs, perhaps give her a few days of hairball gel to help pass them.
When we were treating my kitty, we only had to administer the fluids for a couple weeks every few months, but eventually, as the CKD progressed, it had to be done everyday. But thankfully it's not super expensive either.
A lactated ringer (think IV bag) was only about $10 (Canadian) the line was also about 10 bucks and a box of 100 needles was about the same. The line can be reused for multiple bags so it does not need to be replaced when the bag is empty. A new needle needs to be used for every administration. We gave 100mls a day so a bag lasted 10 days.
I'm glad you contacted your vet as this could be a sign that she might be "crashing", but if you catch it soon enough, she can bounce right back.
Here is a link for a site to all things CKD, it really helped me when treating my kitty.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat
I have all of the supplies for subcutaneous fluids, but not the solution. She was not a fan of it when I last gave it to her (post hospitalization). Her skin snaps right back - no tenting - so I am not sure if she is dehydrated? I know obviously vomiting will dehydrate her. She is not behaving or looking at all like when she crashed before (skin tenting, refusing to eat, lethargic, bad breath, poor coat, etc). She seems to want to eat (gets very excited when feeder goes off or hears the can) but being particular about it, then vomiting the foam certain times of day.
 

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Does she have food available to her all/most of the time? Maybe a motion activated feeder instead of a timed one? White foam vomit can mean acid build up in her stomach and allowing her to have food to her avail all the time might help with that. There are also CKD cats that have acid reflux - is she on any sort of meds for that - like famotidine?
 

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Well the other thing could be too much stomach acid????

One thing to keep in mind...Any from of nausea can cause a kitty to associate feeling sick with the food. So, if she associates the smell/taste of her food with being sick, she may start refusing that particular food.
We went thru this with Toby so we always rotated a different smelling/tasting food for every meal. You don't need like 20 different foods, just a few so you don't give the same one 2 times in a row.
 
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angela638x

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Does she have food available to her all/most of the time? Maybe a motion activated feeder instead of a timed one? White foam vomit can mean acid build up in her stomach and allowing her to have food to her avail all the time might help with that. There are also CKD cats that have acid reflux - is she on any sort of meds for that - like famotidine?
She does have dry food available to her all the time but after she had that episode of vomiting with the hairball doesn't seem interested in that - still wants treats and the wet food though. She wanted the dry after the cerenia. I do wonder if it is acid reflux- she isn't on anything for that.
 
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angela638x

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Well the other thing could be too much stomach acid????

One thing to keep in mind...Any from of nausea can cause a kitty to associate feeling sick with the food. So, if she associates the smell/taste of her food with being sick, she may start refusing that particular food.
We went thru this with Toby so we always rotated a different smelling/tasting food for every meal. You don't need like 20 different foods, just a few so you don't give the same one 2 times in a row.
I am wondering if I could stop the dry all together then - as in stop the auto feeder for now? It's her RX kidney food...
 

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I am wondering if I could stop the dry all together then - as in stop the auto feeder for now? It's her RX kidney food...
Wet food is always better than dry for CKD kitties, but like as FeebysOwner FeebysOwner mentioned, snacking throughout the day can help with stomach acidity issues, so it's not a bad idea that she have something available should she need it. There are several different brands and flavors of CKD food out there so you could rotate them. There are also several different CKD wet foods if you want to stick with prescription food....not sure if you already offer her RX wet food.
If you're home most of the day, you could just feed her more small wet meals and just leave the kibble out for overnight and if you leave the house....
 
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angela638x

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Wet food is always better than dry for CKD kitties, but like as FeebysOwner FeebysOwner mentioned, snacking throughout the day can help with stomach acidity issues, so it's not a bad idea that she have something available should she need it. There are several different brands and flavors of CKD food out there so you could rotate them. There are also several different CKD wet foods if you want to stick with prescription food....not sure if you already offer her RX wet food.
If you're home most of the day, you could just feed her more small wet meals and just leave the kibble out for overnight and if you leave the house....
She ate wet RX food initially then decided she hated it after a couple of weeks. She loves the dry RX food which I have come out of a timed auto feeder - unfortunately I work in healthcare and I am not home on a predictable basis so I wanted a way to make sure her meals were scheduled. I leave hydracare out in the AM and PM - typically she drinks it all. I am going to try switching brands of the wet RX food - lately I have been giving her some of the weruva wet food (with the lowest phosphorus possible) just to get wet food in her and she seems to like it.
 

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There are covered, motion activated timers - some even with a compartment below for an ice pack - that could be left out for her all day while you are gone too.
 

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Not sure what you're feeding but...
Royal Canin has 3 dry and 3 wet options
Hill's has only the one (I think) KD dry flavor, but has 4 wet food flavors
And Purina Pro plan now has a prescription line for CKD. One each of dry and wet "early care" and "advanced care"
Well...at least in my area...not sure of the availability where you live.
 
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angela638x

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Not sure what you're feeding but...
Royal Canin has 3 dry and 3 wet options
Hill's has only the one (I think) KD dry flavor, but has 4 wet food flavors
And Purina Pro plan now has a prescription line for CKD. One each of dry and wet "early care" and "advanced care"
Well...at least in my area...not sure of the availability where you live.
I have tried all of the Hill's wet - she lost interest in them all. She is eating the Hill's dry no problem though. I have seen RC and Purina!
 

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Since she is vomiting the foam in the morning, it does sound like an over acidic tummy to me. All of my three kidney cats did that until we got them on famotodine. We gave it as an injectable since it was just easier. If you aren't already doing it, I would also advise feeding her a hearty meal right before bedtime so she has plenty in her tummy to get through the night. I used to feed mine twice in the middle of the night even, using ice paks to keep the wet food "safe". I fed just one tablespoon for each of those feedings, and fed right in bed so I didn't have to fully wake up. (I did these additional feedings because mine never ate much at any one meal, so I'd feed 8 - 9 meals per day)
 
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angela638x

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Thanks everyone for your replies- I really appreciate it. The vet has her on a little cerenia daily for now. Lola is eating normally, peeing, but now I noticed she’s constipated - sigh. I noticed her going in and out of the litter box and straining (peeing fine) so I gave her some pumpkin with some tiki stix on top and that produced a poop yesterday. Today she’s in an out again, no poop :( I’m not sure if the nausea med causes constipation?
 

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Very weird. If anything, Cerenia is more inclined to cause diarrhea - although dehydration can be another side effect which could cause harder stools. If she is eating more dry than wet that could also be contributing to her issue.

I am not sure - but did you check out any information on Tanya's web site about CKD cats and constipation just to see if that might give you any clues?
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Constipation (felinecrf.org)
 
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angela638x

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Very weird. If anything, Cerenia is more inclined to cause diarrhea - although dehydration can be another side effect which could cause harder stools. If she is eating more dry than wet that could also be contributing to her issue.

I am not sure - but did you check out any information on Tanya's web site about CKD cats and constipation just to see if that might give you any clues?
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Constipation (felinecrf.org)
I’m giving her mostly wet now (which I add water to) but she is drinking less water/hydracare. Arghhh. If it’s not one thing it’s another with this girl :frustrated:maybe I will just keep adding pumpkin to her wet food..
 

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I’m giving her mostly wet now (which I add water to) but she is drinking less water/hydracare. Arghhh. If it’s not one thing it’s another with this girl :frustrated:maybe I will just keep adding pumpkin to her wet food..
It would stand to reason that she is drinking less if she is getting mostly wet food. I guess as you suggested, continue with the pumpkin and see what happens. I am not a big advocate of pumpkin because it can work either way - to help with constipation and to help with loose stools, depending on the cause. I personally would be more inclined to give her 1/8 tsp of Miralax mixed with water first and then added to her food, as needed - that is strictly my opinion. If her food is low fiber, then maybe pumpkin might be the answer.

Does she pass the 'scruff' test for hydration? Is she on any meds that are prone to causing constipation?
 
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angela638x

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You bring up a point re: the pumpkin that I was worried about to begin with. I don’t want it to make it worse! She is on amitriptyline (for her ureter.. she had a stone) which can cause constipation- since starting it her poops have definitely been different, but then again she began it right after hospitalization and I changed her food then too. But still, she used to poop multiple times a day, and now she definitely doesn’t. I just don’t like the in and out of the box. She definitely passes the scruff test.
 

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I cannot see how trying the Miralax at that low dose - just as needed - could present an issue - but certainly get the OK from your vet. It is possible that this problem will pass (no pun intended ;)) once she has been off the amitriptyline for a while.
 
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angela638x

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I cannot see how trying the Miralax at that low dose - just as needed - could present an issue - but certainly get the OK from your vet. It is possible that this problem will pass (no pun intended ;)) once she has been off the amitriptyline for a while.
The issue is she is supposed to be on the amitriptyline indefinitely :ohwell:
 
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