Vomiting in Cats

Vomiting can be caused by primary gastrointestinal disorders or systemic disorders.

Primary gastrointestinal disorders:

Diet change: any sudden change in diet can cause vomiting. We normally suggest a 7-10day change over period to avoid upsets.

Diet intolerance: sometimes cats may become hypersensitive (allergic) to a food type. The intestines and stomach can become inflamed due to the allergic reaction and vomiting can be a symptom of this.

Infectious causes: Bacterial (campylobacter, salmonella, E. Coli) can be contracted from uncooked contaminated food; Parasitic (worms, protozoa, coccidian) can be contracted from eating mice and other faeces; Viral (parvovirus, feline leukaemia) can be contracted from other cats.

Fur balls: Cats who over-groom, or cats who have thick or long fur can ingest more hair than normal and cause clumps to form in the stomach which can either cause irritation or a blockage leading to vomiting.

Ingestion of foreign bodies: cats can pick up toys, string, hair bands, coins or anything that looks tasty and swallow it. If it is not digestible these can get stuck in the stomach or intestines. Any blockage of the digestive tract can cause vomiting. This is an emergency.

Intestinal masses: Abscesses and benign masses like polyps can form in the stomach and digestive tract. Neoplastic (cancerous) masses can also grow in the stomach or intestines and cause vomiting.

Inflammatory bowel disease: can be reasonably common in cats and causes inflammation of the digestive tract and vomiting and or diarrhoea.

Constipation: if faeces builds up then vomiting may occur.

Systemic disorders:

Acute kidney failure: toxins from the kidneys can cause nausea and ulcerations in the digestive tract which lead to vomiting.

Acute liver failure or cholangitis (gall bladder disease) can cause nausea and vomiting.

Pancreatitis can cause vomiting and diarrhoea

Diabetes can cause vomiting if the cat becomes ketotic (build-up of toxins)

Reactions to medications. Some medications can cause gastrointestinal irritation and vomiting and diarrhoea

Toxins can irritate the stomach and digestive tract and cause vomiting or diarrhoea. Sometimes it is advisable to induce vomiting if a patient has eaten something toxic to prevent it from being absorbed and causing further problems e.g. Lilly plant toxicity. This should be done as close to ingestion as possible to avoid any absorption.

Other. There are many other less common causes of vomiting.

Your vet will examine your cat and, depending on the information you can provide about the vomiting and the findings of your cat’s clinical exam may either recommend treating your cat symptomatically (see below) or recommend further investigations.

These investigations can include:

• Blood tests: to investigate for systemic disease such as kidney, liver disease or diabetes. Additional blood tests can be done to check the pancreas and digestive function. Blood tests are available to check for food allergies however these may or may not be accurate and a more accurate way of diagnosing a food allergy would be with a diet trial.
• Diet trial: this can be a diagnostic step as well as a treatment option. It involves providing a diet that eliminates a food source (e.g. cereals, chicken etc.). Royal Canin and Hills both have diets designed for this purpose. Other food companies are available.
• Radiographs (X-rays): these can be used to identify masses or obstructions in the digestive tract
• Ultrasound: can also identify masses and obstructions in the digestive tract and can be used to check the thickness of the gut lining in the case of Inflammatory Bowel Disease (IBD) or tumour processes. The other abdominal organs can also be checked using ultrasound.
• Endoscopy: can be useful to visualise the oesophagus and stomach. Biopsies can be taken this way and foreign material may be able to be removed.
• Biopsies: tissue samples from the digestive tract can be taken at surgery or via endoscopy. This can give more information about the type of disease process. Usually this will follow ultrasound findings.
• Faecal sample: this is used to identify infectious causes of vomiting.
• Urine sample: this can be useful to identify kidney disease, infection and diabetes.

The treatment of your cat’s vomiting will depend on the cause. However, symptomatic treatment may be started initially or during a period of further investigation.

Symptomatic treatment involves with-holding food for a short period (12-24 hours) and then reintroducing a bland diet fed in small regular meals. Water should not be with-held from vomiting cats but should also be offered in small regular amounts.

Changing the diet to a bland, highly digestible food can help to settle the stomach. Royal canine gastrointestinal or sensitivity control foods are appropriate, but others are available. Home cooked diets of plain boiled chicken or white fish can also be helpful but for a short time only as alone they are not a balanced nutritious diet.

If vomiting continues during the period you with-hold food or recurs when food is reintroduced, your cat should be seen by the vet again.

Other treatments which can be used to treat vomiting include:

• Fluid therapy: If cats are unable to keep food or water down then there is a risk of dehydration which will require fluid therapy in hospital. You should expect your pet to be in hospital for at least 24-48hours after vomiting has stopped if they require fluid therapy.
• Medications: Anti-emetics (anti-sickness) medication and antacids can be helpful in certain circumstances, but your vet will make an assessment and treat as necessary. If an underlying cause has been found, appropriate medication will be prescribed by your vet.
• Surgery: Removal of obstructions such as ingested toys or masses will require surgical treatment.
• Endoscopy: removal of foreign material from the stomach may be achieved with endoscopy in some situation.

The majority of vomiting cats have a favourable prognosis and resolve with symptomatic treatment only.

However, there are a number of different reasons for vomiting and in some cases your cat's condition may be life threatening so please consult your vet if you are concerned.