if you have cats, you’ve probably seen one of them vomit at one time or another. It is common for cats to vomit, but it is never normal for them to do so. That said, it’s also not always something that needs to be treated, nor is it necessary to take the cat to the vet every time he vomits. In this resource, you’ll learn when to take a vomiting cat to the vet, why cats vomit, and what treatments are available to help felines feel better.
chronic and acute vomiting in cats
Vomiting can be divided into two broad categories: chronic and acute vomiting. Chronic vomiting means vomiting with some regularity (at least once a month, but it can be every day) over a long period of time. the cat usually only vomits once or twice with each occurrence. when a cat that doesn’t normally vomit starts vomiting, that’s the acute type. this is generally a concern for you and your vet only if the cat vomits multiple times. Diagnosis and treatments for acute and chronic vomiting can differ, as can the urgency of taking the cat to the vet.
More urgent care is usually required for a cat with acute vomiting. the exception to this is a cat that has only vomited one to three times and is otherwise normal. If the cat still wants to eat and does so without further vomiting, is behaving normally and seems comfortable, there is no need to take him to a veterinary hospital unless you know he ate something toxic.
If your cat is vomiting more than three times, is unable to keep food down, and appears tired, she should be seen by a veterinarian as soon as possible. you may only be experiencing transient nausea, but if it is something more serious, treatment should be implemented as soon as possible. Unless the cat is in severe discomfort or doesn’t want to move, you usually won’t need to go to an emergency clinic. but if it appears to deteriorate rapidly overnight, an emergency visit is recommended. Cats that continually vomit and don’t keep food down are prone to many secondary changes, especially liver disease, so waiting for treatment can be dangerous for them.
A cat with chronic vomiting should still be seen by a veterinarian, but it is not urgent if the cat is still eating and retaining food, shows no signs of weakness, and appears comfortable. If these things are not true, a chronically vomiting cat is either an acutely vomiting cat or is having an acute bout of whatever is causing its chronic vomiting.
In the past, a cat that vomited several times a month was considered normal, but that idea is changing. It is even thought that a cat that vomits hairballs frequently may have a gastrointestinal disease that does not allow the normal passage of hairballs. Treatment may not be implemented for a cat with chronic vomiting, but an examination and study should be performed to ensure the cat is comfortable and does not need any intervention at this time.
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causes of vomiting in cats
The causes of acute or chronic vomiting can be the same, but there are exceptions. toxins are generally not a cause of chronic vomiting (unless a cat is chronically exposed to the same toxin, such as eating a toxic plant). Swallowing a foreign body (typically a string) is not normally a cause of chronic vomiting, although if the foreign object remains in the stomach, it may be a cause of chronic vomiting.
Unfortunately, vomiting is a very vague symptom and the causes are extremely varied. in fact, almost any feline illness can cause vomiting. In general, the causes of vomiting can be placed in one of these categories: toxins, drugs, diet (including eating inappropriate things), gastric (stomach), intestinal, organic dysfunctions, endocrine, neurological (typically related to the brain), infectious and cancer. In each of these categories there are dozens of specific diseases and syndromes. some of the more common causes are listed below:
- toxins: irises, antifreeze
- medications: chemotherapy, antibiotics, anti-inflammatories
- diet: dietary intolerance to something in food, sudden change in diet, eating something dead
- gastric: foreign bodies, ulcers, inflammation of the stomach
- intestinal: foreign bodies, acute inflammation, inflammatory bowel disease (more typically chronic), cancer, constipation
- organ dysfunction: liver disease, kidney disease, pancreatitis
- endocrine: hyperthyroidism (overactive thyroid gland), elevated calcium, diabetic ketoacidosis
- neurological: vestibular disease (may be associated with inner ear disease), encephalitis (inflammation of the lining of the brain), cancers
- infectious: feline infectious peritonitis, feline panleukopenia, heartworm
- cancer: can be a direct cause, such as intestinal cancer, or an indirect cause, such as mast cells in the skin
- Was the cat exposed to plants and other toxins?
- when did the vomiting start?
- what is the cat’s normal diet?
- Does the cat come out and if so, does the cat hunt?
- what’s in the vomit?
- Is the cat on medication?
- Is there diarrhea too?
- Is the cat eating?
- when does the vomiting occur (in relation to eating or other activities)?
- Is the cat losing weight?
- Does the cat drink a lot or urinate a lot?
- Does the cat play with strings?
- Yellow vomit: This is bile and can be a sign of liver disease, but often occurs on an empty stomach. it can also mean the cat ate something yellow.
- clear vomiting: this may be regurgitation from the esophagus or from an empty stomach.
- Frothy white vomit: Again, this is usually regurgitation from the esophagus or from an empty stomach.
- Blood in vomit: Blood is from the mouth, esophagus, or stomach.
- vomit that looks like coffee grounds: This type is due to stomach bleeding, most often seen in ulcers.
- Stinky brown vomit: This can be from bleeding in the upper GI tract or from eating something brown and smelly.
- Undigested food in the vomit: This means that the food never left the stomach. it can occur with food intolerances or allergies, obstructions, or just about anything that causes irritation of the upper GI tract. it is important to know when the cat last ate. For example, if the cat hasn’t eaten for a day and is vomiting undigested food, that would indicate an obstruction or motility disorder.
diagnose the cause of vomiting
It can be difficult to diagnose the cause of vomiting in a cat. most cases of acute vomiting are transient and improve with only symptomatic therapy and time. however, a basic workup is often recommended to ensure a more serious problem does not develop.
The starting point for determining the cause of vomiting is to obtain an accurate history. Here are some questions your vet might have:
Based on the answers to these questions, your veterinarian will have a better idea of which diagnosis to use, if any. The appearance of the vomit doesn’t give a definitive answer as to why the cat is vomiting, but it can give the vet a place to start looking. Although by no means a perfect correlation, the following characteristics of vomiting may offer some clues:
veterinary exams and tests
The next step is a complete physical exam by your veterinarian. The vet may look for things like abdominal pain, masses in the abdomen or elsewhere, an obvious foreign body (such as a thread under the tongue), evidence of weight loss, a heart murmur, an enlarged thyroid gland, and fever. again, the exam can help determine what diagnoses, if any, are needed.
abdominal x-rays and blood tests
If warranted, initial tests are usually abdominal X-rays (also known as X-rays) and blood tests with a urinalysis. X-rays may reveal abnormalities in the size and shape of organs, foreign bodies, tumors, constipation, and other abnormalities that the veterinarian may not be able to assess with a physical exam. the blood test can detect things like organ dysfunction and can diagnose endocrine disorders like diabetes and hyperthyroidism. A urinalysis is needed along with a blood test to diagnose conditions such as diabetes, kidney disease, and urinary tract infections.
Blood tests can also give clues as to whether an animal has been exposed to some toxins, such as antifreeze. Unfortunately, there are not many easy tests to diagnose toxin exposure. awareness of potential toxin exposure and the presence of classic signs of toxin exposure are often required by the cat person.
barium study, ultrasound and endoscopy
X-rays often do not diagnose the problem (other than foreign bodies and a few other conditions), but they do help determine if further abdominal studies are needed. These other tests might include a barium study, which will help determine if there are any foreign objects in the intestines or if there are any motility problems in the intestines. another study could be an ultrasound to observe the architecture of different organs; ultrasound can be used as a means of sampling different organs to obtain a definitive diagnosis.
In addition, your veterinarian may recommend an endoscopy (using a scope to examine the stomach, upper intestines, or colon). Endoscopy is a way to look for foreign objects in the stomach that do not show up on x-rays and can be used to retrieve foreign objects. This procedure also allows the lining of the stomach and upper intestines to be viewed for abnormalities, and can be used to collect samples from the upper gastrointestinal tract.
exploratory surgery
In a cat with persistent vomiting that is not controlled with symptomatic therapy, exploratory surgery may be necessary. this is true with some acute vomiting situations (ie, concern that a foreign body may be present) and some chronic vomiting situations (ie, looking for signs of bowel cancer, non-intestinal abdominal disease, or inflammatory bowel disease ).
In the case of foreign objects, surgery is used both to diagnose and to solve the problem, by removing the foreign object. if no foreign object is found, biopsies may be taken during surgery. The intent of performing surgery for chronic vomiting is usually to take biopsies of the intestines, stomach, liver, pancreas, lymph nodes, and any abnormalities in hopes of diagnosing the problem. the most common things to diagnose are inflammatory bowel disease or a form of cancer.
As a diagnostic tool, some veterinarians prefer surgery to endoscopy because the entire intestinal tract can be evaluated, as well as different organs in the abdomen. additionally, full-thickness and larger intestinal biopsies may be taken during surgery. in addition, biopsies of the liver, pancreas, and lymph nodes may be taken. conversely, endoscopy may be preferred because it is generally less expensive (although not much), usually results in a representative sample of the intestines to provide a diagnosis, and is much less invasive. It may take several weeks for a cat to recover from surgery, while an animal that has had an endoscopy and endoscopic biopsies usually recovers within a few hours to a day.
Because some of the diagnostics can be invasive and expensive (endoscopy can cost up to $1,500 and exploratory surgery can cost more than $2,000), many people choose not to have them. there are treatments that can be implemented without a full diagnosis, but those decisions will require communication between you and your veterinarian about the risks of performing those treatments.
treatments for a vomiting cat
Treatment for vomiting varies greatly by cause, and describing treatment for each individual cause is beyond the scope of this resource. however, we can give some generalizations for treatment.
liquids
If the physical exam reveals no abnormalities and nothing in the cat’s history raises a red flag, a veterinarian may choose to perform some symptomatic therapy, such as giving fluids subcutaneously (under the skin). even if an animal is not clinically dehydrated, it may be important to give fluids to flush the system and maintain hydration. a vomiting patient is likely to be slightly dehydrated simply from fluid loss due to vomiting and not being able to keep water down.
Dehydration is a self-perpetuating problem, which means that when an animal is dehydrated, it does not feel well and therefore does not eat or drink, and may even vomit more. this dehydrates her more, which makes her feel worse, which makes her less likely to eat or drink, and then she becomes more dehydrated.
Some form of fluid therapy is given for almost all causes of vomiting. if an animal is severely dehydrated or weak, intravenous fluids are often recommended. this involves placing a catheter into a vein and administering fluids to the animal through the catheter. it is a more direct way of giving fluids and more fluids can be given through this method throughout the day. the downside is that giving intravenous fluids is significantly more expensive and requires the cat to stay in the hospital. however, especially in a very dehydrated patient, subcutaneous fluids are not very well absorbed and intravenous fluids are needed to help the cat.
medications against vomiting
Another common therapy for most types of vomiting is to administer an antiemetic (anti-vomiting) medication, which can help stop vomiting and thus decrease fluid loss. these medications can also help relieve abdominal discomfort and make the cat more likely to eat. stomach protectors such as pepcid or sucralfate may sometimes be prescribed, but the usefulness of these is debated. however, they usually do not cause any damage. If antiemetics do not provide adequate pain control, an analgesic may be added to the cat’s treatment plan.
diet changes
For cats with chronic and acute vomiting, one of the most important treatments is a change in diet. If your cat has an acute case of vomiting, this may involve a temporary switch to an easily digestible diet, such as Royal Canin Gastrointestinal High Energy Cat Food, Hill’s Id Cat Food, or a bland human food such as Baby Food with beef flavor (no onion or garlic powder) or boiled chicken. keep in mind that chicken and baby food are not complete cat diets and therefore should only be used for a few days. For cats with chronic vomiting, a change in diet can be both therapeutic and diagnostic.
If the new food controls vomiting, it was caused in part by a dietary intolerance or allergy or possibly by low-grade inflammatory bowel disease. Regarding diet tests for cats with chronic vomiting, keep them on the new diet for several weeks to see if it’s working. the cat should be on one of the prescription diets listed above or a limited ingredient prescription diet, to ensure it is a complete and balanced diet.
prednisone
As mentioned above, inflammatory bowel disease may be the cause of vomiting in some cats. treatment for inflammatory bowel disease often involves the drug prednisone. We do not recommend that you try prednisone in your cat undiagnosed because prednisone has many side effects, including increased thirst, increased urination, a weaker immune system, and weak muscles. giving a cat prednisone can also worsen some of the causes of vomiting (such as pancreatitis, diabetes, and kidney disease). however, if your cat’s blood tests and x-rays are normal and you do not want further diagnosis, a prednisone test might be considered. you’ll want to have a detailed discussion with your vet about the risks.
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