Vomiting in cats: It’s normal until it’s not

Summary:

• Some vomiting in cats may be normal.
  • Frequency less than 1-2 times per month
  • Consists of hairballs or partially digested food if a cat eats too quickly
• Chronic vomiting in cats is common
  • Frequency is often at least once weekly, typically multiple times per week
  • Patients may seem otherwise normal
  • Chronic vomiting that lasts for months typically has an underlying gastrointestinal cause
    • Food intolerance
    • Inflammatory bowel disease
    • Types of lymphoma (cancer)
• Acute vomiting in cats may be an emergency
  • Sudden onset of frequent or severe vomiting within a short period of time (1-2 days)
  • Patients often appear ill
  • Multiple causes, some serious
    • Organ dysfunction (liver, pancreas, kidneys)
    • Intestinal obstruction
    • Toxin ingestion
    • Gastroenteritis, parasites
    • Cancer
    • Progression of chronic vomiting from worsened underlying condition

When to seek veterinary care:

• Multiple episodes of vomiting in one day
• Increasing episodes of vomiting overall when cat chronically vomits.
• Inability to keep down food or water
• Decreased or absent appetite, lethargy, progressive or sudden weight loss
• Vomiting of blood
• Known underlying disease, toxin ingestion, or foreign body ingestion

Diagnostics to expect:

• Depend on frequency and severity of vomiting and if other clinical signs are present
• Multiple diagnostics may be recommended
  • Blood panel to look for underlying organ dysfunction, severe electrolyte changes, severe dehydration
  • Fecal to look for parasites that may contribute to vomiting
  • X-rays to look for masses or obstruction
  • More advanced diagnostics including ultrasound or biopsies
    • Often require referral

Treatment to expect:

• Depends on severity
• Different ‘types’ of treatment which often depend on results of diagnostics, if performed
  • Empirical therapy, aka ‘best guess’
    • Often if no minimal diagnostic work-up is pursued
    • Often for acute vomiting
    • Anti-nausea medication
    • Fluids under the skin
    • Diet change
    • Hospitalization if severe disease is present
  • Directed therapy for known diagnosis
    • Requires diagnostics
    • For severe disease, may require hospitalization
    • For chronic intestinal disease, long-term treatment
      • Steroids
      • Chemotherapy
      • Prescription diet
    • Surgery if obstruction is present
  • Symptomatic therapy
    • Used while awaiting directed therapy to take effect or in addition to directed therapy
    • Used for management of chronic disease processes that do not have directed therapy
      • Chronic kidney disease
      • Pancreatitis
    • May be used long term
    • Typically consist of anti-nausea pills
• ‘Types’ of therapies overlap
• Additional therapies depending on veterinarian’s assessment

Take away:

• Vomiting in cats is not always normal or benign
• Vomiting may indicate serious, life-threatening disease
• You know your cat best.  Contact a veterinarian if you are concerned, even if vomiting seems ‘mild’.