*UPDATE* Cat Vomiting Bile & Other Stuff, WBC in Urine

[mamaof4soon]

Well you know your cat best and i am glad that you are being carefull with how fast you change foods. I also had training for nutrician, funny thing is my first experience was with Hills about 14 years ago and i received my nutritional consultant through them. I continued with it after I left the vet i was working for. Now i am actually doing Hills new Veterinary Nutritional Advocate program. I love keeping up to date. But i also do my research on the other diets out there. I agree with the politics thing, people do tend to make it policical when it has nothing to do with polictics. I do understand though that people who dont like the raw diets are very very not for it and say that most people who do it are nuts and say there is so much out there that is against it. And people who do raw are very very into saying "I wont ever do any other diet but raw" and say there are so many articles for it! Everyone has their own opinions. It has taken years for dog food companies to come up with their version of what is best. Personally I stopped using commercial dog foods for my dogs becuase the food i was using or a beloved pet that past on was causing so many problems with his skin, we were so desperate and changed foods thinking it would work yet he was allergic to many kinds. That is when we thought of a raw diet. I will never tell someone that raw is best. It is true many many people think giving raw meat and walking away is the way it is and that is so not true. You have to really be carefull and even when you are your animal still needs to be checked out by your vet atleast once a year but more just in case. I dont like what is used as one of the ingredients in commercial dog food that is why i do not like to use it. But that doesnt mean if i had to use it to help my dogs if there were a problem i wouldnt. I do hope they find out what is going on with Tage. And i hope that if dr. recomends the Prescription Diet that it is giving slowly. From what you say i am sure you will . Sometimes they just dont do well on any food but Rx diet. I have seen many cases with cats do well on the diet from hills. Prayers for kitty to get better.(((((((tage))))))))))

[AngelZoo]

I fully agree. I received my formal training from Waltham, though many of the vets I have worked with got their training from Hills in addition to Waltham. While I'm personally not in love with any Rx diet, I do know that they sometimes work when nothing else will.

The doctor just called me again, as my s/o brought Tage in to see her.
The x-rays only in one view showed something a little abnormal, she gave him fluids waited 20 minutes and then took another x-ray, the abnormality was still there but it had moved a little. So at this point she is not too concerned about it but will monitor it. She said she doesn't feel any problems from examining him and he doesn't seem to be in any discomfort when she touches him.

She doesn't want me to give him any food or water until tomorrow morning. In the morning I can give him water, if he manages to keep everything down, I can start him on the bland diet. If not then I will be needing to go back in possibly do a barium anemia, and/or she'll send Tage to a specialist for more help.

She also mentioned that she wants him on a hypo allergenic diet after 3-5 days on the bland diet. So this gives me a little time to still continue my hunt for what food we should try next and then discuss it.

[Traci]

Water shouldn't be withheld for that length of time...given his dehydration status, the vomiting, etc, water should not be withheld. (regardless of sub-q fluids administered today, it's probably not enough,..also given the lack of diganostic results for urinary tract infection and/or crystal development)

As suggested before, and pending any further developments with the "abnormality" seen on xray, a bland diet should have been initiated sooner, then followed with a hypoallergenic diet, which would be amoung the first course of action for ruling out dietary sensitivity. If he responds well, then you can pretty much sum up the problem was the prior diet or an ingredient(s)...unless there is an inflammatory condition going on. IBD would require a hypoallergenic diet anyway....unless it was a mass or infiltrative process that diet may or may not address and would require further diagnostics.

The "taking things slow" approach isn't always the best approach. In a vomiting, dehydrated cat, you need to address it quickly so that other vital organ function is not affected or compromised. Each step of course has it's place, but we're talking about a month-long problem, and the sooner it is addressed, the better.

[mamaof4soon]

Why would a vet knowing fully well that the cat is dehydrated say to stop water for a night? Not sure I would be comfortable with that at all. Seems dangerous to with hold food and water from a cat who vomits and is loosing fluids.

If the xray shows something then why isnt there being anything else done to find out what this abnormality is? If there is an obstruction that is causing it why wouldnt the dr. do an exploratory(which I would unederstand the NPO at that point) on the cat? Or atleast wait a day and do another xray? This seems very odd.

As i said before It is great that you are taking the diet change slow because you dont want to upset the tummy any further but sometimes you must change it and be aggressive in order to save the animal. You might look at what you have to with the raw diet but I think the best one that will have to be done is a Rx diet. Weather it is an obstuction which they should rule out(should have already have ruled out by this time) or it is IBD this is going on too long for the cat. Just becuase kitty doesnt show signs of pain doesnt mean he isnt in pain.

Get the abnormaly checked out, there might be something stuck, you never know. Where was this abnormality? Colon? This just doesnt seem to add up. Taking it slow is one thing but this is way to slow and this kitty will suffer the consequences for it.

[AngelZoo]

I am not going to be with holding water from Tage tonight, it also seems cooky to me when she first mentioned it. Since I've gotten home I've been reading through my text books for more information on something I might have missed.
If he's going to vomit again, I really don't think it's going to be because he drank a little water (he hardly drinks as it is!)

As nice as this vet is I am starting to question her honestly. I will be around for this weekend, so when I start Tage on the bland diet I'm going to feed it in small meals through out the day. He should be just fine switching onto the bland diet, it's switching from one commercial diet to the next that he has problems with.

Unfortunately I was not there today, my s/o brought Tage in, so I did not get to see the x-rays myself. But I plan on stopping in tomorrow and taking a look at them. She said she didn't know what it was, or if it was a solid object but she didn't think it was anything to worry about.

This seems to be a normal procedure with her. The last time one of the cats fell ill and all tests that we ran were normal she said "Ok give her the pepcid ac at night, with hold water for a night, try in the morning, and later try a little food, and slowly increase the amount of the bland diet." (I was not feeding a RAW diet at this time.)
The problem cleared up and went away on it's own. After that time I put my cats on the RAW diet and they all blossomed, until this problem with Tage. Though his problems and the problems my other cat was having were very different.

If the urine culture comes up negative, and he vomits either food or bile one more time, I'm going to be getting a 2nd opinion.

[AngelZoo]

As far as converting to another commercial food after the bland diet, what do you think of these ones I have selected out of about 50 brands. As far as hypoallergenic/Limited Ingredient canned foods go.

Royal Canin - Rabbit & Peas
Hills - z/d
Natural Balance - Venison & Green Peas
Sensible Choice - Adult Chicken
AvoDerm - Select Cuts Chicken Chunks
by Nature Organics - Chicken & Chicken Liver

If you can't find the ingredients easily online just ask and I will post them here.

[kk]

I only know about one of these diets: Sensible Choice. It's the one that I used to feed my Nina, and then they changed the ingredients and she started reacting to it. This was the dry, though. I now use the Wellness Super5Mix Adult and she has no probs. I don't envy your quest! Good luck in finding the 'right stuff.'

[mamaof4soon]

Since I only know Hills I would have to go with the Z/D. BUT I do firmly recomend a 2nd opinion on the xrays. If that cat has something in there blocking him that could be cuasing the problems. I had a great dane and in 1994 he was throwing up bile(green) and having diarreah and finally dr. did an xray and said "what is that!?" I looked at it(i worked for vet and did xray myself and said that is corn on the cob! I was shocked! He said no way. I demanded that he do exploratory on his and would ya know that darn corn on the cob was so gross. Dr. couldnt believe it. I had to give him up to someone else when i left my first husband in 1995 and would you believe that numbscull did it again in 1996 with her! She was so upset but we got it out again. Thank God. He passed on in 2002, he was almost 12.

For your Vet to say it is nothing still strikes me funny. I hope you get a 2nd opinion. Maybe she is right but it seems that not looking further into the abnormalty is wrong.

[Traci]

I'd recommend a prescription diet, since commercial diets really aren't formulated for limited ingredients, it is the source of the protein you should probably be concerned about when considering "hypoallergenic". Preferrably a protein source kitty has never been exposed to.

Rx recommendations:

Hill's D/D or Z/D
Eukanuba Low-Residue
Purina EN

And, depending on whether your vet carries the following:

IVD Select Care Neutral or Sensitive Formula or Limited Ingredients
Royal Canin Sensitivity RD (Rice & Duck) or Sensitivity VR (Venison & Rice)

Your vet will have to check her stock/availability or talk to her rep to see if the diets have switched to Royal Canin labeling rather than IVD's labeling. The diets above are equivalents.

Have you started the bland diet today, and assuming it is chicken and rice? (be sure to remove all fat from the chicken before boiling, and do not add any other ingredients, such as salt, etc). You might need to be prepared that this may predispose kitty to soft stools or diarrhea, so if it occurs, I'd recommend getting him on the hypoallergenic diet sooner.

I'm also concerned with your vet's comments about the x-ray....where exactly was the location of the abnormality?

[AngelZoo]

I just called the doctor and she should be calling me back soon. I will ask her where the "thing" was located and what she thinks it possibly is, and why she's not overly concerned about it. I'm also going to stop in and take a look at it after work. I used to work at a vet so I'm very familiar with looking at x-rays. If she can't give me any real answers I will request the x-rays and bring them to another vet to look at, and hopefully get them reviewed tonight.

Traci: Have you looked at the diet by Natural Balance? Their diets are made by veterinarians. I am still inconclusive on which one I want to feed, but I'd like to pick up one of the diets today or over the weekend. I'm trying to find as many opinions on these foods as possible but most people just don't know enough to say much.
The only diet my vet carries is Hills, but I will see if she is willing to write a prescription for something else if needed.

I started the bland diet last night, just a tiny amount which he seemed to do fine on. He's still not drinking water, and none of my cats seem interested in drinking water much since we moved to this new place. So I'm going to pick up some filtered water at the store and try that.
Even I don't like the taste of the water at the new place and were already using a filter on the faucet.
I got Tage some organic rice & chicken, and added a little extra water to the rice while cooking so it would hold a bit more moisture.
I've used this diet before, so no I did not add in anything extra.
He is back in quarantine at my house with his own water and litter box so I can monitor his habits.