What medication options do I have for cat who vomits more than occasionally?

My older cat, almost 12, vomits food more than in comfortable with. No food allergies. We've been to the vet at least a dozen times over the past year and a half. The keep calling it IBD, but I honestly think she has stomach problems (sour stomach or maybe reflux, plus the tendency to gorge). I'm very particular and careful about the food I feed her (she's also become picky). She doesn't handle dry food well at all, so I try to leave wet food out for her (have 2 others who get the dry from an auto feeder overnight). I give her little bits at a time so she doesn't gorge. I give her 1/4 a Pepcid twice a week. That helps some, but is difficult to give her. She also takes Metoclonpramide and Lactulose (she's a bobtail and has trouble with constipation due to spinal deformity, according to our vet). I'm not sure the Metoclonpramide does much for her stomach problems. The vet described it saying "it keeps things moving" so it sounded promising.

Do I have any other medication options for her? Is Cerenia an option? I thought Cerenia was an appetite stimulant.

I'm also thinking I should get her a multivitamin to try. I know in humans, medications like Pepcid dull the absorbtion of B vitamins and I worry she may have deficiencies as a result of the meds and vomiting.

Thanks for the help.

You would need an internal medicine vet for help with meds.

Often times they prescribe Prilosec or other antiacid meds-Pepcid is common.

When is the vomiting? only after eating or in the middle of the night?

If after eating-try to raise the dish up or slow down how fast eating.

If the middle of the night-stomach acid-antiacid Pepcid or other prescribed from vets is very helpful. I recommend internal med because they often have experience reading the ultrasounds and have the extra schooling to deal with IBS.

How is the poop? firm or runny?

Canned pumpkin can be added to wet food to stop the wet or constipation- 1tsp a day is typical dose-plain pumpkin no spices.

Cerenia is an anti-nausea shot. 

With your kitty, I'd look at diet.  I had a cat who would throw up every time we fed her a fish flavored wet food.  This was after many trips to the vet. 

What are her kidney values like?  Has she had bloodwork done recently to check her BUN and Creatinine?

Blood work is great. It's not a reaction that happens every time with a certain food. We try to do pumpkin as often as possible (usually every morning blended up in wet food, but she doesn't always eat much of that wet food).
Vomitting more frequent at night, so I dose her meds in the evening. Poop is harder. She's never had runny poop. She has had an endoscopy with a vet other than her normal vet, who also does surgeries, so my impression was that the surgeon is a specialist in that area.

onebratt08 said:

Blood work is great. It's not a reaction that happens every time with a certain food. We try to do pumpkin as often as possible (usually every morning blended up in wet food, but she doesn't always eat much of that wet food).
Vomitting more frequent at night, so I dose her meds in the evening. Poop is harder. She's never had runny poop. She has had an endoscopy with a vet other than her normal vet, who also does surgeries, so my impression was that the surgeon is a specialist in that area.

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What were the results of the Endoscopy?

stephanietx said:

 
Cerenia is an anti-nausea shot. 

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They can also give it in pill form, but the pills are pretty big. I don't think it's meant for long-term use either.

Pepcid doesn't seem to stay in a cat's system for long, I have to dose Smoochie every night. It was hard to pill her, so the vet ordered it as a liquid for me. Much easier and chicken flavored! 

I looked for the test results and couldn't find them, although I know I have them in our fire safe (which is very disorganized right now). They ruled it IBD, but I think that was by exclusion. They were looking for lymphoma. She's only had vomiting and constipation and I questioned the vet about IBD because of no diarrhea, but they insist on calling it IBD. seems to me like she has acid reflux and perhaps IBS. She manages fine if she eat small amounts often and avoids dry food (which is hard to keep her away from at night - the other cats get a small amount of dry from an auto feeder. I bought an auto feeder to give her wet food at the same time, but she still will eat dry food sometimes).

one of mine is greedy - ie will eat & eat - even prior to the overactive thyroid diagnosis (& meds started).  woudn't it be easier to ENSURE she doesn't get dried in her tummy by stopping feeding it to any of your cats?  More meds can't be good for the cat is my feeling

My cat was doing all that and was just diagnosed with megaesophogus

Not sure Pepcid just twice a week will help much. Have you noticed any pattern between the vomiting and giving the Pepcid? Does he vomit on the nights you don't give Pepcid or does he also on the nights you do give it?

onebratt08 said:

I looked for the test results and couldn't find them, although I know I have them in our fire safe (which is very disorganized right now). They ruled it IBD, but I think that was by exclusion. They were looking for lymphoma. She's only had vomiting and constipation and I questioned the vet about IBD because of no diarrhea, but they insist on calling it IBD. seems to me like she has acid reflux and perhaps IBS. She manages fine if she eat small amounts often and avoids dry food (which is hard to keep her away from at night - the other cats get a small amount of dry from an auto feeder. I bought an auto feeder to give her wet food at the same time, but she still will eat dry food sometimes).

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An endoscopic biopsy could give you a fairly definitive of IBD. Cats don't have to have diarrhea to have IBD. Lower GI inflammation leads to diarrhea and upper GI leads to vomiting.

Knowing the results of the endoscopy is critical before proceeding but if the vet says it showed IBD then it would seem a good bet that they are correct, however vets make mistakes and there can be gradations of interpretation so now would be the perfect time to get a second opinion.

Pepcid twice a week seems to be the minimum effective dose that works. I don't want to give her any more meds than necessary, but she for sure needs the lactulose or something to help prevent constipation. I'm not sure if I feel Metaclonpramide is doing much, although I did notice it's effect early on - I am concerned about side effects with that one because in humans, it can have some pretty bad side effects.

I would like to remove dry food totally, but I have one who is extremely picky about food and won't eat much wet food. They get a very small amount of dry food daily to eat and he eats most of it. I recently bought an auto feeder to give her wet food in the middle of the night, which I hope will work to keep her away from any dry food and from getting too hungry (I guess perhaps part of her issue is that she can't go for long without food - if she does, there's a greater likelihood that she will vomit after eating, even if not over-eating in one sitting). 

I have thought about second opinion - my concern is that without another endoscopy, I'm not sure that the conclusion would be any different. Unfortunately, her endoscopy was performed immediately following a pretty bad episode of constipation and gastritis, so this is why I'm doubting the result. 

Did you can have an ultrasound? Sometimes, I mean sometimes, they can see some thickened bowel. In that case the thought of IBD or lymphoma can be discussed. You really do need to find the gastroscopy report. Your Vet should have a copy of it.

If it is IBD, I agree with all the above posters, that he should definitely be seen and followed by an Internal Medicine Vet. At least to get you on a routine with meds and/or food.

Have you noticed the vomiting is related to a certain food? Like chicken or such...I was able to correlate my guy's vomiting with chicken. Each time he had chicken, he would come out of the kitchen and vomit. My guy has had a biopsy and he does have IBD.  He has constipation rather than diarrhea. He takes Pepcid, 1/2 tablet daily, a steroid, a medicine to help his poop move along and miralax with his food. He is also on a novel protein diet. He is eating rabbit which is mixed with pork.

I would also think about using a different brand of food. Try one which has a single protein and not all the additives. I have found that Natures Variety is very good. It is pricey, but well worth it. Sometimes the additives can irritate the system--like an allergic response. 

Sometimes kitties can vomit because they are constipated also.. I give my guy 1/4 tsp miralax, mixed with some water twice a day.

You could try 1/8 tsp once a day to see if that may help his poops....

My guy is a grazer also.. I leave food out for him all day and night--a little at a time, sometimes I give him dry food alongside the wet. I do that when I know I will be away from the house all day. 

good luck....