Simon (pictured above with his beloved orange carrot catnip toy in background) started vomiting at 4 am last night. I tried to go back to sleep. He proceeded to continue to vomit small piles of white foam everywhere. By 8 am I estimated he had vomited about 50 times. Of course, I got teased mercilessly for this once he was at the hospital (50? not 49? or 47? were you counting?).
I got him the first available appointment in the morning (it didn't seem to be a true emergency in the sense that I felt he could wait the four hours until the non-emergency part of the hospital opened). I would have liked to ignore it and wait longer but one thing that I learned as an emergency technician is that things can go wrong pretty quickly if you are unlucky and that ignoring a problem does NOT actually make it go away much as you might wish it did.
My student clinician did a thorough physical exam. A good look under the tongue with a tongue depressor to help revealed nothing. Kidneys are on the small side of normal at 3-3.5 cm. Stool in colon. Nothing very remarkable.
Radiographs, much to my relief, were also unremarkable.
My student clinician sent Simon home with some SQ fluids and pepcid on board.
He CONTINUED to vomit at home. I was just about to lie down for a nap after lunch when my student clinician called to check on him and so I brought him back in for more diagnostics.
Bloodwork was unremarkable. I was relieved. His total protein was high but his hematocrit was normal. BUN, creatinine, everything else normal (except his cholesterol was a little high).
Urinalysis by cystocentesis revealed some WBCs, RBCs and bacteria. He had a urinalysis and culture and susceptibility last week because of his intermittent inappropriate urination problem and it came back negative. What the heck that he now has some bacteria this week on UA??? At any rate, we couldn't attribute his vomiting to a UTI as he has no other clinical signs of one. (Though we will probably start him on antibiotics tomorrow and we did submit a sample for culture and susceptibility so we can switch antibiotics if need be).
We gave him Cerenia (which I know from school inhibits neurokinins)-- he tried to eat me alive while I restrained him for it and I almost got bit (way to go, almost getting bit by my very own fractious cat) and I took him home.
He hasn't been vomiting since.
I just gave him his next dose of pepcid SQ. He tried to eat me alive again. I swear, if he gets kidney disease I am NOT treating him for it. Thank goodness Lindy is sweet for her treatments, if she weren't then she wouldn't still be alive.
We have a recheck appointment scheduled in the morning. Did I mention my student clinician rocked? She was awesome.
Fingers crossed no more vomiting tonight.
And yeah, as for one possibility of what caused it-- stress related to my upcoming move. Same thing happened last year, when Lindy had a bout of prolonged vomiting just before I moved (see
this post). Have I mentioned how much I dislike moving?
Above: The view out my new bedroom window. I like all the trees but their leaves don't make that soothing, whispering bronchovesicular sound that the trees at my old place did. Still, I'm settling in and happy here.
