Gastroenteritis and recovery timeline?

[trishia42]

Yes me again and this time a different cat (8-month old male kitten). Oliver had been having some loose stools for a bit and we thought he was having issues with hairballs maybe so we were trying a few different things. This progressed to diarrhea with him vocalizing in the box and some scooting afterwards. Then some vomiting, and so we took him to the vet ER on Sunday morning, worried he was constipated or had an obstruction.

Examination was fine, bloodwork came back normal, and x-rays were clear with no signs of obstruction or constipation (empty bowel at the time). Gave him a shot of Cerenia and some subQ fluids and sent us home with metrodinazole. We were cautioned that if he vomited again while the Cerenia should be active, we would have to bring him back for further diagnostics and potential "exploratory surgery" (is that normal?!).

He seemed to be getting better over the last couple of days and even had a well-formed poop yesterday evening around 11 PM. BUT he threw up food around 7 PM yesterday morning and then some watery stuff twice this morning around 8 AM. Not sure if it's nausea from the gastro and/or the antibiotics and the morning was stomach acid from not eating overnight? We have been feeding him multiple small meals of wet GI food throughout the day and there is access to dry food but it doesn't look like it was touched overnight. We have contacted the vet and are waiting to hear back, but if anyone has any insights/experience on gastroenteritis recovery and what to expect, I would love to hear it because at this point I'm terrified they will want to "open him up"... : /

I should add that throughout all of this, he has acted fairly normal and still is acting like this today - follows us, uses scratchpads, chases laser, plays with his sister and is not displaying any signs of pain (we've been lightly palpating his abdomen) or dehydration.

 

[stephanietx]

No, surgery is NOT the next step. I would go to your regular vet and have him checked. Ask your vet to run the test for pancreatitis. It honestly sounds like he's got either pancreatitis or IBD (irritable bowel). Both can cause vomiting Gastroenteritis can also cause vomiting, but there's obviously something going on with his GI tract.

The pancreas test is the fPLI test and can be run in the office. It takes about 45 mins to get the results. Usual treatment is steroids.

Other meds to ask your vet about: steroids (prednisolone), Zofran (ondansetron, an antacid), Simethicone (baby gas drops, which are over the counter)
Cerenia is good for gas, but it doesn't necessarily treat the nausea that comes from having gas. Ondansetron is a 12 hour antacid. Simethicone helps our boy tremendously. We use Rugby brand. You want something dye free, saccharine free, and flavor free

What is your kitty eating? You may need to look into a prescription food. We feed Royal Canin gastrointestinal (canned and dry) and Instinct Venison. This has helped firm up his poops. We have also started giving him Slippery Elm Bark syrup that I mix up. This has also helped firm up his poops and keep his tummy happy.

Lastly, I don't know why they suggested surgery! If the x-ray didn't show anything like an obstruction, then there is no need for surgery. However, you can ask your vet to perform an ultrasound to check the gastro tract and make sure everything is working. They can also see if the pancreas, spleen, or liver is unhappy. My vet said that if the pancreas isn't happy, the rest of the gastro tract isn't happy.

There's a lot of things you can do to help your kitty. My not-so little guy has had tummy issues since he was 8 months old and he's now 13 and we've never once been told he needs surgery.

 

[trishia42]

I did think about pancreatitis (one of our previous cats had it) but because he's acting SO WELL (like he's literally chasing me right now) and there is no abdominal discomfort, we felt that was unlikely (GGT value also good, although I know that's not a 100%). I would not be opposed to running the fPLI or an ultrasound; just want to spend the money where it will actually count since the cost has been significant so far. We did talk about IBD, but we were told although it wasn't impossible, it was not very common in kittens and apparently diagnosis was through biopsy?

I do have experience with ondansetron, but since he didn't throw up for 56 hours after the Cerenia injection, we felt perhaps Cerenia was also an acceptable choice. We have contacted the ER vet he was at (which is also a standard clinic). We fed him a bit of wet food this morning, which he threw up about 30 minutes later so obviously we need to do something if he can't keep anything down. I just don't know if it's the metrodinazole causing him this nausea/emesis.

Right now we are feeding him the Purina GI EN food but before that he was mostly getting wet Tiki Cat food (and a bit of high-protein dry Tiki Cat food), with an occasional can of something else thrown in. We feel these issues slowly developed over the last two weeks (starting with looser stools).

I'm not sure but I believe the reason they mentioned surgery might have been because my other kitten ate some sewing thread pieces two weeks ago (posted about this) and although we were pretty sure he hadn't gotten to it (she was on the counter by the sink, thread in her mouth and we believe she pooped most of the thread that would have been there out, while he was on the counter but on the other side of the stove looking at her - he's also not quite as much trouble, whereas she tries to get into everything and everywhere), perhaps they were worried about that? Although I feel if that had been the case to cause the issues he has been having, we would have seen the evidence/pliation on the x-ray and the vet assured us there was no sign of that. So yeah, I'm not really sure but the idea of randomly opening up my 8-month old kitten is just... so very terrifying.

 

[trishia42]

Update: after four hours of not hearing anything back, we were able to get through by phone and have an appointment at 3 PM for follow-up. They said they wanted to do another x-ray in case they had missed anything (he's now vomited about 4-5 times since last night, all food and then water/foam).

I'm skeptical the x-ray will show anything given the ones taken just Sunday were clear so I'm going to discuss the possibility of an ultrasound instead, I think? They are more expensive but I don't want to do an x-ray that tells us anything and then still have to pay for an ultrasound afterwards. Not sure if both are required; I feel every vet we talk to always has a different opinion.

I will also inquire about pancreatitis, although because he's so well apart the vomiting, it would seem a little weird (at least based on my experience with a previous cat with pancreatitis). I think they can also usually diagnose it through ultrasound, or at least that's what happened last time?

 

[stephanietx]

Both pancreatitis and IBD can present with vomiting. I wonder if a steroid would help and if a different food would help.

 

[trishia42]

We got a second set of x-rays taken where everything still looked normal and given he's acting normal and his young age, the vet seemed to think pancreatitis was unlikely and that his first choice (like the first vet we saw) was gastroenteritis and basically to stay the course of the antibiotic (metrodinazole) but add in Cerenia for the duration of the treatment. His last two poops were normal as opposed to liquid so that is certainly encouraging but I am very nervous he will start throwing up again once the treatment is over. Mainly because when he started throwing up the first time (once treatment had begun), it had been 56 hours from a Cerenia injection but also at least 12 hours from a metrodinazole dose and its half-life doesn't appear to be all that long so I'm not sure if it was 100% related to an upset stomach due to the antibiotics - haven't been able to find much in online threads except usually vomiting shortly after administration so I have no clue...

IBD would be the next thing to investigate if things do not resolve so basically would have to book a full ultrasound for that first; at that point I think I would ask for a referral to an internal medecine vet2q. He's currently on the EN GI food wet food and I intend on keeping him on it for a couple weeks to see if things have resolved before trying anything else. Steroids here are only prescribed with a confirmed diagnosis for IBD, which requires a biopsy - and I'm not sure I would want to go that way unless we have exhausted all other pathways, as surgery is always something scary.

 

[stephanietx]

If he has gastroenteritis (gas in his colon), he could've been nauseous. If he was nauseous, it could've caused the vomiting. It sounds like your kitty is on the road to feeling well.

 

[trishia42]

I sure hope you are right! He is still eating well and I upgraded the probiotics today. He does seem a little off at times (hasn't slept with us the last two night : (), but I guess that wouldn't be surprising if he's not 100%. REALLY hope that this will be resolved soon; feels like it's been thing after thing since we adopted these two siblings and I would just love for them to be able to enjoy their little kitten lives!