It seems that cats were made to vomit (particularly on white carpeting). Although we can accept that the occasional (i.e. every 2 – 3 months) hairball is “normal”, at which point does frequent vomiting become a medical concern?
What is vomiting?
Vomiting is the forceful expulsion of stomach content through the mouth. Vomiting is triggered by a complex pathway within the vomiting center of the GI tract and chemoreceptor trigger zone of the brain, which responds to, among other factors, changes in the GI tract, GI pressure, and toxins. The chemoreceptor trigger zone specifically responds to changes in the vestibular center to cause vomiting (i.e. this is the area that causes the sensations of nausea after dizzying rides). Prior to the actual vomiting episode, there are signs of nausea (drooling, swallowing, smacking the lips, retching, restlessness). These signs are helpful at differentiating from the passive regurgitation of undigested food.
What causes vomiting in cats?
There are many diseases, both within the GI system and outside of it, in which vomiting is a symptom. A brief list of possible causes can include:
Primary GI
Obstruction of the GI tract from foreign bodies, parasites, tumors, or twisting of the intestines
Gastroenteritis
Toxins (such as plants) and other forms of “dietary indiscretion”
Diet (both intolerance and true allergy)
Inflammatory bowel disease (IBD)
Cancer (mostly lymphoma)
Constipation
GI ulcers
Extragastrointestinal (i.e. systemic disease that have vomiting as a symptom)
Kidney disease
Liver disease/hepatitis
Pancreatitis
Urinary tract disease (both infection and obstruction)
Hyperthyroidism
Diabetes
FIV/FeLV associated disease
Vestibular disease
Pain
How do we diagnose the cause of vomiting?
As vomiting has many possible causes, there are several steps in diagnosing a cause.
History: Important history can include how often your cat is vomiting, when did it start, what the vomitus looks like, recent changes in diet, exposure to plants or a history of getting into garbage. Other information such as additional changes (i.e. changes in water intake or weight loss) may help in cases of systemic illness.
Physical exam: In addition to a full physical exam, any acute vomiting case, your doctor will look extensively in your cat’s mouth (especially under the tongue) for signs of foreign body.
Lab work: Basic blood work and urine analysis will be run to look for signs of systemic illness, including changes in liver enzymes and pancreatic digestive enzymes. In older cats, this blood work with include a check of thyroid hormones to rule out hyperthyroidism. If parasites are suspected, than a fecal analysis may be run.
Imaging diagnostics:
X-rays: X-rays provide a quick snapshot of the abdomen and are helpful at looking at structures. Some foreign bodies, such as a twist tie, may show up clearly on x-ray because it contains metal. Unfortunately, cats can have serious causes to the vomiting (such as pancreatitis or a foreign body) without a lot of change being seen on x-ray. .
Ultrasound: Ultrasound is better suited then x-rays at looking at soft tissues and it provides a real time exam of the organs (i.e. we can look at how well the intestines are peristalsing). Unfortunately ultrasound can only find big (gross) changes in tissues and may not find small changes in the abdomen or tell us what is going on at the cellular level.
Exploratory surgery: Exploratory surgery is often the last step in working-up primary GI vomiting as it is the most invasive. It is considered treatment for cases of foreign body. In cases of chronic vomiting patients, biopsy samples are taken at time of exploratory surgery to evaluate the GI tract at the cellular level for signs of inflammation (such as in inflammatory bowel disease) and cancer (such as lymphoma).
What are the treatment options?
A treatment plan largely depends on the cause of vomiting. Conservative care can include anti-emetics, GI rest, and diet change to bland diets. In cases of systemic disease, such as hyperthyroidism, treatment of the underlying illness often helps to control the vomiting.
As this is for informational use only, we encourage you to talk to your veterinarian about health concerns in your cat. Although we strive to have current and accurate information, Wild Rose Cat Clinic is not liable for any errors or omissions.
