Vomiting Cat, Appetite Loss: No Diagnosis

[sarah c]

Just wondering if anyone has had a cat in a similar situation as Taz, as the vet doesn't know what's wrong. Our cat has had nausea and vomiting on and of since July, but lately it's been much worse. He's been to two different vets in the last few weeks and had two rounds of blood work, all of which is normal. Originally we thought it was related to increasing kidney values (this is what our old vet implied in the summer) but strangely enough his kidney values have improved and both the recent vets he saw don't think this is an explanation. Dental problems have been ruled out, the vet doesn't think it's a GI problem or allergy, since that should be combined with itching and diarrhea, which he doesn't have. His belly felt very normal to the vet.

Every time he's been to the vet he's had an anti nausea shot which works for a few days to a week. He's able to eat well briefly until the the appetite goes increasingly down and the vomiting goes up. The lack of eating is the bigger problem. Obviously we can't afford to go to the vet every week and just treat the symptoms. When my husband took him in Wednesday I thought the vet would do another test, but he didn't think an x ray would tell us anything. He gave us a b vitamin supplement to give daily, apparently this can help with appetite and strength in older cats, but the vomiting started last night again. (always seems to get worse on a Saturday, so we have to wait till Monday to get to the vet.)

Taz woke me up in the middle of the night pulling on my hair/blindfold, and wouldn't stop. It must have happened at least 20 times so on top of everything else it's hard to sleep and function properly at work. I think he is hungry, thus the chewing on hair/computer parts, blankets, he seems to want to eat but can't. Taz is 15 and also has hypertropic cardiomyopathy, but this is being managed well with medication. He still has a good energy level for his age but has lost two pounds with the recent problems. We're at a loss as to how to procede, I don't want him to slowly starve to death, but we don't want to put him down when we don't even know what the problem is. We love Taz very much and definitely don't want to have to do this. He still has a strong will to live too!

Finally just wondering if worms or a parasite are worth asking the vet about? He did have fleas a yr ago, have never seen worms in his litter box though. Thanks so much for reading, sorry for the long post!

 

[maggiedemi]

With roundworms, you often don't see them until you de-worm the cat and they come out in his poop. Tapeworm segments kind of look like rice or sesame seeds on their fur.

 

[sarah c]

Thanks for your reply!

 

[babiesmom5]

I would request an ultrasound of the gastrointestinal tract. No, an X-ray will not tell you anything unless it is a mass or an obstruction. The ultrasound will look at the entire gastrointestinal tract. It will tell you if there is inflammation, thickening of the intestinal lining, fluid accumulation or other abnormalities. It would also reveal any mass.

A cat that vomits with increasing frequency as yours does has something going on in its GI tract. You don't necessarily need to have diarrhea. If the problem is centered in the cats stomach or small intestines, you will see vomiting. If the problem is centered in the large intestine, then you will more likely see diarrhea.

The chewing on hair, blanket and non-food items indicates an irritation, inflammation going on in the GI tract. I had a cat that did that too prior to being diagnosed with IBD.

Yes, I agree you can't just keep treating symptoms. You need to get to the bottom of this. I recommend you see a good Internal Medicine Specialist and request an ultrasound...the sooner the better. I wish you and Taz all the best.

 

[sarah c]

I would request an ultrasound of the gastrointestinal tract. No, an X-ray will not tell you anything unless it is a mass or an obstruction. The ultrasound will look at the entire gastrointestinal tract. It will tell you if there is inflammation, thickening of the intestinal lining, fluid accumulation or other abnormalities. It would also reveal any mass.

A cat that vomits with increasing frequency as yours does has something going on in its GI tract. You don't necessarily need to have diarrhea. If the problem is centered in the cats stomach or small intestines, you will see vomiting. If the problem is centered in the large intestine, then you will more likely see diarrhea.

The chewing on hair, blanket and non-food items indicates an irritation, inflammation going on in the GI tract. I had a cat that did that too prior to being diagnosed with IBD.

Yes, I agree you can't just keep treating symptoms. You need to get to the bottom of this. I recommend you see a good Internal Medicine Specialist and request an ultrasound...the sooner the better. I wish you and Taz all the best.

 

[sarah c]

Thank you that is good advice and gives us clarity on the next step we should take. We'll ask for a referral in the morning.

 

[carebare]

My cat had an ultrasound after he vomited and stopped eating. It revealed a kidney infection. You wouldn't know now, except that he is drinking slightly more water. My vet said he would have recommended an ultrasound over an xray for more bang/buck. The xray and blood worked showed nothing abnormal except gas. The vet may also want to look at a urine culture. Could be something going on with GI like irritable bowels, or kidneys/UT...or both, like my cat...who I think ought to recover.

These symptoms could also be tied into a food intolerance, which is slightly different than food allergy...and won't necessarily trigger the dermatitis or colititis if he's throwing it up. You could look at trying a special diet to see if it improves symptoms.

 

[sarah c]

Thanks, hope your cat gets better carebear. I was wondering about a food intolerance or GI problem. Think the vet may have ruled that out too prematurely. We have changed his diet, but he's still eating mainly turkey and chicken.

I just read an article on inflammatory bowel disease, (different from IBS) but the vet said it has to be diagnosed only with an intestinal biopsy, but that you could do a trial run of the meds before doing a biopsy, which I think we would choose given his heart condition.

 

[stephanietx]

Also, you might consider food intolerance. Did you change his food before this all started or have you introduced a new food?

 

[sarah c]

Babiesmom5

Can I ask how you got a diagnosis of IBD? this article I read stated that an intestinal biopsy is the only why to diagnose it, so an ultrasound may not be of help there. Thanks in advance.

Feline Irritable Bowel Syndrome vs Feline Inflammatory Bowel Disease | Ask The Cat Doctor

 

[carebare]

hmmm.... I thought the ultrasound could help tell you if it's irritable bowels (my vet did), but then again I am sure it's a fine art needing an experienced operator. I thought diarrhea was a symptom if it as well.

What I am finding out the hard/expensive way is that medications have side effects, cats can very well be allergic to poultry, and not all vets know about these sorts of things. My vet expects the irritable bowels (a secondary disease) to clear up once I resolve the cause/allergy, which could very well be diet with an emphasis on no chicken and beef.

What is the meds he is talking about? Steroid such as prednisolone?

 

[sarah c]

The article I linked to above talks about the difference between irritable bowel syndrome and inflammatory bowel disease, he mentioned ibd required the biopsy. In the article he talks about prednisolone and metronidizole. We haven't talked much to our vet about it yet though as he didn't think Taz had this.

How is resolving the allergy going for you? Sounds like it could be quite challenging obv. Are you doing trial and error or can they do tests for that? Sorry I'm not very knowledgeable on this topic.

 

[sarah c]

We changed his food after. He was eating fancy feast, but insisted on a big flavour rotation. Now he's eating natural balance pouches cut up in small chunks and a bit of nutro.

 

[carebare]

I think it depends on the cat. Metronidizole did not help my cats, and may have contributed to a severe rash in one cat. Prednisolone did help my cat, but it treats the symptoms not the cause, and was a lesser evil (vs scratching himself raw).

The diet worked quickly for his colitis, but it took a few weeks for the dermatitis and conjunctivitis to clear up. I first tried a prescription diet, but my cat refused it. So I went to commercial canned food and freeze dried food, then raw food.

I read the ingredients list VERY carefully. He is on a novel protein--no seafood, turkey, chicken, dairy, beef, wheat, dyes. This means very limited options in most pet food stores, but I found a few with rabbit or lamb. I found more options in specialty pet stores and for raw meat. For dry food, the only kind I could find was Royal Canin Selected Protein.

He is super picky, so I asked makers for samples. In response, they assured me I can return or exchange food he does not like. So what I did was give the stray cat any food he does not like, and returned any food that the stray cat won't eat. I also donated some food to other cat people. Neither cat likes freeze-dried or air-dried food so look for those in sample sizes for <$5.

 

[carebare]

Oh and yes can ask them to check for parasites in stool, and for dehydration. Parasites are an easy solution so the vets should rule them out first. Dehydration makes appetite disappear, and fluids will help Taz feel better temporarily. There are other common causes like viruses and bacteria but the vets should know to test/treat for those first.

If you want some food samples I have extra, PM me for them. Just enough to see if he likes the flavors. My cat still likes Fancy Feast but it makes him very sick so I had to stop.

 

[sarah c]

Thanks so much for the info that's very helpful. Will definitely ask about parasites and viruses, don't think our vet checked for those. That's incredibly generous of you to offer to send samples, but we're in canada so the shipping might be expensive. Taz has been mostly eating wet food but it this point I'd try dry food if he could keep it down. Will have to try more novel proteins, although we buy them whats available at our store is always mixed with other meats.

 

[babiesmom5]

Babiesmom5

Can I ask how you got a diagnosis of IBD? this article I read stated that an intestinal biopsy is the only why to diagnose it, so an ultrasound may not be of help there. Thanks in advance.

Feline Irritable Bowel Syndrome vs Feline Inflammatory Bowel Disease | Ask The Cat Doctor

You START with a GI Ultrasound. If this shows thickening of the gastric wall, or generalized small bowel thickening,or fluid in the abdominal cavity and/or abnormalities in the colon, you have a problem. The Vet Radiologist will tell you this as will the report.

Your next step is an endoscopic or colon biopsy. Under anesthesia, they run a small lighted scope down the cat's esophagus into the stomach and small intestines taking small cell samples. Or they go up the cat's anus (like a human colonoscopy) taking cell samples. These samples are sent off to a lab for analysis. The cat recovers quickly and goes home next day. The results are back in a week.

If the cell samples are consistent with IBD, the report will indicate this and your Vet will advise you further.

If the cell samples show cancer, usually Small Cell Lymphoma or Large Cell Lymphoma, the report and vet will advise you further.

I cannot emphasize STRONGLY enough at this point to GET AN ULTRASOUND!!!

DO not wait or fool around with this!

 

[sarah c]

Thank you for taking the time to reply and you're emphatic advice. Your opinion helps bc other people have suggested different things, for example my step MIL was advising us to get a barium xray as her cat had swallowed something he shouldn't have, a lot of fur got caught around it and his symptoms were very much like Taz's. So my husband was wanting to start with that. I myself think an ultrasound would be a better first move.

 

[babiesmom5]

Thank you Sarah! Your thinking is correct. I am glad to have substantiated it.

A GI ultrasound done by a good radiologist trumps barium x-rays or regular x-rays.
Save your money. Start with a GI ultrasound then go from there.

I have been down this road now with 5 cats with IBD/Lymphoma.

I am trying to save you some heartbreak!

 

[sarah c]

Very much appreciate it! You are heroic to look after so many sick cats.
cheers