Need thoughts and support.

Obi has been on 5 mg pred, fortiflora, metameucil for the past 6 months for hairball vomiting as many reading this know.  He has done well, with a hairball about once every week or 2 weeks at the most. He eats, mood is good, is no longer overgrooming his belly.  He is on Nature's variety rabbit.

Lately - the past week - he is throwing hairballs almost every day.  I have an appt with the vet on Tuesday, but am worried and dont know what to do.  I sent her an email last week and she has not responded.  I am not too fond of that but I realize a hairball throwing kitty is not a priority, like a post op dog or  cat.  I will try to reach  her again today.  I   switched this week to Proviable, to see if that would help, and added in a capsule of dried egg yolk lecithin.  I dont know how long it takes for these things to work, or whether I should go back to fortiflora...

Since small cell lymphoma was never ruled out, as I did not biopsy, I am of course worried that Obi has it, and it is progressing.  Whether it is or not, it cant be good for him to throw hairballs this much; that is what caused him to have a mild bout of pancreatitis last year.  Tuesday seems like a long ways away.

Any thoughts or suggestions will be most appreciated.

Have that ruled out IBD?

My cat takes Pepcid for the throwing up issues/hairball and it really seems to help. has your vet suggested that?

Is their another vet you can go too? whether a cat is throwing up hairballs or not, throwing up is not good for a cat.

There is a lot of history here...we are treating Obi for IBD, essentially, hence the pred, the rabbit (novel protein) and the probiotic.  We cannot rule anything in or out because I have not ustrasounded him or had him biopsied.  I did not do these things because of 1.  His age, 16    2.  these tests can be inconclusive, especially the US.   3.  the treatment is the same, essentially, if he had IBD or lymphoma - up to this point.  I have used pepcid in the past.  I dont know that it helped.  

Obi has had several vets, including taking him to Internal Medicine when he had pancreatitis.  I doubt another vet would do anything different - I have read enough here to think she is a very good vet.  The internal medicine people did not suggest much, in the final analysis - they supported him taking B12 injections, and treated him for the pancreatiitis, which resolved back in the summer.  I hope I answered your questions...I know throwing hairballs is not good.  Once in a while - not a problem.  Daily - problem.

I would ask about the Pepcid. Do you have hair ball cream?

I would call again and ask if you could come in sooner

I did ask about coming in sooner. No appts. are available.  I asked the vet to get back to me about what I can do in the meantime.  Am waiting for a response.

There are certain seasons when hairballs are worse than others, and if memory serves, we are just starting into one of those seasons.  This may be why Obi is having more, but one a day still seems way more than "normal".  I would think the egg yolk lecithin should help.  Have you also tried Vet's Best Hairball and Digestive Relief tabs?  Those seem to help my guys quite a bit, and they love them to boot

I would think as long as he continues to act normal (eating, drinking, pooping and peeing) you should probably be ok to wait for your scheduled appointment, but IF he should stop eating, then I would then either call another Vet or take him to an emergency Vet.

Is Obi long haired?  Do you brush him daily, or better yet, comb him? 

Hi, MrsGreenJeans:  Obi is a DSHM.  He has always been a fastidious groomer, but I also have a furminator and brush him and my other kitty once a day.  Vets Best caused him to vomit FOOD both times I tried it , so, it disagrees with him.  :  (  I wish it did not.

One thought is, do I 1.  increase his metamcucil from 1/4 tsp to a bit more?  I know to be careful with that.  I was giving him one capsule of the EYL, can i give more of that??  I have NO idea about that; it is certainly not causing diarrhea at one capsule.  I wondered if it was shedding season and looked it up on line but it is in spring and summer, I read, not now, although when I had my OTHER cat to the vet in December, she said that cats were shedding and that there is a winter shed.

Yes he is acting normal, but if he continues to vomit hairballs daily, my fear is that it will stir up his pancreas...

I don't see any issue with increasing the Metamucil to perhaps 1/4 teaspoon TWICE a day.  (I've even read you can go up to 1/2 teas twice a day!)  You could also try canned pumpkin for his fiber rather than the metamucil.  Up to one tablespoon per day.  Some cats love it, some don't.  I sometimes have given as much as 1 1/2 capsule of the EYL during heavy shedding season.  You can also try adding some  butter to his food.  1  teaspoon  (i would use unsalted) per day for a week.  OR, try a dab of vasoline on his paw for up to 4 days.  Those last two should help the hairballs exit the rear vs the front

Thanks very much, Mrs. Greenjeans.  My vet suggested some pepcid - he has been on that before - before the pancreatitis - and it did not help consistantly , but I noticed that the pepcid I was giving him was way out of date , so may have lost its efficacy.  I have the Swanson's powdered EYL; I hope that is what you mean when you refer to "capsules" as it comes in capsules.  I think I will double up on that - AM and PM - he is tolerating the one capsule very well.  I gave him pumpkin early on and he threw up - pumpkin and food, and he rarely vomits food.  Very rarely.  So I am not eager to try that again.

Because Obi has that sensitive gut - IBD almost for certain if not something worse - I am reluctant to add too much at one time, and then I will not know what works.  Since he is tolerating the EYL, it seems to make sense to increase that first.  I can always try a lubricant -althoug  those have also yielded poor results.  I know some people use fish oil, olive oil or butter - I have tried fish oil but he would not eat his food.  Butter seems like a good choice. 

I have used the Swanson's EYL before, so yes, that's what I am referring to when I say "capsules".  Wow, Obi really does have a sensitive stomach if he vomits Vet's Best AND pumpkin . 

My kits refuse their food with fish oil on it too .  Who'd think?

Well, maybe pepcid (although frankly I don't see how that would help with hairballs since it's for over acidity), or the increased EYL will help.

Yes, I know what you mean about the pepcid; I think my vet is fishing in the dark until Obi sees her on Tues.  But then, he did not throw up this morning.  His pattern is to toss a hairball after he defecates.  I increased his EYL last night too.He is getting a casule twice daily now.

myrnafaye said:

 
  His pattern is to toss a hairball after he defecates.

Click to expand...

Hmmm.  That's interesting.  My old girl with kidney disease usually throws up after  defecating too, or sometimes she actually does it half way thru the act .   I attribute this to the fact that she's constipated (an issue with kidney cats), so has to push so hard that it causes her to upchuck.  She doesn't throw up hairballs, however, usually it's just that frothy stuff that is also common to kidney cats.  I'm trying to alleviate this issue with Miralax and additional water in her canned food, but am still working on the correct amount. 

I ran that issue past my vet a while ago; she said that sometimes if they are straining to defecate, that causes the vomiting refllex.  I give Obi metameucil - and when I see the vet on Tuesday, I will ask her about adding in some miralax depending on the CBC and chem panel results.  In the meantime, I just had to get some Cerenia because he vomited - and not a hairball.  However he is not missing a beat and still wants his mid day meal.  Go figure.

I would be most unhappy with this vet if I was concerned enough about my cat to reach out for advice or help and she didn't bother returning an email or a phone call. It's really the least she can do, if you are like me you have spent big bucks in pet care over the years at that clinic. To not take a few minutes out of their day, or after their day, to respond to a simple question is NOT okay. My vet ALWAYS responds to emails or phone calls and if I am really worried about one of my cats she will find time to see him/her even without an appointment. I would be upset with anything less. In my line of work, not returning emails and phone calls is grounds for disciplinary action, it should be in the veterinary world too. I hope everything goes okay until Tuesday, and then I would really have a conversation with this person about her lack of effort to make time for your concerns. As many folks say here, this is a good place to learn from others' experiences that are similar to your own, but it is not a substitute for the advice of the trained professional to whom you pay the $$$!

Hi, Cat Pal: 

I hear you.  And the beat goes on, I stopped at the vet clinic this afternoon to pick up some Cerenia, and asked the vet who was there (not my regular vet) to give me a call, and she didnt.  

What is different here than what i am used to is this is a clinic and veterinarians who do surgery.  Vets with surgical practices seem to be much busier, and with critical care.  So, I am trying to be understanding.  I like her and Obi likes her, so maybe I do need to have a conversation with her about phone calls and emails, and what is reasonable of me to expect from her, and vice versa.  I think if it was urgent and I expressed that, I would get a response.  I am basing this on previous experience.

Also, this clinic is 1. close to my home, about a 5 minute car ride, which as we know is HUGE if we have a sick kitty 2.  they have hours on weekends and evenings.  This in of itself saves me money, because I dont have to take off work; and as we know, all emergencies happen on weekends or evenings, don't they? so I save on expensive emergency clinic visits.

My vet also does surguries - at least the more straight forward ones - she removed my cat Vivian's thyroid tumor and diseased lobe in September. She provides hospitalization and care to critically ill animals - my cat Nina was there for two days before her death from kidney failure in May. She runs a regular veterinary practice with check-ups and vaccines. And she still makes time to answer a question about diet or medication or "what next" decision-making. Since May I have spent - I don't even know - probably  $3000 or more on helping one cat leave this world and trying to keep two others - with ongoing unresolved intestinal/sinus problems - in it. Every procedure, trial, test or appointment that doesn't provide the desired outcome results in the recommendation for an additional procedure, trial, test, etc. Does Vivian have IBD or cancer? How long should I stick with the diet change and Metronidazole before taking the next step? Should I put her through ultrasound and biopsy or go straight to the meds? Is Willis' continued congestion after many antibiotic trials due infection, allergy, cancer? Should I try more meds for a longer period? Should I have his xrays sent to a pathologist for further analysis? Should I have the tissue slides from his nasal flush sent to a pathologist for further analysis? Many of these are quite expensive steps which may or may not result in definitive answer and resolution of the problems. The vet understands this and also understands her obligation to guide me through these decisions to be best of her ability. I don't email or call her often, but when I do she responds - certainly not before she attends to her surgeries and care of critically ill animals - in a timely manner.  I have had to email her after hours about cats getting sick with diarrhea or vomiting because of medications or illness and she has always gotten back to me, suggesting a reduction or even stopping meds, and even offered to meet me at night at the clinic with an injectable anti-nausea med. My sister's vet actually calls her at least twice a week to check in on her 18+ year old cat who has been sick. One way to open this subject tactfully would be to say, "I tried to contact you to ask, but when I didn't  hear from you and my cat was vomiting I made the decision to..." I am just saying that an empathetic vet understands the anxiety people feel when their pets are ill and at least acknowledges that, without delay.

.  

Hi, Cat Pal:

Update:  the OTHER veterinarian, the one who was on yesterday, called me last night at 7:30.  She was very kind; I know her from way back.  So one option might be to switch - however, unlike you, I probably call more often.  I have learned that there is probably no "perfect" vet and that there are tradeoffs; I might find a vet that is m ore reponsive to my calls, but he or she might require a long drive, or what I consider a long drive.  I am understanding of their time, their lives.  The veterinarian profession has a very high rate of suicide - a very well known veterinarian with a national reputation killed herself last year, it made the news big time.  As a mental healh professional myself, I try to be understanding.  It is a balancing act.  I do appreciate your thoughts and comments, and it has nudged me to have that conversation with her about what is realisitic for me to expect from her when I call with questions or concerns.