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nekovet
nekovet, Cat Veterinarian
Category: Cat
Satisfied Customers: 18310
Experience:  Hello, I am a small animal veterinarian. I am happy to answer any questions you may have on any species.
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Cat vomiting lots of water. What do I do?

Customer Question

My 20 year old cat Maxwell, vomited once lots of water yesterday. And a second time with hardly any water. Then last night he vomited a bit more liquid and it has a pink tinge to it. This has happened before too. From reading online it sounds like possible inflammation from puking. Also he had kidney failure even beginning two years ago.
He drinks lots of water. He hasn't eaten for a day or so and a couple days ago I fed him wet food four times over the course of the day because he was in the kitchen as he does when I'm there getting him his morning wet food. I usually just give it once or twice. I was gone for 3.5 weeks recently and friends took care and he ate fine. I’m planning to be out of town for a week next week.
Submitted: 8 months ago.
Category: Cat
Expert:  nekovet replied 8 months ago.
Is he on any treatment for his kidneys?
Can he keep any water down?
Are his gums pink or pale/white? Moist or sticky?
If you press on his belly, does he have any discomfort, tenderness, or tensing?Could he have eaten something he should not have (ie bones, toys, rocks, plants, chemicals, etc)?
Has he had any diarrhea?
Customer: replied 8 months ago.
No treatment for kidneys. He wouldn't eat the food. And attacked me and bet when we tried fluidsI'm not sure when he last drank water to know if he's kept it down.He doesn't seem bothered when I press his tummy.I don't think he'd have eaten anything odd. That's rare for him. When he does it's the fake plant.More often there's much urine and little bm. Hmmm. When I cleaned letterbox this morning there may have been a very small Urine spray or it was very small diarrheaHis gums are white.
Expert:  nekovet replied 8 months ago.
If his gums are white, then I am very worried about Maxwell. Given his kidney status, this white discoloration is likely anemia secondary to the kidney disease (since kidneys actually produce the hormone that tells the marrow to make red blood cells). And I have to say that while I am concerned about his gut signs, to see this tells us we need him seen as soon as his vet is open (sooner if he is weak or having breathing issues) as this does need to be addressed.
Otherwise, in regards to the GI signs, while this could be related to gut infections, pancreatitis, and ingestion of harmful items; with his kidney issues we also have to be wary of progression of that disease. Especially as we often see nausea from kidney issues alongside uremic gastritis and even secondary opportunistic infections preying on his weak immune system. And I'd not that any of these would cause both his vomiting and his anorexia.
Again with this in mind and your being away, we'd want him seen. Though at least in the meantime until you do have him seen, we can try some home supportive care to at least try to settle his stomach. To start, if he hasn’t just vomited (since otherwise we’d need to rest the stomach for a few hours first), you can consider treating with an OTC pet safe antacid like 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 offering food to allow absorption. Of course, do double check with your vet if he has a known health issues or is on any medications you haven't mentioned. Also if you give this and he cannot keep it down due to nausea that is usually a red flag that we need to bypass his mouth with injectable anti-vomiting medication from his vet.
Once he is more settled, you can plan to try small meals of a light/easily digestible diet. Examples you can use are boiled chicken, boiled white fish, or scrambled eggs, or meat baby food (garlic/onion free only) There are also OTC vet diets (ie Hill’s I/D or Royal Canin’s sensitivity) that can be used 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. As long as improvement is being seen, I usually advise continuing this until the signs are settled, and then weaning slowly back to what you normally feed.
Overall, I suspect all of your lad's signs are due to the kidney disease worsening. The gut signs are a worry if he is starving himself (as they can develop secondary liver issues doing so) but the pale gums are even more a worry. So, we do want him seen as soon as we are able but you can at least try the above until he can see his vet to soothe his stomach.