It’s distressing to witness your feline companion vomiting. Occasional vomiting in cats might seem normal, perhaps after eating too quickly or a hairball incident. However, when your cat keeps throwing up, it signals a potential underlying issue that warrants attention. Understanding why your cat is vomiting, and what steps to take, is crucial for their health and well-being. This guide will walk you through the common causes of vomiting in cats, diagnostic procedures your veterinarian might recommend, and the range of treatment options available to help your feline friend get back to their happy, healthy self.
Understanding Cat Vomit: Deciphering the Clues
The appearance of your cat’s vomit, while not a definitive diagnosis in itself, can offer valuable clues for your veterinarian. Observing what the vomit looks like can help them narrow down the possibilities and guide further investigation. Here’s a breakdown of common vomit characteristics:
Yellow Vomit: Bile and Potential Causes
Yellow vomit typically indicates the presence of bile, a digestive fluid produced by the liver. While it could suggest liver issues, it more frequently occurs when a cat vomits on an empty stomach. It’s also worth considering whether your cat might have ingested something yellow, such as certain cat foods or household items.
Clear Vomit: Empty Stomach or Regurgitation
Clear vomit can arise from two main scenarios. It might be simple regurgitation, originating from the esophagus, often expelled with little abdominal effort. Alternatively, it could be vomit from an empty stomach, consisting mainly of gastric fluids.
White, Foamy Vomit: Similar to Clear Vomit
Like clear vomit, white, foamy vomit is often associated with regurgitation or vomiting from an empty stomach. The foamy texture is due to air mixing with stomach fluids or esophageal contents.
Blood in the Vomit: A Sign of Irritation or Injury
The presence of blood in the vomit, known as hematemesis, is a more concerning sign. The blood can originate from various points in the upper digestive tract, including the mouth, esophagus, or stomach lining. It suggests irritation, inflammation, or injury in these areas.
Coffee-Ground Vomit: Digested Blood and Stomach Ulcers
Vomit that resembles coffee grounds points to digested blood. This appearance occurs when blood has been in the stomach long enough for stomach acids to partially break it down. Coffee-ground vomit is often associated with stomach bleeding, most commonly due to ulcers.
Brown, Smelly Vomit: Potential Intestinal Issues or Diet
Brown, smelly vomit can be indicative of bleeding higher up in the gastrointestinal tract, where the blood has been digested and altered as it passes through the intestines. It can also simply mean your cat has vomited up something brown and odorous they ingested.
Undigested Food in the Vomit: Problems with Digestion or Obstruction
Seeing undigested food in your cat’s vomit suggests that the food hasn’t properly moved out of the stomach. This can happen due to various reasons, including food intolerances or allergies, gastrointestinal obstructions, or general irritation of the upper digestive tract. Knowing the timeframe since your cat last ate is crucial. Vomiting undigested food many hours after a meal, especially if they haven’t eaten since, could point towards a more serious issue like an obstruction or a motility disorder affecting stomach emptying.
Questions Your Veterinarian Will Ask About Your Vomiting Cat
To effectively diagnose the cause of your cat’s vomiting, your veterinarian will need a comprehensive understanding of the situation. Be prepared to answer questions such as:
- Was your cat exposed to plants or potential toxins? Ingestion of toxic plants, household chemicals, or medications can trigger vomiting.
- When did the vomiting episodes begin? Knowing the onset and duration of vomiting helps determine if it’s acute or chronic.
- What is your cat’s regular diet? Changes in diet, food sensitivities, or dietary indiscretions can be contributing factors.
- Does your cat go outdoors, and if so, does it hunt? Outdoor cats have more exposure to parasites, infections, and potential toxins, including prey animals.
- What does the vomit look like? As discussed earlier, the appearance of the vomit provides important clues.
- Is your cat currently on any medications? Certain medications can have vomiting as a side effect.
- Is your cat also experiencing diarrhea? The combination of vomiting and diarrhea can suggest gastrointestinal infections or systemic illnesses.
- Is your cat still eating? A decrease or loss of appetite alongside vomiting is a concerning sign.
- When does vomiting occur in relation to eating or other activities? Vomiting immediately after eating might suggest rapid eating or food intolerance, while vomiting at other times could indicate different issues.
- Is your cat losing weight? Weight loss can be a sign of chronic vomiting or underlying disease.
- Is your cat drinking or urinating more or less than usual? Changes in thirst and urination can point to systemic conditions like kidney disease or diabetes.
- Does your cat play with string, yarn, or similar objects? String or linear foreign bodies are a common cause of vomiting and intestinal obstruction in cats.
Providing detailed answers to these questions will equip your veterinarian with valuable information to guide their examination and diagnostic approach.
Veterinary Examination and Diagnostic Procedures
Following the initial questions, a thorough physical examination by your veterinarian is the next crucial step. During the exam, the vet will assess various aspects of your cat’s health, looking for:
- Abdominal pain or tenderness: Pain upon palpation of the abdomen can indicate inflammation, infection, or obstruction.
- Masses in the abdomen or elsewhere: Abnormal growths or masses could be tumors or other underlying conditions.
- Obvious foreign bodies: The vet will check for easily accessible foreign objects, such as string lodged under the tongue.
- Evidence of weight loss: Assessing body condition helps determine if chronic illness is a factor.
- Heart murmurs or other abnormal heart sounds: Heart conditions can sometimes contribute to vomiting.
- Enlarged thyroid gland: Hyperthyroidism is a common condition in older cats that can cause vomiting.
- Fever: Elevated body temperature suggests infection or inflammation.
The findings of the physical exam, combined with the history you provide, will help your veterinarian determine the most appropriate next steps in diagnosis, which may include further testing.
Abdominal X-rays and Blood Work: Initial Diagnostic Tools
If further investigation is warranted, abdominal radiographs (X-rays) and blood work, often accompanied by a urinalysis, are typically the first-line diagnostic tests.
Abdominal X-rays: X-rays can reveal a range of abnormalities within the abdomen, including:
- Organ size and shape abnormalities: Enlarged or shrunken organs can indicate disease.
- Foreign bodies: Radiopaque foreign objects (those visible on X-rays) can be identified.
- Tumors: Large masses may be visible.
- Constipation: Accumulated fecal matter can be observed.
- Other structural abnormalities: X-rays can help visualize general organ arrangement and identify deviations.
Blood Work and Urinalysis: Blood tests are crucial for evaluating organ function and detecting systemic illnesses. They can help identify:
- Organ dysfunction: Liver and kidney function can be assessed through blood chemistry panels.
- Endocrine disorders: Conditions like diabetes and hyperthyroidism can be diagnosed through blood tests.
- Electrolyte imbalances: Vomiting can lead to electrolyte disturbances that blood work can detect.
- Exposure to certain toxins: While specific toxin tests are often limited, blood work can sometimes provide clues about toxin exposure, such as antifreeze poisoning.
- Urinalysis: Analyzing urine in conjunction with blood work is essential for diagnosing conditions like diabetes, kidney disease, and urinary tract infections.
Advanced Diagnostics: Ultrasound, Endoscopy, and Barium Studies
In many cases, initial X-rays and blood work may not pinpoint the exact cause of vomiting. Further, more specialized imaging and diagnostic procedures might be necessary.
Ultrasound: Abdominal ultrasound uses sound waves to create detailed images of internal organs. It is particularly useful for visualizing the architecture of organs like the liver, kidneys, pancreas, and intestines. Ultrasound can also guide the collection of tissue samples (biopsies) for definitive diagnosis.
Endoscopy: Endoscopy involves using a flexible scope with a camera to directly visualize the inside of the gastrointestinal tract. It can be used to examine the esophagus, stomach, upper intestines, and colon. Endoscopy is valuable for:
- Detecting non-radiopaque foreign bodies: Foreign objects that don’t show up on X-rays can often be visualized and even retrieved via endoscopy.
- Examining the lining of the GI tract: Endoscopy allows for close inspection of the stomach and intestinal lining to identify inflammation, ulcers, or tumors.
- Collecting biopsies: Tissue samples can be taken during endoscopy for microscopic examination and diagnosis.
Barium Study: A barium study, or contrast radiography, involves administering barium (a radiopaque substance) orally or rectally, followed by a series of X-rays. It helps visualize the passage of barium through the digestive tract, which can reveal:
- Intestinal obstructions: Blockages in the intestines can be identified by the barium’s inability to pass.
- Motility issues: Abnormalities in the movement of the intestines can be detected.
- Foreign bodies: Barium can outline foreign objects that are not directly visible on regular X-rays.
Exploratory Surgery: When Other Diagnostics Are Inconclusive
In some cases of persistent vomiting that doesn’t respond to initial treatments, or when there’s a strong suspicion of a serious underlying condition that remains undiagnosed, exploratory surgery might be considered. This is particularly true in situations involving:
- Suspected foreign body ingestion: If there’s concern about a foreign body that hasn’t been located by other means, surgery may be necessary to find and remove it.
- Chronic vomiting: For cats with long-term vomiting unresponsive to symptomatic treatment, surgery allows for a thorough examination of the abdominal organs to look for signs of:
- Intestinal cancer
- Non-intestinal abdominal disease
- Inflammatory bowel disease (IBD)
During exploratory surgery, the veterinarian can:
- Visually inspect the entire intestinal tract and other abdominal organs.
- Take full-thickness biopsies: Surgical biopsies are often larger and can provide more comprehensive tissue samples compared to endoscopic biopsies. Biopsies can be taken from the intestines, stomach, liver, pancreas, lymph nodes, and any other abnormal areas.
Surgery vs. Endoscopy for Diagnosis:
Both surgery and endoscopy have their advantages and disadvantages as diagnostic tools.
Surgery:
- Pros: Allows for a complete evaluation of the entire intestinal tract and other abdominal organs. Enables larger, full-thickness biopsies and biopsies of organs beyond the GI tract (liver, pancreas, lymph nodes).
- Cons: More invasive, higher cost, longer recovery time (several weeks).
Endoscopy:
- Pros: Less invasive, typically less expensive, quicker recovery (hours to a day), often provides representative intestinal samples for diagnosis.
- Cons: Limited to visualizing the inner lining of the GI tract. May not detect problems outside the GI tract or in deeper tissue layers.
The choice between endoscopy and exploratory surgery depends on the individual cat’s situation, the suspected underlying causes, and the owner’s financial considerations. Both procedures can be costly, with endoscopy potentially reaching $1,500 and exploratory surgery exceeding $2,000. Many owners may opt for less invasive or less expensive treatment approaches initially, and it’s crucial to have open communication with your veterinarian about the risks and benefits of each option.
Treatment Options for a Vomiting Cat
Treatment for vomiting in cats is highly dependent on the underlying cause. While addressing every specific cause is beyond the scope of this guide, we can discuss common general treatment approaches.
Fluid Therapy: Combating Dehydration
Fluid therapy is a cornerstone of treatment for vomiting cats, regardless of the underlying cause. Even if your cat doesn’t appear clinically dehydrated, vomiting leads to fluid loss, and dehydration can quickly worsen their condition.
Subcutaneous Fluids: For mild to moderate dehydration, or as a preventative measure, veterinarians often administer fluids subcutaneously (under the skin). Subcutaneous fluids help rehydrate the cat and flush out their system.
Intravenous (IV) Fluids: In cases of severe dehydration, weakness, or when subcutaneous fluids are not adequately absorbed, IV fluids are often necessary. IV fluids are delivered directly into a vein via a catheter, allowing for rapid and controlled fluid administration. While more effective for severe dehydration, IV fluid therapy is more expensive and requires hospitalization.
Dehydration creates a vicious cycle. Dehydration makes cats feel unwell, leading to decreased appetite and fluid intake, and potentially more vomiting, further exacerbating dehydration. Fluid therapy breaks this cycle and is crucial for recovery.
Anti-Vomiting Medications (Antiemetics)
Antiemetics are medications specifically designed to stop vomiting. They are commonly used to provide symptomatic relief, reduce fluid loss, and improve patient comfort. By controlling vomiting, antiemetics can also help relieve abdominal discomfort and encourage the cat to start eating again.
Stomach Protectants: Medications like Pepcid (famotidine) or sucralfate are sometimes used as stomach protectants. Their effectiveness in treating vomiting in cats is debated, but they are generally considered safe and may provide some benefit in cases of stomach irritation.
Pain Medication: If antiemetics alone don’t provide adequate pain relief, pain medication might be added to the treatment plan, especially if abdominal pain is suspected.
Dietary Modifications
Dietary changes are a vital part of managing both acute and chronic vomiting in cats.
Easily Digestible Diets (Acute Vomiting): For acute vomiting episodes, a temporary switch to an easily digestible diet is often recommended. These diets are gentle on the digestive system and can help reduce irritation. Examples include prescription diets like Royal Canin Gastrointestinal High Energy, Hill’s Prescription Diet i/d, or bland homemade options like plain meat-flavored baby food (ensure no onion or garlic powder) or boiled chicken (skinless and boneless). It’s crucial to remember that chicken and baby food are not nutritionally complete and should only be used short-term (a few days).
Dietary Trials and Limited-Ingredient Diets (Chronic Vomiting): For chronic vomiting, dietary changes can be both therapeutic and diagnostic. Switching to a novel protein diet or a hydrolyzed protein diet can help identify and manage food intolerances or allergies. Prescription limited-ingredient diets are often used for these diet trials to ensure they are complete and balanced. Diet trials for chronic vomiting require patience; it may take several weeks on the new diet to see if it effectively controls the vomiting.
Prednisone: Managing Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a potential cause of chronic vomiting in cats. Prednisone, a corticosteroid medication, is often used to treat IBD by suppressing the inflammatory response in the intestines. However, prednisone is not a first-line treatment for vomiting and should only be considered after discussion with your veterinarian and ideally after some diagnostic workup.
Important Considerations for Prednisone:
- Side Effects: Prednisone has numerous potential side effects, including increased thirst and urination, increased appetite, weakened immune system, and muscle weakness.
- Exacerbation of Other Conditions: Prednisone can worsen certain conditions that may cause vomiting, such as pancreatitis, diabetes, and kidney disease.
- Diagnostic Workup Recommended: Prednisone should generally not be used without some prior diagnostics (blood work, X-rays) to rule out other underlying causes of vomiting.
If initial diagnostics are normal, and further testing is not pursued, a trial of prednisone might be considered under veterinary guidance, after carefully weighing the risks and benefits.
When to Seek Immediate Veterinary Care
While some cases of mild, infrequent vomiting might resolve on their own, certain signs warrant immediate veterinary attention. Seek prompt veterinary care if your cat:
- Is vomiting frequently or forcefully.
- Is vomiting blood or coffee-ground material.
- Is lethargic, weak, or unresponsive.
- Shows signs of dehydration (sunken eyes, dry gums).
- Has abdominal pain or distention.
- Is not eating or drinking.
- Is experiencing other symptoms like diarrhea, fever, or difficulty breathing.
- You suspect may have ingested a toxin or foreign object.
Don’t hesitate to contact your veterinarian if you are concerned about your cat’s vomiting. Early diagnosis and treatment are key to ensuring a positive outcome and getting your feline companion back to their happy and healthy self.
