? Need advice, lethargy vomiting pain but appetite coming back

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Update after update below: vet says the blood im the vomit was probably broken capillaries or something from vomiting. Said xrays looked normal and no urine blockage or anything. Said elevated levels that indicate kidney problems, may be early kidney disease but it may just be temporary dehydration, and to get kidneys checked in a few weeks. I said "what more info could we get from a urine test" and "if it was your cat would to do the urine test now" and she said no she wouldnt urine test now because we wouldnt learn anything. Shes giving him a shot to help with nausayand sending us home with oral nausea meds.

Update a few hours after update below: we're at the emergency vet and waiting on trst results. They did say he has a heart murmur. We ran all tests they recommended except for urine cuz we need to test urinfle again in two days to see if the antibiotics worked. But now im thinking we should rin that test to see if he has ketones or anything, what do you think or can it wait a couple days? Also he just vomited again and there was red in it, im so scared

Update a few minutes after posting: nevermind he just vomited again :(

Original post:

Chant vomited a few times yesterday, middle of the day and after his dinner, and again twice this morning. It was food after a meal and watery the other times. He usually does a few times a month but not this often, He didnt finish his food yesterday, but he was fed some different food yesterday, details below.

He seems like he might be sick or in pain, late last night noticed him sway a little bit a couple times, and he did kind of like an ouch noise when I picked him up. This morning he is a little lethargic and floppy, ears kind of flat sometimes. Looks like he's walking fine.

Seems interested in food though, not meowing and begging like usual and but seemed interested, and we're slowly feeding him by the spoonful, which he's eating not as enthusiastically as normal, but he ate that spoonful, so we gave him more.

I know lethargy can be a sign of a big problem, but only the emergency vet is open today and it's very expensive, but we'll go if its needed. But I'm hoping it was maybe just how he was fed different stuff? Is fish or urinary care food more likely to bother his stomach? Or maybe a delayed reaction to the antibiotics? Any advice is welcome, thank you

Notes on general health: We haven't given him a shot since early November. When we shot around 100 he went fairly low, and he hasn't been above that, usually ranges 70s to 90s, vet agrees to not shoot at that range and he might be in remission (yay??) He started oral antibiotics on 11/25 for bacteria they found in his urine, and he took his last pill last night 12/7, although he probably didnt keep it down. He seemed to tolerate the antibiotics fine though.

Notes on feeding: I bought him more food but i forgot to bring it home and theres none of the flavor he needs in town, so all we had was the other cat's food and fancy feast pate but fish (he usually eats chicken sometimes beef, way in the past fish wasn't his favorite). So here is what he ate the past few days:
12/06 morning: normal fancy feast chicken pate
(got food but left it at someones place out of town)
12/06 night: half can normal fancy feast chicken pate, half can purina proplan urinary turkey and giblets pate
12/07 morning: half can normal fancy feast chicken pate, half can purina proplan urinary turkey and giblets pate, he didnt finish all of it but we dont know how much cuz other cat got to it
12/07 night: fancy feast fish pate, ate about half, at a little more late night
(got normal food)
12/08 morning: normal fancy feast chicken pate, so far we've been slowly feeding him, hes had about a third of a can and is interested in more
 
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Hi Billy
I just looked at the SS and it looks like Chant is in remission. Is this correct?
I note he had ketones at diagnosis. Have you tested him in the last few days for ketones? If you haven’t, I would recommend you test for them just to check there are none with this latest issue. It’s always a good idea to check for ketones if your normally well diabetic kitty becomes unwell.
With the vomiting, do you have any ondansetron or cerenia at home you could give him?
I’m wondering if he could have pancreatitis with the vomiting, pain and seeming unwell. That required a specific test called the fPL spec or the fPL snap to see if it is pancreatitis. That test is not included in a normal blood test so you would have to ask for it. If it Is pancreatitis he will need treatment from the vet.

Was the BG 122 taken today?.
If he continues to vomit I would take him to the vet. Pancreatitis is painful.
 
I agree with Bron. If you can test for ketones, that would hopefully address one potential problem. Is there any chance that Chant ate something that didn't agree with him? Other than hairballs or eating too fast, vomiting is a sign that something's up. Frankly, you know your cat. If you're going to stay up worrying, I'd vote for a visit to the emergency vet.
 
Hi Billy
I just looked at the SS and it looks like Chant is in remission. Is this correct?
I note he had ketones at diagnosis. Have you tested him in the last few days for ketones? If you haven’t, I would recommend you test for them just to check there are none with this latest issue. It’s always a good idea to check for ketones if your normally well diabetic kitty becomes unwell.
With the vomiting, do you have any ondansetron or cerenia at home you could give him?
I’m wondering if he could have pancreatitis with the vomiting, pain and seeming unwell. That required a specific test called the fPL spec or the fPL snap to see if it is pancreatitis. That test is not included in a normal blood test so you would have to ask for it. If it Is pancreatitis he will need treatment from the vet.

Was the BG 122 taken today?.
If he continues to vomit I would take him to the vet. Pancreatitis is painful.

We took him to the ER and are awaiting results. Yes the 122 was today but it was like 108 a few minutes later so it may have been a fluke. We're running all the tests they recommended except for urine because he will need a urine test in two days anyway. I forgot about testing ketones, is that something that shouldnt wait a couple days or is it dangerous right away? And they didnt say anything about pancreas I'll ask about that test.

Edit: can he still have ketones even if his bg is normal?
 
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