Sunday, January 26, 2014

Myrna Vomits Late at Night After Meds, Middle of the Night; and So Then Do Two Others; What to Do About Meds?

Myrna vomited up food and liquid and possibly meds last night at bedtime and again in the middle of the night.  And then this morning, two of her siblings also began vomiting.  Concern or coincidence?  I've written about this before: there's vomiting by a cat, and then there's vomiting.   How do you determine what is serious, what help the cat needs, and when to see the vet? And more importantly, what do you do for your HCM cat which may have vomited up medications?

Since Myrna vomited over an hour after receiving her meds, I didn't give her more to replace what was vomited because I didn't know how much was digested nor did I want to risk that she was still going to vomit. Sure enough, she vomited at 4:30 a.m. and this time, vomited up the aspirin she received at 2:30 p.m. Aspirin takes quite awhile before it is digested.  Either this contributed to her vomiting or was simply a coincidence.  I did not give a new one the next day.  In this case, while the aspirin in necessary, it can be withheld until the next regular dose which will be Wednesday.    

If your cat vomits and you believe they've not digested medications, the best thing to do is to keep to the regular medication dosing schedule because you don't want to risk overdosing with heart meds. (But it depends on the reason for taking a med and this possibility should be discussed with the vet.)  And you need to make sure the cat won't continue vomiting   Often, a cat receives the same med more than once a day so you can give the normal amount of a med at the next scheduled time.  The only possible exception would be lasix.  If you believe your cat has vomited up lasix, once you think the cat is done vomiting, you can give 1/4 dose of lasix and then the regular dose at the next scheduled time (assuming a few hours will pass between those two doses.)  Lasix is one medication that shouldn't be skipped. I will see how she does on Wednesday when she receives her next dose of aspirin.  If she gets sick again after taking aspirin, then I will address it with her cardiologist.  If I thought a med she took a few times a day was possibly making her vomit, then I would also address that with the vet and possibly withhold the medication unless it was necessary that she receive it-such as atenolol and lasix.

Never withhold a medication without discussing it first with the vet, although with time and experience, you may come to know what to do when on your own. For example, this summer when Myrna was on antibiotics (those horrible skin lesions) and after five days was sick to her stomach because of them, I stopped the med and said enough was enough.   We watched the lesions to make sure they healed and things were eventually fine. Had she had some other infection or needed longer term antibiotics, we would have had to try yet another med to see which one better suited her. You must weigh the effect on the cat and the effect and necessity of a med due to a disease before you decide what to do without discussing it with the vet.

Always observe your cat after it vomits.  Make sure the cat isn't anxious-as if it will continue to be sick; make sure the breathing rate falls to normal soon enough and that it doesn't seem fast;  and see if the cat bounces back or curls up and sleeps suddenly after vomiting-which indicates that it is sick and needs the vet. After she vomited at 4:30 and had settled down, I watched her for a few minutes to make sure she seemed calm, was breathing easily and at a normal rate, and did not seem anxious.  She fell asleep and her breathing calmed down within a few minutes.
Myrna Loy waiting at the counter for food-not where she is
suppose to be but she tries to sit here in hopes of getting fed

Types of vomiting: there's vomiting up food and a hairball, or just a hairball or just food;  maybe with a lot of food and liquid, maybe with a little.  Maybe it happens over five minutes or in just one; maybe it happens over an hour or more. There's vomiting where the amount tossed up increases as the cat continues to vomit. Maybe the cat vomits more than once a day or over the course of a few days.

Does the cat always appear to be fine afterwards and bounces back and later eats and is still active? Or does the cat not bounce back?  It sleeps, it hides, it won't eat?

Any of these are potentially troubling signs.  Either the cat has a large hairball that needs to work its way out; the cat has an object that needs to come out naturally; the cat may need a lot of Laxatone to help pass hair/objects; the cat may need to see the vet; the cat could have a virus; the cat may need water by mouth at home or sub q fluids at the vet's to replace what it vomited (vomiting leads to dehydration which means a lack of electrolytes which contributes to weakness, sleeping, not eating, and more vomiting); the cat may need surgery to remove hairball/object.

The best thing is to observe your cat to see if there is a pattern. Write down when the cat vomits, what is vomited, and how often it vomits and see if you can determine a pattern.  Did hair come up? Then give it Laxatone a couple times a week.  Did a lot of liquid come up? Then give it water by mouth with an eye dropper (one you have on reserve just for this purpose).  Does the cat always vomit after a certain med? Then stop the med if it's not life threatening and call and discuss with the vet. Either the dose needs to be decreased and eventually increased; a new med should be tried; or the med needs to be suspended.  Has a food gone bad or is it potentially risky to give (there have been numerous food recalls these last few years)? Does the cat have a virus and need to see the vet?  Does the cat have a temperature-take the temp if possible and anything over 103 at home means the cat is sick and needs to see the vet.  If the vomiting continues, you should see the vet.  Has the cat vomited up blood? Then see the vet.  If the cat is hiding, sleeping, inactive, and not eating, you should see the vet.  If the cat is sick but you cannot get to the regular vet's office, then the cat must see the ER vet.

As for her siblings, Elizabeth and Bette vomited up dry food, treats, and hair this a.m.  Troubling yes but they bounced back and had breakfast and have kept it down. But we will keep an eye on them to see if any of them are coming down with something.  I gave them both water by mouth with breakfast to replace the liquid that was vomited.

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