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Dr. John
Dr. John, Texas Veterinarian
Category: Cat Veterinary
Satisfied Customers: 11375
Experience:  Over 14 years of clinical veterinary experience
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My cat has been regurgitating and an x-ray shows an enlarged

Customer Question

My cat has been regurgitating and an x-ray shows an enlarged stomach which has led to a bleeding ulcer. Treatment Options?
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. John replied 1 year ago.

Hello, thanks for writing in. My name is***** and I would be happy to help you. First and foremost, I would differentiate regurgitation from vomiting. They are very different things and suggest very different issues. Regurgitation just comes out with no warning (no retching or abdominal contractions) and is usually a problem with the esophagus. Vomiting comes from the stomach or small intestinal tract and involves retching and abdominal contractions. If your vet has determined that this is a bleeding ulcer, he needs to be on sucralfate to help coat the stomach lining and allow it to heal, along with either Pepcid or Prilosec (better option) to determine acid buildup in the stomach. Because some of these issues may be related to a certain bacteria called Helicobacter, antibiotic therapy is usually recommended. Typically metronidazole and amoxicillin used together is the best choice. The metronidazole will help with some inflammation in the GI tract as well. Please let me know if you have any other questions or concerns. Hope this helps.

Customer: replied 1 year ago.
I know it is regurgitation and don't consider the comparison useful. I want to know about the enlargement of the stomach "what it is called" and the problem with mucous not blocking the acid.
Customer: replied 1 year ago.
the x-ray shows that the stomach is enlarged and stays full of food until the regurgitation which happens every night. The Vet says the fullness of food keeps the mucous from neutralizing the acid thus causing the bleeding ulcer.
Expert:  Dr. John replied 1 year ago.

I am not able to do phone calls at this time, but I will opt out to see if another expert can handle your request.

Customer: replied 1 year ago.
chat is ok, let's please continue
Expert:  Dr. John replied 1 year ago.

Sorry for the wait. I am in and out of exam rooms right now. I guess the question is why is the stomach remaining full? Has your vet determined if there is a blockage causing it to not empty correctly? How did they diagnose the stomach ulcer? Was it suspicion based on blood work or endoscopy of the stomach? Has he had an ultrasound of the abdomen done? If I don't reply quickly, I may be with a patient and will get right back with you as soon as I am free.

Customer: replied 1 year ago.
He is doing an ultrasound tomorrow and we should have the results then. He indicates this is a condition where the food doesn't digest and expands the stomach which holds it and causes him to regurgitate or "perhaps" vomit the food on top each night. The main question I have is" What is the name of this problem and can it be cured or treated long term or do we need to be preparing to euthanize him?
Expert:  Dr. John replied 1 year ago.

Thanks for the clarification. I understand your question now. It sounds like your vet has diagnosed him with dysautonomia. It is a neurological condition that affects the autonomic nervous system, which controls the natural movement of the GI tract. It is not a very common disorder. The long term prognosis for this disease is guarded because there is no cure for it. There is a high risk of developing life threatening pneumonia from aspirating the regurgitation. The metoclopramide and help to improve movement of the GI tract, but sometimes it isn't enough. Another medication that can be used is bethanecol. It helps to counteract the abnormal neurologic transmissions. You have to be very careful with this medication, though, because overdosage can cause some life threatening heart and lung issues. They may also empty their bladder more when on this drug because it causes the bladder muscles to contract. Because this disease is not well understood, though, medications may not be enough to control the signs, and some cats may aspirate anyway. I hope this is the information you are looking for. If not, please let me know.