posted 02-06-2004 02:08 PM         

I'd like to discuss this from the point of view of what happened to my kitty, Alex at the first of this year, so I'll go through everything I found out when he was vomiting constantly for a couple of days as well as what caused the vomiting to begin with.

I took Alex (who is 9.5 yrs old) to a new vet around the middle of December '03. He had lost some weight over the previous 6 months and didn't seem to be eating quite as much as he used to, although he was still interested in food. The vet ran a battery of blood tests and the only anomalous finding was a slightly elevated T4 value. Actually, the T4 wasn't necessarily elevated, but was in a "grey zone" for cats his age.

For those who haven't had to deal with this, the T4 value on a blood test is for Thyroxine, which indicates thyroid functionality. A good place to go to find out what those blood results mean is:

http://www.cah.com/library/labtests.html

There are probably even better sites than this as well.

Anyway, the T4 value, even though not necessarily high caused the vet to want to treat him anyway. This should have stopped me in my tracks, but I had never dealt with a hyperthyroid cat before and I decided to trust the vet. Since then, I've had 3 other vets, one being an internal specialist, that say his value should have just been monitored, not medicated.
I started him on a low dose of Tapazole, the most common drug to lower thyroid output. Two weeks later, he started vomiting. I thought at first he was doing this because he hadn't been eating well. The vomit was clear. In fact, I missed it for the first few hours because I had to work most of the day on New Years Eve. When I got home and found that he had vomited at least several places, I fed him. He ate a decent amount, so I hoped that would help him. Approximately 6 hours later (while I was asleep), he vomited food. He hadn't eaten anything else, so I started to worry. The food was only partially digested. I got up and started searching everything I could about vomiting. Here are somethings that I found:

Cats can vomit pretty much any time and at will. Sometimes it doesn't mean much and sometimes it means everything. The timing is very important. If a cat vomits right after eating, it could (not necessarily, though) mean an allergy to something in the food. At 6 to 8 hours after eating (with food in the vomit), though, there is either an obstruction or a motility issue. The GI tract of a cat (or dog or human, for that matter) is constantly moving. If something like a toxin, obstruction, or metabolic imbalance is introduced, this movement will slow or stop, causing vomiting hours after eating.

A good place to read about this is:
http://www.vetmed.wsu.edu/ClientED/vomiting.asp

After he vomited food, I was puzzled, but fed him some more because he didn't seem to feel bad and he wanted to eat something. I had stopped the Tapazole, just on instinct, earlier that day. On New Years day, he got worse. He vomited somewhere in the neighborhood of 20 times during the course of the day. He was more lethargic and was starting to hide. Finally, when he was vomiting water and the water was tinged pink with blood, we went to the emergency vet hospital. I had wanted to take him back to his vet, but I'm glad I didn't wait.
The emergency vet on duty put him on IV fluids with anti-nasea medication and some potassium thrown in. He didn't vomit again that night.

They started talking about cancer, intestinal blockages, etc. But what I wanted to know is the following:

Suppose that my kitty wasn't hyperthyroid and he had been taking two weeks of medication to lower the functionality of a normal (for him) thyroid level AND metabolic reasons can cause decreased motility. Could the medication have been the cause? No one wanted to answer this for me. His own vets office told me that his vet was out and none of the others in the office would discuss the case with me. The vets at the emergency hospital still wanted to look for cancer and intestinal blockages. So, I let them. He had a barium x-ray series and an ultrasound. The ultrasound showed that he had a motility disorder. His intestines were no longer moving as they should. I can't say that I was exactly shocked at this finding. The internal specialist found nothing obviously wrong with his organs, nor any apparent blockages or tumors. He could find no reason for the lack of motility. The barium x-ray series later that day showed no blockage, either. There was simply nothing that could have done this except the Tapazole. But what about the Tapazole? Was I right about the metabloic functionality or was the Tapazole toxic to him for some reason?

After the ultrasound, Alex started vomiting again and I demanded that the T4 value be rechecked (which came in days after I took him home as only squeaking by the normal range for any cat). I contacted the internist the next day when the emergency vets started talking about using an endoscope and exploratory surgery. I didn't feel these were justified at that point. Also, they were STILL looking for the blockage that didn't exist.

The internist called them and told them to give him some injectable Reglan, which was supposed to be stronger than what they were giving him. It turns out that the reason Reglan is an anti-nasea medication is because it promotes motility. This stuff did the trick for Alex. He didn't vomit again.

After over $1800 in emergency vet care bills, I was able to take him home. He had lost an entire pound since he began care under his new vet a little over two weeks before. I'm still considering filing a complaint against his vet who would not call me back or ever bother to call to see how Alex was doing. I just never heard from her again. When the front desk person called to ask about Alex days after his release (when his vet was supposed to call me two days before), I told them he was no longer their concern. At that point, I was thinking about filing a legal suit.

I went to his previous vet and got his blood test values from about a year and a half before. His T4 value was the same as when he was tested in December (and he was in perfect health a year and a half ago).

Alex has much more energy, now. He's up most of the night romping in other parts of the house. His new vet is taking a slow approach with him to find out what was wrong with him initially. She thinks that he could have some intestinal issue that caused him to react to the Tapazole the way he did (maybe IBD or IBS). She doesn't think, however, that the Tapazole knocked his metabolism down far enough to have caused his motility disorder. I still wonder, though.

Even though this isn't strictly about vomiting, there are a few things from this to remember.

1. If you're starting your pet on new medication, monitor him carefully. I think it is important for people to know what can happen to their pets under the wrong set of circumstances.

2. If you don't think your vet is doing the correct thing for your pet, find one that will do a good job or discuss this with your vet based on your research. Perhaps they will listen to you.

3. Read everything you can about the symptoms your kitty has, but only do this in order to help your vet reach a diagnosis, not to diagnose the kitty yourself.

4. Be sure you know why your vet wants to do the things they want to do and be informed. I still don't think that an endoscope or exploratory surgery was necessary for Alex, but if I hadn't contacted the interal specalist, he might have undergone both, for very little reason. If it ends up that he needs these things, it is better not decided under extremis.

5. Even though I didn't agree with everything the emergency hospital wanted to do, I think they did an excelent job of taking care of Alex. I was concerned about the vomiting leading to dehydration over the evening, so it was a good idea to take him in. Dehydration would have only complicated things. Please take your animal in at the first signs of something wrong. I think I waited too long with Alex and that he should have gone in the day before. Fortunately, that turned out okay this time.

From here, I invite you to read up on Inflammatory Bowel Disease. There are a number of supplements that you might give your pet if he is suffering from vomiting or diarrhea. Just don't do these things instead of vet visits.

IBD: http://web.vet.cornell.edu/Public/FHC/ibd.html

Here's a message thread I ran into that argues about the holistic approach to treating a kitty with chronic diarrhea:
http://www.austinlostpets.com/board/showthread.php?s=&threadid=11

If anyone besides kimmie (thank you for your previous comment, if you read this one) reads these, there are other topics we might focus on in the future.

Examples include:

- Holistic approaches to treating animals
- Hypertrophic Cardiomyopathy (I just lost my dear calico, Claudi-monster, to congestive heart failure, so I've read up on this one. I can give tips on warning signs that I unfortunately thought were something else until it was too late.)
- Hyperthyroidism (there's a wealth of information about this out there, so I could just point people in the right direction to find treatments. However, vets usually just start with Tapazole.)
- Things you can do to learn more about your cats, their problems, their behavior, and what to do if there is a problem.

If anyone is interested in my continuing to put these things out there OR has good things to add that I've left out, just reply!