Throwing up more often recently

vana

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My cat, Dalila, is about 5 years old and a longer-ish haired calico.

Recently, in the past two weeks, she has thrown up about 6 times - most recently being this morning. In about half a time, she has expelled hairballs, but other times she has just thrown up yellow foamy liquid sometimes with, sometimes without a bit of undigested food. She also throws up several times in short successions, regardless if there is a hairball or not.
Other than those throwing up episodes, she has been acting completely fine - eating, drinking, normal bathroom habits and behavior.
I took her to the vet once already - they told me she is dehydrated and gave her some s.c. infusion and a shot of Cerenia. They also prescribed 1/8 of omeprazole tablet every 24h for nausea and a 1/2 of silymarin capsule every day, to support her liver as her liver parameters on her check up 2 months ago were slightly higher. This is the fourth day of omeprazol/silymarin therapy for her.
I noticed her appetite has slightly dropped after the vet visit and she didn't drink a lot of water these past three days, sometimes even just holding her head above water and waiting a few seconds before giving it a few licks, but since yesterday afternoon, she's been back on track with her eating/drinking habits once more. I've been giving her her therapy along with keeping her on a hairball diet (both dry and wet), brushing her and giving her malt paste daily.

And still, she threw up three times this morning, at first just yellow liquid foam and hair, then a hairball, and about 2h later just yellow liquid and foam. Taking her to see the vet again this afternoon. Once again, she is acting completely normal. Even chased after a moth that flew in during the night, after her throwing up episode. She's always eager for food in the morning and eats it right away as I put it down.
It's been extremely hot here, however we have bouts of high temperatures every year and this is the first time she has thrown up so often, practically every 2-3 days.

I'm am actually terrified it's something else, masking as hairballs. On top of that, the vet won't be able to do much for her this afternoon, so I'd most likely need to leave her overnight so that they could do the necessary tests tomorrow, because they'll need her to be under anesthesia. She has already had two since the begining of the year.
I am at complete loss how to help her. The AC is always on, I changed her diet, brush her, give her malt paste, omeprazole and silymarin, she's acting completely normal during the day only to suddenly throw up around 2-4 am. I can't even sleep properly anymore, waking up and waiting to her throwing up.

Sorry for the extremly long and probably confusing post, but I am scared out of my wits. I'm looking for any advice or idea what the problem might be.
 

CatEng

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Does she throw up right after eating (if she's free feeding)? IBDCat had pretty much that symptom presentation. Perfectly healthy, ate some food, threw up several times, then right back to being perfectly healthy and happy. Rinse and repeat almost every day. He also had very small bumps on his legs which were previously diagnosed as being allergic in nature, though the vet just shrugged it off and said "it's not cancer don't worry about it". Our vet also basically shrugged off all his digestive issues as "he just needs to eat a vet diet full of fiber instead of the high protein you feed him".

Turns out he was allergic to chicken and tuna, which is basically what we fed him all the time. Changing his diet to a limited ingredient raw diet resolved 99% of the vomiting (the remaining 1% is likely due to him eating plants, but I can't be completely sure). The skin bumps disappeared too. Might be worth discussing with your vet and putting your cat on an hypoallergenic diet or a novel protein one with limited ingredients just to see if the vomiting resolves.
 
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vana

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Does she throw up right after eating (if she's free feeding)? IBDCat had pretty much that symptom presentation. Perfectly healthy, ate some food, threw up several times, then right back to being perfectly healthy and happy. Rinse and repeat almost every day. He also had very small bumps on his legs which were previously diagnosed as being allergic in nature, though the vet just shrugged it off and said "it's not cancer don't worry about it". Our vet also basically shrugged off all his digestive issues as "he just needs to eat a vet diet full of fiber instead of the high protein you feed him".

Turns out he was allergic to chicken and tuna, which is basically what we fed him all the time. Changing his diet to a limited ingredient raw diet resolved 99% of the vomiting (the remaining 1% is likely due to him eating plants, but I can't be completely sure). The skin bumps disappeared too. Might be worth discussing with your vet and putting your cat on an hypoallergenic diet or a novel protein one with limited ingredients just to see if the vomiting resolves.
Thank you for your reply!
She is free-feeding, however the amount of food in her dishes is always the recommended daily amount and she is very casual eater, eating both wet and dry food along the day so that the dishes are typically emptied out before the next fill. Not to mention that with the start of her therapy I've been removing her food around midnight to make sure she takes omeprazole on an empty stomach like the vet recommended.
When she does throw up it's usually not related to eating, at least from what I noticed. She's completely fine during the day and exclusively throws up during the night and when there is food, it's literally just a couple of pieces of dry or wet.
The vet did mentioned possible allergies both to the environment and food after I mentioned she might be shedding more and asked me about the food I give her or if I had recently changed it, or if I noticed her grooming more often, but it's all the food she has been eating before without a problem and her grooming habits are about as same as always. Didn't say anything else about it afterwards.
I'll definitely discuss it with them when we go today.
 

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Hey! Once she has the hairball, her tummy is empty and then bile can build and cause her to throw up the bile.

Have you tried shaving her tummy hairs a bit shorter? She will have less hair to injest. With climate change it's getting hotter and it can cause extra shedding, especially of her skin gets dry.

Did they do bloodwork?
 
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vana

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Hey! Once she has the hairball, her tummy is empty and then bile can build and cause her to throw up the bile.

Have you tried shaving her tummy hairs a bit shorter? She will have less hair to injest. With climate change it's getting hotter and it can cause extra shedding, especially of her skin gets dry.

Did they do bloodwork?
Hi, thank you for the reply!
I guessed the same, and usually when she does throw up, she expels a hairball and bile before or afterwards. Usually, it's during the shedding season (spring/autumn or very hot summer week). It's why I wasn't too concerned when it happened the first two times, but this just seems like too much. And we're just about to hit the really hot days, too.
As for bloodwork... No, the first time I took her they just felt her stomach, measured her temperature and then gave her some s.c. fluids and cerenia. They said that we should call in she she starts throwing up again and then possibly do bloodwork and an ultrasound, but to just continue with the given therapy for now. Since our appointment is for later today, they said that if anything is to be done, she'd stay the night and they'll do it tomorrow.
 
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vana

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Update from the vet:

Essentially, nothing.
There was a mix up apparently, and they are completely full and couldn't accommodate her for the night. Gave her a shot of Cerenia. Said that there's definitely discomfort, due to gastritis so that's probably why she's been grooming herself more and why she's been licking fake plants. Food alergies would change her stool, environmental alergies would make her suddenly twitch and lick herself more than just 1-2 times a day. The vet is leaning more towards problems with the GI tract.
Told us to give her omeprazole and silimaryn tomorrow and then come see them again, when she will actually stay the night and then, the next day, they'll do bloodwork, ultrasound and urinoanalysis.

I feel incredibly sorry for my cat which was essentially stressed out for nothing and which I had to take out on an incredibly hot day, only to have to do the literally same thing tomorrow once more. Not to mention that their original plan was to just do the bloodwork and I had to ask for additional diagnostics because they do everything in anesthesia/sedation.
 

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Of course, it's always an issue if it becomes more frequent. With the heat, even Magnus has had a hairball...his second ever.

The Furmiator has helped us prevent more but we had to shave Ghost's belly to prevent hairballs even with daily brushing. He seems to have issue passing the amount of hair he has otherwise. Even with daily Furmiator last year, he threw up every day for a bit.

Hopefully it's only that!
Let us know how it goes.
 
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vana

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I have about 5 different brushes for her, Furminator being one among them and the one we use the most. I've been brushing her daily with it recently, so much I think we're going to have to switch to another brush, because I think the coat on her back is becoming a little thinner compared to other parts. She loves brushing so it's a little hard to tell when to stop.

Well, they'll have to shave her belly for the ultrasound, so hopefully that'll also help with the hairballs.

Will make sure to update!
 

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Update from the vet:

Food alergies would change her stool, environmental alergies would make her suddenly twitch and lick herself more than just 1-2 times a day. The vet is leaning more towards problems with the GI tract.
While it's possible it's not allergies, my cat with allergies had only vomiting as the first symptom something was wrong. It then progressed to the skin bumps on his legs, and to severe constipation which led to an hernia. Not saying it's the case here for your cat, just to keep in mind not to exclude that potential cause too rapidly.

Hopefully the ultrasound shows that everything is fine and it's just hairballs!
 
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vana

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Oh yes of course. I'm still keeping an eye for the allergies, I was just saying what the vet told us.
She did have bouts of diarrhea when she was younger that no one could figure out the cause of, but it all cleared up suddenly when she turned one, though that's also when I happened to upgrade her to a better quality food with no grains or chicken.
However, the dry hairball formulation has been a constant in her life, because I always mix it up with the main food. I figured if there was a problem, she'd surely show it the moment she eats even the smallest amount of food she's allergic too. But there weren't any problems right up until now...
 
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vana

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Update from the vet #2:

Well, they couldn't find anything that would suggest why she'd be throwing up more often.
There was no foreign body, the fPl test is negative. Her ALT, AST and amylase levels are just slightly higher than 2 months ago, so I asked the vet if it's possible that there might be some minor ingredient in the food that could be giving her trouble. He thinks that it possible, but wouldn't do any allergic testings for now. They recommended me to give her gastrointestinal food to calm down her stomach. And to continue with omeprazole.
However, here's the actual not-so-good news. Her creatinine levels are also just a bit higher than before, she has proteinuria (also higher than before) and they also noticed during ultrasound that the medulla of her kidneys is dilated. We're currently waiting for SDMA results.

Depending on the results, we'll see if she'll need to be on renal food, or could get by with just supplements, according to the vet.

It's honestly shocking to me, because she's not even fully five years old. She did have to take meloxicam daily for about 7 months due to her limp&FHO surgery, but it was prescribed by the vet and they never said anything is wrong even when proteins started appearing in her urine for the first time a month and a half after starting the treatment. I can't think of anything else that could have caused the kidney damage. Did I misunderstand the vet, should I have stopped the treatment on my own, was it really necessary for her to take the pain meds for so long? She's just so young for a kidney disease. It feels cruel and unfair, it's devastating to think about.
 

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I don't think you can what if over it. It could be genetics as well.
The only thing you can do is start from today and go forward.
 

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I'm wondering, since you mentioned they gave her a shot of Cerenia, did they give you a prescription for it? I keep it on hand for those times when it's needed for my furbabies and it does help. I believe that shot only lasts for 24 hours, and so do the pills, but they work.

Additionally, when I looked up omeprazole , I see it should be used with caution if the cat has kidney or liver issues, so it's a little surprising that they want you to continue with it, especially since it doesn't seem to be helping. The problem is, almost any medication will have certain effects on both those organs though, to some extent (I think)

What did they say about her rise in liver values? Are they going to switch up what you are giving for that?

As far as switching to kidney foods, normally that isn't done until late stages of the disease, which it doesn't sound like she is near, but I'm not familiar with this dilated medulla business. I've had three kidney cats, but none of them ever had an ultrasound. And with my current cats, sometimes their SDMA is higher than it should be, and I freak out, but then with their next blood workup (with no changes done by us), it's back down, so I don't really know what to think about it. Our Vet doesn't worry when it's a little high because apparently she sees this often. Same with the creatinine. Many things can cause it to go up, things like dehydration, what they had to eat that day, even stress.
 
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vana

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Hi, everybody, sorry for disappearing like that, but life got a little busy for me. Thank you all for your replies.
Her SDMA levels came back normal, so the vet said there's no need to start any kind of kidney therapy. She she's been on gastrointestinal food since we came back, and we did end up finishing her omeprazole therapy a week ago, along with continuing to brush her daily and give her malt paste.
She has been fine since that last vet visit, though she did throw up a hairball today, but the really high temperatures have started again a few days ago. I don't know what to think anymore honestly.
 
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vana

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I don't think you can what if over it. It could be genetics as well.
The only thing you can do is start from today and go forward.
Oh I know, I tell myself that though it's hard to put in practice sometimes...
 
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vana

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I'm wondering, since you mentioned they gave her a shot of Cerenia, did they give you a prescription for it? I keep it on hand for those times when it's needed for my furbabies and it does help. I believe that shot only lasts for 24 hours, and so do the pills, but they work.

Additionally, when I looked up omeprazole , I see it should be used with caution if the cat has kidney or liver issues, so it's a little surprising that they want you to continue with it, especially since it doesn't seem to be helping. The problem is, almost any medication will have certain effects on both those organs though, to some extent (I think)

What did they say about her rise in liver values? Are they going to switch up what you are giving for that?

As far as switching to kidney foods, normally that isn't done until late stages of the disease, which it doesn't sound like she is near, but I'm not familiar with this dilated medulla business. I've had three kidney cats, but none of them ever had an ultrasound. And with my current cats, sometimes their SDMA is higher than it should be, and I freak out, but then with their next blood workup (with no changes done by us), it's back down, so I don't really know what to think about it. Our Vet doesn't worry when it's a little high because apparently she sees this often. Same with the creatinine. Many things can cause it to go up, things like dehydration, what they had to eat that day, even stress.
Honestly, I was worried about omeprazole too, but I guess they thought the benefits would outwin the risks. She didn't seem to have any issues till the end of therapy though. As for Cerenia, unfortunately where we live it's only available as solution for injections and tablets for dogs. So they said to continue omeprazol and even add metoclopramide if needed. Luckily, we didn't.
As for her liver values, they are not sure, because everything seems fine on ultrasound, but they said it's possible that some minor food ingredient is responsible for the elevated parameters. Her glucose is also high, but since there's none in her urine, they think it's just stress.
She was taking sylimarn for liver but they stopped it after a few doses, because they said it could also contribute to vomiting. Didn't give her anything else.
 
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vana

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She has been fine since that last vet visit, though she did throw up a hairball today, but the really high temperatures have started again a few days ago. I don't know what to think anymore honestly.
My mistake it was some loose hair apparently. I wasn't with her when it happened, so there was a bit of miscommunication there.
 
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vana

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The Furmiator has helped us prevent more but we had to shave Ghost's belly to prevent hairballs even with daily brushing. He seems to have issue passing the amount of hair he has otherwise. Even with daily Furmiator last year, he threw up every day for a bit.
Sorry, I hope you don't mind me asking, but did you shave off just his belly hair or did you also trim the hair on the rest of his body? And do you continue to do so?
She had her belly shaved for the ultrasound, but the fur is slowly starting to grow back. She's a longhair, but with very sleek and thin hair - no undercoat, so I'm a bit hesitant to try trimming it. With our east facing windows it gets pretty hot right as the sun comes up, and the AC basically works from 7 AM to 7 PM so I'm worried about both possible sunburns and lack of thermoregulation. Everywhere I look, there seem to be completely opposite opinions on shaving longhaired cats for the summer heatwaves.
 

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V vana How it was explained to me is that for dogs, you should never shave dual coats as they need thermoregulation as they are outside. Cats who are inside, it's less important.

Anyway I'm not shaving him to the skin, so it's less risk and his ultrasound already shaved him to the skin so maybe the fur is already messed up.

I just shaved his belly, and his bottom because he's very fluffy and his poo gets on his fur and I have to wash him. He doesn't like it, obviously. But he doesn't mind the shave.

To make the decision for your cat it's weighing the risk vs reward. Vomiting hairballs frequently isn't good for your cat either. And getting hairballs stuck in the digestive tract can be life threatening. Vs can you keep your cat cool on hot days because heat stroke and dehydration can be serious too.


For me, I considered the hair is likely messed up already if its going to be.
- I have air conditioning, some cement flooring he can access and two cooling mats. The mats don't need electricity.
- He doesn't go outside except occasionally and in a harness and when the weather is good.
- He liked the "vent" when he was shaved and would press it to cool surfaces to cool off.
- He had no hairballs with a shaved belly AND he didn't pant from heat which he did frequently before.
- I shaved him at home using a quiet dog grooming product and he had low stress.


Hopefully you can see well enough in this photo how his belly is. He's short haired, but the second photo shows how fluffy and thick his fur is. Sometimes, we think there's something on him because where his nipples are look like black spots from all the shade his thick fur provides. But when you pull him close and check, his skin is pink, healthy and no dirt on him. The third shows the difference between his fur and when his skin was shaved post ultrasound.
 

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vana

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Alldara Alldara Thank you so much for your reply! Yes, when you do put it like that it would be better to trim her. I wouldn't want to shave her to the skin, but still make her fur shorter. I just have to see if we'll go for a professional groomer because I'm not too confident in my skills and there's not a lot of options for grooming products available here.
Do you mind telling me which one you are using? Or if there are any specifics I should be mindful of when choosing it?
P.S. That's Ghost, right? He's super cute! Thank you for the pics!
 
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