Emesis in Cats
Cats vomit. It’s just a fact of life. The question is, is it for a benign reason like a hairball, or a more serious problem like liver disease? The answer is determined by observation and testing.
What to Watch For
Vomiting is often preceded by drooling, lip licking, excessive swallowing, or even yowling. The act of vomiting, meanwhile, is characterized by strong abdominal contractions and head-bobbing. It is important to note what the cat vomits up, how much he vomits, how often he vomits, and if the vomit is associated with eating or drinking, especially before the first episode of vomiting.
Vomiting is caused by anything that irritates the stomach or prevents stomach contents from moving forward along the digestive tract. (Regurgitation, in which stomach contents move backwards up the esophageal track and into the mouth, is caused by anything that may prevent food from entering the stomach, which usually means problems with the esophagus.)
A single episode of vomiting is usually benign, as long as no foreign material or blood is seen. If your cat is vomiting multiple times within a day (acute vomiting), use the following steps as a guide:
Check your cat for pale or cold gums, listlessness, diarrhea, fever, or other unusual symptoms.
If possible, locate the food or item that caused the vomiting.
Remove food from trays for about 12 hours, but continue to provide water.
If the cat stops vomiting, try offering a teaspoon of his usual food.
If he keeps this down, continue offering small amounts of food every few hours for the next 24 hours, then go back to his usual schedule if all others symptoms subside.
If for any reason your cat cannot keep water down, does not cease to vomit, has blood or unusual material in the vomitus, or if you have witnessed him eat something dangerous, call your veterinarian or an emergency hospital immediately.
If your cat vomits frequently -- once a day to once a month (chronic vomiting) -- there is an underlying problem that will need to be diagnosed by your veterinarian. You can help by noting other symptoms like diarrhea, increased thirst or urination, change in appetite, etc. If the vomiting can be associated with any particular food or activity, eliminating that food or activity may eliminate the vomiting.
Since so many different things can cause your cat to vomit, your veterinarian will need to do a careful evaluation of your cat to determine the cause. This starts with a thorough physical exam of your cat and a discussion of what you are observing at home. From this basic information, your veterinarian will order a series of tests, which may include: blood tests, urine tests, fecal tests, X-rays, barium studies, endoscopy, ultrasound, and biopsy.
Because of the many causes of vomiting, treatment will depend on the diagnosis. Cats with acute vomiting are often dehydrated and will need intravenous (IV) fluids until the vomiting is under control and your cat can eat and drink normally. If there is concern for infection, antibiotics will be given. If the vomiting will not stop, antiemetics and/or stomach protectants (like aluminum hydroxide) may be given. If a foreign body is suspected, surgery will be performed to remove it. There may be other treatments given specific to the cause of vomiting.
A partial list of things that can irritate the stomach or otherwise cause vomiting include: infection, parasites, various plants and toxins, kidney, liver, or pancreatic disease, foreign objects, cancer, etc.
Living and Management
Some causes of vomiting can be self-limiting, or cured by surgery or medication, after which your cat can resume his usual lifestyle. Other causes of vomiting are due to chronic inflammation or other problems, which require permanent dietary changes, medications, or other restrictions. It is important to follow the veterinarian’s instructions and contact him or her if your cat won’t cooperate or gets worse.
If your cat refuses to eat for more than one day, she is at risk of developing hepatic lipidosis. The longer she refuses to eat, the greater the risk becomes. This is a serious, potentially fatal condition in which the liver becomes clogged with fat as the result of not eating. The treatment for this condition is long and intense, so it is best to avoid it if possible.
Many causes of vomiting cannot be prevented. The best thing you can do is to remove any potentially harmful foods or objects from your cat’s environment.