Cat - Vomiting

Vomiting describes the return of food from the stomach. It may be related to disorders of the stomach but is a sign that can occur with many other different 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. This is particularly true if the vomited material consists largely of hair. It is a normal process for cats to retain hair and vomit this back as a fur ball periodically.

How serious is vomiting?

Most cases of acute vomiting (i.e. the vomiting has been present for less than 2-3 days) resolve readily with simple treatment without the underlying caused being diagnosed. Severe or chronic vomiting is more serious. It can lead to secondary problems, particularly dehydration and disturbances in the levels of electrolytes (salt etc.) in the blood. It is important to investigate such cases to identify the underlying cause if effective treatment is to achieve a cure.

Recognising vomiting

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

It is important to differentiate this from the abdominal contractions associated with coughing. Cats may cough up some froth which they subsequently swallow creating more confusion with vomiting. Cats usually crouch down on all four legs when coughing with the neck stretched out.

It is also helpful to differentiate vomiting from regurgitation which is usually associated with problems affecting the oesophagus or gullet. Features which help to differentiate vomiting from regurgitation are:

• whether return of food involves abdominal contractions and effort
• whether the returned food is in the shape of a sausage
• whether the returned food is re-eaten
• the relation to feeding time

Acute vomiting

Acute vomiting is vomiting which has been present for no more than 2-3 days. Most cases will respond quickly to simple treatment. The cause of such cases is often never established and may often be due to relatively trivial factors such as eating spoiled food etc. In a minority of acute cases of vomiting, usually because the vomiting is severe leading to complications such as dehydration or because a more serious underlying cause is suspected, further investigations, specific treatment and more supportive care will be required. Features that you may be able to identify which will help the veterinary surgeon decide whether simple treatment or further investigations are appropriate would be:-

• if the cat appears otherwise well or is ill - depressed, lethargic /any other specific signs
• if the cat is eating
• if there has been weight loss
• if there has been any blood in the vomit (a few specks of fresh blood may not be abnormal but more copious or persistent bleeding is significant)
• any pain or distress, particularly affecting the abdomen
• whether faeces are being passed
• the frequency of vomiting
• the relationship of vomiting to feeding - particularly if there is a long delay
• any offensive odour to the vomit
• what the cat has been fed
• any recent change of diet
• any possible access to other foods or other substances
• any treatment given recently
• whether other cats in the household are affected

Symptomatic treatment for vomiting

Symptomatic treatment is usually tried initially in mild cases of vomiting. It may involve a number of measures:-

1. Withholding of food for up to 24 hours. This may help to allow the stomach to recover.
2. Provision of a simple, bland diet. A simple, easily digestible diet will normally be offered initially in small quantities. A diet based on boiled chicken or sometimes fish with rice is often used. It is important that the cat does not receive any other foods during this period. This includes milk. Water should be freely available and is important to combat dehydration. If the cat is progressing well, the quantity of food offered can be gradually increased back to normal over several days and then the cat's normal diet reintroduced gradually over several days.
3. Drugs. Certain drugs are available to control vomiting and the veterinary surgeon may advise the use of these.

Further investigation of vomiting

If the vomiting is severe or the veterinary surgeon suspects a serious underlying problem, other treatment and investigations may be required. It may be necessary to hospitalise your cat so that a drip can be given to combat dehydration as well as correcting any imbalances in the levels of electrolytes (salt etc.) in the blood. It will also be possible to administer drugs by injection as required to control the vomiting.

Further investigations may also be required in cases of chronic vomiting in which the cat has been vomiting for more than 2-3 weeks, even though the vomiting may be intermittent and the cat may appear otherwise well. Such cases can often not be treated successfully until the underlying cause has been determined. Some of the more commonly used tests are:-

• Blood tests - to check for serious viral infections, kidney and liver problems, thyroid disease and provide other clues to the diagnosis.
• Radiographs (x-rays) - these may show up abnormalities of the oesophagus or an intestinal blockage. It may be necessary to give a barium meal or something similar to help show up any blockages, tumours, ulcers, foreign bodies etc.
• Endoscopy - in some cases a diagnosis can be made by viewing the inside of the stomach and intestine directly through an endoscope, a flexible viewing tube, which is passed through the mouth under a general anaesthetic, and allows small biopsies to be taken from these areas for examination under a microscope.
• Laparotomy (surgival investication) - in some cases an exploratory operation is necessary, particularly if some obstruction or blockage is suspected. This may also allow surgical treatment of the problem.