Sick cat... need advice

my 13 yo male cat is sick and i am so upset I hope this forum will provide me some other questions to ask vet and perhaps other options I can try at home. I am exhausted taking care of two little kids and running around trying to feed Shadow....

It seemed to start about 3 months ago when he escaped and spent his first night ever outside and it stormed that night. when i realized he wasn't inside, the kids and I went outside to find him. He came tearing into the house and began hissing at my 3yo which is very uncharacteristic of him. He is normally very gentle and sweet even with the kids. He had a scratch on his neck but that healed fine and there was no infection. After a couple days of quiet time in my bedroom with food/water and litter he seemed to be better and he resumed to full run of house and gentle with kids. 

A few weeks ago 10/24, I noticed he wasn't eating very well and he began throwing up dark liquid a couple times. After he threw up I brought him into vet and when they weighed him he was down to 16 pounds from his normal 20. When she provided him some dry food in a dish he scarfed it down so I thought maybe he was finicky with his food. She ran a full blood panel and everything came up fine - leukimia, fatty liver disease, diabetes, white blood cell count, thyroid issues, etc. I cleaned out his food and water dish and when i did that I saw mold at the bottom of the dish like water had gotten into dry food which had caused the mold (could he be poisoned? would that have only been transient?). I tried feeding him the food the vet had provided and he wanted nothing to do with it. I tried a variety of different foods that he rejected. I finally found BFF wet food that he ate some - like 5 oz a day much less then the 10 he should be having. He kept looking at the dry food like he wanted to eat it but just didn't like it so I put some of the old stuff in there and he ate some of that and seemed happy. I purchased another fresh  bag of the premium edge that he had been eating earllier. 

10/26 Vet Rx predisone thinking irritable bowel disease. Shadow did not seem to react well to steroids and has become very jumpy and nervous, preferring to hide in dark then to come out and eat or socialize. I tried it for a while, just to give it a fair shot but am now weaning from the initial Rx of one full in morning and half pill in night to just a half a pill every other day. Since 10/26 he has now gone to eating barely a couple oz of wet food a day and when he eats I have to hold plate in front of him to encourage him. It takes almost 30 min for me to get him to eat that. He at times will gag while eating. There are now bald patches on his body from overgrooming. ON his back there is a bigger patch with red scabs. It is awful. His back will twitch like he is ready to jump out of his skin. 

I have to bring him to litter box and bring him to his food otherwise he will hide all day long. When I visit him he will purr, but he is just not acting the same.

I am at my wits end.... I am trying to raise 2 little kids and desperately tyring to save my cat. The vet had indicated that if not IBD it likely is cancer since his blood test was normal. I still think perhaps the stress of spending night outside and my newly mobile 8 month old constantly going after his food pushed him over the edge. 

what do i do now (( He is my first baby.

I will bring him in tomorrow for another exam and see what the vet suggest but I was hoping I could come in with some other ideas on what to do. 

thank you all in advance.

He just threw up yellow bile with hair mixed in... luckily it was in shower and not on carpet. I am not feeling optimistic about this outcome. But I certainly want to try everything (within reason) before giving up.

Hi there,

The dark liquid he'd been vomiting ---- how dark?.....dark like coffee grounds?......dark brown?

Has Vet ever done xrays or abdominal ultrasound to check for issues with the intestines?   (twist in bowel, partial obstruction, mass in bowel, etc)>   I would be requesting this.

Did Vet examine kitty's teeth to see if a bad tooth is causing issues with wanting to eat? (namely kittys aversion to dry food).

Did you tell Vet about the mold in the bowl?

Did Vet give kitty deworming meds in the event kitty ate something bad while he was gone? 

Based on what you've written it almost sounds like Vet was maybe a little too quick to just chalk all this up to IBD, particularly if no xrays/ultrasound done.    Is there another Vet you could see to get a 2nd opinion?   If so, I would simply request currently clinic make you copies of your cat's file...including all notes, lab results, testing done to date, meds prescribed, etc..........and take all of this with you to another Vet and get a 2nd opinion.  

I think the gagging is of significance.  
 

Dark liquid - not coffee grounds, more like the cat food he was on at the time partially digested but a little darker if that makes sense, orangish brown.

No xrays or U/S

I did not tell vet about mold in bowl. At the time I just thought it would be transient issue and getting him on non-contaminated food would improve his health.

No deworming meds but she indicated she had run a full panel that could determine if there was parasites/worms but now I think it would be better if I get a copy of lab results myself.

I initially thought his teeth were the issue. They clipped plaque of his teeth and his gums did not seem swollen or red so she said they were "fine."

Thank you for your time responding. It is very much appreciated. 

Maybe they need to give kitty something for nausea?...like a shot of Cerenia?

They might need to give him some subcutaneous fluids because with such poor intake, kitty could be getting dehydrated.   Dehydration can make a cat feel even worse, and less likely to want to eat, more apt to hide.   A quick check for hydration level is.....run your finger over his gums....do the gums feels slippery and most (which is good) or do they feel "sticky" and your finger doesn't slide easily?  Another way to check though is somewhat less reliable in older cats as they have less elasticity to their skin....is to pinch a good bit of skin on the scruff of their neck then release.   If it drops back into place instantly, that's good......if it takes a couple seconds or more, can be sign of dehydration.

I think it's so important some good diagnostics done.......xrays can show things to an extent but I'd say abdominal ultrasound would show more in terms of inner organs (intestines, liver, adrenal glands, pancreas, kidneys, etc).   Ask Vet about possibility of Pancreatitis.

The gagging COULD be just due to nausea?

Maybe read up on Feline Pancreatitis.   I have had cats with this, generally causes low temperature (when they check their temp at vet), vomiting, diarrhea (though not always the latter), abdominal tenderness, poor appetite, hiding due to pain.   There is a very specialized bloodtest that can check for it (TL1?)......but again an ultrasound would be helpful, too.....to show if pancreas is enlarged/inflamed.   Here's a good link on feline pancreatitis, symptoms, bloodtests to check for it, treatment, etc:  http://www.2ndchance.info/pancreatitiscat.htm