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Dr. Joey
Dr. Joey, Board Certified
Category: Cat Veterinary
Satisfied Customers: 4723
Experience:  15 yrs in practice, specialist canine/feline medicine
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My elderly cat just drank a lot of water and threw it all up.

Customer Question

my elderly cat just drank a lot of water and threw it all up. Plus, she is peeing excessively and going outside the litterbox.
Submitted: 2 years ago.
Category: Cat Veterinary
Expert:  Dr. Joey replied 2 years ago.
Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.
The increased water consumption and urinations are key symptoms in several diseases, and unfortunately not specific for one particular problem. This could be due to anything from a resistant urinary tract infection to bladder/kidney stone, kidney issues, liver issues, endocrine problem (such as diabetes mellitus or hyperthyroidism) and the list continues.
If not already done, then my top recommendation would be if she was my patient is to do some screening lab work that would include a chemistry profile with electrolyte, CBC, thyroid check, and urinalysis. This should give us some indication of the problem. If a persistent infection is found, then a urine culture should be submitted to know what bacteria this is and what antibiotic may clear (because it is probably a resistant organism). If not, then X-rays are indicated to screen for stones and tumors/masses. If still nothing is found then an abdominal ultrasound can be very useful to look inside all the organs, especially kidneys or bladder.
Until we know the problem I would not restrict her access to water. If she has kidney or liver issues or diabetes, and we restrict access, then she could get quite sick.
I am at a point I need to know what questions you have. We can continue our dialogue in this setting.
I hope that the information I provided has been helpful.
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Customer: replied 2 years ago.
What you're suggesting sounds extremely costly for such an elderly cat. She has also lost a great deal of weight since I rescued her a year ago. The vet I took her to a couple weeks ago didn't suggest going further because she seemed to feel it's simply that the cat is old. At that time, she was given antibiotic to fight off any infection. She did improve quite a bit, up until last night. I will, of course, put water back down for her now that it's morning and I can follow her in case she barfs it up again. It was quite a lot of water last night and was quite the chore cleaning it all up. I just couldn't go to sleep wondering if she were going to continue drinking then barfing. She did keep her food down.
Expert:  Dr. Joey replied 2 years ago.
I understand your dilemma here. In my opinion, the lab work is well worth the investment. If we find hyperthyroidism, this is easily treatable with a daily medication (I know it is daunting to think about administering something daily, but if a pill is not going to work then this can be compounded into a liquid or gel you rub onto the inside of the ear daily). True there is no cure for kidney disease, but there are things we can easily do to slow down its progression. And if she still has an infection, then this is treatable. Diabetes is also treatable but a bit more effort and cost in the initial 3 months until we find an insulin dose that will work.We must remember age is not a disease. However, if you feel this is our big sign with her that her quality of life is low and you do not want to proceed further, then this is a judgement call you must make keeping her best interests in mind. You know her best.One simple thing you can do at home to help with the vomiting is to give her Pepcid AC (famotidine) which you can purchase at the pharmacy for people (do not get Pepcid "complete"; just regular Pepcid and I recommend get the generic because easier to split) and then give one-fourth tab once daily. This helps reduce nausea quite well in most cats.
Expert:  Dr. Joey replied 2 years ago.

I'm just following up on our conversation about your pet. How is everything going?

Dr. Joey