14-year-old cat throwing up every night after dinner, BUT bloodwork, urinalysis, and X-rays all came back 100% normal

[dulcemir]

My beloved 14-year-old male cat (see photo of my handsome boy) is not doing too well these days. He's been throwing up daily after dinner for more than two months. Breakfast is a bit better for him, but he doesn't eat the entire 3 oz can of I and Love You turkey food.

He only eats wet food (3 oz can for breakfast and another for dinner). I and Love You is the only brand he'll eat these days. I spend $3 a day on food for him.

Took him to the vet, and they ran bloodwork, urinalysis, and X-rays. $1,100 later, they determined that nothing was amiss. No masses, no increase in WBC, nothing. Urine was normal too. He was very dehydrated because of all the puking, so they gave him IV fluids. They sent him home with some Hill's digestive care food and a prescription for fatomidine.

Vet told me to call back to see how he's doing two weeks after he started the prescription. I'm about 5 days shy of two weeks, but I'm super worried. He's still puking after dinner and not finishing his breakfast these days, eating only half of a can.

He was about 10 lbs last year. He's 9 lbs today.

I'm terribly worried about him. I know his days are numbered, but I don't get why he's still puking despite the diagnostics telling me that there's nothing fundamentally wrong with him.

Have any of you guys experienced this with your senior cats? I was so upset I cried into his stomach tonight.

 

[dulcemir]

Correction: 14.5 years.

 

[denice]

There are digestive issues that won't show up in lab tests. I would ask your vet about an ultrasound. Someone who is experienced with reading those can see issues such as thickening and inflammation of the intestines that aren't found through lab tests.

 

[BlackCatOp]

Took him to the vet, and they ran bloodwork, urinalysis, and X-rays. $1,100 later, they determined that nothing was amiss. No masses, no increase in WBC, nothing. Urine was normal too.

I know it can be frustrating to feel like you don’t have any answers after having all of the diagnostics performed but just wanted to help you look on the positive side - it’s really great that urine/kidney function came back normal in a 14 year old kitty, and while a foreign body on x-ray would have provided answers, surgical recovery on her would have be rough given her age (let alone not cheap.) My own kitty had a overtly high WBC out of nowhere an ended up spending 3 nights in the ICU. I had answers (somewhat) regarding his vomiting and lethargy but it also cost over 3k.

I guess my point is while you may not feel any closer to a diagnosis for you kitty - the diagnostics you had performed allowed for a lot of rule outs that didn’t have great out comes anyways. Plus knowing that her kidneys are functioning well is a good thing to know in a senior kitty


I agree that an ultrasound sounds like a next logical step and also repeating bloodwork depending on when it was done as a lot can change in 48 hours. What has your veterinarian recommended as next steps? Is she on any anti-nausea meds?

EDIT:
Sorry see that kitty is a male....

 

[FeebysOwner]

Hi. How/when are you administering the fatomidine? It should be given without food in order for it to be most effective. And, because you seem to be fighting an over production of acids, feeding your guy multiple times a day would help to reduce the acid production and also aide in absorbing the acid that is being produced. The other possibility is that fatomidine doesn't agree with him, and in that case could actually cause nausea and vomiting. Since he is still vomiting after nearly two weeks, he might be getting dehydrated again.

I would call your vet before any more time passes and give them an update on what is going on at this point.

His days are only numbered as all of ours are! Feeby is going on 16+ and I won't even dare (yet) to make such a statement about her - even it is a valid about her as it is all of us! He is a very good looking cat, and looks very happy and healthy! Is his name Dulcemir?

 

[dulcemir]

There are digestive issues that won't show up in lab tests. I would ask your vet about an ultrasound. Someone who is experienced with reading those can see issues such as thickening and inflammation of the intestines that aren't found through lab tests.

Call the vet and he suggested an ultrasound, like you all discussed. What would it show, though? More detail in the intestinal lining? Possible cancer? Just want to know in advance so I can prepare my heart.

 

[dulcemir]

I know it can be frustrating to feel like you don’t have any answers after having all of the diagnostics performed but just wanted to help you look on the positive side - it’s really great that urine/kidney function came back normal in a 14 year old kitty, and while a foreign body on x-ray would have provided answers, surgical recovery on her would have be rough given her age (let alone not cheap.) My own kitty had a overtly high WBC out of nowhere an ended up spending 3 nights in the ICU. I had answers (somewhat) regarding his vomiting and lethargy but it also cost over 3k.

I guess my point is while you may not feel any closer to a diagnosis for you kitty - the diagnostics you had performed allowed for a lot of rule outs that didn’t have great out comes anyways. Plus knowing that her kidneys are functioning well is a good thing to know in a senior kitty


I agree that an ultrasound sounds like a next logical step and also repeating bloodwork depending on when it was done as a lot can change in 48 hours. What has your veterinarian recommended as next steps? Is she on any anti-nausea meds?

EDIT:
Sorry see that kitty is a male....

No anti-nausea meds. He didn't eat and puked a lot this time last year, and the vet prescribed anti-nausea meds, which worked wonders. He got his appetite back quickly. This time, even with the famotidine, he's not responding much.

 

[dulcemir]

Hi. How/when are you administering the fatomidine? It should be given without food in order for it to be most effective. And, because you seem to be fighting an over production of acids, feeding your guy multiple times a day would help to reduce the acid production and also aide in absorbing the acid that is being produced. The other possibility is that fatomidine doesn't agree with him, and in that case could actually cause nausea and vomiting. Since he is still vomiting after nearly two weeks, he might be getting dehydrated again.

I would call your vet before any more time passes and give them an update on what is going on at this point.

His days are only numbered as all of ours are! Feeby is going on 16+ and I won't even dare (yet) to make such a statement about her - even it is a valid about her as it is all of us! He is a very good looking cat, and looks very happy and healthy! Is his name Dulcemir?

Actually, I was mixing it with food, but I reread the bottle and started administering it directly into his mouth. He HATES it, but I chase it with breakfast.
He had a really violent episode of vomiting last night. He projectile vomited, then got really anxious and ran while throwing up. I felt so bad and starting bawling for him.
The vet recommended getting an ultrasound as the next step. I'll call tomorrow to schedule.
I am really heartened to hear that Feeby is going on strong! I'm hoping for 25 years for all our kitty kritters!
His name is Dulce! We adopted him from someone who gave him up (HOW?!) when he was 3. He's been with us for 11 years now and is just a wonderful boy in every way. Our very first cat.

 

[FeebysOwner]

Thanks for telling us his name - Dulce - love it! The ultrasound would show things like tumors, thickening of the intestinal lining, and similar type abnormalities in the stomach and/or bowels. It could be some sort of inflammation that they might be able to treat.

Take some solace in the fact that the projectile vomiting might just be due to him being so upset over all of this. But, be sure to tell the vet about it. They may be able to give him something for it. Also, find out if the famotidine can be given in any other form - I know they can administer all kind of meds via transdermal gels, but I have not heard of one for famotidine.

 

[daftcat75]

Digestive issues don't normally show up in blood work or on X-rays. For that, you need an ultrasound.

A couple of things you can try before an ultrasound if you're concerned about the expense.

1. Smaller meals, more often. Cats normally eat up to 10 times a day in the wild. They really aren't tooled for twice a day. Their digestion is too fast for that. You could be having a stomach acid issue making him wait so long between meals. But rather than reduce the stomach acid he needs for digestion, just add a couple more meals. If you're not home for them, use a timed feeder. I would start with a lunch and a midnight (or whenever you go to sleep.) If you go to sleep early, you may give him an overnight meal instead.

These are my favorite timed feeders. Extremely affordable, not easily defeated by an eager cat, and it won't rotate uneaten food back inside the feeder like those rotating feeders.

Pet Supplies : WOPET Automatic Cat Feeder, Pet Feeder for Dogs and Cats with Ice Pack Included - 2 Meals : Amazon.com

So if he normally eats two 3 oz cans, I'd feed him 2 oz at breakfast and dinner and put the other 1 oz into lunch and overnight feeders. Or you can make each meal 1.5 oz each.

2. If he only barfs at dinner, you can split his dinner into two dinners. One at say 6 pm and the other at 10 pm or whenever you go to sleep.

An ultrasound can't tell the difference between IBD and lymphoma. If he's maintaining his weight, it's probably not lymphoma. But I also believe they both exist on a spectrum with IBD progressing into lymphoma if not sufficiently controlled. So give the two approaches a try. But if the vomiting doesn't resolve, I strongly recommend that ultrasound. It will allow you to try stronger medication like steroids. These are often helpful. But you may also require a food change as IBD is thought to be a learned immune response to food proteins leaked from an inflamed gut.

 

[dulcemir]

Digestive issues don't normally show up in blood work or on X-rays. For that, you need an ultrasound.

A couple of things you can try before an ultrasound if you're concerned about the expense.

1. Smaller meals, more often. Cats normally eat up to 10 times a day in the wild. They really aren't tooled for twice a day. Their digestion is too fast for that. You could be having a stomach acid issue making him wait so long between meals. But rather than reduce the stomach acid he needs for digestion, just add a couple more meals. If you're not home for them, use a timed feeder. I would start with a lunch and a midnight (or whenever you go to sleep.) If you go to sleep early, you may give him an overnight meal instead.

These are my favorite timed feeders. Extremely affordable, not easily defeated by an eager cat, and it won't rotate uneaten food back inside the feeder like those rotating feeders.

Pet Supplies : WOPET Automatic Cat Feeder, Pet Feeder for Dogs and Cats with Ice Pack Included - 2 Meals : Amazon.com

So if he normally eats two 3 oz cans, I'd feed him 2 oz at breakfast and dinner and put the other 1 oz into lunch and overnight feeders. Or you can make each meal 1.5 oz each.

2. If he only barfs at dinner, you can split his dinner into two dinners. One at say 6 pm and the other at 10 pm or whenever you go to sleep.

An ultrasound can't tell the difference between IBD and lymphoma. If he's maintaining his weight, it's probably not lymphoma. But I also believe they both exist on a spectrum with IBD progressing into lymphoma if not sufficiently controlled. So give the two approaches a try. But if the vomiting doesn't resolve, I strongly recommend that ultrasound. It will allow you to try stronger medication like steroids. These are often helpful. But you may also require a food change as IBD is thought to be a learned immune response to food proteins leaked from an inflamed gut.

Wow, thank you for taking the time to share suggestions! I read up on Krista the calico's health issues. It sounds like she's doing better and has a healthy appetite!

I'm going to give your suggestions a shot. I might also try to put him on non-poultry food, maybe rabbit, as I read that senior cats can develop food allergies and/or certain proteins that used to sit well with them no longer do.

He ate last night at around 8:30 p.m., but puked at 4:00 a.m. I don't know why it sits in his belly for so long before he expels it.

 

[dulcemir]

It's about 3 hours since he last ate (a small serving of canned rabbit). I just put my ear lightly against his stomach and heard some pretty consistent gurgling. Given this, I do wonder if it is some GI or IBS-type thing.

I also heard some gurgling last night, about 4-5 hours before he puked.

 

[daftcat75]

Did you switch him to rabbit food in one meal or is that food already in his rotation? Rapidly changing a cat’s diet can cause stomach troubles. You’re supposed to mix the new with the old and transition over a few days. 1/4 new to 3/4 old. Then halfsies. Then 1/4 old to 3/4 new. And finally all new.

Yes. Cats of any age can develop intolerances to foods they routinely eat. That’s why having a few different foods in rotation is recommended.

That said, Krista has so many intolerant proteins that I can only feed her Rawz rabbit pate and Rawz rabbit and pumpkin pate. Because even other brands of rabbit have either additional proteins (you have to watch out for this) or gums that don’t work for her. Carrageenan and agar agar make her tummy rumble and xanthan gum rips right through her. Guar gum is the only one I know she can tolerate.

If you did transition him quickly and he throws up. Don’t give up. Try the slow transition. In fact, when I try new foods with Krista, I only transition one of her meals. That way if it doesn’t work, I only have one meal to transition back. Meanwhile her other meals remain the same. Whatever trouble she might have with the new food isn’t replicated across all her meals.

 

[Jojo&Tutu]

Unique protein like rabbit really helps as does a proper evaluation and medication. Ondansetron 1/2 of a 4 mg pill for anti nausea can be used once or possibly twice a day and Budesonide a steroid that mostly affects the GI and not all the other organs helps with Inflammatory Bowel Disease (IBD). My cat takes .4mg once a day Budesonide for IBD. We started her at higher doses and reduced them until symptoms came back to find the right lowest dose for her. I have it compounded into a tiny capsule. Also I am giving her 1/4 of a 10 mg Pepsid AC twice a day. She takes everything with a little food. including the Pepsid AC so it doesn’t bother her tummy. See if you can get into an internal medicine vetetinarisn as they are experienced with inflammatory bowel disease, intestinal lymphoma and ultrasounds. An endoscopy biopsy can determine the difference but sometimes just trying the medication for IBD (Budesonide) to see if it works and watching the intestinal lining on ultrasound over a few months time to see if it is rapidly thickening will help determine the difference. Leukeran is used both for extreme cases of IBD and intestinal lymphoma but the dosing is different. My cat has had IBD (inflammatory bowel disease) since she was a kitten when I got her and she is 17 years old. Slowly transition into the new food. Also check your cats stool to see if it is hard. Constipation can cause vomiting and my cat has this with IBD. I add a half teaspoon to one teaspoon of organic baby food pumpkin to her food (5.5 ounce can of cat food) once or twice a day and it helps her bowel movements so it all doesn’t back up. My cat also has had some chronic hepatitis since she was one and severe pancreatitis for a few years now. Her IBD is currently under control. I’ve also had blood allergy food testing. Some veterinarians day it is not valid but I myself had skin and blood allergy testing and they matched. My cat was only ok with rabbit. Neither IBD nor intestinal lymphoma are immediate death sentences and can be controlled with medication. My friend has three cats that were on Leukeran for intestinal lymphoma and a few years later are still around. The other thing I would recommend is opting out of your smart meter and turning off your wifi whenever you are not using it. An elevated radiofrequency environment can truly increase inflammatory responses.

 

[dulcemir]

OK. It's been more than two months, and my cat is still throwing up almost every night. He usually throws up his dinner (served at 8pm) at around 5am. He'll sometimes throw up his breakfast, but that's not as common.

At this point, I feel like he's in pain, and I can't figure out what it is. I'm at a loss. I don't have funds to spend on trying to diagnose this further. I called another vet to get an opinion, and it's $595 for an ultrasound, plus $155 for the consult. This is the most I can pay. If he needs more work, I don't know if I can do it.

Honestly, because my cat is a senior and he seems to be losing weight dramatically (he's lost more than half a pound in two months), I almost want to just put him down. I am really tired of dealing with the puke EVERYWHERE and he doesn't seem to be happy.

Help me think of this differently. I really don't know what to do at this point.

 

[optimispar]

I'm sorry your kitty is still having issues with vomiting Did you try switching up his food and feeding times? I feel like losing half a pound over two months isn't that concerning and I'd attribute it to the fact that he's not getting enough calories (bc he throws up). I could be completely wrong though. My own cat's daily weight fluctuates between 6.1-6.25kg in a single day (0.5lbs~200g).

I personally wouldn't put my cat down without ensuring that I did everything I could. If you think you can afford this ultrasound and consult (even as a last resort) I hope you try. You haven't mentioned any other symptoms like pain or lethargy - your kitty is probably unhappy because of all the vomiting. My cat gets pretty sad after a vomiting episode too.

 

[FeebysOwner]

Did you ever try smaller meals more frequently? How much is he eating now - less than before or about the same as 2 months ago?
I don't recall reading anywhere in this thread about how digested the food is when he throws up, or how much of it he is actually throwing up vs. what he is eating. Is he still on famotidine?

Are you keeping him hydrated? Being dehydrated will make a difference in his demeanor, as in lethargy - which can be mistaken for looking like pain. And, as said above, I can't imagine he is happy about throwing up. I know when Feeby has vomited, she is totally upset by it. I think older cats tend to be more bothered by 'abnormal' events than younger cats who 'snap back' faster and easier.

For all of the vomiting he has done, a 1/2 pound loss in two months is not bad at all, IMO. Feeby is still losing weight for unknown reasons, but there was a point last year where she lost 1 1/2 pounds in about 3 months. Of course, hers is/was not related to vomiting.

If you can financially swing the ultrasound, I would do it. It just sounds like until the ultrasound is done, the vet doesn't want to consider potential remedies. Are there any current vet records of Dulce's you could share with the new vet that might reduce the cost a bit? If additional testing would need to be done, have you considered applying for something like carecredit.com? There are other similar type programs as well.

Ultimately, it is your call; but if I were you, I wouldn't be ready to 'throw in the towel' at this point. Too many things yet to be explored that could give Dulce years of time left to be with you and you with him.

 

[amandag1]

I'm sorry your kitty is still having issues with vomiting Did you try switching up his food and feeding times? I feel like losing half a pound over two months isn't that concerning and I'd attribute it to the fact that he's not getting enough calories (bc he throws up). I could be completely wrong though. My own cat's daily weight fluctuates between 6.1-6.25kg in a single day (0.5lbs~200g).

I personally wouldn't put my cat down without ensuring that I did everything I could. If you think you can afford this ultrasound and consult (even as a last resort) I hope you try. You haven't mentioned any other symptoms like pain or lethargy - your kitty is probably unhappy because of all the vomiting. My cat gets pretty sad after a vomiting episode too.

Ask the vet if they offer options like carecredit if that is in your ability. Im so sorry you're dealing with this, this sounds silly but have you tried other foods or food topper/supplements?
Maybe even lickable treats- like delectables, puree, squeeze ups, Tiki cat broths....etc to get some more into him.

I'd definitely have him seen at a specialty vet if you can 14.5 isnt too old!!!!

 

[daftcat75]

The ultrasound and consult is a good idea. It may not give you a definitive answer. But it can help rule out tumors and such. It can also suggest IBD and/or small cell lymphoma. Since cost is a factor and biopsies are poorly tolerated by older cats, I would suggest declining the biopsy. It's probably not cancer because the weight loss is not all that much. If he's able to gain or maintain his weight, it's probably not cancer (lymphoma.)

Some thoughts:

1. Smaller, more frequent meals. If he is being fed twice a day, can you split that into three or four meals? He should have at least four hours between meals but they don't have to be evenly distributed around the clock. For example, if he's getting half a can in the morning at 8 am, you could give him a quarter can at 6am and the other quarter at 10am. You can do the same for dinner at 6 pm and 10 pm. It's entirely possible that your old man has old man digestion and needs diet adjustments in terms of timing and serving size.

2. Food trials. You're going to have to be diligent about reading food labels. Just because a food says it's "Rabbit Dinner", it may still have chicken ingredients. I would start by eliminating chicken and fish entirely. Including treats. Switch him to turkey or rabbit. Rawz is expensive but they make good food that's single protein which makes food trials easier. They'll send you samples if you write them.
Where to Buy | RAWZ

3. Vomiting itself is not a terminal disease. I had two plus years with Krista from when her vomiting started. If IBD was all she had, she'd probably still be with me. You can sort this out. But you're going to need a journal and you're going to need to be serious about #1 and #2 above. If you do decide it's too much for you, please don't euthanize him. Please ask your vet, contact a shelter, or search for a rescue. I'm sure there are individuals or non-profits who would be willing to give a special needs senior a second chance.

4. B-12. Because he's been vomiting often for awhile now, his B-12 stores are likely depleted. B-12 is important for so many systems including the co-factor needed for its own absorption. When depleted, it makes it difficult to absorb it from diet alone. Ask your vet about buying a bottle of B-12, the syringes and needles, and learning how to give him B-12 shots at home. This isn't that expensive (less than $100.) These aren't that hard. You can watch how to do it on YouTube. They can make the difference between success and failure in controlling IBD, pancreatitis, and lymphoma.

 

[maggie101]

My beloved 14-year-old male cat (see photo of my handsome boy) is not doing too well these days. He's been throwing up daily after dinner for more than two months. Breakfast is a bit better for him, but he doesn't eat the entire 3 oz can of I and Love You turkey food.

He only eats wet food (3 oz can for breakfast and another for dinner). I and Love You is the only brand he'll eat these days. I spend $3 a day on food for him.

Took him to the vet, and they ran bloodwork, urinalysis, and X-rays. $1,100 later, they determined that nothing was amiss. No masses, no increase in WBC, nothing. Urine was normal too. He was very dehydrated because of all the puking, so they gave him IV fluids. They sent him home with some Hill's digestive care food and a prescription for fatomidine.

Vet told me to call back to see how he's doing two weeks after he started the prescription. I'm about 5 days shy of two weeks, but I'm super worried. He's still puking after dinner and not finishing his breakfast these days, eating only half of a can.

He was about 10 lbs last year. He's 9 lbs today.

I'm terribly worried about him. I know his days are numbered, but I don't get why he's still puking despite the diagnostics telling me that there's nothing fundamentally wrong with him.

Have any of you guys experienced this with your senior cats? I was so upset I cried into his stomach tonight.

View attachment 343418

My cat throws up in the morning after eating. She no longer does after given a b12 shot. It's been a problem for almost 5 yrs.

Just recently she had blood,chemistry,and my vet even called a specialist. Before I brought her home she was given a b12 for the first time. Throw up stopped for 2 weeks then came back so another b12 it stopped then came back. I started feeding her freeze dried morsels in water. That stopped it