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Posted on 03-25-2016

Vomiting in Cats

Every cat owner knows that sound….the up-chucking sound in the middle of the night on your new rug. Or, you awaken in the morning to step barefoot in a cold splat that your precious kitten left for you in the hallway.  Vomiting in cats is disgusting and can take a toll on your upholstery and flooring. But what about your cat’s health? Is the occasional “hairball” normal or is it a sign of a deeper problem?

Vomiting Isn’t All it Seems….

If your cat vomits more than just rarely, it is important for you to talk to your Claremont Montclair veterinarian. When you discuss the issue, it is important to note a few things about the vomiting episode, if you see it happen.

Vomiting is different from regurgitation. If your cat produces a “tube” of undigested food soon after eating, this is likely regurgitation. When most cats do this, you don’t see any heaving or abdominal movement. 

Vomiting, on the other hand, has an “abdominal component”, where the cat retches and squeezes their belly to get their stomach contents out.  Vomiting vs. regurgitation have different causes and can be important in diagnosing your cat.

What you see in the vomit is also important for the veterinarian to know. Is it foamy? Is the food digested or undigested?  Is there any evidence of foreign material in it, such as string, bird feathers, etc?  Ingested hair is a common finding in cat vomit. Most people refer to these as “hairballs” and that their cat “coughs” them up. In reality, your cat vomits up hairballs. Frequent production of hairballs can signify a problem within the digestive tract or mean that your cat has a skin issue.

Common causes of vomiting include:

  • Sudden diet change

If you run out of your cat’s regular food and grab what you can from the corner store to get you through the weekend, this can incite an episode or two of vomiting. Suddenly changing your cat’s food can cause a little bit of stomach upset, just like when you eat something you’re not used to.  Not every cat food is formulated the same way and some have a higher fat content than others, which can cause stomach upset. If your cat is vomiting after a food change, contact your veterinarian so your cat can get some relief.

  • Food Sensitivity

This may seem similar to the comments about diet change, but it is very different. Certain ingredients, such as proteins like beef or chicken, or grains like wheat and corn, can cause digestive upset in certain cats. A food sensitivity can also be a food allergy. Unfermented milk products contain lactose, and most cats are lactose-intolerant as adults.  Your cat may like the taste and smell of milk, but it can cause some serious side effects!  So, the next time you pour yourself a glass of milk, skip the saucer for your feline friend.

  • Hairballs

Hairballs are common, but they are not normal in most circumstances. Hairballs can be a sign of other digestive disorders, like inflammatory bowel disease.

Cats are fastidious groomers and ingest hair during this process. The normal feline gastrointestinal tract should be able to pass small amounts of hair under normal circumstances. Excessive amounts of hair can be problematic and can cause irritation in the stomach.  Vomiting helps to rid the system of this irritation. Also, other inflammatory processes can make cats more sensitive to ingested hair.

Long-haired breeds, like the Ragdoll, are more prone to suffering from hairballs. Daily brushing can help to reduce the amount of hair that your cat ingests during grooming.

Skin disease or parasites like fleas can cause your cat to ingest more hair than normal. Some cats will obsessively over-groom parts of their bodies, which can in turn lead to digestive issues.

  • Foreign bodies – such as ingested string

Cats, especially kittens, LOVE to play with string. When ingested, string can cause serious and even life-threatening problems. It can bunch up in the stomach and cause an obstruction, leading to vomiting. String can also get trapped in the intestines as a “linear foreign body.’ This linear substance is irritating to the intestinal wall and as the intestine tries to move the string along, the string stays put and causes the intestines to bunch up, possibly leading to a painful condition called intussusception. If you or your Montclair-Claremont veterinarian is suspicious of a foreign body as the cause of vomiting, surgery is often necessary.

Strings can also get trapped around the base of the tongue and dangle into the throat. This can cause immediate and chronic irritation. Many of these cats will vomit, refuse to eat or eat less, paw at the mouth, and retch. Veterinarians will often sedate vomiting cats to thoroughly examine the back of their mouth and around the tongue for string.

If your cat goes outdoors to hunt, bird feathers and bones can also cause vomiting. It is important to consider your cat’s lifestyle when talking to your veterinarian about vomiting issues.

  • Gastrointestinal irritation or malfunction

Stomach irritation sometimes has a cause, as previously mentioned. Hair, foreign bodies, and food are common culprits. Sometimes, there is no obvious reason for stomach irritation. Viruses and parasites can also cause gastrointestinal upset, leading to supportive care for the cat until the virus runs its course or the infection is properly treated.  Tumors or neoplasia of the gastrointestinal tract can also cause vomiting.

  • Hyperthyroidism

Middle-aged to older kitties can develop nodules on their thyroid gland that produce excessive amounts of thyroid hormone. These high levels can wreak havoc on your cat’s metabolism, cardiovascular and digestive health. Many cats with hyperthyroidism will have a voracious appetite, lose weight, and vomit frequently.  If your cat is diagnosed with a thyroid disorder, specific treatment will reduce or eliminate your cat’s vomiting. Hyperthyroidism can be cured in >90% of cats by using radioactive iodine (I-131) therapy.

  • Kidney or urinary tract disease

Cats with bladder infections or urinary blockage will vomit. Sometimes these conditions are only diagnosed because the owner took the cat into the vet for vomiting. Older cats should be screened for kidney disease if they vomit frequently. High levels of by-products in the blood that should be flushed out by the kidneys can cause nausea, decreased appetite and vomiting.

Other less common causes of vomiting include:

  • Pancreatitis
  • Inflammatory bowel disease
  • Liver disease
  • Heartworm disease
  • Diabetic ketoacidosis

Diagnosis

Your veterinarian will ask for a thorough history regarding the vomiting. Describe the vomit to your vet (don’t worry, she won’t think it’s weird) and any circumstances around the event. If vomiting happens frequently, be sure to say how often.  Please let your vet know if your cat likes to play with string, or if any has gone missing.

The veterinarian will perform a thorough physical examination. The most important aspect will be examining the abdomen, genitalia, skin/hair coat and oral cavity. Your vet may ask to sedate your cat for a thorough oral and tongue exam, especially if a string foreign body is suspected.

Bloodwork, such as a serum chemistry and complete blood count (CBC) is often recommended, especially for middle-aged and older cats.  A thyroid screening may also be included to rule-out hyperthyroidism. If urinary or kidney disease is suspected, a urinalysis will be performed.

Advanced diagnostics may be considered depending on your cat veterinarian’s evaluation. Abdominal ultrasound, x-rays and even exploratory surgery could be possible.

Treatment

As mentioned above, treatment will depend largely on the cause.  Many times, regardless of the cause, your veterinarian will want to quickly provide relief. Vomiting cats often don’t feel well and are nauseated.  Injectable medications are available to provide relief as quickly as possible.

Veterinarians don’t recommend withholding food from vomiting cats. The thought of “resting” the stomach may be okay in other species, but cats don’t do well when they don’t eat. Cats are designed to eat frequently. If they don’t eat anything at all for 24-72 hours, severe metabolic problems can occur. Anorexia and withholding food can predispose your cat to more medical problems, specifically fatty liver disease.

If your cat is vomiting, continue to offer food. If they are not eating well, let your veterinarian know. A diet change or even nutritional support in the hospital may be necessary, depending on how severe the cat’s problem is.

Pain medications may be necessary if your cat has abdominal pain. Always give these as directed. Gastro-protectant drugs, such as antacids, may help in certain circumstances.

Studies have found that petroleum-based hairball remedies don’t often help with vomiting associated with hairballs. Hairball remedy foods can help the digestive tract rid itself of hair and decrease vomiting. Many of these dry foods have a higher fiber content. The shape of the dry kibble may also help to prevent hairball production, with “triangle” shaped kibble being better than “round” shaped.  Most cats do not chew their kibble very well or at all before swallowing. The thought is that the “triangles” help to grab onto hair in the stomach and help it along down the digestive tract.

The Bottom Line

We all want our feline friends to be as happy and healthy as possible. If your cat is vomiting several times a week, it is time to talk to your veterinarian. Sometimes small changes in diet can be all it takes to fix the problem, while others may need long-term medical management.  

By Dr. Nichole Agarwal

Resources

Cooper, Edward. The Vomiting Cat: What to Do? International Veterinary Emergency and Critical Care Symposium Proceedings. 2011.

Scherk, Margie. Hairballs. NAVC Clinician’s Brief. September 2012;10(9):20-21.

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