Cat vomiting, vet not sure

Hello. My lovely cat, Dusty, has been vomiting recently. She's about 10 years old and has been taking fluconazole for about 8 months for valley fever. She's been vomiting somewhat regularly (maybe three times a week? but sometimes a couple days in a row and then nothing for a while...) for about two months now. The vomit sometimes looks like a hairball and sometimes looks like digested food. It's never with partially digested food. Sometimes there will be grass mixed in, if she's gone outside and chewed on some grass recently. She will always vomit twice in a row - first with some clear liquid and then with the actual substance. She's been eating and drinking normally and has been having normal BMs. Her activity level is normal (if not maybe more active recently than in the past), her coat is nice and shiny, her eyes are clear. She looks perfectly healthy.

She's dropped from 14.5 lbs to 12 pounds since February. This could be because she has moved to a completely dry food diet. (She had a mixed wet/dry diet (with IAMS wet and IAMS multicat) then to just IAMS multicat, after the vet recommended stopping the wet food.) It's also not a bad thing (at least in theory) because she was a tad overweight at 14.5 and is close to her ideal weight at 12 pounds.

She went to the vet a week ago (for a titer test to check on the valley fever) and I talked to the vet about the vomiting. The vet ran a preanesthetic test which tests for the health of various organs and vet said that the tests came back normal to good. She also did a physical exam and said that her organs (liver, especially?) felt normal.

Anyways. The vet said to keep an eye on Dusty and the vomiting. She has continued to vomit. She just vomited an hour ago, in fact. But, as I said, she doesn't seem any different other than the vomiting. It could be because of the fluconazole that she's on, but I can't stop giving her that (and the alternative to fluconazole are far less effective and far worse for kitties). Could she be vomiting because of the food (even though the change happened in February)? Also, when would you call the vet again? Just if the vomiting continues, or perhaps if the frequency increases? Of course, I'll definitely call if she stops eating or drinking or other things go wrong, and she'll have another appointment in three months (for another titer test), so it won't be <i>ages</i> until the vet sees her again.

I'm just not sure what to do. I don't want to 'cry wolf' and bring her in for the vet to say, again, that she can't see what's wrong, nor do I have a lot of money to run a lot of extra tests and surgeries, especially as her other behavior seems normal. On the other hand, vomiting is a bad thing and I do worry about her. So, any thoughts?

Thanks so much for any advice you have to give!

Since sometimes it may be due to hairballs, you may want to try a hairball gel like Petromalt or Laxatone. It doesn't sound like she's eating too fast, since the food is digested. You can ask your vet about giving a small amount of Pepcid to settle her stomach (your vet should know the proper dosage).

Since you mentioned that her activity has increase and her weight has decreased, it would be worth doing a thyroid screen on her, including a Free T4 test. If you haven't already, ask your vet for a copy of her blood test results. He may have already run a T4 test on her. If so, if it's on the higher end of normal I would definitely recommend a Free T4 test.

Thanks for the advice, cloud_shade. I actually have some hairball medication already (Dusty had a bit of constipation earlier in the year and the vet gave it to me to help. And it certainly did!) so I'll start giving it to her as recommended on the box and see if it helps.

I believe that her thyroids were tested in the pre-ansethetic test, although I'll call again to make sure. I certainly don't want to make it sound like she's running all over the place all the time. In fact, right now she's sprawled out snoozing on the floor - her favorite pasttime! In previous months, though, she had been quite lethargic (likely because of the Valley Fever) and so I'm thinking that her increased activity level may be because the meds are finally starting to work for that and she's (slowly!) getting back to her normal self. I plan to call the vet tomorrow, though, just to check about the T4 test.

Thanks again for your help!