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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 16278
Experience:  Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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My 16 yr old cat was fine yesterday. This morning she

Customer Question

My 16 yr old cat was fine yesterday. This morning she vomited (food), and had a slightly runny bowel movement. She was basically off her food for most of the day. She vomited one time in the afternoon (just liquid) and had a little bit of diarrhea with some mucus and a little bit of reddish-pinkish blood. This evening I gave her some Valley Fresh ( 100% natural chicken breat in water with rib meat). It is people food, but I often give her it if she is under the weather. I gave her mostly the juice and some of the chicken, but she only lapped up the juice. About 4 hrs later, she vomited again (just liquid) and then had a little bit of diarrhea, covered with what looked like bloody mucus. She does take prednisone for her arthritis. Yesterday, our other cat (3 yrs old) vomited about 6 times within about 15-20 minutes. His was all food and he had no diarrhea. I would like your opinion on whether you think that both cats have/had the same thing, or if prednisone could cause this (although she has taken prednisone on and off for a few years now) or what you think it is and what I should do? My problem is that I am the only person that can even get close to her and if I even try to pick her up, she panics and I end up being the one that needs medical attention, so maybe you can give me some advise. Please, please help.
Submitted: 11 months ago.
Category: Cat Veterinary
Expert:  Dr. B. replied 11 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your situation, and wanted to help.

Did she have her Prednisone despite being off food?

Any black material in those stools?

Can either cat keep water down?

Are their gums nice and pink (not white/pale)? Moist or sticky?

If you press on each cat's belly, does she have any tensing, tenderness, discomfort, or pain?

Could either of them have eaten anything she should not have (ie bones, plants, chemicals, human meds, etc)?

Customer: replied 11 months ago.
She doesn't take prednisone every day and today was not her day to take it. No black material in stools. Dipstick (3 yr old) is perfectly fine after yesterday's vomiting (6 times in 20 minutes; all food). Nadia (16 yr old) does keep going to her water bowl and drinking a little bit. In fact, I finally got her to eat about 3 little bites of A/D Hills Science Diet can food. Nadia doesn't really let anyone open her mouth, but from what I see, her gums look pink as usual. I have pressed on the sides of her belly, but not very hard, and she did not object. I noticed that she has been growling some when she is lying on her purr pad, but she does that sometimes, even in her sleep. I one thing that I can think of that she ate that is not in her regular diet is grass. My husband grew some grass because sometimes she likes the kitty grass from the pet store. But this was not kitty grass, he grew just regular grass (backyard stuff). She had been nibbling on that for the past couple of days. She does seem to be feeling a little bit better and she hasn't vomited or had diarrhea for almost 4 hrs. now. The problem with her is that when we saved her as a kitten, someone has tried to kill her. She was a mess and the vet didn't think she would make it. She doesn't trust anyone except she trusts me some. She is afraid of everyone, and everything but me. Once in a great while I can pick her up for just a second, but other than pets, she doesn't like to be touched. Even after all these years, I can only now trim her nails sometimes. I know she is getting up there in age and I did finally find a female vet (she absolutely hates men) that will make house calls. I just don't know if we could actually find her (she hides when scared) and if so, if she would even let the vet near her. I am hoping this is something simple and we go away in a day or so, but I didn't like the sort of pinkish-red bloody mucos in her diarrhea. If it was niter all it wouldn't be red, right? She is now sort of looking around like she is hungry, but doesn't know what to eat. I have some A/D down and some chicken, but now she just said smells it and keeps looking around. Any other thoughts would be appreciated. Thank you.
Expert:  Dr. B. replied 11 months ago.

Hi again,

My apologies for my wee delay, as the computer seems to have eaten my reply (technology can be a mixed blessing at times). I will retype that quickly and repost in a moment.

Dr. B.

Expert:  Dr. B. replied 11 months ago.

Hi again,

Now what I had typed before was that if we have 2 cats with similar signs, then infectious agents and shared exposures would be most likely here. With her long term use of steroids, its low frequency dosing and lack of black stools; the Prednisone is likely innocent here. That said, it plus her aged immune system may be why this is taking a bigger toll on Nadia and causing her to have these colitis type signs (the mucus/blood) as well. Just to note, as long as the grass isn't treated with any chemicals, its likely innocent too.

Now I appreciate she isn't keen for vet visits, but I do want to note that we need to tread with care. Especially if she isn't able to eat. This is because Nadia's signs are suggestive of nausea still being an issue. Cats with nausea often go off food to avoid vomiting. While this is logical, it isn't a good idea for them as they can end up with secondary fatty liver syndrome if they do so for too long. Therefore, we need to be proactive and get her settled and eating for us as soon as possible.

With this in mind, I would note that you can try her with an antacid just now. This is good for settling stomachs but also is good to use before steroid treatments (to offset its GI upset effects). Common OTC pet safe options would be: Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid)or Tagamet (More Info/Dose Here @ http://www.petplace.com/article/drug-library/library/over-the-counter/cimetidine-hcl-tagamet). Whichever you choose, we’d give this 20 minutes before food to allow absorption. Of course, do double check with your vet if she has a known health issues or is on any medications you haven't mentioned.

Once that has had time to absorb and she is steadier on her stomach, you can re-offer the foods you have. Or you can try her with boiled white fish, scrambled eggs, or meat baby food (as long as its garlic/onion free). There are also OTC vet diets that can be used (ie Hill’s I/D or Royal Canin’s sensitivity) too. The aim of these diets is that they will be better tolerated/absorbed by the compromised gut. Therefore, it should get more nutrients in and result in less GI upset and diarrhea. As long as improvement is being seen, I usually advise continuing this until the signs are settled, and then weaning her slowly back to her normal diet.

Since dehydration is a risk here, we need to keep an eye on her hydration. To check that she isn't dehydrated, there are a few things you can test. Further to checking for gum moisture, do make sure she doesn’t have sunken eyes and that she doesn’t have a "skin tent" when you lift the skin. To see how to check these parameters for dehydration, you can find a good video HERE (http://www.ehow.com/video_12232503_dog-dehydrated.html). If you are seeing any signs of dehydration already, then that would be our cue to have her seen before this becomes an additional issue for her (especially as it is often dehydration that makes them feel unwell).

Finally, since her colitis signs are likely secondary to the loose stool, you can consider trying a pet safe anti-diarrheal. As I am sure you appreciate, these would not be a cure for infectious issues; but it can still be of benefit. It will reduce diarrhea load, allow the body to absorb more water/nutrients, and soothe the upset gut. In regards ***** ***** options, the one we most commonly use is Kaolin/Kaopectate (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/kaolin-and-pectin-kapectolin-k-p)). This is available OTC at most pharmacies but do avoid any with aspirin/salicylic acid (as these are not cat friendly and will interact with steroids). Otherwise, Propectalin, Fast Balance, and Protexin Pro-Fiber (all OTC at vets, pet stores, and even Amazon) would be another option. All will slow diarrhea and those last ones have the added bonus of providing support to the delicate good GI bacteria. So, these can be used as a short-term means of soothing her upset GI.

Overall, there are a wide range of agents could trigger this GI upset we are seeing but with both cats showing signs this is most likely infectious (so bacterial or viral). Therefore, we’d want to start supportive care to settle her stomach. If she cannot keep that or water down at any point, appears dehydrated already, or doesn’t respond to the above within 12-24 hours (since she is a delicate older lass); then we'd want to get her mobile vet involved. They can assess her hydration, rule out fever, make sure there is nothing in her stomach that shouldn't be there or any sinister viruses present. Depending on their findings, her vet can treat her with injectable anti-vomiting medication +/- antibiotics to settle her stomach and get Nadia back feeling like herself.

Take care,

Dr. B.

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Expert:  Dr. B. replied 11 months ago.
Hi,
I'm just following up on our conversation about Nadia. How is everything going?
Dr. B.