I took him off the heart medicine to see how the Zyrtec worked, and he went a couple of days without gagging. Then when it started again (although not as often), I put him back on the heart meds and the Zyrtec. It's a little too early to tell, but so far so good! Oh great, just as I was typing this he gagged three times! I'll post an update after I've taken him back to the vet.
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