Veterinarian's Assistant: I'll do all I can to help. Hopefully it didn't make a mess. Did Crakya eat anything unusual?
She probably hunts small animals outside, I have seen her with mice and bird a few times
Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Crakya?
She was picked up very young outside and was probably not weaned from her mother; I think I have read that it migth cause later digestive issues or others ones in the cat...
Expert: Dr. Michael Salkin is typing. Please be patient.
Expert: Can you upload a photo(s) of this spot to our conversation? You can upload photos by using the paperclip or add file icon in the toolbar above your message box (if you can see those icons on your particular device) or you can use an external app such as dropbox.com/ Please check that the photo(s) is in focus prior to uploading it. I don't know of a correlation between a skin condition in that area and excessive vomiting.
It was pertaining to food allergies
Expert: Thank you. Give me a moment to take a look, please...
I could also provide phot of last few vomit recording it needed
Expert: The chin is so well-haired, I can't see if the darkness represents normal pigmentation or, instead, feline acne - hyperpigmentation is a feature of feline acne. Are you seeing pustules (pimples), papules, furuncles (boils), and/or comedones (blackheads) as well?
I am seeing what I suspect are comedones; I have browsed through a few online feline acne photos when inquired about it, and it looks like many of the photos I have been seeing
Her chin also didn't used to be as such
Expert: Thank you. I'll post my entire synopsis of feline acne for you and then we can discuss her vomiting if you wish. You’ve described feline acne which is a disorder of follicular keratinization and glandular hyperplasia. It's common in cats. Asymptomatic comedones (blackheads) form on the chin, the lower lip, and occasionally, the upper lip. Papules and pustules and, rarely, furunculosis and cellulitis may develop if lesions become secondarily infected. In severe cases, affected skin may become edematous, thickened, cystic, or scarred. Here's a primer on how to treat feline acne:1) Any secondary bacterial infection should be treated with appropriate systemic antibiotics for at least 2-3 weeks. Malassezia (yeast) should be treated with fluconazole for 30 days. Antibiotics of choice are potentiated amoxicillin (Clavamox) or enrofloxacin (Baytril).2) Hairs around lesions should be clipped, warm water compresses applied, and affected areas cleansed with human alcohol-free acne pads, or with benzoyl peroxide-, sulfur-salicylic acid-, or ethyl lactate-containing shampoo every 1-2 days until lesions resolve, then as needed for maintenance control. These shampoos can be found over the counter in pet/feed stores or at her vet’s office. Often frequent chin cleaning (every 2-3 days) is needed to prevent relapses.3) Alternative topical products that may be effective when used every 1-3 days or on an as-needed basis include the following:Mupirocin ointment or cream (prescription drug)2.5% benzoyl peroxide gel (might be irritating in some cats/over the counter product)0.01-0.025% tretinoin cream or lotion (prescription drug)0.75% metronidazole gel (prescription drug)Clindamycin-, erythromycin-, or tetracycline-containing topicals (prescription drugs)4) For severe refractory cases, systemic vitamin A therapy may be effective.The prognosis is good, but lifelong symptomatic treatment is often necessary for control. Unless secondary infection occurs, this is a cosmetic disease that doesn't affect Crakya's quality of life.
Just texted you last vomit photos
Expert: Regrettably, the photos didn't upload here. If you need help, please see http://ww2.justanswer.com/help/how-do-I-send-photo-or-file-expert-0
Expert: Thank you. Give me a moment to take a look, please...
Expert: Undigested food suggestive of regurgitation rather than vomiting. This is seen in cats eating too rapidly and triggering the stretch reflex in the stomach. The last phot revealed nondigestible greens which often results in vomiting. In summary, she appears to be both vomiting and regurgitating and so there are quite a few differentials to consider. These cats are most often diagnosed with inflammatory bowel disease (IBD) - an idiopathic (unknown cause) inflammation of the gastrointestinal tract which usually responds to a glucocorticoid (steroid) such as prednisolone, the anti-inflammatory antibiotic metronidazole, or both. We also need to consider a particularly nasty type of hairball called a trichobezoar, chronic pancreatitis or hepatitis, as well as food intolerance. Crakya's vet will want to thoroughly examine her including performing diagnostics in the form of blood and urine tests. If nothing untoward is found, an abdominal ultrasound is indicated because that imaging modality is particularly sensitive for evaluating the gastrointestinal tract itself. We're mainly interested in seeing if the inflammation associated with IBD or its sequela small cell lymphoma (older cats, usually) is present. Confirmation of IBD requires scoping and biopsy of the gastrointestinal tract. 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 Crakya's immune system doesn't "see" anything to be allergic to. 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 my patient has been eating the same food for quite some time.Please continue our conversation if you wish.
Expert: You're quite welcome. Thank you for your kind accept. I appreciate it. I'll set a follow up for a couple of weeks from now but please return to our conversation - even after rating - with an update at your convenience.