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Intermittent vomiting can be tough. So it sounds like the vomiting occurs early in the morning, possibly when he hasn't eaten for many hours?
Are his stools normal?
Has he had any bloodwork done?
Have you tried anything--diet changes, meds, etc?
His stools seem normal. He had some blood taken last vet visit to check for heartworm, and it came back clean.
We've changed his food at least once, hasn't made a difference. We're holistic.
At his age, it would be worthwhile to have full bloodwork done--a complete blood count, chemistries, and thyroid (T4) level, to look for any underlying issues. There may not be, since this has been going on for awhile, but there might be something else brewing and it would be good to find it early.
It sounds like you've read about Addison's disease, since you mentioned he didn't seem any worse when stressed. Addison's can certainly cause intermittent vomiting, but after 5 years and no worsening with stress, it does seem less likely.
I actually haven't heard of Addison's disease, I was just noting his behavior.
I would be thinking about delayed gastric emptying, where food stays in the stomach much longer than it should. Vomiting is the predominant sign associated with delayed gastric emptying. Although vomiting may occur at any interval following a meal, it is easier to suspect delayed gastric emptying if the vomiting occurs > 12-16 hrs after ingestion. A normal stomach is empty of a meal in approximately 6 to 10 hours (depending on species and meal content).
Sometimes there is a "mechanical" obstruction (like a polyp or tumor), or a defect in propulsion--the intestines don't move food through very effectively.
Sometimes adding in something like Reglan (metoclopramide) can help as this medication helps the intestines move things more effectively.
Inflammatory bowel disease can cause intermittent vomiting +/- diarrhea.
Interesting. Thanks for this, I have to convince my mother because she's the one paying the vet bill. I'll see if I can talk to the vet, and I'll try adjusting his food in the meantime.
Sometimes feeding a "novel protein" diet exclusively can help. This would be something completely different from what Bear has ever eaten--something like venison & potato or whitefish & potato. Exclusively means NO treats, NO other food, NO table foods, etc.
Feeding small, frequent meals can also help. Maybe meal feed him, rather than just leaving the food down.
I'd probably start with the metoclopramide (which isn't terribly expensive), since he otherwise seems to be feeling fine.
This was helpful.