Cat Vomiting Blood (Hematemesis) – Causes and Treatment

Hypercalcemia in cats

Vomiting is caused by the forceful ejection of the stomach contents and is a relatively common “symptom” in cats. More often than not, it contains food, but you may also notice vomit which contains bile (a green substance) or blood.

Blood in the vomit (also known as hematemesis) has a number of causes. The vomit may contain bright red blood (fresh blood), which indicates the vomiting has come from the upper digestive tract (mouth, throat, and esophagus), or it may be dark red with the appearance of coffee grounds, which has been partially digested.

While the occasional vomit is generally not something to worry about, a cat who has vomited blood should be seen by a veterinarian as soon as possible.

What are the causes of blood in vomit?

Common causes of blood in vomit include:

  • Foreign body (such as a bone) which can cause laceration of the intestines or stomach.
  • Ulcers of the esophagus or stomach.
  • Aspirin poisoning (due to inflammation or ulceration of the stomach).
  • Inflammation of the esophagus or stomach.
  • Blood clotting disorders (coagulopathies) – Caused by liver failure or ingestion of certain toxins (such as rat poison).
  • Infections.
  • Tumours of the esophagus or stomach.
  • Certain medications.
  • Intestinal worms.
  • Swallowed blood – From the mouth, nose, esophagus or coughed up and swallowed from the lungs.

How is the cause of vomiting blood diagnosed?

Your veterinarian will perform a medical examination of your cat and obtain a medical history from you, including accompanying symptoms you may have noticed and exposure to medications or toxins. Symptoms, along with the type of blood (new or old) can help your veterinarian narrow down a cause. He will need to perform some medical tests to determine the cause, some of which may include:

Complete blood count, urinalysis, and biochemical profile may be performed to check the overall health of your cat, look for signs of infection, inflammation, liver function.

Endoscopy – A narrow tube with a light and a camera on the end are inserted into your cat’s digestive tract to look for the presence of tumours, ulcers, and foreign objects.

Ultrasound or x-ray to evaluate for foreign objects, growths and look at the internal organs.

How is it treated?

Treatment is aimed at addressing the underlying cause of vomiting blood and may include:

  • Anti-inflammatories to treat inflammation.
  • Antibiotics for bacterial infections.
  • De-worming medications for parasitic worms.
  • Surgery for tumours or foreign bodies.
  • Treatment to reverse poisoning may include pumping of the stomach, activated charcoal or induce vomiting.
  • Stop any medications that may be causing the vomiting.

Your cat may need to be hospitalised and given supportive care. He may need to be given IV fluids to treat dehydration and he may be fasted temporarily to rest the stomach. Once he is allowed to eat, he may need to be fed a highly digestible but bland diet while he recuperates.

Severe blood loss can lead to anemia, a blood transfusion may be necessary.

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