Vomiting in Cats

What is vomiting?

Vomiting describes the active evacuation of food from the stomach. Vomiting is a clinical sign that can occur with many diseases and problems; it is not a specific disease or diagnosis itself.

Cats vomit quite readily and occasional vomiting in an otherwise healthy cat may not indicate anything abnormal, particularly if the vomited material is mainly hair. It is normal for cats to swallow hair while they groom themselves, and they will vomit hairballs periodically. If your cat is vomiting hairballs more than once a month, contact your veterinarian.

How do I recognize vomiting?

Vomiting may begin with a stage of nausea, in which the cat appears restless and possibly anxious. The cat may lick its lips, salivate, and repeatedly swallow. Vomiting itself involves forceful contractions of the abdominal muscles, leading to expulsion of fluid, froth, or food. The severe effort associated with vomiting may be distressing to the cat.

It is important to differentiate vomiting from the abdominal contractions associated with coughing. When cats cough, they may cough up some froth or foamy material and then swallow it. Cats usually crouch on all four legs and stretch out their neck when coughing. It is helpful if you have a video of your cat exhibiting the behavior so your veterinarian can help you distinguish coughing versus vomiting.

It is also important to differentiate vomiting from regurgitation, which is usually associated with problems affecting the esophagus and is a more passive process. Key differences between vomiting and regurgitation include the following:

• Vomiting typically involves abdominal contractions and effort.
• Regurgitation typically occurs quickly, without abdominal contractions.
• Regurgitation often occurs immediately after eating or drinking.

When should I be concerned about my cat's vomiting?

The seriousness of vomiting depends on the underlying cause. Many cases of acute (sudden) vomiting improve on their own within 24 hours, without medical intervention or finding a cause. However, seek veterinary care immediately if your cat is vomiting and has any of the following signs:

• Fever
• Lethargy
• Loss of appetite
• Abdominal pain
• Diarrhea
• Dehydration
• Blood in the vomit
• Suspected ingestion of a foreign object or toxic substance

Your veterinarian can identify the underlying cause of the vomiting and provide treatment. If your cat otherwise seems well, but continues to vomit for more than one to two days, seek veterinary care. Ongoing vomiting may indicate a more serious condition or lead to complications such as dehydration or electrolyte imbalances.

What could cause vomiting?

Vomiting can be caused by minor intestinal upset due to:

• Intestinal parasites
• Dietary indiscretion: eating plants, table scraps, spoiled food, or foul-tasting things such as certain insects
• Hairballs
• Intolerance or allergy to certain ingredients in the food

Vomiting can also be a sign of more serious illness, such as:

• Bacterial infection
• Viral infection
• Intestinal obstruction from foreign bodies (indigestible objects that get stuck in the stomach or intestines)
• Ingestion of toxins
• Urinary tract obstruction
• Pancreatitis
• Liver or kidney disease
• Thyroid disease
• Inflammatory bowel disease
• Cancer

 Left untreated, these illnesses can lead to serious complications, including death.

How is the cause of vomiting diagnosed?

If your cat is not lethargic or experiencing other symptoms, the cause may not be serious. In this case, your veterinarian will perform a minimal number of tests to rule out certain parasites and infections.

If vomiting is associated with several other clinical signs, your veterinarian will perform a series of tests to determine the exact cause of the illness. Diagnostic tests may include the following:

• Blood and urine tests
• Radiography (X-rays)
• Ultrasound
• Biopsies of the stomach and intestinal tract by endoscopic examination
• Exploratory abdominal surgery, especially if a foreign body or a blockage is suspected

How is vomiting treated?

Your veterinarian will usually advise feeding your cat an easily digested, bland diet. A prescription diet may be prescribed, or your veterinarian may recommend feeding a specific home-cooked diet, in small portions given frequently.

It is important that your cat does not receive any other food during this period. Water should be freely available and is needed to prevent dehydration. If your cat progresses well on this diet, the portion size can gradually be increased and the normal diet can be slowly reintroduced over several days.

Minor cases of vomiting may also be treated with medication, which allows the body's healing mechanisms to correct the problem:

• Anti-nausea medication, such as maropitant citrate (Cerenia®)
• Medication to soothe and coat the stomach, such as Sucralfate (Sulcrate®, Carafate®)
• Antacids to help soothe the stomach, such as famotidine (Pepcid®) and omeprazole (Prilosec®)

What other treatment may be required?

If vomiting is severe or if your veterinarian suspects a serious underlying problem, such as kidney or liver disease, more aggressive treatment may be required. It may be necessary to hospitalize your cat for intravenous fluid therapy to combat dehydration and correct any imbalances in electrolyte levels. In some cases, it may be necessary to administer injections to control the vomiting and other symptoms.

In less severe cases, you may be able to treat your cat at home. You may be asked to administer fluids and medications at home. If your cat becomes distressed by home treatment, contact your veterinarian for further instructions.

You should expect improvement within a couple of days. If your cat does not improve within 48 hours of treatment, your veterinarian may change their medication or perform further tests to better understand the problem. It is important to keep in touch with your veterinary clinic so your pet's condition can be managed properly.