Expert: Jessica - 7/5/2010

Question
I week ago I brought my cat to a vet who was vomiting. The cat has no fever we took the conservative approach and they gave him a "pepto bismal shot" plus a water sac in his neck. The next day continued with more vomiting, repeated above and changed food to ID. He's on a Cd diet, he's 2 /1years old and was blocked this time last summer. He's had xrays and bloodwork. Everything checked ok. I cannot figure out how to get this cat eating/drinking again. We've even tried canned tuna fish. The final option is a stomach ultrasound. He's been to the vet 4xs this week. He's never had a fever. His behavior has changed around the house and he sleeps a lot or just sits. We want to help him, please give us some advice. He's a lynx point Siamese born Feb. 2008 and we love him.

Answer
Hi Melissa,

Sorry to hear your kitty is going through this.  I'm not sure what this "Pepto Bismol" shot was, but you may want to look on your invoice and see if you can get the real name of it.  There is a very good anti-emetic (anti-nausea/anti-vomiting medication) called Cerenia.  If this is the injection that was given, you can't really get much better than this.  But it also comes in pill form so that you can continue the medication at home.  You may want to ask the veterinarian for this.  Metoclopramide (brand name Reglan) is another medication that is sometimes used.  Results aren't as good, in my experience, and the medication must be given more frequently.  However, this also comes in injectable and pill form, so either way, your cat could receive treatment at home.

The subcutaneous fluids would also be good to give at home to prevent dehydration.  Your vet can show you how to do this.  With most cats, it isn’t nearly as difficult as it may seem.  You simply lift the skin between the shoulders, insert the needle and allow the fluids to trickle in.  The vet will specify how many units he should receive and how often.  The fluids will help to keep his electrolytes balanced to prevent complications such as brain, heart and kidney problems.

If the vomiting has subsided a little, it would probably also be wise to have the kitty on an antibiotic for his belly.  Usually the first choice is metronidazole (Flagyl).  This is a good choice because it not only treats bacterial and protozoan infections that can cause your kitty’s symptoms, but it also has calming anti-inflammatory properties that might provide him some relief right away.  The downside to Flagyl is that it tastes HORRIBLE.  I find that my cats will usually vomit if given the liquid, so I will choose the pill form whenever possible, even if it means splitting pills.  Then I coat the pill using butter and wash it down with a squirt of turkey baby food using a syringe.  The cat never tastes it.  If I must use the liquid, I mix it with equal parts of turkey baby food and shoot it down with a syringe, to take the edge off.

You should discuss all of the above with your vet and see whether or not they would be appropriate for your kitty at this point.

As for the ultrasound, I would really recommend it at this point, as you have nowhere else to go.  Earlier this year, I had a cat in a similar situation as your kitty.  X-rays seemed normal, but he was vomiting for almost an entire week, and it began to seem like he was vomiting fecal matter, a sign of an intestinal blockage.  Too week to undergo exploratory surgery, he was hospitalized awaiting an ultrasound.  The vets administered Prednisone, a steroid, to help shrink inflammation in his intestines, just in case a blockage was present.  Just as we feared we were going to lose him, out came a small piece of plastic in a bowel movement!  The plastic had caused so much inflammation that his intestines had swollen shut, causing an obstruction, leading him to vomit.  But because the tissue was soft, it wasn’t easily detectable manually, and it didn’t appear opaque on an x-ray.  The plastic was too small for the x-ray to pick up.  An ultrasound may have been helpful for detecting the thickening of the inflamed tissue and for detecting the foreign plastic.  Thankfully, my guy made a slow but full recovery.  Foreign bodies are often fatal in less than 5 days.  Ultrasounds are also the best way to initially detect diffuse cancer (and any cancer for that matter).  This is uncommon in cats your age, but unfortunately, it is not unheard of.  If you have the monetary means, an ultrasound will very often turn up an answer for you.  In fact, I have never had an ultrasound done on my cats that has not shed some light.

I will be keeping my fingers crossed the he has something very treatable!  Hopefully it’s just an infection that can be treated with the right antibiotic.

Best wishes!

Jessica