Thank you Peter,
When a older cat showing chronic intermittent vomiting, it is a vague clinical signs that can occur with a range of conditions. This includes grumbling bacterial infection, viral disease, dietary sensitivity, parasitic infestations, pancreatitis, inflammatory bowel disease, immune mediated sensitivities, cancer (ie GI lymphoma), metabolic conditions (diabetes, hyperthyroidism), organ troubles (kidney, liver), toxin and/or foreign material ingestion (these 2 are less likely here).
And often, these can be niggling low grade conditions that our cats cope with, so we see the vomiting and sometimes weight loss but they behave as if everything is fine. If your kitty has been showing an intermittent chronic vomiting at his age, then this is a wee bit concerning and we need to make sure that he isn't experiencing this vomiting for a reason other then stomach upset. Specifically, I would be concerned that this may be an hint of a chronic condition progressing to a state that it is inducing vomiting. And in that vein, I would say we need to double check that he isn't quietly developing any metabolic or organ based issues. As well, while it is never nice to think about, we can see cancer in older cats lead to intermittent vomiting, weight loss and little else (since the tumor will often just be stealing nutrients or compressing the stomach rather then impinging on the body to give us any hint it is there).
Therefore, it would be ideal to see if you can get to the bottom of what is triggering his signs at this stage. If he is due for a booster soon, it'd be worth moving that appointment up and just having his vet check him at the same time. They'd be able to have a feel of him and just make sure there are no sinister lumps and bumps present in his abdomen, that the liver/kidneys feel normal, assess his hydration, auscult his heart and just make sure there are not any overt disease signs. From there, it would be ideal for a blood sample to be checked. This would be the most straight forward means of detecting which of the above issues might be at the root of his signs. But alternatively, you could just submit a urine sample to them. We can usually obtain a urine sample from our kitties by placing the cat in a carpet-less room with an empty (or with non-absorbable litter) litter box overnight. The sample can then be checked by the vet determine if there are bacteria and white blood cells present (signs of infection, and commonplace with diabetes), check for ketones/glucose (markers of diabetes), bilirubin (seen in the urine with liver disease). As well, they can check the urine's specific gravity, since urine dilution can be a big hint for kidney disease. This is quite a non-invasive means of checking for a few of those concerns. But of course if hyperthyroidism was suspected for him after examination, then a blood sample would still be required (since hormone levels would only be appreciable in blood).
As well, if we have vomiting kitties, we often have a nausea component to their condition. To manage this, you can certainly try Charlie with an antacid at this stage. There are a number of antacids that are available over the counter and pet friendly. I would advise only treating with one, but the two I tend to recommend are Pepcid (More Info/Dose) or Zantac (More Info/Dose). Of course if your kitty has a pre-existing condition or is on medication, then you do want to discuss use of these meds with your vet first. But this could just help settle the vomiting to allow you to determine the significance of this potential weight loss.
Furthermore, if you feel that you just cannot get a proper amount of nutrition into him with these multiple small meals, you can consider offering diets like Hill's A/D (LINK), Royal Canin Recovery (LINK), or Clinicare Canine/Feline Liquid Diet (LINK). All are nutrient dense critical care diets, so a little will go a long way to providing nutrition. As well, a short term option would be to try him with kitten food. Just as the critical care diets, it will be more nutrient dense per bite and could get more into him even if we cannot get a proper amount of food in. As well, if you suspect the vomiting is related to dietary sensitivity, then diets like Hill's I/D or Royal Canin Sensitivity Control would be worth trying with him.
Overall, I am concerned about this intermittent vomiting because Charlie's weight loss just hints that something is underlying this situation. It tell us that there is more then just a niggling GI upset afoot. Therefore, do try the above diets and perhaps settling his stomach with an antacid. Still while doing this, it would be worth considering having him checked or at least a urine sample checked to rule out some of our concerns here. Depending on his response to your home treatment and the urine results, you may wish to then follow-up with your vet at that stage. A physical exam is a very good diagnostic aid and will help shine light on what is trigger this vomiting in your kitty. Blood samples can also be very helpful in these kinds of cases, as they tell us if there are any metabolic diseases or organ issues that we might not otherwise appreciate. And once you have an idea of the specific cause, you will know if his situation is similar to your previous kitty or whether this is an issue that you can address effectively for Charlie and help settle his vomiting for the long term.
I hope this information is helpful.
If you need any additional information, do not hesitate to ask!
All the best,
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