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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 26245
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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I've had my cat at the vets quite a lot of times. Other than

Resolved Question:

Hi, I've had my cat at the vets quite a lot of times for vomiting. Other than one sickness where he got very lethargic and dehydrated when he was very small, 8-10 weeks, he was only really very sick once, when he was a year old, again lethargic and seemingly dehydrated. I've noticed that he vomits every now and then maybe 2 times a week and then will go weeks without it happening at all. The vet said he thinks he eats too fast each time. The last ten days he has vomited 5 times, 3 days in a row at one point. Though he shows no other symptoms of sickness. He is alert, playing, drinking his water etc, I know one of those days was a big hair ball, but other than that I don't know what to do and he's eating really good food that I buy from the vets. He is 18 months old, though he is small, smaller than my 9 month old.
Submitted: 8 months ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 8 months ago.

Peter, I'm sorry to hear of this with Sid. These cats most often are eventually diagnosed with inflammatory bowel disease (IBD) - an idiopathic (unknown cause) inflammation of the gastrointestinal tract usually responsive to the antiinflammatory antibiotic metronidazole and/or a glucocorticosteroid such as prednisolone. Presumptive therapy with either or both of these drugs is reasonable but only scoping and biopsy of my patient's GI tract is confirmatory. An abdominal ultrasound can "see" the typical inflammation associated with IBD but can't confirm it.

A food intolerance may be associated with IBD or exist as a sole entity. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Sid's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (a hydrolyzed protein diet is my preference because it avoids the possibility of my patient being intolerant to even a novel protein). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.

I don't believe that eating too fast is an important differential diagnosis. Please respond with further questions or concerns if you wish.

Customer: replied 8 months ago.
He had a biopsy before back in March and blood tests and ultrasound scans etc to see if he had anything like this and everything came back normal, that cost me €1,000 ! So it's hard to keep bringing him to vets, money wise. Since then he has been fine though , I've spoken a lot to my own vet about his vomiting which as I stated is sometimes only once every 3 or 4 weeks, at his last check up 3 weeks back he had even gained weight and they said he was thriving, but these past 10 days the vomiting seems a bit much. His food is Hills science plan at the moment, he's a fully indoor cat, and my other cat Lemmi lives exactly the same lifestyle as Sid but at 9 months has already grown larger. Sid was a rescue, who I'm pretty sure was away from his mother too soon, so I think his immune system is not as good as it could be, but other than vomiting he seems totally fine, and I bring him to the vet and it costs €70 to find out he's apparently great ! Or 3 days in Dublin's best animal hospital at €1,000 to find "there's nothing wrong with him" , do you think on Monday I should take him to the vet here? Or perhaps call in and speak with them, they've all his history on file there, it's just they're closed on the weekend. Thanks
Expert:  Dr. Michael Salkin replied 8 months ago.

I don't hear of an urgency and so sharing our conversation with his vet on Monday makes sense. At this point if you're going to pursue treatment you can see how a hypoallergenic diet trial (Hill's Science Diet isn't necessarily hypoallergenic for Sid.) or either metronidazole or prednisolone affects him. After having such a thorough work-up performed it's time to see how presumptive therapy works. Please continue our conversation if you wish.

Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 26245
Experience: University of California at Davis graduate veterinarian with 44 years of experience.
Dr. Michael Salkin and other Vet Specialists are ready to help you
Customer: replied 8 months ago.
That's great Michael, I shall talk to his vet on Monday, Thank you kindly for your time.
Peter, Sid & Lemmi
Expert:  Dr. Michael Salkin replied 8 months ago.

You're quite welcome. Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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