Frequent Vomiting - similar experiences? also thank you

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Tigger Mom

Tigger Mom

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Firstly, I wanted to thank those who have replied to my questions here in the past and whoever created this message board. The posts here and those answers helped me tremendously in navigating through the (overwhelming) diabetes journey for Tigger. Tigger has been in remission for some time now. I do occasional BG testing just to make sure. I do think, in addition to Lantus, Dr. Pierson's food recipe played a huge role in putting him in remission. I've been feeding him that recipe since he was first diagnosed so it's been years now.

Unfortunately, Tigger has been vomiting frequently since about May of this year. His blood and urine tests are normal. He also underwent ultrasound testing which only indicated "mild colonic wall thickening" which "may represent inflammation (e.g. IBD or other chronic enteropathy) or neoplasia (e.g. small cell lymphoma)." Now, they are recommending GI biopsies which I held off on. To sum up, vets have not been able to provide a plausible explanation as to why Tigger is still vomiting. Perhaps I should go through with a biopsy - it just feels that IBD cannot be an issue given I've been feeding him raw.

Here are things I've done: I used to feed him 2x day; now I portion out his meals into at least 4x day. I've changed the main protein source from chicken to rabbit/quail (based on my research that IBD can be caused by building intolerance to certain protein sources). He still vomits at the average frequency of once every other day. Rarely it is immediately after meal. Mostly it happens in between meals. Sometimes it is only bile. With Cerenia, it stops for about two days and then it comes back. Giving him Cerenia doesn't seem to be a viable long-term solution.

Just looking to see if anyone has had similar experiences (understanding I'm not getting medical advice here) and has found causes or solutions. I am so confounded as to what's causing this. I even think about changing his diet to commercial canned food, thinking raw diet may have stopped working for him. But of course, carbs in those commercial food possibly kicking him out of remission is the concern.
 
IBD may still be a possibility. You may need to try an elimination diet in order to identify if there is a sensitivity to one or more proteins. Just as an example, if Tigger has a sensitivity to chicken, quail could potentially be a sensitivity as well given that both are fowl.

I've used the site, Raw Feeding for IBD Cats as a resource with my IBD cat. @Wendy&Neko has a link to another site (that I can't remember or find) that has information on an elimination diet.

While this is unlikely, one of my cats went through a bout of vomiting and was vomiting bile. She had an obstruction -- she's swallowed dental floss -- which a very talented vet diagnosed.
 
So you say his bloodwork is all normal? Kidney function food? Thyroid levels good? If it’s been 6 months since the last bloodwork, I would repeat. Same with the ultrasound if it has been more than 6 months since the last one (certainly before any biopsies are done, either surgical or endoscopic. )

My cat was recently diagnosed with IBD via surgical biopsy. Since the ultrasound had pinpointed the location of the inflammation being in the small intestine, the vet only had to take two small full thickness samples from the small intestine and didn’t need to sample all over the place (so the incision was smaller.) He did really well. He only stayed one night at the vet as a precaution and so they could make sure he had no fever and could start eating again in small amounts. He wanted to eat a lot, of course. I kind of wish we could have just done an endoscopic biopsy, but that’s hindsight of course now that I know the exact location of the inflammation (lamina propria) and know it’s not SCL. He did so much better than expected and we didn’t even need pain medication at home for him (which absolutely amazed me— I had buprenorphine on hand, but he didn’t need it ). Of course there are lots of considerations for surgery such as the overall health of the cat, etc.

Marcus’ only real symptom was vomiting. It started slowly back in May and June. I started noticing he was vomiting occasionally and with more regularity — I took him to the vet a couple of times because he was not a regular vomiter (almost never- not even hairballs.). Bloodwork was all good. He even had a course of antibiotics for URI like symptoms at this time. Gradually his vomiting became more frequent and finally he vomited daily- usually not food but watery brown liquid (so a little food residue with water.). I had to give daily Cerenia for a while to prevent it. He also was losing weight despite still having a good appetite. We did new bloodwork, which came back unremarkable. Next step was an abdominal ultrasound which showed that his intestines were quite thickened. So we went ahead with the biopsy. He’s on a pretty high dose of prednisolone right now, which we will be tapering off at the end of this week. The odd thing is that he never vomits at all now. That’s fantastic, but he’s now having daily diarrhea, which he never had before. It was never one of his symptoms. The diarrhea is not responding to Metronidazole at all. So that’s where we are right now. I haven’t changed his diet yet, but I know I need to. Vet recommended Hill’s Z/D of course but I hate the ingredients. I won’t feed raw because he has FIV. I would need to cook the meat. Where do you purchase your meat?
 
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If your kitty does have IBD and it cannot be diet-controlled — and they want to start a steroid — hopefully you could use Budesonide, which doesn’t have the same impact on BG as prednisolone. My IBD boy is not diabetic so we didn’t have to consider that.
 
Sienne and Gabby (GA) said:
IBD may still be a possibility. You may need to try an elimination diet in order to identify if there is a sensitivity to one or more proteins. Just as an example, if Tigger has a sensitivity to chicken, quail could potentially be a sensitivity as well given that both are fowl.

I've used the site, Raw Feeding for IBD Cats as a resource with my IBD cat. @Wendy&Neko has a link to another site (that I can't remember or find) that has information on an elimination diet.

While this is unlikely, one of my cats went through a bout of vomiting and was vomiting bile. She had an obstruction -- she's swallowed dental floss -- which a very talented vet diagnosed.
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Thank you for the referenced site - very informative. I will try eliminating all fowl as well!
 
Suzanne & Darcy said:
If your kitty does have IBD and it cannot be diet-controlled — and they want to start a steroid — hopefully you could use Budesonide, which doesn’t have the same impact on BG as prednisolone. My IBD boy is not diabetic so we didn’t have to consider that.
Click to expand...

Your cat's past symptoms sound very similar to Tigger's. Thank you for sharing. Tigger's bloodwork as of 2 months ago was normal and my vet has ruled out all of those causes you referenced. The only concern is regular vomiting - he seems pretty normal otherwise - no diarrhea, good appetite and good energy (for his size). He hasn't been losing weight yet. After reading your reply I am more inclined to proceed with a biopsy.

And thank you so much for letting me know about Budesonide.
 
Suzanne & Darcy said:
So you say his bloodwork is all normal? Kidney function food? Thyroid levels good? If it’s been 6 months since the last bloodwork, I would repeat. Same with the ultrasound if it has been more than 6 months since the last one (certainly before any biopsies are done, either surgical or endoscopic. )

My cat was recently diagnosed with IBD via surgical biopsy. Since the ultrasound had pinpointed the location of the inflammation being in the small intestine, the vet only had to take two small full thickness samples from the small intestine and didn’t need to sample all over the place (so the incision was smaller.) He did really well. He only stayed one night at the vet as a precaution and so they could make sure he had no fever and could start eating again in small amounts. He wanted to eat a lot, of course. I kind of wish we could have just done an endoscopic biopsy, but that’s hindsight of course now that I know the exact location of the inflammation (lamina propria) and know it’s not SCL. He did so much better than expected and we didn’t even need pain medication at home for him (which absolutely amazed me— I had buprenorphine on hand, but he didn’t need it ). Of course there are lots of considerations for surgery such as the overall health of the cat, etc.

Marcus’ only real symptom was vomiting. It started slowly back in May and June. I started noticing he was vomiting occasionally and with more regularity — I took him to the vet a couple of times because he was not a regular vomiter (almost never- not even hairballs.). Bloodwork was all good. He even had a course of antibiotics for URI like symptoms at this time. Gradually his vomiting became more frequent and finally he vomited daily- usually not food but watery brown liquid (so a little food residue with water.). I had to give daily Cerenia for a while to prevent it. He also was losing weight despite still having a good appetite. We did new bloodwork, which came back unremarkable. Next step was an abdominal ultrasound which showed that his intestines were quite thickened. So we went ahead with the biopsy. He’s on a pretty high dose of prednisolone right now, which we will be tapering off at the end of this week. The odd thing is that he never vomits at all now. That’s fantastic, but he’s now having daily diarrhea, which he never had before. It was never one of his symptoms. The diarrhea is not responding to Metronidazole at all. So that’s where we are right now. I haven’t changed his diet yet, but I know I need to. Vet recommended Hill’s Z/D of course but I hate the ingredients. I won’t feed raw because he has FIV. I would need to cook the meat. Where do you purchase your meat?
Click to expand...

Also, when I did chicken exclusively, I used to go to a local butcher shop. They source organic chicken from an Amish farm. I did bake the chicken for ~10mins to make sure to kill all surface bacteria. For eggs I usually go for Vital Farms. For rabbit I'm ordering from WholeFoods4Pets.

I know every cat is different but I warn people against putting their pets on prescription diets like Hill's. One of the biggest culprits for Tigger's diabetes I believe was having him on Hill's prescription kibble for about a year.
 
Has Tiger had fleas, gone outside recently, or does he catch/eat bugs or mice? The raw food I suppose is a possible consideration too.

I’ll caveat this by saying it seems to be rare in cats, but on the off-off-off chance it’s relevant, here we go…
A veterinarian acquaintance told me he’s seen a couple cases of Physaloptera (stomach worm) recently and that dewormers weren’t knocking them out. The primary symptom was vomiting, otherwise the animal seemed fine. He identified the worms by endoscopy and removed them manually, after which the vomiting stopped immediately.

Again I think it’s rare and probably unlikely in Tigger’s case, but if your efforts to get a diagnosis are futile, it’s worth keeping in the back of your mind (especially if any of the items noted in the first paragraph are true).

In hindsight, I think it’s highly likely I had an immunocompromised rescue cat years ago with that problem. I also had a cat with helicobacter pylori, which was also supposedly rare (main symptom stomach ulcers and vomiting), which was also diagnosed via endoscopy.

They always say “when you hear hoofbeats, think horses, not zebras” … so I’m guessing none of this is relevant to Tigger. But, I’ve had many zebras in my crew, so just just tossing it out there. :)
 
JL and Chip said:
Has Tiger had fleas, gone outside recently, or does he catch/eat bugs or mice? The raw food I suppose is a possible consideration too.

I’ll caveat this by saying it seems to be rare in cats, but on the off-off-off chance it’s relevant, here we go…
A veterinarian acquaintance told me he’s seen a couple cases of Physaloptera (stomach worm) recently and that dewormers weren’t knocking them out. The primary symptom was vomiting, otherwise the animal seemed fine. He identified the worms by endoscopy and removed them manually, after which the vomiting stopped immediately.

Again I think it’s rare and probably unlikely in Tigger’s case, but if your efforts to get a diagnosis are futile, it’s worth keeping in the back of your mind (especially if any of the items noted in the first paragraph are true).

In hindsight, I think it’s highly likely I had an immunocompromised rescue cat years ago with that problem. I also had a cat with helicobacter pylori, which was also supposedly rare (main symptom stomach ulcers and vomiting), which was also diagnosed via endoscopy.

They always say “when you hear hoofbeats, think horses, not zebras” … so I’m guessing none of this is relevant to Tigger. But, I’ve had many zebras in my crew, so just just tossing it out there. :)
Click to expand...

Tigger is strictly indoors (incl. 2nd fl balconies) but I suppose we cannot rule out worm-related issues given the raw meat diet for a long time. I'm hoping and praying it's more benign and acute like stomach infection than other causes like IBD/cancer. Thank you for sharing!
 
This is the other IBD website, a lot of common info with the raw one: https://www.ibdkitties.net/

I've had three vomiters in a row, one including Neko. All three were on raw at the time of diagnosis. Neko could not be diagnosed properly because her heart could not take the anaesthesia needed. But from what I learned later on small cell lymphoma and reading the ultrasound, I think the IM vet and ultrasound vet were right on leaning to SCL. I did try some different proteins for Neko, but she was already on a pretty varied protein raw diet at the time. Neko took budesonide without it impacting her BG.

Kitty 3 was diagnosed with IBD and small cell with an endoscopy. Vet was looking for something else with an endoscopy, but I suggested that since endoscopy vet was going to be in there, he should take some samples. The inflammation was in the right part of the bowels it could be reached. Don't let the words "lymphoma" panic you. SCL is slow growing and can be treated with a large percent of such cats going into remission on the right med protocol. 6.5 years after her original diagnosis, kitty 3 "just" has her IBD to deal with and a recent U/S showed bowels well within normal size. I find IBD harder to deal with.

Are you giving a probiotic? Visbiome is a good one for either SCL or IBD.
 
After seeing your posts I did order Visbiome yesterday! I’ve been giving him Fortiflora but now I see this has a sub par microbiome effect.

Thank you for letting me know about the site. I scoffed initially at the idea of Tigger potentially having IBD or cancer, to be honest. But the more I understand about it I’m now afraid I might be hesitating too long and risk losing the window of early intervention. The study suggesting that 50% of those kitties with IBD symptoms were cancer really blows.

I contacted my vet earlier for a referral to IM. She suggested a biopsy could cost up to $10K… I couldn’t believe it - is this true? I’m inclined to go with a endoscopy, not surgical.
 
Tigger Mom said:
I’m inclined to go with a endoscopy, not surgical.
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You don't always get to choose. It depends where the inflammation is, what part of the bowels and in what layers of the bowels. Sometimes surgery is needed to obtain the sample needed. Laparoscopic surgery is an option there, but needs someone trained in it. The cost quoted for biopsy seem really high.
 
If you need to start chemo for Tigger You can just lightly cook the protein and probably tge rest of your recipe the same.
 
Thank you @tiffmaxee. I’ve received the same recommendation on Group.io. Do you know what to use for substitution for bone content? Cooked bone cannot be fed of course.
 
You can use egg shell. Look into EZComplete. Many here use it. The only,potential issue might be it contains chicken liver which is why I have been afraid to try it. I have been told by others that it’s been okay for their cats who don’t eat chicken and often consider trying it. Like you I fed lots of proteins and my allergy kitty has run out except for very exotic proteins.
 
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