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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 24426
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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Dodger has been doing projectile vomiting. s vet prescribed

Customer Question

Dodger has been doing projectile vomiting. His vet prescribed prednisolone, which seems to help but hasn't stopped it. I was told he shouldn't still be vomiting but, in the past 8 days, it has happened 5 times (once each of 5 days). The other times he got sick, were really early in the morning, 2 or 3 a.m., so I wasn't able to see how it started but yesterday, I was able to witness it happening and noticed that he looked like he was trying to sneeze but it came out as vomit. Mostly fluid and just a few pieces of food. And, this morning, he did the whole "body motion" thing and vomited. He has lost weight and is down almost a pound since April. But, his appetite is good. His water intake and bowel movements are good. He's still really active and vocal. Obviously, I'm more worried about his weight. I've been giving him prescription ID (dry and canned), Royal Canin gastrointestinal food (which he doesn't like too much, but the other two do) and occasionally Fancy Feast (which I only gave today) and Gerber's chicken in chicken gravy baby food. We have an appointment to visit his vet next Saturday but I am wondering if you have any ideas. (Sorry, this was kind of long...)
JA: I'm sorry to hear that. This sounds like it might be serious. I'll let the Veterinarian know what's going on ASAP. Is there anything else important you think the Veterinarian should know about the cat?
Customer: He'll be 13 next week. And, his brother, Oliver, who is from the same litter, is not having issues although Ollie does have a thyroid issue and is on Tapazole. It has been helping him as his counts have returned to normal and he is gaining his weight back. (Ollie had lost almost two pounds during the year between vet visits.)
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Veterinarian about your situation and then connect you two.
Submitted: 5 months ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 5 months ago.

I'm sorry to hear of this with Dodger. It appears that his vet is considering that Dodger suffers from inflammatory bowel disease (IBD) which is the most common cause of such vomiting but isn't the only cause. Hence, the following considerations...

1) There may be a pancreatitis, hepatitis, nephritis or any number of metabolic disorders responsible for his vomiting refractory to prednisolone. A diagnostic panel of blood and urine tests needs to be performed and if nothing untoward is found, his gastrointestinal tract needs to be ultrasounded - the most sensitive and readily imaging modality for the GI tract.

2) IBD may have transmuted into small cell lymphoma which isn't as responsive to prednisolone as is IBD.

3) The dose of prednisolone may need to be increased or metronidazole - an antinflammatory antibiotic - needs to be added to the prednisolone therapy.

4) When all else fails - including a hypoallergenic diet trial - scoping and biopsy of his GI tract should be definitive. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Dodger's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (a hydrolyzed protein diet is my preference because it avoids the possibility of my patient being intolerant to even a novel protein). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.

Please respond with further questions or concerns if you wish.