Hello Lynn,
I guess first thing to ask and I'm sorry I have to do this- can your cat still get to the dracaena? If he still is eating the plant, well there ya go. But I'm sure you've already removed the source of the problem...

A routine panel can rule out many metabolic diseases. Did the bloodwork include T4 to rule out hypertyroidism? If not, I'd definately have that included with any additional lab work.

There are several other things that can make a cat vomit, feel fine, and have normal bloodwork.
Foreign body with partial GI obstruction; he has a history of eating a plant, which isn't entirely digestible.
Other obstructions- masses, intussusception (folding of intestines over itself); probably the reason for the radiograph
Pancreatitis- cats don't always have routine bloodwork changes with this condition; can do additional blood tests (PLI, TLI) that are more sensitive
Food sensitivity/allergy/intolerance
GI cancer- usually hard to see with radiographs and sometimes ultrasound doesn't pick it up either, because it tends to be diffuse infiltrative disease, not discrete masses
Famotidine causes some people to vomit; it doesn't have much documentation for use in veterinary med, so it's possible the meds are making him vomit
Toxins- probably not in an indoor only cat, unless there are other plants within reach
Parasites- also unlikely but possible in an adult indoor cat

That's just a start. Some things are hard to diagnose. My own Aleksander (husky) had GI cancer, but it wasn't diagnosed until after 3 sets of routine labwork, one test for Addisons, 2 ultrasounds by boarded radiologists, with attempts to aspirate a thickened pyloris, and finally got it diagnosed on endoscopy. All he was doing for the first month was vomiting once a day.

Unfortunately vomiting is a very non-specific problem and almost anything can cause a cat to vomit. Sounds like the vet is progressing in a logical manner to me- has history of eating non-food items so look for evidence of that, and continue ruling out other common metabolic diseases just based on his age.

I hope he does OK. What's his name?

My cat, 14 yrs. old, was vomiting several times a week. She was diagnosed with inflammatory bowel disease. She is now on cortisone and doing really well.
Lois

Hi Meghane and Lois thanks for responding.

Hank (my cat) has been separated from the Dracaena plant. His blood work did include T4 and was okay. I just tried giving him the canned i/d prescription diet food last night and this morning in case I'm unsettling his stomach with his regular dry food. Perhaps I'm giving him the food too fast for his stomach to settle?

If it was an obstruction, could it be small enough to not notice with physical exam? And would it not cause pain for him at first?

Also, if it is anything other than an obstruction or eating too much Dracaena would you expect to have seen him vomiting little by little over time? Such as once a month and progressing to once a week?

Nothing has changed in the house or with his food other than bringing that plant in from the screened in porch which he had access to before (although much more limited).

Lastly, it is usual practice to start with more blood work and then if that doesn't give an answer do the x-ray?

Thanks, I appreciate the responses!

Lynn

Lynn, I hate to say it but that was exactly what Aleks did with the progressive amounts of vomiting over time. He wasn't painful and he didn't feel bad at all, until 2 months later when he was nauseous all the time. Then he stopped eating. Still never vomited more than twice a day, even at the end. He had gastric adenocarcinoma, which is a horrible thing to get, no matter what species you happen to be.

Unless it's an obstruction with a solid mass, it's hard to feel it on a PE. Can't palpate the stomach very well unless it's huge, and wouldn't necessarily feel it. Normally the most you can feel is thickened bowels, maybe a solid mass like a rock or something, but if there is a plant leaf blocking the GI tract you probably couldn't feel it. It's almost impossible to feel a partial obstruction. But you maybe could see those things on radiograph, or at least the effects of the obstruction on the GI pattern.

As far as doing bloodwork vs radiograph, it depends on what the vet thinks is going on. She she mention what the next labwork would be and what she is looking for in both labwork and radiograph?

Hank is a great name!

My indoor neutered cat who is 9 is doing the same thing, mainly brown liquid with a bit of fur. All his labs were normal. He had been constipated the vet said so had an enema. He has been on Lactulose for 6 days but is still vomiting. He eats all his food, runs around the house, plays, does not act sick. Waiting to hear back from the vet.

My cat is doing the same exact thing. You just described what’s happening to my cat to the exact. His blood work was normal as well. However, he don’t eat plants or anything. Did anyone give you a solid answer. ? Thanks

My cat was 14 and did that but no eating plants they said they wanted to do a ultrasound to look in stomach wich was $500 i dint have he was starving to death had to ket him go 😢