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Dr. Barbara
Dr. Barbara, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 1614
Experience:  Over 30 years experience in veterinary medicine and surgery.
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Good evening, I have a cat that is about four years old.

Customer Question

Good evening,
I have a cat that is about four years old. About a week ago he started vomiting up food and fo***** ***** stuff about 5 hours after each meal. He greatly slowed the amount he was eating and we took him to the vet. They said he had jaundice though the vet used the term hapatic lipidosis when talking to the recptionist at the clinic. he stayed for three days and then sent him home. He will not eat, we are having to force feed him this AD high cal food. We have purchased one of every kind of cat food the clinic had and some baby food to try. he just lays curled in a ball. He wants to be laying on you when we are home. We are super scared and don't know what to do. do you have any suggestions?
Submitted: 2 years ago.
Category: Cat Veterinary
Customer: replied 2 years ago.
The vet has given him cerenia 1/2 a tab a day, zentonil, and mirtazapine. we are wondering if his non responsiveness to food is to be expected with what has happened and how long it might take before he eats properly. also when he drinks his water it is like he is trying to eat it. he doesnt lap it up with his tongue
Customer: replied 2 years ago.
(Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Customer: replied 2 years ago.
Now he just got up and vomited the food we had force fed him, no white foam this time
Expert:  Dr. Barbara replied 2 years ago.
Welcome to JustAnswer. I'm a licensed veterinarian and I'll be happy to help. I am so sorry to hear about Stubby!
Hepatic lipidosis results in cats when they don't eat. In Stubby's case, you haven't indicated that we know the original cause of his nausea and not eating, and because he hasn't been eating he now also has hepatic lipidosis which in itself will likely be fatal unless it is turned around.
Has your vet done a blood profile, including a check for pancreatitis? Has he done an x ray or an ultrasound of Stubby's abdomen?
There really is nothing more you can do for him at home since he isn't responding to the Cerenia.
I will put you in for a phone call, but it is more expensive and we could continue here.
Just let me know. . .
Dr. Barbara
Expert:  Dr. Barbara replied 2 years ago.
Welcome to JustAnswer. I'm a licensed veterinarian and I'll be happy to help. I am so sorry to hear about Stubby! So many things can cause vomiting. . .from a foreign body, to pancreatitis, to cancer (less likely in a young cat). Stubby needs to be adequately diagnosed as to the cause and not just treated for the symptom of vomiting.
Hepatic lipidosis is caused in cats who don't eat for several days, and it in itself can/will be fatal. The treatment for this is to control the nausea it alone causes and get food into him.
In Stubby's case he now has two serious problems, the unknown initial cause of his nausea and lack of appetite and now the hepatic lipidosis from not eating.
There really isn't any treatment for him at home since Cerenia isn't controlling his nausea and vomiting, and just waiting for him to start eating is going to make him worse. My educated guess is that he won't start eating without further diagnostics, support and treatment in hospital.
Stubby needs aggressive diagnostics, support and treatment, or I'm afraid you will lose him. . .I am so sorry! Has your vet checked him with an x ray or ultasound of his abdomen? Has he checked his blood for pancreatitis along with liver and kidney function? If these have been done without any concrete diagnosis, then we need to look further. I think my computer or the web site is having trouble and I had to resend my answer. I hope at least one gets to you. I also did offer a phone call if you'd like.
Customer: replied 2 years ago.
Thanks for the phone call offer, I wasnt sure what the button did when I clicked it. Messaging will be fine. I am taking him to the vet first thing in the morning.
Customer: replied 2 years ago.
The bill from the vet shows that they did a checmical profile, complete blood count and exam. I'm curious your thoughts on his eating the water. its like he cant lap it up with his tongue. also his fur is soaked as he is dunking his chin in the water dish and then chomping and he isnt trying to clean himself like he normally would. i had a look in his mouth and his gums look quite red along the teeth.
Customer: replied 2 years ago.
The vet said that he was eating fine at the clinic once they gave him the anti nausa meds and the iv fluids but they had to change his food brand everyday which is strange as he normally only like kibble (blue brand)
Expert:  Dr. Barbara replied 2 years ago.
Thank you for your response.
When a cat needs to have his food type or brand changed every day, this alone can cause stomach upset. Also, it indicates that there is a decrease in appetite. . .for some reason.
I'm so glad he will see his vet tomorrow. I'd request actually whole body xrays (cats can nicely fit on one screen), and an abdominal ultrasound, all to hopefully lead to a diagnosis. My hunch is that Stubby has a stomach or intestinal foreign body. A linear foreign body is not uncommon in young cats.
The way he is not eating and drinking his water indicates to me a sore mouth, dehydration and nausea. He feels pretty miserable and is therefore not grooming as he should.
I hope that your appointment tomorrow with your vet is first thing in the morning. . .he needs care ASAP.
Customer: replied 2 years ago.
I will be outside the clinic when it opens in 8 hours, I don't have a scheduled appointment. We gave him his anti nausea meds at 6pm and fed him with the syringe at 7pm and then he brought it up at 10pm. Thanks for the information, We are both trying very hard not to freak out :)
Expert:  Dr. Barbara replied 2 years ago.
I very much understand your concern.
Every veterinary clinic has emergency procedures in place. Often, it is one of the regular vets that take calls at night. I'd recommend that you call your veterinary clinic. I think you will get an answering machine or an answering service. My thought is that you can give your vet a heads up that you will be bringing Stubby in first thing for more diagnostics and treatment.
For tonight, I'd let him rest the best he can. You've treated him and any more food will just lead to vomiting.
Please keep me informed about him. Even after a rating this thread will stay open for further communication.
Best of luck with Stubby,
Dr. Barbara
Customer: replied 2 years ago.
Hi again,We took Stubby to the Vet this morning. They did an ultrasound on his belly and fully body xrays. The vet is still unclear what is the cause. He said he was expecting his liver, i believe, to be enlarged but it wasnt and there was something on the top part of it that he was unsure what it was. He has suggested exploratory surgery on Monday if Stubby doesnt improve over the weekend. He gave him injections of metacam, b12, convenia. He suggested we give him 4CC of AD every hour to see if that helps. Stubby has kept it down the last four times but he immediately went in the room and vomited this batch up. Before that he was going to have some water after and looking out the patio door to smell the air. He is still dipping his chin way down in the water and then chomping the water up to drink it. The vet suggested giving him b12 daily to help with his energy and a nutri-cal cream to rub on his gums. He isnt sleeping all day like normal but that might be because of the b12 injection i'm guessing. What are your thoughts on the surgery?
Customer: replied 2 years ago.
Here is a copy of his blood work from the other day.
Customer: replied 2 years ago.
Hey,I'm freaking out a bit, his skin color is now yellow. How bad is that?
Expert:  Dr. Barbara replied 2 years ago.
That yellow is the jaundice from the hepatic lipidosis. His bilirubin was high in the blood work you sent, and bilirubin is yellow and causes jaundice (a yellowing of tissues). This is not harmful in itself, but does indicate there is a problem. . .which we already know.
There really does seem to be a blockage in Stubby's intestine. He eats some and then vomits about 5 hours later.
I'm just realizing that what I wrote a bit ago didn't make it to our conversation. Stubby's bloodwork shows dehydration (RBCs and serum protein are up), and he has elevated liver enzymes and bilirubin. Really, these show a healthy response to whatever is ailing Stubby. There is not a pancreatic test, but everything else is there.
An exploratory surgery is a very good idea if Stubby is rehydrated and has a good electrolyte balance. The other way to diagnose a blockage is to do a barium (contrast) swallow and a series of x rays. Better yet, it would be better for him to have a non-toxic iodine study. This is also a contrast media, but is not toxic if his intestines are now compromised and leaking. I prefer an exploratory surgery myself as long as Stubby is well hydrated with a balance electrolyte solution and his heart sounds normal. Also, your vet should take some biopsies anywhere there is questionable tissue.
I hope you all can have a peaceful night. Since Stubby did vomit again, you might make the AD more watery and feed him 2 cc each time.
Talk with you tomorrow,
Dr. Barbara
Customer: replied 2 years ago.
Good Evening Barbara,I've been observing Stubby and have a theory I wanted to run by you. Could his nose be blocked? I've been watching closely as he drinks. He puts his chin in the water but extends his tongue fully down to lap the water. Usually after a few times he will make a nasal wheezing sound. I got up at 7 this morning and took him out to the kitchen to feed him. He went to his water dish, didn't drink but vomited and then went in the room and vomited. A small bit AD and the rest whiteish clear liquid but not as foamy as before and not as much. I fed him 1CC t 7:30, 2cc at 9 after which he went to the litter box, cleared his spot and sat there for a min or so before leaving without urinating or defecating. At 9:50 i got 1/4 tab of cerenia + .6 CC of metacam. I fed him 4 CC of AD four more times at 11:15, 12:15, 2:20, and 3:30. Each time he had water afterwards. At 5:53 (its now 6:36) I gave him 4CC - he had a good amount of water and went to the door. I let him outside and he went and tried to eat a bit of grass kinda unsuccessfully. He would turn his head and bite once or twice and move to another spot. He was also putting his nose against the branches, etc to smell them. The wind was blowing and he wasnt raising his head sniffing like he normally would. He did give the tree a could scratching three times. When he came back in I gave him another 4 CC. I am saying 4 CC but am putting 5 CC in the syringe as some usually doesnt make it hehe.
He is still holding it down but hasnt defecated for urinated yet.
Do you have any suggestions? Could his nose be blocked, if so how can I unblock it? Google says to see a vet, use steam, or put vix under his chin. My Finance is afraid to get the exploratory surgery tomorrow in his condition, she is worried opening him up might be hard on him. Also should I increase the amount of AD per sitting? What are your thoughts on him being able to rest vs feeding him every hour?
Thanks for all your information so far, I hope the above makes some sense.
Customer: replied 2 years ago.
I just noticed that he is cleaning the area on his arm they shaved to put in the IV. That's a good sign right? Also I have put the nutri-cal cream stuff on his gums a few times today. (messy stuff lol)
Expert:  Dr. Barbara replied 2 years ago.
Stubby is behaving very well. . .doing things that do indicate fairly good health, and I'm very glad to hear about his grooming, scratching, and tolerating, so far, your feedings.
I am concerned about the attempting to go to the bathroom without success. Do you feel he is frantic at all about trying to urinate? A urethral blockage is serious. . .but Stubby doesn't sound too frantic.
A block nose of course is possible, but doesn't explain the vomiting and the jaundice (yellowing of his skin).
Until your last note, I questioned whether Stubby was a good surgical candidate, but what you have shared about his activities and demeanor makes me feel quite positive.
If he doesn't vomit by tomorrow, then I would wonder if he is getting better, and we should hold off. I think he will vomit when the food you've given hits the blockage. . .but hopefully I'm wrong.
We could do a barium swallow to find see if that goes through his intestines. . .a nonsurgical diagnosis. However, to take care of a blockage is only surgical.
Little Stubby is definitely a complicated case, but it sure seems that he has a foreign body obstruction with secondary hepatic lipidosis. You'll know more tomorrow, either through exploratory surgery or a barium swallow.
Let me know how he does this evening. . .OK?
Customer: replied 2 years ago.
Hi Again Barbara,Regarding the blockage, shouldn't that have shown up on the two xrays or the physical examination the vet and his assistant did on his bladder? I'm just curious. I agree with the timing of his previous vomiting, it seemed to me from the beginning, there was a blockage.
Customer: replied 2 years ago.
I guess I should have mentioned that he did urinate at some point yesterday and also the day before. Just not so far today.
Expert:  Dr. Barbara replied 2 years ago.
Hi George!
You are right that an overly full bladder would show up on an x ray or ultrasound, but it is my understanding that yesterday when he had these diagnostics he was urinating OK. Really, all of his other symptoms point to a blockage of his intestine and not a urinary blockage. If he now has a blocked urethra this would be since his tests yesterday. If he is not frantic to urinate, then I don't think that this is a problem. I did mention this because he was attempting to either urinate or defecate in his box, but he hasn't become frantic. . .if I understand you correctly.
Customer: replied 2 years ago.
That makes perfect sense Barbara; the xray showed a full bladder when he had it done but he has urinated once since then. He cleared his spot in the litter box, sat for a bit and then just walked out (he didn't even shake his legs like he normally does but I wouldnt call it frantic) Here's to hoping he will pass something out the other side :) Thanks again for your assistance thus far.
Expert:  Dr. Barbara replied 2 years ago.
It's always important to dig around in the litter to see if there is any urine below the surface. Regardless, if he isn't frantically trying to urinate, then he will be fine until tomorrow.
Customer: replied 2 years ago.
Hi Barbara
Stubby hasn't vomited any, we are getting more food into him today. 12 cc per sitting. He urinated overnight but still has yet to defecate. He seems to have more energy. We were wondering with what he has been through if the ad formula should be causing him to have a bowel movement and how frequently cats defecate. We got so excited pumpkin puree and we're thinking of giving him some via syringe.
Customer: replied 2 years ago.
He did it!!! I've never been so excited about poop lol
Customer: replied 2 years ago.
So I guess my only questions now would be regarding your recommendations on getting him to eat on his own.
From a very happy george
Expert:  Dr. Barbara replied 2 years ago.
I'm thrilled!!!!!!!!!
Eating is the cure for hepatic lipidosis ( or the main cure) . Your vet will have liver supplements to help the liver to heal also.
AD seems to be working well for Stubby. If his stool was normal, then the canned pumpkin isn't necessary.
With how well he is doing with your feedings, I would imagine that he will quickly return to eating on his own. If he usually chooses a dry food, you could begin offering him a few nuggets each feeding, and if he continues to do well, then increase the amount each time. Right now his GI tract is recovering and his hunger will return. Try to force feed him less to cause some hunger and that should get him back to eating on his own.
I wonder if hearing you and your vet talking about surgery scared him into getting better on his own??? Just kidding of course!
This is great!!!!!
Customer: replied 2 years ago.
Good Evening Barbara,I wanted to thank you for everything. Stubby finally ate on his own a few hours ago!! You have been a great help, I'm not sure of the timezone difference...but being able to contact someone on a Friday night at 10:30 pm my time was a huge thing for me. I am not your typical guy per say and the kitty you have helped is loved by a very special group of people. I have sent you a picture of him with my sister who has downs syndrome. I can tell you if you were here she would be giving you the biggest hug ever! Being able to double check what the vet was doing and also getting answers late at night, when I was losing my mind, is beyond words. Stubby is our fur baby and for now our child. Thank you very, very much for your time and information.
Kind regards,
Expert:  Dr. Barbara replied 2 years ago.
Dear *****, Stubby, et al,
I think I am as thrilled as you about Stubby's road to recovery! My personal pets and my patients are my fur babies. I do know just how you feel!
Thank you so much for the photos and for sharing your thoughts. This is exactly why I do what I do. . .and love every minute!
I'm turning in for the night with a huge smile on my face!
Sleep well all of you!
Thank you,
Dr. Barbara