Hi, I'm Dr Steve. I am sorry to hear about hr problems. Do you remember what the injection she has had or is going to get was called?
I will try to give you some ideas about what could be going on with Sasha. Vomiting like Sasha has been doing can be due to hairballs which it sounds like you have already addressed, Food irritation which feeding the i/d should have helped with and chronic pancreatitis.
Chronic pancreatitis is an inflammation of the pancreas and can cause the vomiting Sasha is experiencing. The antiinflammatory medicines that your vet is giving usually helps with this condition. If you have not had blood work done that would be another set of tests that could be done to evaluate the health of the liver, kidneys and pancreas.
If the blood tests come back with normal liver and kidney function than it may be that the pancreas is the problem and she may need to beon antiinflammatory medicines for a longer period. I have had some cats that needed medication for several months to get the pancreas calmed down and the vomiting to stop .
There are pancreas tests included with the blood work that often times are not increased in cats with chronic pancreatitis. Unfortunately this makes diagnosing chronic pancreatitis a little more challenging. When I suspect this problem, once I have made sure that the other internal organs ( kidney, liver, etc) are ok, then I often treat for chronic pancreatitis. Also feeding a diet low in fat can help with pancreatitis. Hills has one called w/d that sometimes helps. You can ask you r vet about that as well.
One more thought is if the injections are not helping you could try oral daily antiinflammatory medicines, but if the injecitons are working it may be ok to continue if your vet feels comfortable with the results. I hope this has helped give you some more ideas of some of the possible causes of the kind of vomiting Sasha is experiencing. I will check later this evening to see if you have more questions. Thanks for your question and good luck
Pancreatitis is not something I had thought of, but having searched online I think it highly unlikely that this is the cause. I know it is hard to diagnose when you don't even see the patient, but if more info would've been helpful, then you could've asked.
I am sorry that you are not satisfied with my answer. I did ask two questions , but was going to be offline for a while so I like to give some ideas for you to consider so when you come back online you see my initial thoughts, not just two questions. My goal is for you to be satisfied with my answer so I would like to expand on my original reply. You are correct in that it is difficult to diagnose any condition in this format without having lab results and a hands on examination. Since she has already been to a vet 4 times I didn't want to repeat the basic causes of vomiting that your vets have already likely treated or addressed . I went right to Chronic pancreatitis because this is a less common, but possible cause of vomiting. There are two forms of pancreatitis. One is Acute meaning it happens suddenly, the cat has a high WBC count ( blood test) elevated Lipase and/or Amylase and they often have a fever, are lethargic and don't want to eat. The vomiting is often more frequent .
The other form of pancreatitis is Chronic or some experts call it Chronic-Active, but in cats with this condition, the vomiting can be extremely variable from daily to once or twice a week. They can act very normal and often the blood tests are all normal as well. Since this form is so hard to diagnose, it often goes undetected or not addressed. Since Sasha seemed to respond to antiinflammatory injections as you mentioned , then it stands to reason that there is some sort of inflammation going on somewhere in her digestive system which is what made me consider chronic pancreatitis. I have had several consults with board certified pathologists and internal medicine veterinarians on cases where the only symptom was intermittent vomiting and they nearly always recommend treating or atleast considering chronic pancreatitis.
This condition is more common in cats than other species so it is important to not dismiss the possibility even if there are no lab abnormalities to back it up. Giving daily antiinflammatory oral medicines instead of injections is another way to manage this condition. Since it is so hard to diagnose chronic pancreatitis, often the only way to address it is to treat for it and see if things improve. If they do then you have confirmed that is what is going on and you treated it as well.
I am not saying she has this specific condition, but with this service as you mentioned, the purpose, in my opinion is to give a pet owner something more or a different view of their pet;s condition to discuss with their vet. Sometimes having a "new" viewpoint can help. I completely understand if you are still not satisfied with my answer, then I will gladly "opt out" of the question which opens it up to other vets so you can still get some help. My respectful request is that if you would prefer another vet to help you from here, that you would remove the poor rating. IF you don't "accept " my answer you won't get charged for it so you won't be paying for an answer you are not happy with. My goal and the goal if Justanswer is to be sure you are completely satisfied with this experience. Thanks for your consideration. I will be back online later this evening to follow up. If you have more questions, I will be happy to continue. Have a nice day.