Need help with vomiting cat

[InspiredLamb]

Hi,

I have an issue with my 14-year-old cat which numerous vets don't seem to able to help with.

She has always been a cat prone to vomiting. She vomits her food from time-to-time, but it was never enough to cause alarm. A few months ago she began doing what I can only describe as projectile vomiting. There is a marked difference between this and the regular vomiting, both in the amount and in the manner in which she does it.

The regular vomiting is preceded by the usual rhythmic bodily heaving before her undigested food comes out. But the projectile vomiting is quicker when it comes, preceded by what sounds like a coughing sound. And then there is a torrent of liquid, with some food but not a great deal. The force of it is quite alarming.

She has had a number of blood tests and visits with three different vets (we were on the road for a while with her). It was suggested that she has pancreatitis, although our current vet disputes that, while being unable to offer an alternative view. Whatever the issue is it has begun to get worse. Where she was having these bouts of projectile vomiting once every few weeks, we are now at once every few days.

Has anyone else ever experienced this problem? Were you given a diagnosis? Any ideas or suggestions would be gratefully received. Thanks.

 

[Alldara]

We were given a hyperthyroid diagnosis for Lily for this. I'm unsure if all vets include it in regular blood work. Our vet at the time did not.

It could also be a food intolerance. Did the formula of her food recently change?

 

[InspiredLamb]

I'm waiting for the vet to contact me, and I will ask about the hyperthyroid issue. Thank you.

Her food hasn't changed, at least , not since this started. I did change her kibble to a sensitive stomach formula to see if it helped. She has wet food and kibble, both are Blue Buffalo brand.

 

[InspiredLamb]

I'm waiting for the vet to contact me, and I will ask about the hyperthyroid issue. Thank you.

Her food hasn't changed, at least , not since this started. I did change her kibble to a sensitive stomach formula to see if it helped. She has wet food and kibble, both are Blue Buffalo brand.

I meant not BEFORE this started, sorry.

 

[Alldara]

I meant not BEFORE this started, sorry.

You might not have changed her food, but the company might have changed the formula. You can call the companies and ask if there have been any changes around the time the vomiting started.

Most companies changed their formulas between 2020 and now.

 

[InspiredLamb]

Ah, really? That is interesting, thank you.

 

[Astragal14]

I'm sorry to hear you and your cat are going through this, frequent vomiting is never easy and especially while traveling.

This sounds a little similar to one of my cats, he has IBD and is prone to both stress colitis and scarf and barf (eating to quickly), but more information would be helpful.

The regular vomiting you've described sounds like regurgitation. Regurgitation is bringing up undigested food whereas vomiting is bringing up digested food and/or liquid (like bile).

Is her recent vomiting different from her regular regurgitation in any way other than being projectile? And what does the liquid look like? Clear water? White foam? Any bile?

Did her blood work show anything of concern?

If her blood work is normal and if she otherwise seems normal, then I am first wondering if it is stress related due to travel.

 

[InspiredLamb]

I'm sorry to hear you and your cat are going through this, frequent vomiting is never easy and especially while traveling.

This sounds a little similar to one of my cats, he has IBD and is prone to both stress colitis and scarf and barf (eating to quickly), but more information would be helpful.

The regular vomiting you've described sounds like regurgitation. Regurgitation is bringing up undigested food whereas vomiting is bringing up digested food and/or liquid (like bile).

Is her recent vomiting different from her regular regurgitation in any way other than being projectile? And what does the liquid look like? Clear water? White foam? Any bile?

Did her blood work show anything of concern?

If her blood work is normal and if she otherwise seems normal, then I am first wondering if it is stress related due to travel.

The regurgitation has always been a thing with her, so we don't worry about it. It doesn't happen often enough to a threatening issue to her. But the vomiting is very different. Yes, I think there is digested food, and certainly bile. It can be yellowish in color, but there is always more liquid than anything else. And a lot of it.

He most recent bloodwork showed:

• Low Chloride levels
• Slightly low Sodium
• Very low Absolute Neutrophils

None of which the vet seemed too concerned about.

It was suggested that the stress of travel was a cause, but this started before we began travelling and has continued a month after we have settled again.

 

[Astragal14]

I have a few more questions if you don't mind:

Was your cat given any medications for the recent vomiting episodes?

Do these new vomiting episodes have any pattern? Time of day, after certain activity, anything?

Was she tested for parasites/bacteria/viruses?

How long does she go between eating (both meals and snacks)?

Does she ever display signs of nausea (lip licking, drinking large amounts of water, atypical chewing of things, among other signs)?

 

[InspiredLamb]

I have a few more questions if you don't mind:

Was your cat given any medications for the recent vomiting episodes?

Do these new vomiting episodes have any pattern? Time of day, after certain activity, anything?

Was she tested for parasites/bacteria/viruses?

How long does she go between eating (both meals and snacks)?

Does she ever display signs of nausea (lip licking, drinking large amounts of water, atypical chewing of things, among other signs)?

-- Was your cat given any medications for the recent vomiting episodes?
She was given Cerenia to stop the vomiting, a course of Metronidazole, Baytril, and Prednisone. We continued with the Cerenia but really don't want to keep doing it without knowing that she doesn't NEED to vomit, for some reason.

-- Do these new vomiting episodes have any pattern? Time of day, after certain activity, anything?
I would say that it is usually later in the day or evening, but not always.

-- Was she tested for parasites/bacteria/viruses?
I'm assuming so, although I can't be certain.

-- How long does she go between eating (both meals and snacks)?
She has her breakfast around 8:00am, some snacks at lunchtime, and dinner around 5:00 or 6:00pm.

-- Does she ever display signs of nausea (lip licking, drinking large amounts of water, atypical chewing of things, among other signs)?
Yes, often. In fact, we can now predict the next episode by that behavior.

 

[Astragal14]

I know I'm asking a lot of questions and not really giving any advice, there are so many different things this could be and it takes time to narrow it down. Thank you for your patience!

It sounds like the vomiting is caused by nausea, what we don't know is what is causing the nausea.

The low chloride and sodium levels could be due to the chronic vomiting. Have any of the vets mentioned sub-q fluids or dehydration? Giving fluids won't fix the issue but it will help her feel better and also help to keep her from getting worse.
Is My Cat Dehydrated? Signs to Look For | PetMD

Low neutrophils could be caused by many things. Stress or bacterial infections are among the more mild causes. It's good that your vets are monitoring her blood work and can watch for signs of something more serious, like cancer (I don't mean to scare you with that, it's just something to check for in blood work).

Have any of the vets mentioned doing an ultrasound? This would look for inflammation that indicates pancreatitis, IBD or small cell lymphoma.

She was given Cerenia to stop the vomiting, a course of Metronidazole, Baytril, and Prednisone. We continued with the Cerenia but really don't want to keep doing it without knowing that she doesn't NEED to vomit, for some reason.

Are you still giving her Cerenia? I recommend continuing this for the time being, as long as your vet thinks it's okay. My cat took it daily for 8 months after a very bad IBD episode that resulted in an ER stay. He takes it now after any vomiting or regurgitation episodes. Cerenia is an anti-nausea medication that also has some mild anti-inflammatory effects.

Have you given her a probiotic since discontinuing the metronidazole? That's an incredibly strong medication that will remove a lot of good bacteria along with the bad bacteria from her GI tract. The good bacteria needs to be replenished with a probiotic for a while following a course of antibiotics.

Has she been given B12 injections? I highly recommend this, it will help considerably with her nausea and also help rebalance her GI tract so that it can better absorb nutrients and medications (which then helps her feel better and further reduces nausea, it's a win-win). Her GI tract is out of balance now so she is probably low on B12; deficiencies can take a long time to show up on blood work. The injections are inexpensive and have almost no side effects, so it's a quick and easy way to help her feel better.

-- How long does she go between eating (both meals and snacks)?
She has her breakfast around 8:00am, some snacks at lunchtime, and dinner around 5:00 or 6:00pm.

-- Does she ever display signs of nausea (lip licking, drinking large amounts of water, atypical chewing of things, among other signs)?
Yes, often. In fact, we can now predict the next episode by that behavior.

I'm wondering if her nausea is caused by excess stomach acid. It's more common to see this early in the morning because an empty stomach is more easily irritated by excess stomach acid (that's when you see the watery or bile vomits). But that doesn't exclude it from happening at other times throughout the day. This is called bilious vomiting syndrome.
Stomaching the Problem: Could Your Pet Have Bilious Vomiting Syndrome?

Do you think you could intervene with an additional snack or early meal? Try giving her a small amount a food about an hour before she usually vomits, hopefully doing this consistently will lead to a noticeable reduction in vomiting. Stronger options include supplements, like slippery elm or mild anti-nausea aids like Animal Essentials Daily Digestion (my IBD cat takes both of these daily, don't give slippery elm two hours before or after giving any other medication or supplement because it inhibits absorption), or acid reducing medications (like Pepcid or Prilosec). But you should discuss acid reducers with your vet first; hopefully this can be managed without them.

To summarize:

Right now, I recommend giving her a probiotic and B12 injections. You can also ask your vet about giving sub-q fluids for dehydration, and I hope it's a good sign that no one has mentioned that so hopefully she isn't dehydrated. And discuss with your vet if there is any benefit to keeping her on Cerenia (I recommend this for now, while she is still vomiting, but definitely discuss it with your vet).

I would also watch for signs of excess stomach acid and see if you can avoid the excess build up with more frequent snacks and/or meals (and maybe with the addition of some supplements).

If those suggestions don't result in reducing or eliminating her vomiting, then I would ask your vet about 1) trying an acid reducer and 2) if an ultrasound would give any beneficial information at this point.

 

[lisahe]

Astragal14 has (as always!) already asked nearly all my question but I did want to ask if your cat was tested for pancreatitis, I InspiredLamb . What, by the way, is your cat's name?

I also want to add encouragement to get an ultrasound if it's possible. When one of our cats was having vomiting problems -- she'd always been a barfer but she slowly got worse -- an ultrasound identified very bad inflammation in her stomach. (She had to have parts of her stomach removed.) We'll never know what caused the inflammation but (since they've been mentioned in this thread!) parasites are a prime suspect, though some kinds (certain nematodes) are apparently difficult to detect with tests. An ultrasound can also identify thickening in the intestine, which can be a sign of IBD. Ultrasound isn't perfect -- Edwina's spleen looked okay but also had to be removed -- but I'm a huge fan of it after our experience.

I'm also a huge fan of Cerenia, which we nicknamed "Serenity" because it helped Edwina so much, even when she was feeling her very worst, just before her ultrasound and surgery.

 

[InspiredLamb]

I know I'm asking a lot of questions and not really giving any advice, there are so many different things this could be and it takes time to narrow it down. Thank you for your patience!

It sounds like the vomiting is caused by nausea, what we don't know is what is causing the nausea.

The low chloride and sodium levels could be due to the chronic vomiting. Have any of the vets mentioned sub-q fluids or dehydration? Giving fluids won't fix the issue but it will help her feel better and also help to keep her from getting worse.
Is My Cat Dehydrated? Signs to Look For | PetMD

Low neutrophils could be caused by many things. Stress or bacterial infections are among the more mild causes. It's good that your vets are monitoring her blood work and can watch for signs of something more serious, like cancer (I don't mean to scare you with that, it's just something to check for in blood work).

Have any of the vets mentioned doing an ultrasound? This would look for inflammation that indicates pancreatitis, IBD or small cell lymphoma.



Are you still giving her Cerenia? I recommend continuing this for the time being, as long as your vet thinks it's okay. My cat took it daily for 8 months after a very bad IBD episode that resulted in an ER stay. He takes it now after any vomiting or regurgitation episodes. Cerenia is an anti-nausea medication that also has some mild anti-inflammatory effects.

Have you given her a probiotic since discontinuing the metronidazole? That's an incredibly strong medication that will remove a lot of good bacteria along with the bad bacteria from her GI tract. The good bacteria needs to be replenished with a probiotic for a while following a course of antibiotics.

Has she been given B12 injections? I highly recommend this, it will help considerably with her nausea and also help rebalance her GI tract so that it can better absorb nutrients and medications (which then helps her feel better and further reduces nausea, it's a win-win). Her GI tract is out of balance now so she is probably low on B12; deficiencies can take a long time to show up on blood work. The injections are inexpensive and have almost no side effects, so it's a quick and easy way to help her feel better.



I'm wondering if her nausea is caused by excess stomach acid. It's more common to see this early in the morning because an empty stomach is more easily irritated by excess stomach acid (that's when you see the watery or bile vomits). But that doesn't exclude it from happening at other times throughout the day. This is called bilious vomiting syndrome.
Stomaching the Problem: Could Your Pet Have Bilious Vomiting Syndrome?

Do you think you could intervene with an additional snack or early meal? Try giving her a small amount a food about an hour before she usually vomits, hopefully doing this consistently will lead to a noticeable reduction in vomiting. Stronger options include supplements, like slippery elm or mild anti-nausea aids like Animal Essentials Daily Digestion (my IBD cat takes both of these daily, don't give slippery elm two hours before or after giving any other medication or supplement because it inhibits absorption), or acid reducing medications (like Pepcid or Prilosec). But you should discuss acid reducers with your vet first; hopefully this can be managed without them.

To summarize:

Right now, I recommend giving her a probiotic and B12 injections. You can also ask your vet about giving sub-q fluids for dehydration, and I hope it's a good sign that no one has mentioned that so hopefully she isn't dehydrated. And discuss with your vet if there is any benefit to keeping her on Cerenia (I recommend this for now, while she is still vomiting, but definitely discuss it with your vet).

I would also watch for signs of excess stomach acid and see if you can avoid the excess build up with more frequent snacks and/or meals (and maybe with the addition of some supplements).

If those suggestions don't result in reducing or eliminating her vomiting, then I would ask your vet about 1) trying an acid reducer and 2) if an ultrasound would give any beneficial information at this point.

I spoke with the vet and she has recommended a change of diet to a more IBD geared food, and an ultrasound if that doesn't yield any improvements. We had to pop out for a few hours and I gave her a little bit of food to see if she could keep it down. She did, so when we got home I gave her a Cerenia dose, followed by some more food and water after a short period to let the pill 'kick in'. So far, so good.

The vet agrees that the low chloride and sodium levels were due to the vomiting, causing a lack of electrolytes.

She does get Purina FortiFlora with her meals daily and, in line with your suggestion, I had started pacing her food a little more. That is to say, I would give her more intermediate small helpings rather than half a can in the morning and half at night. I'm going to continue with this, I think. She can be prone to inhaling the lot and it doesn't always agree with her.

I feel somewhat soothed by the regular Cerenia doses you have mentioned for your cat. To me, it seems like a miracle cure-all and I'm loathe to overuse it. I'm reconsidering that now. Thanks.

You have been an absolute star. I'm so grateful to you for the time you have taken to share your advice. Hopefully, we'll see an improvement soon. So far, she has kept some more food and some water down (knock on wood). I'll keep you posted.

 

[InspiredLamb]

Astragal14 has (as always!) already asked nearly all my question but I did want to ask if your cat was tested for pancreatitis, I InspiredLamb . What, by the way, is your cat's name?

I also want to add encouragement to get an ultrasound if it's possible. When one of our cats was having vomiting problems -- she'd always been a barfer but she slowly got worse -- an ultrasound identified very bad inflammation in her stomach. (She had to have parts of her stomach removed.) We'll never know what caused the inflammation but (since they've been mentioned in this thread!) parasites are a prime suspect, though some kinds (certain nematodes) are apparently difficult to detect with tests. An ultrasound can also identify thickening in the intestine, which can be a sign of IBD. Ultrasound isn't perfect -- Edwina's spleen looked okay but also had to be removed -- but I'm a huge fan of it after our experience.

I'm also a huge fan of Cerenia, which we nicknamed "Serenity" because it helped Edwina so much, even when she was feeling her very worst, just before her ultrasound and surgery.

My cat's name is Sweety. It was her rescue shelter name and it really does suit her.

The first vet we took her to when the problem started thought it was pancreatitis. Subsequent vets have not been so sure.

Our vet has since recommended a change of diet to an IBD geared one, followed by an ultrasound if that does not improve matters. We'll see.

Love your Cerenia nickname. I'm pinching that!

 

[lisahe]

My cat's name is Sweety. It was her rescue shelter name and it really does suit her.

The first vet we took her to when the problem started thought it was pancreatitis. Subsequent vets have not been so sure.

Our vet has since recommended a change of diet to an IBD geared one, followed by an ultrasound if that does not improve matters. We'll see.

Love your Cerenia nickname. I'm pinching that!

I hope Sweety continues to do well with her new eating regimen. We feed our cats five times a day plus once during the night because Edwina has a tendency to eat too fast and regurgitate her food if she gets too hungry. (This is a particular concern now that she has, literally, lost some of her stomach capacity. It's taken us a couple months to figure out her new limits.) We also try to raise her dishes a few inches off the floor. Tilting them at 15 degrees adds value, too! As our vet told us, leaning a bent neck (and esophagus!) over a dish isn't a good way to eat.

Another thing that can be helpful for a cat who vomits acid and/or has a tendency to regurgitate: feeding one or two freeze-dried chicken treats a few minutes before a meal or as a between-meal snack if the cat's looking dangerously hungry.

Cerenia was definitely a wonder drug for Edwina. I, too, had felt I didn't want to overuse it. When I asked the vet tech how long it's safe to give it to a cat, she said "indefinitely." (Or some synonym for "indefinitely"!) We haven't needed it thus far, about 2.5 months after Edwina's surgery. But I'm glad we have some on the shelf. My husband thought up the "Serenity" nickname -- my bet is that we're far from the only ones who use it for Cerenia!

You didn't say what sort of diet your vet has recommended for Sweety but I hope they've mentioned that some cats have more problems with the thickeners and fillers in foods than with the proteins/meats in foods. Edwina's known sensitivities are with agar-agar, green-lipped mussels, and potatoes: they've all caused vomiting. Between dumb luck and keeping a diary of "incidents" and last meals fed, we were able to figure those out. There's a chance that she has difficulty with xanthan gum and lamb, too, but we're not sure. After all she's been through, it's easier to just not feed either!

I could go on about all this a lot longer but will stop there and say again that I hope Sweety responds well to the new diet!

 

[Astragal14]

She does get Purina FortiFlora with her meals daily and, in line with your suggestion, I had started pacing her food a little more. That is to say, I would give her more intermediate small helpings rather than half a can in the morning and half at night. I'm going to continue with this, I think. She can be prone to inhaling the lot and it doesn't always agree with her.

Smaller, more frequent meals and snacks go a long way towards eliminating bilious vomiting syndrome and the resulting nausea. It's also one of the easiest and quickest ways to test what could be causing Sweety's symptoms without everything that revolves around making a vet appointment (lead time, cost, etc). This is also a good place to mention that appointments for B12 injections are often done with vet techs so you can avoid the doctor's office visit fee. You can also administer the injections yourself at home if you feel comfortable; I don't feel comfortable, so we take my cat to the vet's office and it's $14 per visit.

Have you tried anything to slow down her rate of eating? My IBD cat wants to scarf and barf, so we REALLY had to slow down his meals! We raised his food bowl and only give him 1/4 of his meal at a time, waiting only a couple of minutes in between which seems long enough to prevent him from excitedly eating as fast as he can.

I also STRONGLY recommend a different probiotic. Forti Flora only has one probiotic strain and is overall a weak probiotic; it certainly has it's uses but Sweety needs something stronger right now. Metronidazole is incredibly tough on the GI system and she needs a similarity strong probiotic.

Visbiome is my favorite probiotic in the entire world but I don't know if she needs this much strength. Plus, the minimum purchase on the website is 2 bottles (it's also sold in some vet offices). You could always try other probiotics and switch to this one if she needs more support.
Visbiome® Vet

Two other good probiotics I've personally used with my cats are Proviable Forte and VetriScience Entero Flora Pro. They're also available only through vet offices and most vet's offer one or both.
Proviable®-Forte Sprinkle Capsules For Cats - Proviable®
Entero Flora Pro

Another probiotic I'll recommend is one I just learned about and have not tried, but it's from a good company and the ingredients sound fantastic; I will probably use this the next time one of my cats needs an antibiotic. Animal Biome offers several supplements for GI health and their Kitty Biome GMP specifically replenishes the good bacteria that is lost due to a course of antibiotics.
KittyBiome™ GMP – AnimalBiome

You didn't say what sort of diet your vet has recommended for Sweety but I hope they've mentioned that some cats have more problems with the thickeners and fillers in foods than with the proteins/meats in foods. Edwina's known sensitivities are with agar-agar, green-lipped mussels, and potatoes: they've all caused vomiting. Between dumb luck and keeping a diary of "incidents" and last meals fed, we were able to figure those out. There's a chance that she has difficulty with xanthan gum and lamb, too, but we're not sure. After all she's been through, it's easier to just not feed either!

This is so spot on!! lisahe has great information here and this is exactly what we dealt with when my cat was diagnosed with IBD. Our veterinary specialist made us start with a diet trial focused on protein allergies, even though I had a feeling that wasn't the cause. My IBD cat is fine with all proteins, his problems are with the "filler" ingredients. That's where a journal came in handy for tracking ingredients and recording his reactions. It took a while to realize his trigger foods are high disaccharide foods (ex. potatoes), legumes (lentils, peas) and all gums.

Good luck to you and Sweety! We're here to help if you have any questions at any time!

 

[lisahe]

Have you tried anything to slow down her rate of eating? My IBD cat wants to scarf and barf, so we REALLY had to slow down his meals! We raised his food bowl and only give him 1/4 of his meal at a time, waiting only a couple of minutes in between which seems long enough to prevent him from excitedly eating as fast as he can.

This method for slowing meals sounds very familiar -- this is similar to how my husband feeds Edwina's breakfast!

I feed her other meals and usually put the food on either a small, flat plate, spreading it out, or in a stainless steel bowl that seems to catch the food around the edges so she really has to work for her food.

 

[InspiredLamb]

I hope Sweety continues to do well with her new eating regimen. We feed our cats five times a day plus once during the night because Edwina has a tendency to eat too fast and regurgitate her food if she gets too hungry. (This is a particular concern now that she has, literally, lost some of her stomach capacity. It's taken us a couple months to figure out her new limits.) We also try to raise her dishes a few inches off the floor. Tilting them at 15 degrees adds value, too! As our vet told us, leaning a bent neck (and esophagus!) over a dish isn't a good way to eat.

Another thing that can be helpful for a cat who vomits acid and/or has a tendency to regurgitate: feeding one or two freeze-dried chicken treats a few minutes before a meal or as a between-meal snack if the cat's looking dangerously hungry.

Cerenia was definitely a wonder drug for Edwina. I, too, had felt I didn't want to overuse it. When I asked the vet tech how long it's safe to give it to a cat, she said "indefinitely." (Or some synonym for "indefinitely"!) We haven't needed it thus far, about 2.5 months after Edwina's surgery. But I'm glad we have some on the shelf. My husband thought up the "Serenity" nickname -- my bet is that we're far from the only ones who use it for Cerenia!

You didn't say what sort of diet your vet has recommended for Sweety but I hope they've mentioned that some cats have more problems with the thickeners and fillers in foods than with the proteins/meats in foods. Edwina's known sensitivities are with agar-agar, green-lipped mussels, and potatoes: they've all caused vomiting. Between dumb luck and keeping a diary of "incidents" and last meals fed, we were able to figure those out. There's a chance that she has difficulty with xanthan gum and lamb, too, but we're not sure. After all she's been through, it's easier to just not feed either!

I could go on about all this a lot longer but will stop there and say again that I hope Sweety responds well to the new diet!

Thank you. Chicken is something that Sweety adores, and never regurgitates, so we do give it to her as a treat.

I'm glad Edwina came through all her issues okay. I think there will probably be a certain amount of trial and error with Sweety's diet before we get it right. But we'll get there.

 

[InspiredLamb]

Smaller, more frequent meals and snacks go a long way towards eliminating bilious vomiting syndrome and the resulting nausea. It's also one of the easiest and quickest ways to test what could be causing Sweety's symptoms without everything that revolves around making a vet appointment (lead time, cost, etc). This is also a good place to mention that appointments for B12 injections are often done with vet techs so you can avoid the doctor's office visit fee. You can also administer the injections yourself at home if you feel comfortable; I don't feel comfortable, so we take my cat to the vet's office and it's $14 per visit.

Have you tried anything to slow down her rate of eating? My IBD cat wants to scarf and barf, so we REALLY had to slow down his meals! We raised his food bowl and only give him 1/4 of his meal at a time, waiting only a couple of minutes in between which seems long enough to prevent him from excitedly eating as fast as he can.

I also STRONGLY recommend a different probiotic. Forti Flora only has one probiotic strain and is overall a weak probiotic; it certainly has it's uses but Sweety needs something stronger right now. Metronidazole is incredibly tough on the GI system and she needs a similarity strong probiotic.

Visbiome is my favorite probiotic in the entire world but I don't know if she needs this much strength. Plus, the minimum purchase on the website is 2 bottles (it's also sold in some vet offices). You could always try other probiotics and switch to this one if she needs more support.
Visbiome® Vet

Two other good probiotics I've personally used with my cats are Proviable Forte and VetriScience Entero Flora Pro. They're also available only through vet offices and most vet's offer one or both.
Proviable®-Forte Sprinkle Capsules For Cats - Proviable®
Entero Flora Pro

Another probiotic I'll recommend is one I just learned about and have not tried, but it's from a good company and the ingredients sound fantastic; I will probably use this the next time one of my cats needs an antibiotic. Animal Biome offers several supplements for GI health and their Kitty Biome GMP specifically replenishes the good bacteria that is lost due to a course of antibiotics.
KittyBiome™ GMP – AnimalBiome



This is so spot on!! lisahe has great information here and this is exactly what we dealt with when my cat was diagnosed with IBD. Our veterinary specialist made us start with a diet trial focused on protein allergies, even though I had a feeling that wasn't the cause. My IBD cat is fine with all proteins, his problems are with the "filler" ingredients. That's where a journal came in handy for tracking ingredients and recording his reactions. It took a while to realize his trigger foods are high disaccharide foods (ex. potatoes), legumes (lentils, peas) and all gums.

Good luck to you and Sweety! We're here to help if you have any questions at any time!

Thank you so much for the probiotic advice. We are definitely going to change from the Forti Flora and will look at your suggestions. We'll also make the spaced-out meal portions the standard practice now, and try elevating the bowls a little. If nothing else works then it will be an ultrasound, but we want to try the diet approach first.

You've been so helpful. I can't thank you enough.

Oh, and Sweety has kept everything down since the Cerenia dose, of course. We'll keep her on it until we have stabilized the diet enough.

Sweety says thank you, too.

 

[Astragal14]

Awww Sweety is adorable!

Something I should mention about Cerenia is that it's more effective in preventing vomiting than regurgitation (and it's intended for vomiting anyway). Don't be concerned if you see a reduction in vomiting and less/no reduction in regurgitation. And it's still a good idea to give it when she's regurgitating, it helps to have Cerenia's anti inflammatory properties and it will also help her feel better (i.e. no nausea) if she does regurgitate.