Bile coming up after ~5 or 6 hours after eating

jessv

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Hi all,

Why would a cat vomit bile (yellow and foamy and now, ground bones from Primal rabbit) after only a few hours (usually after 5 but sometimes 4) after a meal? I have fed him 5 times a day to reduce the effect but it still happens now that he's been on a much healthier food. We started with Tiki Cat chicken late January, then Ziwipeak venison because the vet thought the vomiting could come from the chicken but since he had bad stools on Ziwipeak, he is now on Primal rabbit.

He started to vomit bile late 2012, after I put him on some diet, the Chilean vet told me to feed him before going to bed. He still had kibbles at the time so I fed him a small portion overnight. It helped a lot but late 2014, when he was on Science Diet Hairball Control, he started to vomit bile and hairball a lot. After some research, I thought it was the high carb diet and it would get better on high quality, low to no carb food.

His last blood test (+ GI panel + T4) came back normal in May, he is active, has appetite, he's 6ish. I'm scratching my head over this... Could it be that I need to feed him more daily ? Or more at once ?
 

denice

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It sounds like excess stomach acid though it is unusual only 4 or 5 hours after eating.  It sounds like your vet had the same idea which is why he recommended food at night.  I would ask your vet about using Pepcid regular strength.  Usually feeding smaller more frequent meals is recommended.
 
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jessv

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Hi Denice,

Thanks for your answer. I already feed him 5 times a day. I can do 6 but it's a bit more complicated. I bought him the Feed&Go though to help through the day, and I'd put frozen cubes in it but it's plastic, which I'm not fond of.

Would Slippery Elm Bark have the same effect as Pepcid? I think I read that somewhere.
 
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jessv

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I read that a cat's stomach should be empty 6 to 8 hours after after a meal. He vomits bile only (along with ground bones now that he's on Primal Rabbit), no food, after 5 hours, sometimes 4, as you said, it's unusual. I'm trying to help the stomach acid with SEB. But could it also be that he's not fed enough on a daily basis ? I have to say that I have followed the feeding guidelines (so for Primal, 5 nuggets a day), especially because he's an indoor cat, but he always asks for more. 
 

momto3cats

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It could be that he isn't getting enough to eat, that can cause excess stomach acid. Or rather, the normal amount of stomach acid simply doesn't have enough food to work with.
 

mrsgreenjeens

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If he's truly vomiting BILE, then that's probably not excess stomach acid.  There's a difference if I'm not mistaken.  Bile is not clear though.  So is what he's throwing up a clearish yellow froth, or more like a yellowish thicker substance. 

If truly more a clear froth, then it definitely sounds like stomach acid, and perhaps those 5 Primal nuggets per day aren't enough.  I used to feed Primal, and found that when I weighed them, each nugget did NOT weigh 1 oz.  they weighed approx .7 of an oz at that time.  I wouldn't think he should need any more meals...honestly I would think 3 or 4 would be enough...just more at each meal. 

Also, since there are bones in the vomit, it's possible he's having difficulty digesting bones.  Does he have an issue with IBD?  I know from your other thread (in Raw) that you're concerned about changing food too fast and wondered about it because of previous issues with sensitive stomach.  IF he has IBD, he may have difffculty digesting bones, and if that's the case, Radcat, which I know you have tried, may be the best for him, since they use eggshell powder vs bones.  Either that or make your own.  I'm going to refer you to this thread:

http://www.thecatsite.com/t/260871/...d-bit-of-bone-in-stomach-upon-x-ray-a-problem

BTW, the SEB SHOULD help with an over acidic stomach, I would think, but don't give it at the same time as any other medications
 
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jessv

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I didn't know there was a difference. Most of the time, it's yellowish clear froth. He has vomited quite often for the past week, each time, it was like that, with some fur (but he passes a lot of it in his stool) and some pieces of bones (no pieces in his stools which are partly chalky white so I assume, they're digested - referring to the link you posted on X-rays, bones were also found in the feces). Interestingly, the bones have showed up since I switched to Primal rabbit nuggets, there were none when he was on the Pronto. I should add that besides the vomiting, he acts fine, has a lot of energy (when I'm asleep, of course :) ), has great fur and regained some weight lost on the Ziwipeak.

I really do not understand... He is supposed to eat about 194 calories a day if I refer to the 20 calories per day per pound, which means 5 nuggets (I weigh them, it seems they fixed the problem, they weigh 1oz - 1.05oz). If a cat's stomach empties after 6 to 8 hours, that leaves me with 4 meals a day (I don't see him eat every 8 hours for now) so 1.25 oz per meal. I swear he begs for more after 4 hours and after 10 minutes of meowing, ends up vomiting that yellowish froth, and whatever sits in his stomach but no food. I can only assume his stomach is empty. I read a few times that those feeding calculators are guidelines only, it all depends on the cat so I might bump up his daily intake a bit.

We don't know if he has IBD. His main problem is regurgitation/vomiting. Our vet (new since we moved back to the US 4 months ago) was concerned because he had weird soft to bland, stinky feces on Ziwipeak venison twice a day and was losing weight. The husband and I were pretty sure it was the food since I keep a journal and it started exactly when I switched him. Except for some very mild elevated eosinophils (1,290 uL - range 0-1,000), last blood test on 5/20 came back normal, GI panel and T4 were normal as well. I assumed the mild elevated eosinophils might have been from the stool issue on Ziwipeak for the past 6 weeks. Since I switched him to raw, his stool went back to normal directly. 

I want to put him on RadCat, which he absolutely loves, but for some reason, his stool gets darker and somewhat softer than the chalky stool on Primal Rabbit. He's okay with 0.5oz a day, when I increase to 2x 0.5oz a day, it's a bit softer. I don't know if I have to insist and his system will adjust or he has a sensitivity to turkey or egg. Any advice on this? I also wonder if I manage to put him on RadCat what my other choices would be because they only have turkey, chicken and lamb. I hear that lamb is fat and it might be harder to digest. I can only assume that rotating between turkey and chicken is not enough variety allergy-wise. Nature's Variety Rabbit has half the phosphorus content as the Primal's but also half the protein and twice the fat.

Is it safe to feed SEB syrup twice a day for a while? It seems to help but for example, I came back late yesterday so I put his meals in his Feed&Go automatic feeder (frozen portions and ice pack on the top) and I didn't add the SEB on his last meal (11pm), he vomited this morning at 8am, he ate at 4:30 and tricked my husband to give him 0.5 oz at 1am! I read that cats should eat less on raw, because it's so digestible but he didn't get that info!
 

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That 20 cals per pound is ALSO a guideline, depending on how active your cat is.  The range is actually between 20 and 35 calories per day! 

What it sounds like is that your little guy is throwing up excess stomach acid, NOT bile (big difference IMHO), and that is indicative of either not enough food per feeding, or too long between meals.  Since he's getting quite a few meals, then I would think he's not getting enough food.  Also from the sound of how he acts, seems like he needs more.  Have you tried giving him some healthy snacks in between meals to stave off the issue?  Is it mainly in the morning?  I have a kidney cat who doesn't eat enough (even though I feed her 6 meals per day), so I actually keep treats under my pillow to give her during the night. 

When I first get up in the morning, I give all my guys a couple of dehydrated Feline Naturals (raw), which they think are treats, and also gets something on their tummies while I go about my morning business until I can feed them.  This also gives them something to chew, since now they only eat canned food, mainly pate, so don't get much chewing in
.  I like the Feline Naturals better than Stella and Chewy's dehydrated because of both the ingredients AND the size of the things.  They come in little log shapes (about the size of a raw stool
) as opposed to a 1 inch square that S & C comes in,which I'm always afraid will choke them.  And more importantly, THEY like them.  But what I'm getting at is....maybe you could give your little guy a few of these in the middle of the night to tide him over!   Or if not that, something else, like WholeLife or Purebites or something wholesome.  Just a tiny something to put in his tummy. 

As to the softer stool on Radcat...it could just be getting used to it, although I never had that issue with ANY of my cats when they ate Radcat.  Are you giving your guy a probiotic and Digestive Enzyme?  When I started feeding raw, I included a Probiotic and Digestive Enzyme along with the raw, just to help everything along, since it was such a new thing.  No one ever had any issues, other than liking the food or not
.  Well, and occasionally the OPPOSITE issue...perhaps a little straining in the litter box  And when that happened, I would just add a little plain ground turkey to the mix and that would clear it right up.  (and I'm not talking ground turkey from the grocery store here, but from a source for raw feeding
)
 

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My husband and I adopted two siblings last year from the shelter and they both have digestive issues.  One had a biopsy done when she was getting spayed and she has IBD.  We assume the other has it as well.

They were about 12 weeks old when we got them last spring.  They vomited all the time and their litter box was unbearably stinky (regardless of which of the five diff kinds of litter we bought).  I kept a detailed food journal and tried grain-free, raw, limited ingredient, gluten free, pumpkin, canned, wet, human grade ingredients, made-in-USA/Europe/NZ with locally sourced ingredients, probiotics, digestive enzymes, feeding them 5 times a day (or 4, 3, 2, 6, every 30 minutes), non-GMO fair trade sustainably harvested organic free range vegan non-dairy sulfate and paraben-free food mixed with with reverse-osmosis water from a spring fed by a pristine glacier which has been blessed by a religious leader from every denomination,  packaged in recycled glass containers made by monks and shipped using solar and wind energy, etc.  Ok, all but that last one is true but I would have bought that one had it existed.   I went to the library and read all I could find about cats (books by vets, breeders, holistic pet practitioners, mystics).  I spent untold hours on the internet.  I talked to everyone I knew who had ever had a cat.  I talked to every independent pet store owner in the tri-state area.   I had a notebook with list after list of bad ingredients, dodgy reputations, FDA reports, consumer advocacy reports, etc.   I carried a magnifying glass to the pet store so I could read the .5 font sized labels.  A mild case of OCD is helpful in this situation.  But nothing we did helped.   It might get better for 24 hours or so and then revert back.  There were numerous trips to three different vets.  All-in-all, we spent at least $3,000 in just a few months. 

We were completely at wits end.  Everything in the house was covered in blankets to prevent getting ruined.  We put a fan in the window in the rooms with litter boxes and also bought an air purifier. We stopped inviting anyone into our house because of the smell.  We couldn't think about giving them back to rehome because who was going to put up with this (there probably are people who would but surely they aren't in the majority)?  We were afraid of what would happen to them. 

So I started to make their food myself.  All the problems were gone with 72 hours.  They eat chicken, turkey, beef, tuna or salmon.  But mostly chicken. The meat is mixed with a teaspoon of (mostly) cooked squash or sweet potato and a tiny bit of fruit (apple, blueberry, pear) which is fresh, baby food or a combination of both, and water.   I cook a LOT of chicken.  It freezes well.  Probiotics are mixed into one meal per day and they also get some other supplements to ensure they are getting what they need.  It's a giant pain in the butt to do but it works, they are healthy, neither they (nor the house) smells bad and there is no more vomiting.  Hopefully you won't have to take it this far but you might want to give it a shot if all else fails. There is an upside.  We are eating healthier, too (chicken salad anyone?). 

Good luck!
 
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jessv

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Thanks for sharing your experience with me. It's all about patience, isn't it...

Lizzi, I felt so bad reading your story, people like you (along with mrsgreenjeens and many others on this forum) deserve a medal for putting up with so much. Selfishly, part of me felt better: my dude isn't anywhere close to that point. He had a couple loose while eating Science Diet Hairball Control in Chile, he had stinky, mostly formed but soft to liquid inside feces for 6 weeks on Ziwipeak, everything was in the litter, and has now what seems to be the dream stool (knocking wood). I'm left with vomiting. He keeps his food down but he vomits on an empty stomach which seems to empty quite fast. 

I would consider making his diet, I used to make meals for wild animals at a rehab center so why not! but to be frank, firstly, I'm glad the husband agreed with feeding raw in the first place, I'm surprised he's not getting too nervous about the potential bacterias etc. (our home has been meat and fish free for several years) and he is more comfortable with the commercial food being tested before being shipped out; secondly, we would have to invest in a grinder, to quote the said husband: "if you consider getting an expensive grinder, you'll have to make the most of it and make me sausages!". So I'll have to stick with commercial, as long as I can at least but I hear you, your "experiment" is actually quite impressive.

Mrsgreenjeens, I'm sure Ishi would gladly take the 35 calories per pound per day now (cats are supposed to eat less on high quality food, while he was very reasonable on kibbles and SD Hairball Control, he would gobble down a 16 oz Rad Cat container if I let him! Hopefully, it's just a phase...) but he's an indoor cat, and even though I keep him active, he shouldn't need that many calories. Actually, he's been gaining some weight lately, not complaining, he had lost some too fast on Ziwipeak but I don't want him to get fat.

It seems he is adjusting to the RadCat, his feces are partly darker (he still gets more rabbit) but dry. I'll keep increasing slowly and will have to figure out a rotation cycle. I'm not comfortable with feeding him Primal rabbit for too long because of the bones. 

I like your suggestion about treats. I chopped up some Primal freeze dried turkey, it turns into powder, it's way too dry to feed as a treat. I got some PureBites beef liver, those ones are the opposite, big and really dry so I chopped them up. So, I'm trying to feed him 4 times a day, bigger portions, which means ~  217 and 230 calories a day because he seems hungry. Yesterday, 5h30 after his lunch, he started to beg for food, I gave him a couple pieces of PureBites, 15 minutes later, he threw up bile or stomach acid (I'm confused now), the treats, bones and fur. So close to the 6 hour time frame... Unfortunately, treats won't work at night. He used to be fed kibbles for years and when he wakes up (4am in summer... argh) he wants real food. I can't blame him, it's quite normal for a feline and I'm all about Mother Nature. I get back to sleep anyway, so it's not a problem, unless he's been vomiting for a week and I start thinking about what to do during the night... I should check how long it takes to a cube to defrost in his Feed&Go feeder if I place an ice pack on the top, it could be solution too, now that I think of it.

Has anyone heard of Phytomucil ? I just read about it and it seems it could help or is it better to stick to SEB powder.
 
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jessv

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mrsgreenjeens: SEB has helped but I have to increase it: I started with 1/8 tsp of straight powder on midnight meal and lunch; now it's 1/4 tsp of syrup on 3 meals; I will increase to 1/2 tsp of syrup 3-4 times a day until it has reduced at least. Is it better to give less per day but straight powder or more a day in syrup? Is there any reason to get Pepcid if the SEB has the same effect ? Is it more potent? He won't accept pills, that's for sure. I don't have a holistic vet around so I contacted a famous one online but was quite disappointed with the experience, hence I ask here.

Stomach acid came up again this morning (5.5 hours after his breakfast), along with the treats it was chewing on (fed a hour before vomiting). I will go back to 5 meals a day (went to 4 to make the pet sitters' lives easier). mrsgreenjeens, on another thread you said that you feed your cats 6 (or more?) times a day and treats in between, how do you proceed with wet and raw? I portion and freeze, put in the automatic feeder (Feed & Go BTW, great machine!) but I know that the food will be thawed and sit for a few hours between my sitters' visits. I hope it won't be a big deal. Cans might be better in this case... The husband doesn't quite understand why I don't put high quality kibbles for these moments.

Unlike everything I find online, he's got a great appetite, too much to my taste (aren't cats on high quality food supposed to eat less?), he has gained some weight since I've fed him more as we were wondering if it was the cause but he still has issues.
 

mrsgreenjeens

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I think I would go with more of the syrup and NOT powder.  My girl won't touch SEB for some reason.  We have to give her the the Pepcid in the form of injections
, which I hate doing to her, but she is also impossible to pill.  And since she refuses to eat anythingn with SEB in it, even when I just mix it with tuna juice, that leaves us with little options.   So in your case, if the SEB is working, I would definitely use that versus Pepcid...it's more natural, IMHO. 

I only feed ONE cat 6 - 7 times per day (wet food), then feed her treats in the middle of the night that I keep under my pillow.  She is my kidney cat and needs to eat this way because of her health issue.  My other cats get three meals a day.   I am no longer feeding raw here, mainly because 2 of my little ones gave me such fits with it that it just wasn't worth the hassle anymore.  So I feed low carb canned to the healthy ones, and anything she will eat to the kidney cat
.   AND we have resolved that we simply will NOT go on vacation until our kidney cat is no longer with us, because we can't ask a pet sitter to get no sleep, which is basically what I get
.  (We're no longer working, BTW, otherwise this would never work)

What you could do,though,is use dehydrated raw in the middle of the night for those hours to put something in his tummy,using the same Feed and Go.  A little dehyrated food won't hurt, as long as the majority is wet, and as long as you have water available.  I use Feline Naturals as treats, but there are others out there as well.  Primal even has them...you may just have to break them up.

Cats on RAW usually eat less number of ounces compared to canned,, but otherwise it's really calorie driiven as to how much they should be eating.
 
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jessv

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Thanks mrsgreenjeens, your thorough answer is much appreciated.

I will increase the SEB syrup to 1/4 tsp and will go back 5 meals a day, at least for now. Not really a big deal when I'm here, the mid day meal would go frozen in the feeder, it's more of a problem when I'm out of town because food will thaw and stay still a few hours between visits. I completely understand your feeling about making a sitter's life difficult and it's true that if you have to feed your kidney kitty overnight, that's a problem. I'm glad I'm not there (yet), the hubby would get a divorce if we couldn't go out of town. Don't get me wrong, he really loves his cat but traveling has always been our thing, especially because he has to travel for his job and he doesn't understand why we wouldn't go back to mainly grain free kibbles/wet for dinner since he had no issues on that diet. Hard to argue with that since it's true.

Funny, yesterday, I saw the Primal munchies you are talking about! They're less expensive than the Purebites. I really think my cat didn't get the memo that cats are supposed to eat less, even when counting calories. I fed him more, he was still begging! He's back to his initial weight so I have to reduce the amount of food or he will get fat. At this point, I don't know if he's really hungry (he's complaining right now and he ate 2 hours ago) or if he misses the times when he was grazing on his kibbles all day long, which he did for 5 years but we started to feed mainly wet in 2014 so it's not completely new to him but he keeps complaining. I was strict with kibbles and the quantity per day but he was eating little at a time, all day long (I read that wild cats eat 8-12 times a day so his pattern makes some sense). Now if he wants to eat, he will beg for what seems a long long time, then sit and eventually sleep by his mat. Seriously! Obviously, now, something is up with the stomach acid.

Speaking of which, I wonder if the high protein diet or raw diet is right for him. I tried to do some research but couldn't find any information on which cats shouldn't eat raw. I thought of feeding part raw, part wet but I read that because the stomach acid level varies from one type of food to the other, it's not a good thing to do. One of the employees at my local pet stores does that but his cat might not have GI sensitivities. In case I have to go back to cans, may I ask you what brands/proteins of cans you feed your cats? You might have mentioned it in other threads, I could do my research when I get home. 

Thanks again for your inputs!
 

mrsgreenjeens

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I feed mainly Nutro Natural Balance Chunky Loafs, but sometimes even feed Fancy Feast CLASSICS (only) or Pinnacle, or whatever I happen upon that is low carb.  I use this list and just look at the carbs and make sure they are under 1%:  http://www.felinecrf.org/canned_food_usa.htm#canned_usa

In your case, Weruva might be a good food, because it's very low in calories and carbs, but high in protein, so your little one can eat more but not put on weight .  I purposely DON'T feed it because my kidney cat happens to like it, but she has a problem keeping the weight on, and will fill up on it and lose weight


I actually think there are quite a few people who feed raw who have canned food as back-up.  They don't feed it during the same meal, but may do raw for breakfast and dinner, and canned for lunch.  Or canned when they are on away and don't want to subject their petsitters to the rigors of raw.  I really don't think it's that much of an issue.  And, yes, there are some cats that cannot tolerate some raw foods.  Mostly, though, it's certain proteins, not ALL.  Or they cannot tolerate bone, so a substitute is used. 
 
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