3 yr. Old pekechi vomiting

Question
My dog has epilepsy and has been on pheno for the past 1.4 years. 2ml every 12 hours. He hasn't had a seizure in a year. Last week he had 3 small seizures in a week.  I took him to the vet who did his pheno levels (16.1) and CBC  blood panel. He doubled his pheno. Now 3 days later after his morning tissue he became lethargic dnd vomited his breakfast.  He has now vomited a total of 4 times.  I took him to a nearby vet who said fhr needed a liver bile test snd other things (463.0) ehich i dont have she told me to reduce the pheno by 1ML.  She never addressed his vomiting. I called back they were closed. He keeps trying to sleep bit wakes up to vomit. Twice. Should I take him to ER? I really don't have another 100.00. But I will if I have to.  The vet prescribed do meds
Please help.

Answer
Well I am not a vet but it sounds to me like he is having some pancreatic issues. Liver and bile are part of that but vomiting over and over is usually from gastritis, pancreatitis or a liver toxicity.

He may have eaten something unusual for him. If he did, that will start a bout of vomiting like this.

Gastritis and pancreatitis are both pretty serious conditions that do require a vet's care. The increase in the phenobarbital could cause the vomiting as well, but it is more unlikely that it is the cause.

The vet did address part of the vomiting issue because she must have felt that his vomiting was a result of his bile tests being high. But that can also be from eating fatty foods when they are not used to eating them.

So you need to figure out what he has eaten in the last few days that could have caused this. The constant vomiting is also dangerous because he will become dehydrated. For that reason you need to make sure he gets some fluids into him such as Gatorade. Water isn't enough.

But if he keeps vomiting he will need to see an ER vet for some fluids. That might be all he will need to get him through the night.

I would say that if he vomits twice more tonight you need to get him to a vet and get some fluids into him.

That's what I would do if he were my dog.
I hope that he feels better soon.