Medically known as emesis, vomiting is a chain of events of which the end result is the forceful ejection of the stomach contents and is one of the most common reasons cat owners take their cat to the veterinarian.
There are a number of possible causes of vomiting cats, it may be acute (sudden onset), chronic (over a period of time) or sporadic (coming and going). Acute vomiting is defined as vomiting which has been present for less than one week and is usually the result of a single insult to the stomach and is self-limiting, chronic vomiting lasts longer than a week, can be intermittent or persistent in nature.
The most common cause of vomiting is swallowing hair or other indigestible products (such as grass) which cause irritation to the stomach, this is known as irritative gastritis.
Eating food too fast is another common cause of vomiting. You may notice your cat race to eat his food only to vomits it back up thirty seconds later, the vomit looks and smells just like cat food.
Vomiting can be divided into four groups, gastrointestinal disorders, hormonal disorders, systemic and other.
Acute metritis – Inflammation of the lining of the uterus in cats post birth.
Inflammatory bowel disease – A number of related diseases caused by different types of inflammatory cells invading the intestinal wall.
Intestinal obstruction and foreign bodies – Cats aren’t as prone to swallowing miscellaneous objects as dogs are, however, accidental ingestion may occur when playing. Common objects include hair bands, string, sewing thread and cooked bones.
Addison’s disease – Deficiency of corticosteroids, due to the destruction of the adrenal cortices.
Feline diabetes – Endocrine disorder caused when the body doesn’t produce enough insulin or the cells are unable to respond to insulin, starving the cells of glucose.
Hyperthyroidism – Usually caused by a hormone-producing benign tumour of the thyroid gland.
Kidney disease – This may be chronic or acute. Acute kidney disease can occur if your cat has ingested a toxin. Chronic kidney disease is common in middle-aged to senior cats as a slow and gradual decline in kidney function occurs.
Liver disease – There are several causes of liver disease in cats, including hepatic lipidosis which develops when a cat becomes anorexic (stops eating), the body begins to break down fat to use for energy which is sent to the liver, which can overwhelm the liver, ingestion of toxins, liver inflammation, tumours and portosystemic shunt, which is a congenital disorder (present at birth). A portosystemic shunt is seen most often in cats under 12 months of age.
Pancreatitis – Inflammation of the pancreas which may be due to infection, obesity, high-fat diet and trauma.
A foreign body such as a cooked bone, cat toy which has become lodged in the stomach or intestines.
Certain medications including NSAIDs and antimicrobials.
Ruptured bladder – Usually caused by trauma or urinary blockage.
Twisted or obstructed bowel.
Worms – Parasitic worms, most often roundworms, although cats can occasionally vomit a tapeworm.
When should my cat be taken to a veterinarian?
An isolated incident of vomiting where the cat shows no other signs of illness is not uncommon and generally doesn’t necessitate a trip to the vet. If the vomiting continues beyond 24 hours, if the cat is under 12 months or if you notice other symptoms along with the vomiting, then a trip to the veterinarian is necessary.
You should seek veterinary if any of the following symptoms occur:
Foul smelling vomit
If you suspect your cat has ingested a poison or toxin.
Blood in the vomit
Bloated or painful abdomen
If possible, when you take your cat to the veterinarian, bring along a sample of the vomit, this will assist the vet to determine the underlying cause of the vomiting.
Your veterinarian will perform a complete physical examination of your cat and obtain a medical history, including possible exposure to toxins and dietary history (including possible dietary indiscretions) any medications your cat may be on. The type of material vomited, frequency, the age of your cat, and other clinical signs your cat is displaying can all help your veterinarian. He will also need to differentiate between vomiting, regurgitation, and coughing, all of which can be similar.
Being able to assess the vomiting will assist your veterinarian. He may ask about the type of vomiting your cat has been experiencing.
Consumption of food that has spoiled
Ingestion of a non-food item, such as grass or hairballs,
This is occasional vomiting that is not related to eating, the cat vomits on and off.
Heavy worm infestation
Forceful ejection of vomit which goes a considerable distance.
Vomiting clear fluids
This may be due to an intestinal obstruction or in cases of prolonged vomiting, the stomach contents may have already been vomited and all that remains is liquid.
Vomiting blood (hematemesis)
Ingestion of toxins
Vomiting undigested food
Eating too fast
Playing too soon after eating
Vomiting white foam
This can be an indication your cat has an empty stomach and all that is left is water and gastric juices.
Vomiting brown liquid
Eating something brown coloured such as chocolate (which is toxic)
Bleeding somewhere in the gastrointestinal tract
Vomiting bile (yellow/green fluid)
The cat has an empty stomach and all that is left is water and gastric juices. Other causes include pancreatitis or gastritis.
Vomiting only occurs when the cat is travelling.
Long, thin, white, spaghetti-like worms in the vomit are a sign of roundworm infestation. From time to time a cat may also vomit up a tapeworm, which is long, white/cream with a ribbon-like appearance and segmented.
Baseline tests – Complete blood count, biochemical profile and urinalysis to evaluate organ function, check dehydration and look for signs of infection.
Endoscopy – T look for stomach ulcers, tumours, inflammation or a gastrointestinal blockage.
Fecal smear or fecal flotation to look for parasites.
Total T4 – To evaluate for hyperthyroidism.
Abdominal X-rays or ultrasound to check for gastrointestinal obstruction, cancer, and organ size.
Coagulation profiles to look for clotting abnormalities.
Treatment is aimed at finding and treating the underlying cause of the vomiting. In addition, supportive care such as fluids to treat dehydration and correct electrolyte imbalances will be provided.
Bacterial infection: Antibiotics.
Protozoal infections: Antibiotics and supportive care.
Addison’s disease: Life-long administration of corticosteroids.
Pancreatitis: Find and treat the underlying cause (where possible). Painkillers, anti-nausea medication and supportive care.
Foreign objects: Surgery to remove the blockage.
Hyperthyroidism: Radioactive iodine to destroy the tumour, prescription diet or surgery to remove the tumour.
Tumours: Surgery and where necessary chemotherapy.
Liver disease: Supportive care, surgery (for portosystemic shunt), and dietary modification.
Kidney disease: Low protein diet, phosphorous binders, fluid therapy (when needed) and anti-nausea to manage symptoms.
Poisoning: Gastric decontamination (induce vomiting or pumping the stumach), activated charcoal, antidote (where available), supportive care such as fluids to treat dehydration and help the kidneys flush out the toxin.
Viral infection: Supportive care such as fluids and nutritional support for cats with a viral infection. This helps your cat’s own immune system fight off the infection.