Repeated Vomiting

Hello all,

I have an 8 month old kitten who I adopted with her fraternal sister.  A few months ago, she began vomiting up her food maybe once a month.  About a month ago, in the morning we found clear foamy or white vomit on the floor, and she continued to vomit every half hour until she vomited pink fluid.  When we saw pink in her vomit, we brought her in to the vet.  She received an X-ray and ultrasound, which revealed a thickened intestinal wall in one section, but no blockages.  She received subcutaneous fluid and ranitidine and antibiotics and after a day of rest was sent home.

The vet suggested that she may have allergies so we were told to feed her a venison only diet for a year.  Previously we were feeding her a canned only diet, with chicken, beef, and venison rotated (Evo, and before that, First Mate, both supposedly 95% or more meat).  She also tried a raw chicken diet (prepared at home as per vet recipe), but she doesn't like that any more and has not been eating raw chicken diet for the most recent 4-5 months, and not when she had the pink vomit episode.  Her sister, however, prefers the raw food diet and has not been having any vomit problems at all, eating the raw food diet only since the age of three months.

We have been feeding her the venison only diet (Evo 95% venison cans) but since her hospitalization at the vet, she has had two more vomiting episodes, once two weeks after the vet episode, and once yesterday.  So about once every two weeks.  For these vomiting days, she has about 6-8 vomits, at the end being tinged with pink at the end of her vomit series.

For these last two episodes, she has recovered by herself the same day by the evening and begins eating normally, and these episodes begin in the morning, either before or after the first meal of the day.  But while these episodes are going on, she is unable to keep down water or food.

Any ideas what this might be?  She is very young to be having irritable bowel syndrome.

I just applied for cat insurance.  I hope our first claim is not denied.

Wow - the pink coloring says blood to me, so the vomiting must be injuring her insides.  Poor boo boo.  I wonder if there is something in the Evo that is irritating her - it could be carrageenan or some other additive.  Check the label of all the cans she was fed when she vomited.  You might find the common denominator.

You may have to go back to raw - as that seems to be the only thing she hasn't vomited.  There is lots of info about raw feeding her, so perhaps there is something about meats other than chicken to tempt her.

The foamy white and pink vomit really concerns me.  I would call the vet again and see what he (or she) says.  Good luck!

How often do you feed her? Because the vomiting episodes seem to occur only in the mornings, my initial thought is that it's excess stomach acid from going too long without eating. Some cats seem more susceptible to this than others. Try feeding a meal right before bedtime. Also, you can try feeding something to absorb the acid, like a freeze-dried meat snack (Whole Life and PureBites are two brands), waiting about 15 minutes then feeding the morning meal. If neither of these works, you can talk to your vet about using Pepcid to help with the excess acid.

However, while these suggestions may help somewhat, I have to say that I am really concerned about the number, duration and severity of the vomiting episodes. It sounds like something more serious than just excess stomach acid is going on. While IBS or IBD would be rare in a young cat, it is not unheard of. The thickened intestinal wall is certainly an indication of some kind of damage/inflammation. Member @jcat  has a young cat with a very rare form of IBD. It did take many tests and many food trials if I am remembering correctly to get it under control. Many vibes that you and your vet can figure this out.

The EVO does have a small amount of fish in it.  If she is very sensitive to fish it could be enough to cause problems.

Thanks all for the replies.

I feed her four times a day: 7:00, 12:00, 6:00, 10:00-11:00.

I would like to find out how jcat solved the problem for the kitten with IBD, but jcat posts a lot so I will have to take some time to go through the threads.

Interesting suggestion that it could be the carageenan.  Yes, that is an ingredient in all EVO cans.  And yes, there is herring oil in the venison.  I think she may have had a bad reaction to the salmon treats I gave her before, so I threw away the package of that organic overpriced treat.

I don't think the raw food will solve it if I can't get her to eat it, and every time I mixed the raw in with canned (once she refused to eat pure raw), then she had some vomit episodes.

I've also guessed it was the acid from expectation of feeding as suggested as well, so we are trying to feed early in the morning, and we definitely have been giving them food right before we go to bed.

She just had her first bowel movement since yesterday's vomiting, and it is unusual in appearance.  Is that blood on the stool?  Also, usually her stool is darker brown and very dry and hard, but this one is slightly soft.  I hope this is not too serious and not a case of IBD in a young cat.  I am thinking of reverting back to First Mate, which has no carageenan in it, just to experiment, but also switching to canned chicken since First Mate does not make venison.

Also, the reason why I am writing here is that my vet does not know what caused the vomiting, even after her tests.  She did some online research.  Although she is a cat specialist, I wonder if someone on this forum may have experience with similar issues and may have some suggestions for me.  It could be something rare?  She is a very sweet cat and never bites or scratches.

Thank you for writing in to help.

My cat was 18 months old when he had his first IBD flare so it is possible even in a young cat. You said her stool is normally dry and hard, does she have problems with constipation? Light colored stool is usually a sign of malabsorption. I don't know if that's blood or not. When Patches first started he would vomit bile and then later on it was a rust color, or at least appeared that way on the carpet. He got to the point where it was always that color.

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My cat DeeJay a few years back had vomiting issues once a week or so, it was determined she had what is a called a Helicobactor infection (basically an ulcer bug), she was treated with antibiotics, antacids and hasn't had problems since.  She too had a little bit of pinksih coloration to it.  So that is one issue that could cause intermittent vomiting. 

I just wanted to 2nd the suggestion that it could be the carageenan. It was my primary issue with one of my cats. It's in pretty much every higher-end canned cat food, so even as I was trying to avoid certain proteins, etc. for food allergy elimination diet experiments, the biggest piece to my puzzle turned out to be the carageenan. In my case it caused intermittent vomiting that didn't seem food-allergy-related, and it got worse over time, increasing frequency to daily vomiting.

Here is more detail of my experience with one of my kitties, Thomasina, that may help you. When she came to me, Thoma was 10+ years old, diabetic but no longer on insulin (diet controlled), and on a canned low-carb diet (Fancy Feast) after eating kibble her whole life. I was told by her foster mom that she was allergic to seafood so she ate mostly the poultry and beef flavors of Fancy Feast. She would vomit occasionally, but with no apparent pattern. Sometimes with hairballs, but other times just clear foamy fluid. I transitioned her off Fancy Feast thinking I'd upgrade her to a higher quality canned food. She was on Turkey Wellness for awhile, but kept vomiting, so I tried various other low-carb foods. I tried novel proteins (venison, duck, rabbit) wondering if it was a food allergy. I tried raw. I tried digestive enzymes. The frequency of vomiting got worse to the point where she vomited every day, usually in the early AM on an empty stomach. Throughout all this I fed 3x a day (8:30am, 3:30pm, 10:30pm). Through it all she seemed unfazed, always kept her appetite, loved to eat. I just felt horrible since vomiting every day can't feel good and since it got worse under my care, I knew somehow I was contributing to it!

In the end, I think Thoma's vomiting was caused by multiple reasons. #1) carageenan - somehow associated with the daily vomiting clear fluid, mostly in the AM; #2) food allergies - vomits soon after eating, food is not digested; happens with certain specific triggers and the vomiting episodes seem different than the routine-type vomiting I associated with cause #1; #3) vomiting hairballs when excess shedding, doesn't just pass in her stool

So I've figured out that Thoma is very sensitive to carageenan. Unable to eat seafood, beef/lamb/venison, esp. the organ meats, but is able to tolerate poultry (I feed mostly chicken now, but turkey was also fine, and I think duck and rabbit would also be fine, but more expensive and harder to source so I don't feed that). I have tried to get her to eat raw (my other cat eats a homemade raw diet), but if I give her more than 10% raw, she will occasionally vomit again, so I don't think she's able to digest it. I suspect she may be allergic to fish oil. I also suspect she's sensitive to something in the filler in the one brand of digestive enzyme I tried, but I haven't tried any other ones. To help with the hairballs and general GI upset, I also give her slippery elm bark powder (about 1/8 tsp dissolved in water in each meal) -- that seems to help her pass the fur through her stool, and I wonder if it also helps with excess stomach acid. She almost never vomits now.

In your case, I think it's worth trying FirstMate again since it's carageenan-free and see if that makes a difference. I'm not convinced your kitten is actually allergic to chicken/turkey or beef since even after you fed Evo venison only (no longer rotating) you're still seeing vomiting.

Wow, OskarBlues, that was incredibly helpful.

She has an enormous, insatiable appetite when she's not sick, and even on the days she's vomiting, she is interested in eating if she's at least an hour between vomits.

It's true... there is carageenan in almost all the higher end cat foods.  The First Mate has only a small amount of potato as a thickener.  I will definitely try it again.  I'm going back to the store to return all my carageenan-venison.  All I know is that she is continuing to vomit on Evo venison.

And... my first cat when I was growing up I named Thomasina!  I loved that movie, and I loved my Thomasina, who was a manx cross.

Regarding the possibility of hairballs, when Willow had one of her frequent vomit days and was hospitalized for treatment 4 weeks ago, the very next day she coughed up a sizeable hairball.  I am assuming it was hers, because it was mostly black fur, and her sister is white.

We have been combing her daily and there is a LOT of hair coming off.  Why would she be shedding so much going into the winter?

I also think that Willow is allergic to fish.  But it seems most cat foods contain some type of fish oil.  And I have been adding fish oil caplets to the raw food.  Maybe that is the key?

I will try the slippery elm.

And yesterday night she was seen eating some of the raw food that I feed her sister.  Uh oh.  I had been feeding her side by side with her sister, who only eats raw, thinking I was safe because Willow really dislikes raw, but last night she ate some of it, and it has fish oil in it.  I hope nothing bad comes of this.

Thank you for your excellent help.

Thanks also to cprcheetah: Helicobacter?  I will have to do some research on that, but then I would have to get prescription antibiotics for that, right?  Yikes!  More vet bills!  I wouldn't be surprised if it was that ulcer virus, since she has the pinkish vomit and had the inflamed intestine walls.

Just an update.  Good news.  I took the advice of a few and thought it might be the carageenan.  Against the advice of the vet who told me that she has allergies and to keep her on venison for a year, I took her off the EVO venison, which had carageenan.  I put her back on First Mate Chicken.  While she doesn't like eating it as much as the EVO versions, we haven't had any more episodes of diarrhea or vomit.

Now it has only been a little over three weeks, but the frequency of problems was once every two weeks.  Better yet, she has returned to her normal self, engaging in play fighting with her sister and running around at night.  I hadn't noticed that she wasn't as active when she was sick because the change was so gradual.

So, who knows if it really was the carageenan or not, but changing her diet is working for us so far.  If there are any changes, I will update this thread.

Good news!  Thanks for the update.

Glad to hear things are better!

Drat.  I must have cursed myself by writing the update.

She had a big blob of very soft stool today, on the tail end of a solid dump.  Here we go again.

My kitty would have flares with no known triggers.  He would go anywhere from a few weeks to a few months between flares.  The longest he went was 8 months.  Some of the flares would be bad enough for hospitalization on an IV.  I tried different proteins, grain-free versus foods with rice in them, and running Feliway diffusers constantly to help with stress.  I never did figure out what was triggering those flares.  I went to vet after vet for six years .  In the beginning, because Patches always had constipation with vomiting and he was very young it was looking for a foreign object.  After that it was pancreatitis.  He finally became very ill and was at the point of euthanasia when I tried one more vet and she diagnosed the IBD.  At that point is liver was also inflamed and he had fatty liver.  He has been on a steroid for three years now and doing well.  Sometimes, especially when it is very episodic in nature, you simply can't figure out the trigger.

I have 8 cats and I clean vomit up at least every other day, sometimes twice a day. Sally 7yo will over eat. Momma Pooch 20 yo, will drink too much water before breakfast and the white foam will come up, Virgil 3 1/2 has allergies and will cough sometimes so much that he vomits, Ryan 2 yo, never vomits, Rachel and Matthew are brother and sister and both have very delicate stomachs if Rachel eats her dish of soft food 1 1/2 oz. it's a guarantee she will throw it up, so I usually take it away from her after about 3/4 of oz thru. Whereas Matthew will walk around and pick food out of every dish then runs away and throws up.

Now Matthew and Rachel were adopted at 3 mos old from my usual shelter, of course within a day of bring them home they both developed the usual URI and had it real bad. They had snot coming from everywhere, 3 times Matthew had to go to the vet for sub-q and Rachel only once. But they had it for a solid 3 weeks and had to get antibiotics for that long. So I am convinced that (215) 500-4006all those antibiotics at such a young age killed their little stomach's. So now Rachel is eating more hard food then soft and Matthew is still eating running and throwing up. It's never more then vomiting 3 times continually and it's never has any shade of pink. Good luck.