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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 6152
Experience:  Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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my cat is throwing up bile and wont eat or drink anything.

Customer Question

my cat is throwing up bile and won't eat or drink anything. I've been out of town for 5 days and don't know how long this has been going on...he has visibly lost weight. When I pick him up and press into his tummy, he makes a little painful yowl...well at first it was his tummy, now his rib cage makes him do that...I'm giving him water with a little syringe cause he will go and sniff the water bowl, but won't drink...he's 1.5 years old, never had any health issues...will not eat, even wet food won't tempt him...
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. B. replied 1 year ago.
Hello & welcome. I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

If Gremlin has been vomiting and anorexic for at least a few days, then this is quite concerning.

Do you think he could have eaten something he should not have (ie non-edible items, toys, hair ties, ribbons, etc)? Or gotten into people (especially fatty foods) food?

Has he been producing any feces since you got back?
If so, what is he passing (color, consistency, ease of passage)?

When you syringe water, can he keep it down?
Customer: replied 1 year ago.

yes, when I syringe water he keeps it down, but won't drink out of the bowl. He's such an easy going cat, never has OCD tendancies, that's why it's so disturbing. Haven't seen any feces, but he did urinate in the litter box right when I got back home, but there was also a fresh vomit as well...I couldn't tell if it were a very loose stool or vomit, but when I cleaned it up it was vomit...like I said he won't drink water or eat food and he's lost weight, but his nose is cold and he isn't freaking out or anything...so I'm wondering if he has some sort of blockage...he might have eaten something he shouldn;t have, but he lives in a house with a lot of animals, so who knows...


 


I

Customer: replied 1 year ago.

I feel like my cat is dying and this bullshit scam is lying to me and taking the money I would be using for his vet service to give vague non answers.

Expert:  Dr. B. replied 1 year ago.

Thank you for the additional information on Gremlin.

As I noted before, for his signs to be so severe that he is completely off his food/water and is suffering weight loss already, we do really have to be concerned here and act quickly.

The reason we want to manage this pro-actively is because cats were not well designed for the anorexic lifestyle. When they are off their food for extended periods of time, body fat is broken down and released into the blood stream, causing their liver distress (ie. hepatic lipidosis) that can make getting them better even more difficult for us. So, it is imperative for us to determine what is causing his signs and address it as quickly as possible to get him back on track and back to feeling like himself.

Now when kitties start vomiting there can be a number of culprits. This includes bacterial infection, viruses, parasites, pancreatitis, dietary indiscretion, sensitive stomachs, toxins and foreign bodies. Since he is a young lad, we do always have to be extra concerned about the potential that they can get into toxins or may have ingested a non-edible object (ie ribbons, trash, hair ties, toys, etc) that could get stuck in his GI.

Since you had noted that he has abdominal pain when handling, I do want to note that there are two differentials that spring to the top of our list with this sign being present. These are pancreatitis (a condition known to be very painful and this is an organ which just happens to be located just at the junction of where the ribs end and abdomen begin) and GI obstruction with a foreign body. Both conditions often cause severe nausea/vomiting, anorexia and abdominal pain. So, while we do still have a range of potential causes to consider, these would be the ones I would be most concerned about with Gremlin.

And in that case, it would be ideal to have him checked by his vet (as long as he is comfortable just now you can wait until his regular vet is open rather then rushing him to a ER vet). The vet would be able to have a feel of abdomen and determine if there is anything lodged in his GI or whether then pain can be localized to an inflamed pancreas. Depending on their findings, they will be able to advise you to whether this is a situation where they need to go in surgically to remove something he has ingested (hopefully not the case) or if medical management is indicated here. If a foreign body is ruled out and pancreatitis is confirmed, then this often can be managed with pain relief, antibiotics, anti-vomiting medication by injection +/- IV fluids (depending on severity of signs and response to initial medical treatment).

In regards XXXXX XXXXX you can do at home in the meantime to try and give him some relief from the severe vomiting and nausea (which is the likely reason he wont' eat/drink, since kitties avoid the risk of vomiting by going off their food), you can try to him with an antacid. There are a number of antacids that are available over the counter and pet friendly. I would advise only treating with one, but the two I tend to recommend are Pepcid (LINK) or Zantac (LINK). This medication of course shouldn’t be given without consulting your vet if she does have any pre-existing conditions or is on any other medications. Ideally, it should be given about 30 minutes before food to ease his nausea.

As well, you will want continue to try and see if you can get him eating (ideally once the antacid settles his stomach). Favourite foods are allowed as you have but also consider tempting with a light/easily digestible diet. Examples of this would be boiled chicken, boiled white fish, scrambled eggs (made with water and not milk), meat baby food (do avoid the ones with garlic powder in the ingredients) or there are also veterinary prescription diets that can be used here (ie Hill’s I/D or Royal Canin’s sensitivity.) Offer this as small frequent meals (1 tbsp at a time with 30 minute breaks in between to discourage vomiting). If you try this and he isn't keen to eat, then I'd not press him on it tonight (since we'd want an empty stomach when he sees his vet in case they did have to operate to remove a foreign body).

Now with him being so young, dehydration is a major concern here. Vomiting can quickly dehydrate a young cat, so we need to keep an eye on his hydration. To check his hydration status to make sure he is not becoming dehydrated there are a few things we can test. One is whether the eyes appear sunken, if the gums are tacky instead of wet/moist, and whether the pet has a "skin tent" when you lift the skin. To see how to check these parameters for dehydration, you can find a wee video on this HERE. (They use a big dog but it makes it easier to see and the principle is just the same). If you are seeing any signs of dehydration already, then this would be another red flag telling us that he should see his vet first thing in the morning.

Since he is vomiting, we are limited in what we can do via oral rehydration at this stage. That said, if he has kept down the fluids you have offered that is a good thing and may allow us to further support him and fight dehydration. Now if the antacid can settle the vomiting, then you can again try an encourage him to drink by offering fresh water or even low-sodium chicken broth. As well, wet foods (as mentioned above) are 35% water, so getting him to eat will help us deal with water intake as well. Further to that, there is the syringing of fluids. Ideally, we'd want to use an unflavored electrolyte solution (ie Pedialyte) since this will replenish the electrolytes he is losing in his vomit. In regards XXXXX XXXXX of fluids that we'd want to be administering, a kitty daily requirement is 48mls per kilogram of his body weight. This won't cover his vomiting losses (though you can quantify the volume vomited and add it to the total volume) but is a good place to start with trying to keep him hydrated. Of course, you need to do this with caution since we don't want him to end up vomiting because of our intervention.

Overall, there are a range of conditions that can cause vomiting in cats Gremlin's age. In this situation, with the weight loss and potential length of anorexia, we do need to be proactive. Therefore, you can try the above supportive care tonight but consider seeing the vet first thing tomorrow. The vet will be able to have a feel of his belly and make sure he hasn't eaten something he shouldn't have, and determine the underlying cause for his vomiting. As well, the vet will be able to cover him with antibiotics against bacterial gastroenteritis and anti-vomiting medications by injection to help settle his stomach and get him back on track as quick as possible.

And just in case you feel he is deteriorating over tonight and you do want him seen sooner by an emergency vet, you can find one local to you, HERE and @ http://www.vetlocator.com/.

I hope this information is helpful.
Please do let me know if you have any further questions.
If you have no further questions, feedback is always appreciated.

All the best,

Dr. B.

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Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 6152
Experience: Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
Dr. B. and 8 other Cat Veterinary Specialists are ready to help you
Expert:  Dr. B. replied 1 year ago.

Hi again,

It is unclear what you are referring to regarding 'vague answers'.
I had only just asked some initial questions to give me a better idea of Gremlin's situation.

Now I have posted my thoughts on your situation, siting the two major concerns we have here for him.

If there is anything that is unclear or you need further explanation, then just let me know. As well, remember, that you are not charged (nor am I credited for aiding you) unless you choose to click the accept/feedback option.

Dr. B.

Customer: replied 1 year ago.

Hi again, I was unsure if I would be receiving actual advice from a vet...please forgive, I am normally dubious regarding "internet" advice. Your answer was very thoughtful, and helpful, and I will make sure you are paid for it. I'm sorry, this little guy is so important to me, and perhaps I jumped the gun with my comments?

Customer: replied 1 year ago.

I just want to apologize again...your advice was both helpful and thorough. thank you...

Expert:  Dr. B. replied 1 year ago.
Hi again,

I completely understand how stressful it can be to come home and find a normally healthy robust wee lad being so poorly and adverse to eating. And I appreciate that if you hadn't used the website before you couldn't know that we are all licensed vets here in the "cat veterinary" category. So, while I admit I was initially a wee bit shocked by your comment, I understand the strain you are under with wee Gremlin.

And while it did take me a few minutes to type everything earlier (as I am sure you appreciate I did have quite a bit to type regarding his situation), I do still hope that gives you a good guide to what our concerns are for him, what we can do overnight, and what we want his vet to rule out for him. So, I would say as long as he is comfortable at the moment (not collapsed or vomiting continuously), we can monitor him overnight with a view to getting him checked over by his regular vet first thing in the morning. And hopefully, the vet will find a grumbling pancreatitis rather then finding he has eaten something he should not have that has to be retrieved.

Please take care,
Dr. B.
Expert:  Dr. B. replied 1 year ago.
You are very welcome.
No hard feelings, I do understand how worried you are about wee Gremlin.

All the best,
Dr. B.
Expert:  Dr. B. replied 1 year ago.
Hi Shane,

I'm just following up on our conversation about your pet. How is everything going?

nekovet
Customer: replied 1 year ago.
HI! Was working late tonight, sorry about the late response.

I had been thinking of contacting you, but still was mortified regarding my outburst. We went to the Vet the following afternoon, and he showed me that it wasn't Gremlin's stomach that was hurting with light pushing, it was his kidneys...and that infection was causing his fever...Dr. Farmer thought it might be some kind of liver thing. So we did bloodwork, and looks like it was just a nasty indeterminate infection. His liver and white blood cell count were very elevated, and he was so dehydrated that he had to go on IV and stay at the vet's for 2 nights. He just got home today and while he still won't eat (light snacking :)),he is intermittently drinking water...and not vomiting. And on antibiotics...

Thanks so very much for your advice, cannot overstate how much better I felt after reading it. Thanks for your patience. I think he might still be a little nauseated, and that's why he isn't eating, but I'll take your advice and get him some zantac.

And thanks for how often you used the word "wee" in your advice...I live in Austin TX, I don't hear the word wee often...makes me smile just to type it right now...

Expert:  Dr. B. replied 1 year ago.
Hi again,

No worries, I see that we are in different time zones, so your late may actually be my early (since I am in the UK, which you have noticed by my little habit of saying 'wee' when I am typing/speaking quickly).

While I was initially alarmed to just see that his kidneys were sore (since we can see kidney infections that would cause this), I am very glad to see the bloods didn't reflect that being the focus of infection. And it does sound like you have done everything right treatment-wise (rehydrating him, addressing the infection the bloods have revealed). With the dehydration and fever tackled, I suspect he is starting to feel better then he was (since both often plays a major role in making an animal feel poorly with ongoing infection-- just like it does for people as well). So, hopefully he will continue to improve.

If you do think he is nauseated, which is quite possible under the circumstances, then the zantac would be fine to try. The light diet options I mentioned before could also be useful in keeping his stomach settled. And if try these and you find that he still isn't keen to eat, then you can also see if his vet will dispense an appetite stimulant [ie cyproheptadine (LINK) or Mertazipine/Mirtazinpine (LINK)] to just remind him that he should be eating.

And just to note, but likely not necessary if he does continue to eat for us, when we have kitties that are just not eating enough we can use diets like Hill's A/D (LINK) with them. It is a critical care diet that is comes as a soft, palatable pate and is just very calorically dense. That means a little goes a long way nutrition-wise and it is a means of getting some more calories into him even if we can’t get him to eat as much as he should As well, there is also an animal version of Ensure (balanced for animals dietary requirements) called Clinicare Canine/Feline Liquid Diet (LINK). Some cats will lap this themselves, but if we weren't seeing him eat/drink enough, it would be an option to even syringe into him. But again, if he is starting to eat for you, then these are just things to keep in the back of our minds while you first just make sure his stomach is settled with the zantac.


All the best & a lovely evening to you,
Dr. B.

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