This is a lot to digest. We have a 15-year-old dog that has been on meds for congestive heart failure. He was doing fine until…the other day he apparently got into the trash and ingested a paper towel with meat gravy. For the past 24 hours he has been vomiting up food he ate after the ingestion so we obviously have not fed him further. He has been drinking water regularly throughout the day and night but vomiting it up at times as well. I have discontinued giving him water so the vomiting doesn’t dehydrate him. He did vomit up part of the paper towel but now we believe there may be a piece in his digestive tract too. He is resting now but has been very lethargic as one might expect. Not interested in eating, vomit is a combination of yellow and clear. One earlier vomit was very brown and “pudding” consistency. Since then mostly watery. Our vet is in surgery and is unavailable for the entire day, The main question is how dangerous is the paper towel if in fact it is lodged in the digestive tract? Will it degrade fast enough to allow water first and then food to pass. Our vet said the dog’s age and heart condition preclude any surgery. We are at a loss as to what, if any steps are available to us. He is not in immediate distress but is clearly in need of something.

A question for Krista Magnifico:

Hello! Hoping to get some advice on recommended next steps for my cat, Sammie, who is being evaluated for IBD vs. small cell lymphoma.

Sammie is 17 years old and is overall quite healthy! Throughout the time I’ve had her, she’s had a history of vomiting a ~once per week or two (sometimes more frequently). Vomit is usually clear, foamy. No other GI issues or health issues otherwise. She is active and energetic, and has not had any health issues until ~1 month ago when I noticed she stopped eating as much as she previously did. She stopped eating her dry food altogether, and seemed to become quite picky with her wet food. I initially thought her teeth may be bothering her because of the avoidance of dry food, so I brought her to the vet.

Vet found that she had lost a couple of pounds, unintentionally. Based on presenting symptoms, vet thought she might have a GI pathology so ordered an abdominal U/S:

Ultrasound, Abdominal Study Outcome:
Kidneys: overall normal size but mild reduction in detail and small mineral foci. Trace pylectasia noted w/out ureteral disension.
GI: Avg SI thickness normal. Mild corrugation is noted in some regions and some ileus (luminal fluid distension up to 4 mm w/ reduced
peristalsis) noted w/out obstruction. No discrete abnormalities appreciated throughout the small intestines.
Caudal abdominal nodes are prominent to mildly enlarged and rounded w/ smooth texture. One irregular cystic structure noted near right
kidney. The mesentery around the ileus segments is mildly hyperechoic.
A:
Intestines most consistent w/ enteritis
Nodes: r/o reactive vs other
Cystic strucure: r/o benign mesenteric vs inflamed node
Kidneys have evidence of chronic disease.

Here are her prior labs:
PRIOR LABS:

7/15/24: Wt loss 0.28 lb; PCV: 40/7.6; Chem18: BUN 41, creat 1.7, K+ 4.3, phos 4.2
U/A: USG 1.019, pH 6.0, rare wbc/rbc; no bact/cryst; cobalamin: 437; folate: 11.2

2/13/24: Wt loss 0.8 lb; CBCcomp: hct 44, diff wnl (clots in sample; rec. resubmit)
Chem25: BUN 40, creat 1.3; T4: 2.8; SDMA <10
U/A: USG 1.025, pH 6.0, rare wbc, no rbc/bact/cryst, rare fine gran casts.

1/19/23: Wt loss 0.4 lb; CBC: (hct 40, diff wnl); Chem25: (BUN 32, creat 1.3)
T4: 1.8; U/A: USG 1.051, pH 6.5, 1+ prot, rare wbc, no rbc/bact/cryst

11/19/21: CBC: (hct 46, diff wnl); Chem: (BUN 34, creat 1.5); T4. 1.9; DGGR lipase 9
U/A: USG 1.053, pH 7.5, rare amorph. crystals, no wbc, no rbc

6/17/22 Wt loss 0.16 (as desired); USG 1.040; SDMA: 11

Most recent A&P:
A:
1) Intestines most consistent w/ enteritis (IBD vs SCLSA); ileus likely cause of decreased appetite.
2) Nodes: r/o reactive vs other
3) Cystic strucure: r/o benign mesenteric vs inflamed node
4) Kidneys have evidence of chronic disease ; in keeping w/ previous lab findings.
P:
1) Rx: metoclopramide 5 mg: 1/4 tab po every 8-12 hrs.
2) Continue vit B12 as Rxed.
3) picked up Mirataz but hasn't started it yet. Rec. give. metoclopramide for 2-3 days and then if not improved appt, start Mirataz.
4) to consider presumptive pred tx vs ex-lap for biopsies.

Sammie is seeming to eat better with the metoclopramide.

My question:
Is pusuing an ex-lap for biopsy recommended vs. empiric tx for IBD with steroids vs. empiric tx for SCL with steroids + chlorambucil.

Thank you!!!

My 18 year old cat (long hair) has been having some issues for about 2 weeks now. On 2/10/24 he started throwing up at breakfast and didn’t want dinner, Stopped drinking and eating from that point and howl crying by sunday night into Monday. Got hospitalized on Monday the 12th got labs done, a urinalysis, semi ultrasound and xrays. He was severely dehydrated, negative for UTI, severely anemic (6.8 range was 10.9-15 ). Over night he got IV fluids and antibiotics and ate some the morning, labs were normal by discharge except for anemia. Xray ray did reveal, distended stomach with gas, arthritis, one small kidney. He came home didn’t really eat much, followed up with regular vet got subq fluids and appetite stimulant (rubs on ear), 1-2 days after he ate like a horse mostly broths and liquids foods. He is now constipated and vomiting again, not eating and lethargic. Took him to the vet 2/24/24 for subq fluids vet also gave him an enema. He has not pooped still its been about 30 hours. I tried to give him gabapentin yesterday but he threw up. This morning he threw up “poop” like vomit. We gave him 1/2 ish teaspoon of miralax this morning threw up a little while later more poop like vomit. Seems to have broken a bit of his k9 tooth off also, doesnt seem to bee botbering him… We are considering doing at home mineral oil enema with a baby enema glycerin suppository with more miralax. He has eaten a tiny bit of Broth treat today and gotten outside for 2 walks. Are we doing the right steps ? Is there more or less we should be doing ? Trying to get to a more equipped vet hospital but probably won’t be until Tuesday 2/2724. Should I seek emergency medical attention or waiting until Tuesday be okay. Planning to take him to regular small vet tomorrow for subq at the least.Please help.

Dr Magnifico I left a comment about my milkshake on your YouTube, I made a account here to talk more. Milkshake will be 8 on September 3rd, a while ago she was having diarrhea but after time she started having harder bowel movements where each time I would see her go it was hard enough to make a sound hitting the litter pan. Fast forward to this past week and for 6 days now she hasn’t ate or drank, she has not went poo but she did go pee two times yesterday. She has been vomiting a lot, the first day she would vomit every half hour, now it is still happening multiple times a day but not as much and is yellow do to not eating. I have been giving her water with a syringe to hopefully keep her hydrated. Like I said I’m on a fixed income do to my disability, I brought her to the Vet and didn’t even get a diagnosis after spending $200 getting seen having some nausea meds and fluid under the skin we were sent home to fend for ourselves, luckily I had saved that 200 up that was supposed to be for my other cats upcoming apt. I have tried calling other vets and hospitals and no one is willing to even let me do payments to get further information, the vet we went to said it would be at least $2,000 before she could be sure what exactly was going on and I just can’t afford it, we barely have food as it is. I tried applying for care credit and was denied unfortunately. I’m really worried about my milkshake. The only extra information that I did get from the vet was that she did not have a fever which was a good thing. Thank you for sending me this way, it is greatly appreciated.

Hi,
I’m watching a cat for a neighbor for about a month in my apartment. The cat throws up food every 6 days or so. It smells horrible, like raw sewage. I’ve had cats of my own before and I don’t recall any of them vomiting and having it smell as bad as this cat’s vomit. She actually eats relatively slowly, so she’s not inhaling her food in 3 seconds. She’s not that big of a cat, I was told to give her 1 can of Fancy Feast per day ( broken up into 3 feedings per day for that 1 can). She eats it all on the spot, no leftovers. I also give her small handful of dry food when I’m at work for 8 hours so she doesn’t get too hungry during that time. And maybe a few more grains of dry food if she begs me. Dry food isn’t her favorite, but she’ll eat it there’s nothing else. Can anyone offer advice about why her vomit smells like raw sewage? It’s so bad it makes me wretch. She’s basically a happy cat, doesn’t seem otherwise sick or displaying any odd behaviors. Thanks so much for any help.

Hi Krista! I have a 9 year old beagle who periodically (at least twice a month) will vomit all day. He vomits his morning food, then continues to vomit mucus and bile the remainder of the day. His vet has done a physical exam and blood work, and he kept him overnight once to give him IV fluids and anti nausea meds. He always bounces back within 12 hours, but this is getting to be really tiresome. His weight and energy levels are fine after this passes. And his stools look normal. Do you have any suggestions? I will share a picture of the last vomit from a couple of hours ago – this was about the 8th time he puked today. It went from food to mucus to this. I don’t feed him at all when he’s like this. As of right now, he’s perfectly fine and begging for food!

One additional note… we give him Purina One (vet’s suggestion) and use a slow feeder. We feed him small meals 4x/day, rather than 2 big meals. We are also very careful about making sure he doesn’t eat anything he shouldn’t.

Thank you!!

4 year old lab, who LOVES to eat, refused breakfast, had yellow vomit in his bedding and is acting a little subdued. His bowel sounds are so loud. I can’t think of anything he ate that he shouldn’t have. Do dogs sometimes just get a stomach bug? His bm was normal this morning

I adopted a barn cat about 6 months ago. She has been doing well up until 2 days ago… I noticed she wasn’t eating her favorite food, she’s lost weight and now she is vomiting. Her first vomit was foamy and her second was straight runny wet food.

My lab will be 11 in June. He was diagnosed with diabetes 4 years ago. We’ve never been able to regulate his insulin and have tried both human and dog insulin. He’s currently taking 31 units of vetsulin 2 times a day and has been for over a year. No matter what dose/medicine brand we try, his blood sugar is still really high (between 250-400)! Recently, he’s been throwing up a few times a week after eating or drinking. The vomit is white and clear and looks like its mostly slobber with only a very small amount of food. What’s causing this?

I’m taking care of a Siamese who’s over 10, an indoor/outdoor cat. I did a cbc & chem bloodwork. His BUN is only slightly elevated. His issue is throwing up daily, weight loss, & diarrhea. His vomit is undigested food & liquid. He eats very little wet food & his owner just feeds all of them the worst dry food. I give him sq fluids as needed & started cerenia. Yet this is not treating the underlying cause. Does anyone have any advice on this? I have vet bills for my cows & my cats. Yet i still want to help all the animals I can. I obviously have very little money to help though. Thanks