What to Do When Your Cat Keeps Vomiting: Understanding Causes and Seeking Help

It’s distressing to see your beloved cat vomiting. Occasional vomiting might not always be a cause for alarm, but when your cat keeps vomiting, it’s a clear sign something isn’t right. As loving cat owners, we naturally worry and want to understand why our feline friend is throwing up and what we can do to help. This guide will walk you through the potential reasons behind persistent vomiting in cats, what to expect at the vet, and the available treatment options to get your kitty back to their healthy, happy self.

When you bring your cat to the veterinarian because of vomiting, they will need to gather a detailed history to narrow down the possible causes. Be prepared to answer questions such as:

Questions Your Vet Will Ask About Cat Vomiting

To start diagnosing why your Cat Keeps Vomiting, your veterinarian will likely ask a series of questions to gather crucial information. These questions can range from your cat’s environment and diet to the characteristics of the vomit itself. Being prepared with these answers will help your vet quickly assess the situation. Common questions include:

• Has your cat been exposed to any plants or potential toxins? Certain houseplants and household chemicals are poisonous to cats and can induce vomiting.
• When did the vomiting episodes begin? Knowing the onset and duration of vomiting helps determine if it’s acute or chronic.
• What does your cat normally eat? Changes in diet or food intolerances can be triggers for vomiting.
• Does your cat go outdoors, and if so, does it hunt? Outdoor cats have more exposure to parasites, toxins, and may hunt and ingest prey that could cause illness.
• What does the vomit look like? The appearance of the vomit provides important clues (more on this below).
• Is your cat currently on any medications? Some medications can have vomiting as a side effect.
• Is your cat also experiencing diarrhea? Combined symptoms can point to specific gastrointestinal issues.
• Is your cat eating normally? Changes in appetite, especially reduced appetite or refusal to eat, are significant.
• When does the vomiting occur in relation to meals or other activities? Vomiting right after eating could indicate different problems than vomiting hours later.
• Is your cat losing weight? Unexplained weight loss alongside vomiting can be a serious sign.
• Is your cat drinking or urinating more than usual? Changes in water intake and urination can indicate underlying systemic diseases.
• Does your cat play with string or similar objects? Cats who ingest foreign objects like string can develop intestinal blockages leading to vomiting.

Providing thorough answers to these questions will give your veterinarian a much clearer picture and guide them in deciding which diagnostic steps, if any, are necessary.

Understanding Cat Vomit: What the Appearance Means

While the appearance of cat vomit isn’t a definitive diagnosis, it can offer valuable insights for your veterinarian. Observing the characteristics of your cat’s vomit can help them narrow down the potential causes and determine the next steps in diagnosis. Here’s what different types of vomit might indicate:

• Yellow Vomit: Yellow vomit typically indicates the presence of bile, a digestive fluid produced by the liver. While it can sometimes be a sign of liver issues, it more commonly occurs when a cat vomits on an empty stomach. It can also simply mean your cat ingested something yellow.

• Clear Vomit: Clear vomit can be either regurgitation from the esophagus or vomit from an empty stomach. Regurgitation is often less forceful than vomiting and occurs shortly after eating.

• White, Foamy Vomit: Similar to clear vomit, white, foamy vomit often points to regurgitation or vomiting from an empty stomach. The foamy texture is due to air mixing with stomach fluids.

• Blood in the Vomit: The presence of blood in the vomit (hematemesis) is always a cause for concern. Bright red blood indicates fresh bleeding, likely from the mouth, esophagus, or stomach. This could be due to irritation, injury, or more serious conditions.

• Coffee-Ground Vomit: Vomit that looks like coffee grounds suggests digested blood. This indicates bleeding in the stomach, often associated with stomach ulcers. The blood has been partially digested, causing the dark, granular appearance.

• Brown, Smelly Vomit: Brown, foul-smelling vomit can also indicate digested blood from the upper gastrointestinal tract. Alternatively, it might simply mean your cat has eaten something brown and unpleasant, such as feces.

• Undigested Food in the Vomit: Seeing undigested food in the vomit shortly after a meal can indicate that food hasn’t properly left the stomach. This can be caused by food intolerances or allergies, gastrointestinal obstructions, or anything that irritates the upper digestive tract. However, if a cat vomits undigested food many hours after eating, especially after a day of not eating, it strongly suggests a potential obstruction or a motility disorder where the stomach isn’t emptying correctly.

Understanding the appearance of your cat’s vomit is a helpful first step in communicating with your veterinarian and helping them diagnose the problem.

Veterinarian Examination: What to Expect

After gathering information about your cat’s vomiting history, your veterinarian will perform a thorough physical examination. This hands-on assessment allows them to check for various signs that can further pinpoint the cause of your cat’s vomiting. During the examination, your vet will look for:

• Abdominal Pain: Palpating your cat’s abdomen helps determine if there is any tenderness or pain, which could indicate inflammation, infection, or obstruction.
• Abdominal Masses: The vet will feel for any unusual lumps or masses in the abdomen, which could be tumors or enlarged organs.
• Foreign Bodies: In some cases, a foreign body, like a string wrapped around the base of the tongue, might be visually apparent.
• Weight Loss: Checking your cat’s weight and body condition helps assess if chronic vomiting is impacting their nutritional status.
• Heart Murmurs: Listening to your cat’s heart can detect heart murmurs, which, although less directly related to vomiting, can be relevant in some systemic diseases.
• Enlarged Thyroid Gland: Palpating the neck area can reveal an enlarged thyroid gland, a sign of hyperthyroidism, which can sometimes cause vomiting.
• Fever: Taking your cat’s temperature helps detect fever, indicating a possible infection or inflammatory process.

The findings of the physical exam, combined with the history you provide, will guide your veterinarian in determining which, if any, diagnostic tests are necessary to get to the bottom of why your cat keeps vomiting.

Diagnostic Tests for Cat Vomiting

If the physical examination and history don’t immediately reveal the cause of your cat’s vomiting, your veterinarian may recommend further diagnostic tests. These tests help to visualize internal organs, assess organ function, and identify underlying diseases. Common diagnostic procedures include:

Abdominal X-rays and Blood Work

Often, the initial diagnostic steps involve abdominal radiographs (X-rays) and blood work, often accompanied by a urinalysis.

• X-rays: Abdominal X-rays are valuable for visualizing the size, shape, and position of abdominal organs. They can reveal:

  • Organ Abnormalities: Enlarged or shrunken organs.
  • Foreign Bodies: Radiopaque foreign objects that show up on X-rays.
  • Tumors: Large masses in the abdomen.
  • Constipation: Accumulation of fecal matter in the colon.
  • Other Abnormalities: Fluid buildup or gas patterns that are not normal.

• Blood Work: Blood tests provide crucial information about organ function and overall health. Blood work can detect:

  • Organ Dysfunction: Problems with the liver, kidneys, pancreas, etc.
  • Endocrine Disorders: Conditions like diabetes and hyperthyroidism.
  • Electrolyte Imbalances: Dehydration and electrolyte abnormalities often associated with vomiting.
  • Signs of Infection or Inflammation: Elevated white blood cell counts.
  • Toxin Exposure: While not always directly diagnostic, blood work can sometimes provide clues about exposure to certain toxins like antifreeze.

• Urinalysis: A urinalysis is often performed in conjunction with blood work to assess kidney function, detect urinary tract infections, and help diagnose conditions like diabetes.

While X-rays are helpful in identifying certain issues like foreign bodies, they often don’t provide a definitive diagnosis for all causes of vomiting. In many cases, further imaging or procedures may be needed.

Barium Study, Ultrasound, and Endoscopy

When initial X-rays and blood work are inconclusive, or if your vet suspects specific conditions, more advanced diagnostics like barium studies, ultrasound, or endoscopy might be recommended.

• Barium Study: A barium study involves giving your cat barium, a contrast agent that is visible on X-rays. Following the barium’s passage through the digestive tract using a series of X-rays can help:

  • Identify Obstructions: Detect blockages in the intestines.
  • Assess Motility Issues: Evaluate how well food is moving through the digestive system.

• Ultrasound: Abdominal ultrasound uses sound waves to create detailed images of internal organs. It’s excellent for visualizing the architecture of organs like the liver, kidneys, pancreas, and intestines. Ultrasound can be used to:

  • Examine Organ Structure: Identify abnormalities within organs, such as tumors, cysts, or inflammation.
  • Guide Biopsies: Ultrasound can guide needle biopsies to obtain tissue samples for diagnosis.

• Endoscopy: Endoscopy involves inserting a flexible scope with a camera into the gastrointestinal tract. This allows direct visualization of the lining of the:

  • Stomach: Examine for ulcers, inflammation, foreign bodies.
  • Upper Intestines: Visualize the duodenum and jejunum.
  • Colon: Examine the large intestine.
    Endoscopy can be used to:
  • Find and Retrieve Foreign Objects: Remove objects lodged in the stomach that may not be visible on X-rays.
  • Visualize the GI Lining: Identify inflammation, ulcers, or tumors.
  • Collect Biopsies: Obtain tissue samples from the stomach and intestines for microscopic examination and definitive diagnosis.

Exploratory Surgery

In cases of persistent vomiting that doesn’t respond to initial treatments, or when there’s a high suspicion of a foreign body or serious condition, exploratory surgery might be necessary.

• Diagnostic and Therapeutic: Surgery can be both diagnostic and therapeutic. It allows for:
  • Direct Examination: Visual inspection of the entire intestinal tract and other abdominal organs (liver, pancreas, lymph nodes).
  • Foreign Body Removal: If a foreign object is found, it can be surgically removed.
  • Biopsy Collection: During surgery, biopsies can be taken from the intestines, stomach, liver, pancreas, lymph nodes, and any other abnormal areas. These biopsies are crucial for diagnosing conditions like:
    • Inflammatory Bowel Disease (IBD)
    • Intestinal Cancer (Lymphoma, Adenocarcinoma)
    • Pancreatitis
    • Other Abdominal Diseases

Surgery vs. Endoscopy: Both surgery and endoscopy have their pros and cons as diagnostic tools.

• Surgery Advantages:

  • Comprehensive Evaluation: Allows examination of the entire intestinal tract and other abdominal organs.
  • Larger Biopsies: Full-thickness biopsies can be obtained, which are often more representative for diagnosis, especially for IBD.
  • Biopsies of Multiple Organs: Liver, pancreas, and lymph node biopsies can be taken.

• Endoscopy Advantages:

  • Less Invasive: Significantly less invasive than surgery, leading to faster recovery.
  • Lower Cost: Generally less expensive than exploratory surgery, though still can be costly.
  • Representative Samples: Often provides sufficient intestinal samples for diagnosis.

Cost Considerations: Diagnostic procedures like endoscopy (potentially costing up to $1500) and exploratory surgery (possibly over $2000) can be expensive. Due to these costs, some pet owners may choose to pursue treatment without a definitive diagnosis. It’s crucial to have an open conversation with your veterinarian about the risks and benefits of different diagnostic and treatment options based on your cat’s specific situation and your financial considerations.

Treatments for a Cat Who’s Throwing Up

Treatment for a cat that keeps vomiting is highly dependent on the underlying cause. A detailed discussion of treatment for each specific cause is beyond the scope of this article, but we can cover some general therapeutic approaches.

Fluids

Fluid therapy is a cornerstone of treatment for vomiting cats.

• Subcutaneous Fluids: If the vomiting is mild and the cat isn’t severely dehydrated, subcutaneous (under the skin) fluids may be administered. Even in cases without clinical dehydration, fluids help:

  • Flush the System: Help eliminate potential toxins.
  • Maintain Hydration: Counteract fluid loss from vomiting.
  • Address Dehydration: Vomiting itself and reduced water intake lead to dehydration, which can worsen the condition. Dehydration creates a negative cycle where the cat feels unwell, eats and drinks less, and may vomit more, further exacerbating dehydration.

• Intravenous (IV) Fluids: For cats that are significantly dehydrated, weak, or critically ill, IV fluids are often necessary. IV fluid administration:

  • Direct Delivery: Provides fluids directly into the bloodstream via a catheter in a vein.
  • Higher Volume Delivery: Allows for administration of larger volumes of fluids more rapidly.
  • Faster Rehydration: More effective for rapid rehydration compared to subcutaneous fluids, especially in severely dehydrated patients.
  • Hospitalization Required: IV fluid therapy usually necessitates hospitalization and is more expensive than subcutaneous fluids. However, in severe cases, it can be life-saving.

Anti-Vomiting Medication (Antiemetics)

Antiemetics are medications specifically designed to stop vomiting. They are commonly used to:

• Control Vomiting: Reduce or eliminate vomiting episodes.
• Prevent Further Fluid Loss: Help minimize dehydration.
• Relieve Abdominal Discomfort: Reduce nausea and abdominal pain associated with vomiting.
• Encourage Appetite: By controlling nausea and vomiting, antiemetics can make the cat more likely to eat.

While antiemetics are effective at managing vomiting, they are symptomatic treatment. It’s essential to identify and address the underlying cause of the vomiting for long-term resolution.

Diet Changes

Dietary management is crucial for both acute and chronic vomiting in cats.

• Acute Vomiting: For acute cases, temporary dietary changes can be very helpful. This often involves switching to a highly digestible, bland diet for a few days to allow the gastrointestinal tract to recover. Examples include:

  • Prescription Diets: Royal Canin Gastrointestinal High Energy, Hill’s Prescription Diet i/d.
  • Bland Homemade Diets: Plain, meat-flavored baby food (ensure no onion or garlic powder) or boiled chicken (skinless, boneless).
    Important Note: Chicken and baby food are not nutritionally complete for long-term feeding and should only be used for a short period (a few days).

• Chronic Vomiting: For chronic vomiting, dietary changes can be both therapeutic and diagnostic.

  • Diet Trials: Switching to a novel protein or hydrolyzed protein diet, often a prescription diet, can help identify food sensitivities or allergies.
  • Limited Ingredient Diets: These diets contain a limited number of ingredients, reducing the likelihood of triggering an allergic reaction.
  • Duration of Diet Trial: It’s crucial to maintain the cat on the new diet for several weeks (typically 4-8 weeks) to assess its effectiveness in controlling vomiting. If the vomiting resolves or significantly improves on the new diet, it suggests that dietary intolerance, allergy, or potentially low-grade inflammatory bowel disease was contributing to the problem.

Prednisone

Prednisone is a corticosteroid medication sometimes used in the treatment of inflammatory bowel disease (IBD) in cats, which can be a cause of chronic vomiting. However, prednisone is not a first-line treatment and should only be considered under specific circumstances and with veterinary guidance.

• IBD Treatment: Prednisone can help reduce inflammation in the gastrointestinal tract associated with IBD.

• Side Effects: Prednisone has numerous potential side effects, including:

  • Increased thirst and urination
  • Increased appetite
  • Immune system suppression
  • Muscle weakness
  • Potential worsening of conditions like pancreatitis, diabetes, and kidney disease.

• When to Consider Prednisone: Prednisone is generally considered only after:

  • Initial Diagnostics: Blood work and X-rays are normal or don’t reveal contraindications.
  • Discussion with Veterinarian: A thorough discussion with your vet about the risks and benefits is essential.
  • Lack of Response to Other Treatments: If other treatments are not effective and further diagnostics are not pursued.
    Important Warning: Never administer prednisone to your cat without veterinary guidance. It is crucial to rule out other potential causes of vomiting and discuss the risks and benefits with your veterinarian before starting prednisone therapy.

When to Seek Immediate Veterinary Care for Cat Vomiting

While occasional, mild vomiting might resolve on its own, certain situations warrant immediate veterinary attention. Seek emergency veterinary care if your cat exhibits any of the following along with vomiting:

• Frequent or Projectile Vomiting: Vomiting multiple times in a short period or forceful vomiting.
• Blood in Vomit (Hematemesis) or Coffee-Ground Vomit: Indicates potential significant gastrointestinal bleeding.
• Lethargy or Weakness: Significant decrease in energy level or weakness.
• Dehydration Signs: Dry gums, sunken eyes, skin tenting.
• Abdominal Pain: Hunching, reluctance to be touched on the abdomen, crying out when abdomen is touched.
• Vomiting and Diarrhea Combined: Increased risk of dehydration and electrolyte imbalances.
• Suspected Toxin Ingestion: If you suspect your cat has ingested something poisonous.
• Foreign Body Ingestion: If you know or suspect your cat has swallowed a foreign object, especially string or small toys.
• Unproductive Vomiting: Retching or trying to vomit but bringing nothing up, which can indicate a blockage.
• Vomiting in Kittens or Senior Cats: These age groups are more vulnerable to dehydration and complications.

If your cat keeps vomiting and shows any of these signs, prompt veterinary care is crucial to diagnose the underlying cause and provide appropriate treatment, ensuring the best possible outcome for your feline companion.