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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 28441
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My cat who is about 10-12 years old has been vomiting every

Customer Question

My cat who is about 10-12 years old has been vomiting every few days. I changed the food to a sensitive stomach, but it started happening again. Any suggestions
JA: I'm sorry to hear that. Hopefully it didn't make a mess. Did your cat eat anything unusual?
Customer: No, she refuses to eat anything except her cat food and is picky about what kind of cat food it is, she is an indoor cat also.
JA: OK. The Veterinarian will know what to do. What is the cat's name?
Customer: We named her Misty, but that didn't stick so Just Kitty!
JA: Is there anything else important you think the Veterinarian should know about Misty?
Customer: She does have hairballs, but I shave her to help with that. Other than that nothing has changed.
Submitted: 12 months ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 12 months ago.

I'm sorry to hear of this with Misty. Most of these cats are diagnosed with inflammatory bowel disease (IBD) - an idiopathic (unknown cause) inflammation in the gastrointestinal tract - but there are quite a few differential diagnoses for vomiting at Kitty's age including a trichobezoar (a particularly nasty form of "hairball"), pancreatitis, hepatitis, nephritis, and neoplasia in the GI tract such as small cell lymphoma (a sequela to IBD), mastocytosis, and solid tumors such as GI adenocarcinoma.

A methodical approach usually reveals the etiology of the vomiting. A thorough physical exam including diagnostics in the form of blood and urine tests followed by ultrasound of her abdomen if need be should be considered. Ultrasound is particularly sensitive for detecting changes inside her GI tract. If nothing untoward is found, we can scope and biopsy these patients but are more likely to presumptively treat IBD with either the antiinflammatory antibiotic metronidazole, a glucocorticosteroid such as prednisolone, or both.

You also have the option to see if Kitty has developed a food intolerance. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Kitty's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (a hydrolyzed protein diet is my preference because it avoids the possibility of my patient being intolerant to even a novel protein). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time. I understand that her "picky" eating may preclude a hypoallergenic food trial.

Please respond with further questions or concerns if you wish.

Customer: replied 12 months ago.
Can you prescribe some hypo allergenic food?
Expert:  Dr. Michael Salkin replied 12 months ago.

I regret that we're not allowed to prescribe through this venue. Misty's vet will need to do that for you. Please continue our conversation if you wish.

Expert:  Dr. Michael Salkin replied 11 months ago.
Hi,

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

Dr. Michael Salkin

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