Vomiting...next step? (long)

Mikey has been treated for IBD with depo medrol injections successfully for the past 18 months or so. He usually needs an injection every 4 months on average. He is on Hill's Prescription I/D diet. He also loves to eat random things in the house, which contributes to the vomiting. Last week it was a piece of carpet fiber and some mattress topper foam. A lot of variables are involved with this latest bout of vomiting, I'll try to make it clear:

-2 months ago started vomiting hair balls daily. Vet said brush him more, give more petromalt. I did. And it helped. Hairballs vomited up once a week after that.
-1 month ago, no more hairballs at all. But he started vomiting more frequently, 4-5 hours after eating. Got his next depo-medrol injection at the vet. Did fine for about 10 days, vomiting increased in frequency again. He also bitten off tiny pieces of foam from a mattress cover in between sheet changing, vomited it back up.
-Back to vet, had x-ray, which showed a little bit of gas, but otherwise nothing worth noting. Did bloodwork, certain enzymes increased, vet said was suggestive of pancreatitis, but could also be due to the fact that the cat had eaten the foam from the mattress and because his body was trying hard to digest it, the enzymes would be off because of that. Put on flagyl.
-Last week, vomit had tinges of blood in it. Vet checked him out, said most likely popped a blood vessel while vomiting. Esophagus is probably raw. Added pepcid to reduce acid.
-For the past week, he has vomited on average, once every 2 days. Some vomit has fresh tinges of blood, some has nothing but liquidy food.

Vet said we could do an endoscopy, but he doesn't think it's necessary yet, b/c he checked out his abdomen, felt no ambnormalities, cat didn't flinch, x-rays were clear, blood work was fine and Mikey is otherwise acting perfectly normal. He is eating like his normal piggy self, drinking water well, bowel movements once a day (a little hard and dark--maybe a little constipated), playful, affectionate, clean as a whistle. The vet said he would be more aggressive in ordering up an endoscopy if the cat showed any other symptoms or signs of an issue. This vet's office has 4 different vets and we've seen the same 2 and they seem to read his file thoroughly while we're in the exam room together before examining the cat. They take time to explain what they're doing, why they're doing it, and the science behind it.

He hasn't gotten any worse at all over the past week, but he hasn't gotten any better either.

We also have plans to go away from tomorrow night until Thursday morning. We have someone coming in to pill him 2x a day and check up on him.
The vet thought he would be fine for us to go.
Would you feel comfortable leaving him for a couple of days?
Does this sound like another IBD flare-up?
Am I worrying too much about it?

Personally about leaving no one is you and can make that choice ...

IBD is a tricky one and can flare at any time ( I have a dog with it , no grain and raw diet worked with her , you may want to ask the vet )

NO you are not worring to much

Would you feel comfortable leaving him for a couple of days?

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Not unless I had done probably a quadrouple cat-proofing of the place; not unless this "someone" was spending more time with him than twice daily pilling; not unless I were convinced that the "someone" was as skilled as I in watching for and detecting behavioural changes...in a word and as things stand, no.

Am I worrying too much about it?

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If I were you, no. You have every reason to worry.

Also...your absence will be very stressful for Mickey. Stressed-out kitties tend to engage in strange behaviors just to calm themselves. He may, despite your best efforts to cat-proof, search out new nasties to eat.

You haven't once used the term "Pica"...I'm wondering if you've ever come across it. It sounds to me as if Mickey is a "Pica kitty". We've just lost one on this forum due to the ingestion of a small piece of corn cob...here's the thread.

Here's more about Pica.

One other thing...petroleum-based hairball remedies used regularly can prevent the absorbtion of essential nutrients in the intestines (see the paragraph "Lubricant Laxatives") . There are safe alternatives such as Slippery Elm or other formulated products like this or this one, Cat Lube.

Now, this isn't on your list of questions either but, I think that if Mickey were here, I'd be seeking out a consultation with a Homeopathic Vet.

Thanks for the info, Blaise. I am familiar with pica. I mentioned it to the vet a few weeks ago and based on the blood work they've done over the year, he doesn't think Mikey's deficient in anything.

When we go away, we confine the cats to the living room/dining room and kitchen. That's where their beds and food are anyway, so it's not a big change. We go away often enough (2-3 days max) that they are used to be alone. We also set up a surveillance camera that we access from the internet. It has been so useful for us when we go away. We know exactly what they're doing at all times!

I'll call the vet tomorrow and see what the next step should be. We can probably postpone the trip for a week.