|What is nausea? Causes Symptoms Diagnosis Treatment|
What is nausea?
Nausea is the feeling of sickness and is often a precursor to actual vomiting (emesis) although not all cats who are nauseous do go on to vomit. Prolonged vomiting can be extremely debilitating to cats.
The purpose of nausea is to act as a warning as well as being protective. For example, nausea at a particularly unpleasant smell is going to put the cat off eating it and possibly save it ingesting something dangerous. Nausea accompanied by vomiting after ingesting a food or substance is usually to rid the body of a toxin. Such as food which has gone off or an ingested toxin. It also serves as a warning system of organ dysfunction or damage.
Vomiting occurs when the vomiting centre in the brain’s medulla oblongata is activated. This occurs via substances in the blood such as drugs, electrolytes, uremic toxins, metabolic derangements or a number of different pathways including:
Central nervous system
Chemoreceptor trigger zone
- Morning sickness
- Food intolerance
- Travel sickness
- Chronic kidney disease
- Umbilical hernia
- Diaphragmatic hernia
- Motility disorders
- Liver disease
- Infectious diseases
- Stomach ulcer
- Gastrointestinal obstructions.
- Inflammatory bowel disease
- Metabolic acidosis
- Hepatic lipidosis
Symptoms of nausea can be somewhat subtle in cats, and as there is often an underlying cause, it can be difficult to determine if some symptoms are due to the disease or due to nausea.
- Loss of appetite (anorexia)
- Sniffing at food in the bowl and walking away (think about how you feel when you’re nauseous, you are hungry but when food is put in front of you the smell alone brings on a wave of nausea)
- Salivation (drooling)
- Excessive swallowing
- Teeth grinding
- Hunched over position
- Lip smacking or lip licking
Additional symptoms may also be present depending on the underlying condition. Due to the wide range of possible causes, it is not practical to cover symptoms relating to each cause.
As you can see, there are a lot of causes of nausea and the above list is by no means complete. Your veterinarian will perform a complete physical examination of your cat and obtain a detailed medical history from you including onset and frequency of nausea as well as other symptoms you may have noticed and medications your cat has taken (prescribed as well as non-prescribed), all of which may give your veterinarian a clue as to the cause. He will need to perform some tests to determine the cause, some of which can include:
- Complete blood count, biochemical profile and urinalysis to evaluate the organs, look for signs of infection, metabolic abnormalities, evaluate electrolyte and glucose levels.
- Xrays and ultrasound to evaluate the organs and look for blockages, hernia or tumours.
- Endoscopy, a plastic tube with a light and a camera on the end which is inserted through your cat’s mouth and into the intestinal tract to look for cancer, inflammatory bowel disease, stomach ulcer. A biopsy may be taken during this procedure.
The goal of treatment is to find and treat the underlying cause.
- Travel sickness: Cats who suffer from travel sickness may benefit from anti-emetic or tranquillizers which are prescribed off-label. Some medications include diphenhydramine and meclizine which are both antihistamines but also relieve nausea.
- Anti-emetics: For cats who are suffering from a systemic disorder, anti-emetic drugs may be prescribed to help reduce the feeling of nausea. There are a number of drugs which can be prescribed depending on the cause of nausea and vomiting.
- Antacid drugs: Your veterinarian may recommend antacid drugs which reduce the amount of stomach acid produced, forms a layer over damaged stomach tissue (stomach ulcers) or neutralises the stomach acid. Pepcid AC (famotidine), cimetidine, ranitidine, nizatidine can all reduce stomach acid production. Sucralfate (Carafate) forms a protective layer over stomach ulcers.
- Nutritional support: Nausea is enough to stop your cat eating. You can try offering palatable food is unlikely to help if he is feeling sick. A cat who has gone without food for more than 24-48 hours is at risk of developing hepatic lipidosis, which is life-threatening. Therefore it may be necessary to put in a feeding tube until your cat recovers his appetite.
- Bland diet: Your veterinarian may recommend your cat be put on a bland diet until nausea has subsided. This will be a soft, easily digestible source of protein either commercially bought (Hills I/D) or home made (chicken and rice).