Vomiting on an empty stomach

urbantigers

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I could do with some input and advice about Jaffa's vomiting.

First off, he has been to see the vet (and will go back to see the vet) but the vet I saw last time was new and I wasn't overly impressed. I will ask to see another vet next time I think, but in the meantime I'd like to know whether anyone else has experienced the same thing.

Jaffa began vomiting several months ago. He was vomiting approx once a week (sometimes he'd go a couple of weeks without vomiting, other weeks he'd vomit 2 or 3 times in the week) and always on an empty stomach. On all but 2 occasions it's been early morning before breakfast. To begin with he was bringing up a small amount of brownish liquid (bile) but more recently it's just been a tiny amount of clear frothy fluid. I did change his food a couple of months beforehand from a poor quality wet food (mainly felix) to a better quality one with a higher meat content. I wondered whether the new food was too rich for him and was irritating his digestive tract so have gone back to feeding him felix for the past 3 and a half weeks (plus a small amount of James Wellbeloved dry - a good quality dry). He's 9 years old and has eaten JWB dry and felix wet for most of his life with no problems. He gets fed 3 times a day - wet in the morning and when I get home from work, then some dry about 9.30pm.

The vet has had a feel and doesn't think there's any physical obstruction. He's also had a senior blood panel done and everything there is ok, although he did have a slightly high lymphocyte (?) count which the vet said indicated he may have a slight infection. It was only marginally high and the vet didn't seem concerned. He asked what I was feeding him and when I told him the name of the wet foods I feed he hadn't heard of any of them. He had heard of the JWB and suggested I feed him on just dry for a while to see if that helped. I wasn't keen on doing that as I prefer wet food for Jaffa (he doesn't drink much even when on dry) and I'm trying to increase his wet food not decrease it. I also felt the vet was clutching at straws a bit when he suggested that, esp at it was the only food he'd heard of. I haven't ruled out doing that but in the meantime I decided to go back to the felix for the wet food to see if it was the rich food that was causing the problem.

For the past few weeks the vomiting has been much less, although I'm not sure whether he was or wasn't sick 2 weeks ago. I found a small amount of slightly foamy clear liquid on the kitchen floor that may have been vomit or may have just been water splashed over from the sink! I'm not too sure. I was just thinking I'd cracked it and that it was food related when he was sick again this morning at about 6am. The usual thing - just a small amount of clear fluid. Up until he was sick this morning my plan had been to keep him on the felix for 4 weeks (just a few more days to go) then gradually re-introduce the better quality wet food into his diet to see how much of that he would tolerate before it made him vomit. I'd be happy feeding him a mixture of the felix and some of the better foods. Now that he's vomited while on the felix I'm not sure what to do. He's also had a few runny poos the last day or so, but is otherwise showing no signs of being ill. He's not lethargic or off his food and he's not losing weight. The vomiting doesn't distress him at all and he's ready for his breakfast straight afterwards. He never vomits his food back after eating.

I've read a few articles recently that have mentioned vomiting on an empty stomach (esp in early morning) and get the impression it's a well known type of vomiting that is due to bile passing back into the empty stomach and causing irritation. This sounds like what might be going on with Jaffa but I'm surprised the vet didn't pick up on the empty stomach thing. The solution offered is usually to feed more often and especially to feed during the evening so that it's not too long until the morning meal. Jaffa is already being fed at night though and has his last meal about 9.30 - 10pm.

Sorry this is so long - has anyone had a cat with this type of vomiting or got any suggestions for what I should do next? (apart from take him back to the vet which I will do soon - but I think this vet is going to need a bit of help from me!). I'm going to start him on a probiotic but other than that I'm not too sure whether to continue with the felix, go all dry - don't really want to do that - or gradually introduce some other, better foods. Anyone had any experience with this type of vomiting?
 

kittenkiya

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I know this will sound crazy and you may want to check this with a vet, but from what I gathered , you do not have...like dry food down for him to eat at all?

I free-feed. Dry food and water 24/7. I was wondering that if he was soooo hungry in the morning that that could trigger the vomitting? I know it sounds like a long shot, but that's the only thing that comes to mind. I'm sure that the others will be by to help shortly.

Poor baby. You must be feeling kind of bad about it too. Healing headbuts and calming licks from KittenKiya's Clan.
 
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urbantigers

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No - he doesn't free feed. It's just not possible with Jaffa. When he got to about 6 months old he began scoffing all the food down in one go (including his brother's share) so that was the end of free feeding! he's been on scheduled meals ever since. If I put some dry down before bed he'd just eat it all there and then so there'd be none for him during the night.
 

kittenkiya

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Hummmm, best check with your vet. I really can't see any reason for the vomitting, no fur balls, hummmm.
 
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urbantigers

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He's had his liver function checked and it was fine. That's the problem - there doesnt' seem to be any obvious underlying cause
I will specifically ask about his liver when I take him back to see the vet though.
 

jenny82

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Emily threw up a lot of clear frothy liquid this morning. It's the first time I've seen vomit like that. I don't think she has eaten much at all in the last 2 days, so I think I have to take her back to the vet today. I took her to the vet a few weeks ago for not eating. They ran tests and couldn't find anything wrong, but gave her an appetite stimulant which started her eating again. Now the problem is back.


Let me know how your cat is doing.
 

russian blue

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Originally Posted by urbantigers

Jaffa began vomiting several months ago. He was vomiting approx once a week.................... always on an empty stomach. On all but 2 occasions it's been early morning before breakfast.............

I've read a few articles recently that have mentioned vomiting on an empty stomach (esp in early morning) and get the impression it's a well known type of vomiting that is due to bile passing back into the empty stomach and causing irritation. The solution offered is usually to feed more often and especially to feed during the evening so that it's not too long until the morning meal. Jaffa is already being fed at night though and has his last meal about 9.30 - 10pm.
Exactly Nakita! If you do a search on my posts, the same thing started with Nakita 6 months ago. Like a clock, she'll throw up a tbsp of clear bile only between 2am - 5am. Right after she did that, she was wanting food, so clearly the bile was the irritation.

The only solution offered by the first vet I saw was giving her Pepcid-AC (dosage dependant on weight). But, the second vet I saw said that Pepcid-AC wasn't a good long term solution in her research and it could cause cats to go off their food.

Can you post a link to one of the articles regarding the bile backing up in the stomach?

Right now we're also trying to figure out if Nakita has food or environmental allergies, so I'm doing a food trial right now along with some Prenisone. Not a solution for the vomiting, but the Prednisone has stopped Nakita's vomiting along with her itching.

It's also possible that your cat *might* have IBS (you also mentioned soft stools). You might want to look at the food source as well since this is a new symptom.
 

russian blue

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Originally Posted by urbantigers

If I put some dry down before bed he'd just eat it all there and then so there'd be none for him during the night.
You could try purchasing a timed feeder that would open at around 3am to give him another meal at that time.

I also noticed Nakita's vomiting was worse when I only fed her dry. If I gave her wet at night she seemed to vomit less.
 
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urbantigers

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ok, update! Jaffa is still vomiting. He's been sick twice (possibly 3 times - not sure who was the culprit on one occasion!) since xmas. I've been giving him his supper in 2 parts - a little bit of dry at about 9pm (his normal supper time) and then the rest just before I go to bed. I thought I'd cracked it with that but apparently not. He had some dry last night at about 11.30pm yet was still sick at 6am. He goes much longer than that without food during the day yet isn't sick then when his stomach gets empty. I've tried different foods and that doesn't seem to make any difference. I'm now going to try wet food at supper time instead of dry. I'm still convinced the vomiting is due to his empty stomach.
 

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Our older cat started throwing up on an empty stomach in the morning when she had developed hyperthyroidism, which is important to catch and treat early. She would also walk all over my pillow and chew my hair in the night and I think in retrospect she was trying to tell me something was wrong. Night time activity level and throwing up both can be symptoms. Definitely find and ask a good vet. Our first vet missed it because her thyroid levels were in the "grey zone," but in older cats, the "grey zone" is a huge red flag.
 

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My cat has IBD, the first clue was throwing up as the food was irritating his stomach, then came loose stool but he would straight out throw up, then throw up bile later because he was hungry,

he has been on pecid for a year and its helped a lot with hairballs, bile, throwing up appetite.

he had a real bad infection in Dec though so he is now on predisone once a day.

I also switched his food and it has helped so so much.

I would bring him back to the vet or at least call.

Throwing up is never good :(

Good luck!
 

samus

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Foamy vomit can be a sign of high stomach acid with cats with kidney issues. My cat has had intermittent vomiting for years (sometimes a few times a week, sometimes once a month), and was only diagnosed with kidney problems this year. Her creatinine is just barely elevated, and her BUN is normal, but now I wonder if she's had slowly failing kidneys and if the vomiting was an early warning sign. Her last blood test before this one was 2012 and her kidney values were 100% in the normal range, though she had already been vomiting for at least a couple years at that point. (She probably also has IBD/food allergies, the vet doesn't seem concerned enough to do tests for it, though). It sounds like you're already taking steps to reduce kidney issues, with feeding more wet food. The basics of early stage treatment are increasing water intake and reducing phosphorous intake, Tanya's CRF site has a nice list of foods and their phosphorous content if you think CRF might be a possibility.

The timed feeder to give him a midnight snack sounds like a good idea. Feeding small amounts throughout the day has definitely reduced my cat's vomiting, and vomiting does seem to be correlated with when she runs out of food in the night.
 
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