ongoing issues, feeling overwhelmed

[olliepurrington]

hi all.

I'm feeling very overwhelmed, since my cat is sick and I don't know what the issue is. He's been to the vet 5 times so far in the last 2 months. I'm currently awaiting thyroid test results but there's so much going on and I'm having trouble processing it. so here is a summary of the last couple months.

TLDR: cat has been vomiting for a while, gagging when eating/drinking, congested cough, lethargic. vets are still trying to figure it out. not eating much. recent slight breathing issues/wheezing.


may 16 - suddenly vomited into dish while eating. vomited again 3 more times that day, a bit of food but mostly clear

may 17 - still vomiting, went to emergency vet. talked about possibly upset stomach due to a few recent food changes. vet gave cerenia injection and fortiflora probiotic packets.

may 18-21 still vomiting 3 to 4x/day. and sometimes unproductive gagging. Including a few hours after the cerenia injection, so I guess it didn't work. tried a bland chicken and rice diet, hit or miss. he's been slightly lethargic - not exhausted but he is not playing at all.

may 22-30 vomiting about 0-2x/day.
had an episode where he was sort of hyperventilating for about a minute.

may 31 back to emergency vet.
labs - urinalysis, t4, cbc + chemistry
fluids
bloodwork - mostly unremarkable
uti - was later given liquid clavamox
xrays - mostly unremarkable (slight age appropriate kidney deterioration)
wanted to give a prednisone trial but we went back to regular vet instead. (below)

in June he was vomiting approximately every other day and had issues with gagging when eating/drinking, also occasionally had extreme sneezing fits (10-20 times in a row) and I noticed he'd sometimes make a weird "leaky faucet" sound which ended up being the sound of him breathing out and forcibly pushing breath through the side of his mouth (congestion? or??)

june 13- went to regular vet. gave them the bloodwork from emergency vet. was given depo medrol shot for symptoms.

near the end of June I had to leave town for about a week. he was still a bit congested and gagging with occasional vomiting but doing a little better in general and he even played with a toy for the first time since this all started so I felt better about leaving.

july 2 I came back and he looked awful. I was extremely upset with my mom, who had been taking care of him and told me he was doing fine while he was away, but he wasn't. she said he barely ate anything for the first few days and was throwing up the dry food I told her to give him, so she just gave him tiny amounts of tuna,no regular cat food. he had lost a ton of weight and you could feel his spine when petting him and his fur was oily and unkempt. he looked really "off", depressed or something. I was devastated and tried to get him to eat as much as possible, with limited success. of course now with Sunday and the holiday it was impossible to get into the emergency vet so I hoped I could see if he improved over the next couple days.

july 2-7 more vomiting and gagging. very congested, gurgly coughing. regular vet can see him quickly so I made an appointment.

july 7 regular vet, more blood tests. gave him an injection of dexamethasone which unfortunately didn't seem to do anything good, and right after we got home he ate a little and just "drooled" vomit all over himself, instead of forceful vomiting it just seeped out of his mouth. this happened multiple times for the next few days. I was concerned and called the vet and the tech called back saying a vet said the steroid "wouldn't be causing the vomiting" (but I definitely blame it for doing something, as it happened immediately afterwards.) they also said he had a high white blood cell count and the vet who saw him would call back.

july 14th - got voicemail back from the original vet who said his thyroid level was normal but close to high and his appearance would go along with hyperthyroidism. asked me to come back in and take another thyroid test.

july 15-17 still not eating much. sometimes vomiting. gagging every time he drinks water. coughing up mucous. a few times I noticed him once seemingly trying to breathe through his mouth and once he made a wheezing noise. I was again very concerned and tried using vaporizers to see if that would help with congestion (and a "cat sauna" where we sat in the bathroom with the shower running) I'm not sure if that helped.

july 18 went back to vet for t4 test. they gave him a cerenia injection because I said he was vomiting. I don't know if it helped at all because he's eating even less. he ate a little the afternoon of the 18th but that evening I tried to feed him and he was entirely uninterested in even trying. he actually looked miserable and he was breathing through his mouth and making a wheezing noise again for a minute. I took him into the "cat sauna" again and it didn't seem to do anything. he ultimately ended up sleeping under my bed for a couple hours, which he does when he's not feeling well. he came out to drink water and went back and stayed there all night (not like him). this morning he was sleeping on a chair and we hung out for a few minutes and before I could try to feed him again he went back under my bed. I tried putting canned food in front of him under there but he didn't have any interest. later I opened a treat bag and the sound woke him up as usual but when I put some treats right in front of him under the bed he just turned back around and went back to sleep.

so now I'm waiting to hear back from the vet about the third thyroid test. I wanted to call and tell them about the wheezing and the not eating, but the clinic is closed for some reason? which it usually isn't on a Tuesday afternoon.

I considered calling the emergency vet but I am honestly so overwhelmed that I can't think straight and have no idea what is and isn't an emergency, and he's been to the vet 5 times in the last two months and I can't afford another emergency vet visit unless it truly is an emergency. if it is, I will of course take him. but if it isn't, I have to save my money for when it is.

the main thing I'm concerned about at this point is the wheezing (I've only seen him do it twice at this point and only softly and for a minute), congestion (this could be so many things, the vets have never mentioned an upper respiratory issue and it's been going on for perhaps too long to be that anyway, but then what is it?) and the not eating (I *think* he hasn't since yesterday afternoon but I'm not entirely sure. his dry food bowl seems untouched since last night but I did find a small amount of vomit on the floor with food in it this morning).

and as a final note after I wrote all this I heard him vomiting after trying to eat those treats I put down a few hours ago. now he's breathing through his mouth and wheezing again for the last few minutes. I'm actually probably going to call the emergency vet now.

Sorry this was so long and rambly but I'm just trying to make sense of it all, if anyone has any thoughts I would be grateful.


Thanks!

 

[Furballsmom]

Hello - Is your vet clinic a cat-only clinic?
Find a Veterinarian and Practice | The Cat Community

Alternatively, do you have a university medical veterinary department that your vet could consult with?

There may be something here that helps;
Any Good Tips To Get Your Cats To Eat? Share Them Here!

 

[olliepurrington]

Hi Furballsmom, thanks for the info. I'll check it out. His main vet is not cat only, it's a low cost clinic for people with low income so that is the reason I've been taking him there. I will look into cat only clinics, hopefully I can find a reasonably affordable one nearby.

 

[Furballsmom]

I don't know if there would be anything here to help, but just in case;
No Money For Vet Care? How To Find Help And Save Your Cat’s Life – TheCatSite Articles

 

[olliepurrington]

Thank you so much, I'll check this out too!

 

[FeebysOwner]

It would be my guess he has upper respiratory issues - which can be from a whole host of things. And I am personally surprised none of the vets have even mentioned this. It doesn't have to mean just an infection, it could a growth obstructing his throat affecting his breathing and/or eating, and who knows what else. He could have swelling from some sort of infection/inflammation involving his mucous membranes in his head and throat, and beyond. The possibilities go on and on. I don't think the typical x-rays that are done would tell you much about that aspect. There are just too many variables.

I know it is not what you want to hear but get a copy of all the tests that have been done (they are yours for free), ask your vet who they would recommend for a nearby specialty group, check them out, get in touch with them - offering all of his records - and have him seen by an internal medicine vet. It won't be cheap, but they will be thorough. You will spend a lot of money, but you can't just keep throwing money at ER vets and your regular vet at this point. The specialty groups will assess him, give you a cost estimate of what they want to do, sit with you to explain it all, and you can debate with them what is best to do first vs. later.

Regarding his meds: A Cerenia injection does not last longer than 24 hours, so one dose isn't not going to do much. An injection of dexamethasone may or may not have the same short-term duration of Cerenia, so you need to ask about that. And Clavamox is a standard 'go to' antibiotic, that might not necessarily address the actual infection at hand. So, they said he had a UTI - based on what? If all they did was see bacteria in his urine, that means nothing without a urine culture. (And this all goes beyond a slightly high T-4.)

 

[olliepurrington]

It would be my guess he has upper respiratory issues - which can be from a whole host of things. And I am personally surprised none of the vets have even mentioned this. It doesn't have to mean just an infection, it could a growth obstructing his throat affecting his breathing and/or eating, and who knows what else. He could have swelling from some sort of infection/inflammation involving his mucous membranes in his head and throat, and beyond. The possibilities go on and on. I don't think the typical x-rays that are done would tell you much about that aspect. There are just too many variables.

Thanks so much for replying. I was also sort of surprised it didn't come up, but I guess there was always some other issue they were focused on. For example, last time the vet felt a small mass in his throat which led her to focus on the thyroid possibility. But I do think there is something to the upper respiratory idea. The emergency vet today did bring that up, I'll say more about that in a minute.

I know it is not what you want to hear but get a copy of all the tests that have been done (they are yours for free), ask your vet who they would recommend for a nearby specialty group, check them out, get in touch with them - offering all of his records - and have him seen by an internal medicine vet. It won't be cheap, but they will be thorough. You will spend a lot of money, but you can't just keep throwing money at ER vets and your regular vet at this point. The specialty groups will assess him, give you a cost estimate of what they want to do, sit with you to explain it all, and you can debate with them what is best to do first vs. later.

Thank you, I'll start looking into finding a good specialist.

Regarding his meds: A Cerenia injection does not last longer than 24 hours, so one dose isn't not going to do much. An injection of dexamethasone may or may not have the same short-term duration of Cerenia, so you need to ask about that. And Clavamox is a standard 'go to' antibiotic, that might not necessarily address the actual infection at hand. So, they said he had a UTI - based on what? If all they did was see bacteria in his urine, that means nothing without a urine culture. (And this all goes beyond a slightly high T-4.)

I forgot to mention that he had some Cerenia pills also after the first injection.
He had the shot on May 17th at about 3pm and vomited 7 times from 830pm to 12am. Over the next 4 days I gave him the pills which he would vomit up a lot so I'm not sure howuch got in his system, with one exception. On the fourth day he took a pill at 3pm and then ate a whole can of Fancy Feast at 8:30 with no problem! But then he vomited three more times after 11pm. So I'm baffled but it seems the Cerenia generally hasn't worked for him.

The vet said the dexamethasone was "short acting" so I agreed based on that, thinking it would work fast and be out of his system, but I later discovered that may not be the case. I had a bit of trouble trying to speak with a vet since they are really overloaded, I didn't get a straightforward answer yet of how long it would be in his system. He does seem to have mostly stopped the vomiting on himself, although he's still drooling a little more than he had been before.

I was under the impression that they did a urine culture but my knowledge of this is pretty limited so I guess I may have been wrong. The urinalysis said "Bacteria: Cocci occ."

So I went to the emergency vet today after he had breathing difficulty. I'll try to sum that up:

They put him in an oxygen cage while they came and talked to me. The vet did an xray, said he sounds congested and his lungs are a little louder than normal. She said it was unlikely it was a cardio issue since she didn't hear a murmur. He had a "mild bronchial pattern" (he could have a bit of inflammation there). She didn't see much evidence of pneumonia but he does have a lung load that is a little abnormal. Could possibly be a slightly collapsed lung (x ray showed a little congestion there but lungs look mostly clear). Asthma is a possibility but it would be strange that the steroid didn't seem to do anything to help (and that probably wouldn't explain the vomiting).

She mentioned IBD as a possibility, and if that is the case a hydrolyzed protein diet could be a good idea.

And she mentioned that it might be a really bad upper respiratory that was creeping down into his lungs. (I forgot to mention to the vet that he had several really bad sneezing episodes in June, so I might call back later and add that in case it is relevant.)

So there are a lot of different possibilities. They gave him sub q fluids and also tested him for feline leukemia, FIV, and HW which was negative.

They gave me some Azithromycin and Prednisolone with the hope that he might start to get back to where he was (vomiting off and on) and at that point work out the other issues, and if he starts to have another episode of difficult breathing I'll have to bring him back in.

So that's where we are now. Thanks again for the responses, I'll post an update later.

 

[BeccaCat]

Has he had an ultrasound? They are pricey, but often an ultrasound will show the doctors things that X-rays cannot.

 

[olliepurrington]

Has he had an ultrasound? They are pricey, but often an ultrasound will show the doctors things that X-rays cannot.

No he hasn't yet, hmm. I wonder if that could help determine if he has IBD.

 

[BeccaCat]

I don’t think it can detect IBD. And I don’t want to frighten you. But my girl had similar symptoms, and similar treatments, and it wasn’t until the ultrasound that they could see her issues were severe and would need a surgery they felt she wouldn’t survive. That does NOT mean your kitty is that serious. My girl was apparently born with a severe genetic disease, which was hard to detect, and may explain why she was abandoned a few times. But my point being, if you can afford it, an ultrasound may shed some light on what his real issue is, so the vets can better pinpoint the treatment. I hope your little boy gets better very soon. I know how emotionally exhausting the process can be

 

[FeebysOwner]

No he hasn't yet, hmm. I wonder if that could help determine if he has IBD.

It really all depends. The ultrasound may pick up on things that are common to IBD, such as a thickened intestinal wall. But tbh, short of a biopsy of intestinal tissue, the ultrasound is unlikely to be able to confirm IBD. They can, however, increase the odds of accurately assessing IBD vs. lymphoma during an ultrasound by performing a fine needle aspiration cytology of any suspicious looking tissue - much less invasive than a biopsy, but also less accurate.

 

[Astragal14]

Your concern and frustration are very evident, I am sorry both of you are going through this. It would appear your cat does have some separate issues. Let's try to break this down into smaller, more manageable parts.

may 17 - still vomiting, went to emergency vet. talked about possibly upset stomach due to a few recent food changes. vet gave cerenia injection and fortiflora probiotic packets.

This could be a HUGE component or not at all. What was his old food and what is his new food (include treats too)? Also, Forti Flora is a fairly weak probiotic. It certainly has its place, but you need something stronger for right now - especially since your cat is on an antibiotic. It's kind of like Forti Flora is to cats what Pepto Bismol is to people.

I forgot to mention that he had some Cerenia pills also after the first injection.
He had the shot on May 17th at about 3pm and vomited 7 times from 830pm to 12am. Over the next 4 days I gave him the pills which he would vomit up a lot so I'm not sure howuch got in his system, with one exception. On the fourth day he took a pill at 3pm and then ate a whole can of Fancy Feast at 8:30 with no problem! But then he vomited three more times after 11pm. So I'm baffled but it seems the Cerenia generally hasn't worked for him.

Cerenia is less helpful for regurgitation (bringing up undigested food) than it is for vomiting (bringing up digested food). But keep giving it to him because it is still very helpful overall! It's anti nausea and anti inflammatory, two things your cat needs right now. How often has your vet instructed you to administer Cerenia, daily or as needed?

coughing up mucous

And she mentioned that it might be a really bad upper respiratory that was creeping down into his lungs. (I forgot to mention to the vet that he had several really bad sneezing episodes in June, so I might call back later and add that in case it is relevant.)

His sneezing and breathing problems sound like an entirely separate problem. It could be an infection (especially with mucus), or an obstruction, or swelling/inflammation (or something else, but these are probably the leading culprits). How long has he been taking the azithromycin? Have you noticed any improvement? How much longer does he need to take it?

he's still drooling a little more than he had been before

Drooling is a sign of nausea (as is lip licking, and excessively drinking water or drinking water to the point of immediately throwing it up).

He has a lot going on in his digestive tract. Something is making him feel ill, which is causing him to eat less and often vomit or regurgitate what he does it. This can cause irritation and a build up of stomach acid, which makes him feel nauseated and lose his appetite.... which starts the cycle all over again.

Ask your vets about giving him an acid reducer and B12 injections. The acid reducer will help reduce his nausea, and will probably be either famotidine (Pepcid) or omeprazole (Prilosec). Personally, I would choose famotidine if he is also dealing with a respiratory issue because omeprazole has the potential to decrease his white blood cell count, but that is also dependent on how long he needs to take omeprazole, so follow the guidance of your vets. I'm also partial to famotidine because omeprazole has lowered my cat's WBC and often gave him "rebound acid" for a day or two after stopping it. But every cat is different, which is why your vet will know which treatment is best for him.

And definitely ask for a B12 injection, even if his lab work shows his B12 is in a normal range. This will help his nausea and appetite. It can take a long time for a B12 deficiency to show up in labs and cats are often deficient following a GI episode. And he may need continuing B12 injections if he does have something like IBD. Your vet may want him to have B12 injections on a weekly or bi-weekly basis until he improves. Cats absorb the amount of B12 they need and get rid of any excess in their urine, so there's no downside to giving B12. It's also relatively inexpensive compared to other treatments and it can really help a lot. One of my cats has IBD and B12 has helped tremendously.

To summarize:
1. Let us know about his diet change in May
2. Continue with the medications from your vets ask about adding these: a new probiotic (there are several recommendations on this site), an acid reducer, and B12 injections
3. Let us know how the azithromycin is going and if he's seeing any improvement in his sneezing, wheezing and congestion

 

[olliepurrington]

This could be a HUGE component or not at all. What was his old food and what is his new food (include treats too)? Also, Forti Flora is a fairly weak probiotic. It certainly has its place, but you need something stronger for right now - especially since your cat is on an antibiotic. It's kind of like Forti Flora is to cats what Pepto Bismol is to people.

The diet change in May: it is a bit of a novel, but I'll try to sum it up concisely.
1. He was originally on Purina Pro Plan Prime Plus chicken and rice, 1/2 cup per day, and Fancy Feast pate, 1 can a day.
2. Because of ongoing hairball issues, I found a highly reviewed hairball control dry food - Wellness Complete Health Harball Control. I started the process of mixing that with the Purina.
3. Despite originally seeming to like the Wellness, after a while I noticed that he was picking those pieces out and leaving them on the floor. So I guessed he didn't like it after all and started going in the other direction of increasing the Purina chicken and rice again. I bought another bag. However, I didn't realize until later that this was a new formula of the same food.
**At this point was May 16th, when the vomiting into his dish started.
I did some googling and found that this new formula had caused similar problems with other cats.
4. I temporarily put him on only Fancy Feast pate and tried to order some Royal Canin Gastrointestinal, which he did mostly very well on last summer (except that he had awful hairballs on it).
5. It took a while to get the order through so in the meantime I picked something up at the recommendation of a vet - Purina Pro Plan Sensitive Skin and Stomach Lamb and Rice (dry). At first he refused to eat this, but after about a week he started voluntarily choosing to eat it over the Fancy Feast. It seemed to go fairly well (and weirdly enough my allergies to him seemed to decrease at this time, but that could be a coincidence). The only issue was that this was when his bad sneeze attacks started (10-20 times in a row). I was unsure whether it was due to this food or if it was a coincidence.
6. For that reason and because I'd already ordered the Royal Canin GI, I started trying to mix that with the lamb and rice.
7. By June 24th he was solely on the Royal Canin GI (not 1/2 cup at this point, I'd just leave a little out for him) and up to a can (usually less) of Fancy Feast pate per day. As a side note I have not seen him have any sneeze attacks since getting off the lamb and rice--just down to one sneeze at a time now. I'm still unsure if that was causing the sneezing. I have recently started sprinking a small amount of the lamb and rice on top of the RC GI since it seems to make him more likely to want it. This, along with occasional tuna, is what he's eating now.
As for treats, he hasn't had too much, but in that time frame I've given him Rachael Ray Wheelies and Soft Spots (he doesn't seem to care for them) and the occasional Temptations Jumbo.

Also just to be clear, he never had any past major issues with the Royal Canin, Purina, Fancy Feast, Temptations, or anything else I've been recently giving him.

Cerenia is less helpful for regurgitation (bringing up undigested food) than it is for vomiting (bringing up digested food). But keep giving it to him because it is still very helpful overall! It's anti nausea and anti inflammatory, two things your cat needs right now. How often has your vet instructed you to administer Cerenia, daily or as needed?

He currently has a 4-day regimen of Cerenia pills, today will be day 2.

His sneezing and breathing problems sound like an entirely separate problem. It could be an infection (especially with mucus), or an obstruction, or swelling/inflammation (or something else, but these are probably the leading culprits). How long has he been taking the azithromycin? Have you noticed any improvement? How much longer does he need to take it?

He just started it last night. I'm not sure yet if there is any improvement, or if it would work that immediately, but I can say he's doing better than the night I originally wrote this. He's still vomiting but he's at least eating a little more today than Monday night/Tuesday morning. He's still occasionally sneezing (once at a time) and is still congested. He's taking it for a week.

Drooling is a sign of nausea (as is lip licking, and excessively drinking water or drinking water to the point of immediately throwing it up).

He has a lot going on in his digestive tract. Something is making him feel ill, which is causing him to eat less and often vomit or regurgitate what he does it. This can cause irritation and a build up of stomach acid, which makes him feel nauseated and lose his appetite.... which starts the cycle all over again.

Ask your vets about giving him an acid reducer and B12 injections. The acid reducer will help reduce his nausea, and will probably be either famotidine (Pepcid) or omeprazole (Prilosec). Personally, I would choose famotidine if he is also dealing with a respiratory issue because omeprazole has the potential to decrease his white blood cell count, but that is also dependent on how long he needs to take omeprazole, so follow the guidance of your vets. I'm also partial to famotidine because omeprazole has lowered my cat's WBC and often gave him "rebound acid" for a day or two after stopping it. But every cat is different, which is why your vet will know which treatment is best for him.

And definitely ask for a B12 injection, even if his lab work shows his B12 is in a normal range. This will help his nausea and appetite. It can take a long time for a B12 deficiency to show up in labs and cats are often deficient following a GI episode. And he may need continuing B12 injections if he does have something like IBD. Your vet may want him to have B12 injections on a weekly or bi-weekly basis until he improves. Cats absorb the amount of B12 they need and get rid of any excess in their urine, so there's no downside to giving B12. It's also relatively inexpensive compared to other treatments and it can really help a lot. One of my cats has IBD and B12 has helped tremendously.

Thank you so much for the recommendations, I wrote that down.

 

[BeccaCat]

Oh I definitely second the B12 suggestion. Although my kitty’s problems were different, they were also tummy/vomiting/breathing related, and the B12 is the one thing that seemed to give her some relief. Excellent suggestion.

 

[Astragal14]

The diet change in May: it is a bit of a novel, but I'll try to sum it up concisely.
1. He was originally on Purina Pro Plan Prime Plus chicken and rice, 1/2 cup per day, and Fancy Feast pate, 1 can a day.
2. Because of ongoing hairball issues, I found a highly reviewed hairball control dry food - Wellness Complete Health Harball Control. I started the process of mixing that with the Purina.
3. Despite originally seeming to like the Wellness, after a while I noticed that he was picking those pieces out and leaving them on the floor. So I guessed he didn't like it after all and started going in the other direction of increasing the Purina chicken and rice again. I bought another bag. However, I didn't realize until later that this was a new formula of the same food.
**At this point was May 16th, when the vomiting into his dish started.
I did some googling and found that this new formula had caused similar problems with other cats.
4. I temporarily put him on only Fancy Feast pate and tried to order some Royal Canin Gastrointestinal, which he did mostly very well on last summer (except that he had awful hairballs on it).
5. It took a while to get the order through so in the meantime I picked something up at the recommendation of a vet - Purina Pro Plan Sensitive Skin and Stomach Lamb and Rice (dry). At first he refused to eat this, but after about a week he started voluntarily choosing to eat it over the Fancy Feast. It seemed to go fairly well (and weirdly enough my allergies to him seemed to decrease at this time, but that could be a coincidence). The only issue was that this was when his bad sneeze attacks started (10-20 times in a row). I was unsure whether it was due to this food or if it was a coincidence.
6. For that reason and because I'd already ordered the Royal Canin GI, I started trying to mix that with the lamb and rice.
7. By June 24th he was solely on the Royal Canin GI (not 1/2 cup at this point, I'd just leave a little out for him) and up to a can (usually less) of Fancy Feast pate per day. As a side note I have not seen him have any sneeze attacks since getting off the lamb and rice--just down to one sneeze at a time now. I'm still unsure if that was causing the sneezing. I have recently started sprinking a small amount of the lamb and rice on top of the RC GI since it seems to make him more likely to want it. This, along with occasional tuna, is what he's eating now.
As for treats, he hasn't had too much, but in that time frame I've given him Rachael Ray Wheelies and Soft Spots (he doesn't seem to care for them) and the occasional Temptations Jumbo.

Also just to be clear, he never had any past major issues with the Royal Canin, Purina, Fancy Feast, Temptations, or anything else I've been recently giving him.

That's some amazing detail! Your cat is very lucky to have you keeping such a close eye on him

It's also a bit confounding... he's had 5 different dry foods in the last two months. The vomiting seemed to start as soon as the newly reformulated Purina Pro Plan Prime Plus was introduced, which would normally make me think this is the cause but it's not clear at this point. And the vomiting hasn't stopped since removing the Purina Pro Plan Prime Plus from his diet. It sounds like he vomited less on the Purina lamb and rice, is that correct? But he also started sneezing on the lamb and rice.

This is making me wonder about the following possibilities. And of course, it could be something completely different!
1. It could be a chicken allergy/sensitivity (but he was fine with the original Purina Pro Plan and the Wellness)
2. He's extremely sensitive to certain ingredients in the new Purina Pro Plan, and maybe these ingredients are present in varying amounts in the other foods
3. He could have an allergy to storage mites, which develop in dry food and food containers; what you've described seems like too strong of a reaction, but maybe it's not? I'm more aware of itching and skin issues, but perhaps vomiting is also a possibility
4. Maybe he's sensitive to the Temptations if they've been open too long. I know treats like Temptations and Greenies spoil after they've been open a certain amount of time because of the higher fat content (regardless of expiration date). But I don't recall how long that is, 30-60 days?

Purina Pro Plan Sensitive Skin and Stomach Lamb and Rice (dry).... It seemed to go fairly well (and weirdly enough my allergies to him seemed to decrease at this time, but that could be a coincidence)

Actually, it may not be a coincidence! Cats can give off fewer allergens when they have a less inflammatory diet. I hope it was just a coincidence that his sneezing started on this food, because it sounds like it could be a good choice for both of you!

He currently has a 4-day regimen of Cerenia pills, today will be day 2

You could also ask your vet if it would help to extend the duration of the Cerenia, it can be given for longer than 4-5 days at a time. Maybe it would help to see how he does on a longer regimen of Cerenia, an acid reducer, a probiotic and B12. And if the azithromycin works (I hope it does!) then it could help increase his appetite by reducing his congestion. One of my cats loses her appetite when she's congested because she can't smell her food very well, so it's not as enticing.

 

[Astragal14]

Oh I definitely second the B12 suggestion. Although my kitty’s problems were different, they were also tummy/vomiting/breathing related, and the B12 is the one thing that seemed to give her some relief. Excellent suggestion.

B12 is such an underutilized treatment! It's easy and inexpensive and it can help SO much! I'm surprised it isn't recommended more often.

 

[BeccaCat]

How is your kitty?

 

[olliepurrington]

How is your kitty?

Hi BeccaCat, thanks for asking and sorry to not respond right away.

Thankfully he seems to generally be doing better. He has finished the antibiotic and is still taking the steroid for a few more weeks. For a couple days about a week ago he had a big problem of sort of silently "refluxing" (if that is a word) all of everything he ate straight into his water bowl and I was worried he wasn't absorbing anything at all. For whatever reason, he has stopped doing this (I bought some Pepcid to be safe but I haven't had to try to use it yet).

He's been on methimazole for hyperthyroidism for about a week and he's going in to have it rechecked in a couple weeks. I mentioned the B12 shot to the vet and they took it into a consideration as something we might do after we know where he stands with the thyroid levels.

He does seem to have *less* congestion but I'll still see mucous occasionally hanging from his mouth, and he's still coughing after eating/drinking (to be honest I can't tell if this is a congestion issue or something else, as it seems to be a dry cough now, but I could be wrong).

He's had a couple very minor breathing irregularities in the last week. It scared me for a second when he started breathing faster, but it only lasted 5 seconds max (I've seen him occasionally do this over time). I still have yet to find a good specialist in my area but I do want to address this with them when I find one.

Also his purr/meow are still very faint, I can't remember if I mentioned that before, but I heard him faintly purring today and he actually tried to bat around a toy today.

So he still has some things we need to figure out, but I'm relieved he's generally doing better.

 

[BeccaCat]

I’m glad to hear he’s doing better! I hope he continues to improve

 

[JDB]

Im sorry your little one is having issues. You're a good parent and you are doing everything you can to care for your little one.
Ours was having similar problems with eating. He would regurgitate everything within a few minutes, and sometimes continue vomiting after for quite some time. We tried 5 wet foods and 3 dry foods. We were in and out of vets clinics, animal hospitals for a few weeks. We were given pills that he couldn't get down so they switched to liquid meds.
We ended up with an internal medicine doctor who did an ultra sound and found that he has esophageal motility disorder, which means he cannot swallow food properly and get it to his stomach. We now have him on a liquid diet (blending wet food with water 1:1 ratio, we choose food with a higher water content so its easier to mix - usually a recovery formula mixed with something delicious). We haven't had any accidents in about 10days.

I'm not saying that is what you have going on, but might be worth looking into.