10 year old cat vomiting bile

Hi all. My older cat has somewhat recently started vomiting bile quite regularly. She has always had the occasional tummy trouble as kitties do, but overall has been an exceedingly healthy cat, though she is overweight.

Usually the vomiting comes late at night (1-4 AM), which I know because she spends the evening on my bed and I get to hear the commotion...lucky me! She usually vomits up something yellow and/or clear, with just a bit of hair that isn't formed into a hairball. Afterward, she seems totally fine. It's possible this has been more common than I realize over time, since she could vomit in areas of the house like the basement where I wouldn't notice as often, but since I'm noticing it occur more regularly it seems like there's a definite uptick.

We went to the vet a week and a half ago and all of her blood levels were great, temp was fine, and the vet gave her a clean bill of health, though she was a little shocked she didn't have diabetes. I brought up the bile with the vet tech but our actual doctor didn't seem concerned enough to address it. I was anxious about other things and forgot to bring it up again.

This past summer we recently switched her from a free-feeding kibble diet to a wet food diet fed around 7 AM and 5 PM, in an effort to monitor calories and bring her tubby levels down a bit. She has lost three pounds over the past four months (pushing 19 lb, now just shy of 16 lb) and is on a steady track to lose more. I'm wondering if it's just the separate feedings and the early morning empty tummy catching up to her? Or should I be worried about something else and call the vet? I recently lost a cat in a separate home to FIP, so I'm extremely on edge, worried I brought corona virus and/or FIP to my kitties at home on a duffle bag/my shoes/clothes/etc., so maybe I'm just looking for a bit of reassurance.

Thanks for your help!

Honestly, I've never had my mind immediately go to FIP with my cats. Of course I'm lucky in the sense I never heard of it before coming to this site, unlike so many others.

Do you happen to know the blood work they did on her, or did you get a copy of it by chance? Was it just the senior panel or the full shebang (with CBC and T4 included). And is she still throwing up every night? Did your doctor ever suggest anything to help with the vomiting? It is not normal for a cat to be throwing up every night so even if things are normal on the blood work, they should still be addressing it.

I'm not sure about with bile, but I know with hyper-acidity (which I always thought was caused by bile) we've had to treat it with Pepcid at night. Sara also has early CKD though, but that took several sets of blood work to determine.

I would've never been worried about FIP before we lost our dude to it, either. I have anxiety that flares up with stress, so of course I'm probably being unreasonably paranoid since it's a place to put my energy. =) I've also just latched onto specific symptoms, e.g I've been watching her eyes...but it turns out she has a lot more colors in there than I ever noticed before!

I didn't get a copy of the panel, though I likely could. I believe it was just a chemistry panel, looking at proteins, enzymes, liver, kidneys, etc. I con't recall CBC or T4 being on the test. All of the levels they did test for were within the normal range.

She threw up last night, though the last time she did so in my room/to my knowledge was a week or two ago. Again, she could be doing it in her secret kitty places, but there did seem to be a bit of a lull. Before that, it seemed to be happening every few days.

One of our cats vomits bile if she goes too long between meals so I'm inclined agree with your empty stomach theory. We feed our cats four or five times a day, which keeps the vomiting to a minimum. (Most problems now are due to human errors!) Might it be possible to feed your cat three small meals a day, adding one at bedtime? Feeding a caloric meal at bedtime seems to be the most helpful thing for our Edwina. Most of her vomiting had also been in the early morning.

It's great to hear that your cat has lost so much weight on her wet-only diet!

Perididdle said:

 
I would've never been worried about FIP before we lost our dude to it, either. I have anxiety that flares up with stress, so of course I'm probably being unreasonably paranoid since it's a place to put my energy. =) I've also just latched onto specific symptoms, e.g I've been watching her eyes...but it turns out she has a lot more colors in there than I ever noticed before!

I didn't get a copy of the panel, though I likely could. I believe it was just a chemistry panel, looking at proteins, enzymes, liver, kidneys, etc. I con't recall CBC or T4 being on the test. All of the levels they did test for were within the normal range.

She threw up last night, though the last time she did so in my room/to my knowledge was a week or two ago. Again, she could be doing it in her secret kitty places, but there did seem to be a bit of a lull. Before that, it seemed to be happening every few days.

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Despite your sad history with FIP, this is the last thing I would be worrying about but I'll tell you what i see from here.

When cat's get hungry, a meal usually follows because they and their stomachs are trained on a schedule.  When their brain tells them its meal time, they start secreting stomach acids in anticipation of the meal they think is coming.  And then for some reason (like the humane is late, or changed the schedule with sending an email to the cat's brain) and all that stomach acid with no food to digest upsets their tummys and they throw up - bile.  So YES, the empty stomach theory!

Your cat has a weight problem, so you quite rightly went from free feeding to two meals a day, the last meal being at 5pm.  The next meal is 14 hours later  and your cat is hungry, really hungry, and gets upset tummy and barfs, late at night when she's hungry!

Weight loss is important, but loosing too quickly can be dangerous.  And because your cat is at risk of diabetes i would discuss my suggestion with your vet, but i have seen this solution work over and over again.  Your cat could use a late night 3d meal.  It could be a wet meal, or a measured amount of dry, but it is that late night meal that can get her through until 7am

Thank you for sharing your experiences/advice, @LisaHE  and @StephenQ! The empty stomach theory seemed about a thousand times more likely than FIP, so just hearing that echoed back helps the silly paranoia.

Lisa, I was surprised at how "easy" it was to help her lose weight just switching to wet food. It seemed that no amount of measuring or restriction on dry food, of any type, would help. But switching to wet helped us monitor calories a lot more effectively and seemed to suit her system. And her taste buds! We also eliminated a lot of grains and carbs along the way, just because of the nature of the switch, which may or may not have anything to do with it.

Stephen, thank you for the extensive explanation. I've kept a sharp eye on the amount of weight she is losing and making sure it's not too much, too quickly based on my research and the vet's advice. I will try splitting up the food a little differently and adding a meal right before bedtime. We usually turn in around 10 or 11 PM. Hopefully this will be the easy solution!

Perididdle said:

 
Thank you for sharing your experiences/advice, @LisaHE  and @StephenQ! The empty stomach theory seemed about a thousand times more likely than FIP, so just hearing that echoed back helps the silly paranoia.

Lisa, I was surprised at how "easy" it was to help her lose weight just switching to wet food. It seemed that no amount of measuring or restriction on dry food, of any type, would help. But switching to wet helped us monitor calories a lot more effectively and seemed to suit her system. And her taste buds! We also eliminated a lot of grains and carbs along the way, just because of the nature of the switch, which may or may not have anything to do with it.

Stephen, thank you for the extensive explanation. I've kept a sharp eye on the amount of weight she is losing and making sure it's not too much, too quickly based on my research and the vet's advice. I will try splitting up the food a little differently and adding a meal right before bedtime. We usually turn in around 10 or 11 PM. Hopefully this will be the easy solution!

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Please let us know the results!