My 7 year old tabby cat is very ill

by Stacey
(Toronto, Canada)

Hi Dr. Neely

Since April, my 7 year old tabby has been showing signs of gas, shaking his head and mouth. Then he started to be fussy about eating until he stopped eating altogether. He has always been an easily stressed cat and this seemed to increase the cat illness symptoms.

He was hospitalized with our veterinarian in May and bloodwork showed nothing. There was nothing wrong with my cat’s teeth or mouth. He had 13 xrays which also showed nothing. He came home after this visit and started eating normally again until last week when the symptoms re-occurred.

I have seen my cat eat green onions before, but he has not done so since, as I have removed them from the garden. My cat stays only in my yard so I know he is not exposed to other toxins. He stopped eating, hiding from me and shakes his head and burping up gas. He was hospitalized again.

Both times he was on tagamet for gas and amoxicillin in case of an infection. Because he was showing signs of depression and started eating again, we brought him home again, hoping he would improve like the last time. I have had to segregate him in order to give him medications because he runs when I would try to catch him for meds and food.

In addition to tagamet and amoxicillin, we introduced cyproheptadine to increase his appetite and sucralfate to treat what may be ulcers as he vomited blood a couple of times. Unfortunately he is not improving and has projectile vomited with blood since last night. My cat cannot keep food or medication down.

I am concerned there is a tumor but we cannot afford to do any further tests like ultrasound and endoscopy. I notice he has been twitching which I am concerned is because of pain. His eyes are still bright and gums ok too but he is depressed and unhappy.

In your professional opinion, do you think that this could be something treatable? I hate to think that I would have to put him down but I do not want him to suffer.


Dear Stacey,

Honestly, with normal bloodwork, but not eating and suffering from projectile vomiting with blood, halfway through your letter, I immediately thought that your cat needed further testing. All in all, the cat illness symptoms you described sound like primary GI problem. In most cases, my recommendation would be to explore testing such as ultrasounds, MRIs, or even an exploratory surgery.

The feline illness symptoms you described could certainly indicate cancer, but feline irritable bowel could present with similar symptoms. The only way to determine whether your cat is suffering from irritable bowel definitively would be to conduct an intestinal biopsy. That said, however, over the years, I have had many clients who, for one reason or another, were unable or unwilling to explore such possible diagnoses further, and we began treatment for irritable bowel to see if there was any improvement in the cat’s symptoms.

If further testing is truly not an option, I recommend talking to your vet about beginning your cat on a trial of prednisolone and metronidazole to treat for possible feline irritable bowel. For most cats, I would also recommend exploring the possibility of introducing a hypoallergenic cat food diet, but in your situation, it sounds as though the main focus is to get your cat eating whatever he will eat. However, even without a hypoallergenic or low-allergen diet, the feline medications alone should help treat irritable bowel if this is in fact your cat’s condition.

If there haven’t been multiple fecal exams that have been repeated, these should be done to make sure that a simple thing like feline parasites are not causing your cat’s illness symptoms. Even if the normal GI parasites aren’t present and the fecals are negative, a very wise veterinary professor once told me, “Every vomiting cat deserves a trial Panacure.” While stomach worms are not common in cats, they can be present, and treating your cat with Panacure would address this very simple issue that your veterinarian otherwise might miss. Discussing this option with your veterinarian would be wise as well.

Toxins are still a possibility, even if you haven’t seen your cat ingesting onions from your garden. Other plants, even grass, can irritate a cat’s stomach, and unless you are watching your cat at all times while he is outdoors, there are no guarantees that he isn’t venturing into a neighbor’s yard and eating something toxic or irritating. For this reason, especially while he is sick, keeping him indoors is very important.

At very least, more exploration, such as the medication trials for irritable bowel and deworming treatments, would be recommended for your cat. Talk openly with your veterinarian about your financial concerns and discuss the possibilities of conducting these trials as intermediate steps before giving up all hope.

All the best,
Dr. Neely