Vomiting describes the active expulsion of food from the stomach. It may be related to disorders of the stomach but is a clinical sign that can occur with many diseases and problems. It is not a specific disease or diagnosis itself. Cats vomit quite readily and occasional vomiting in an otherwise healthy cat may not indicate anything abnormal. This is particularly true if the vomited material consists largely of hair. It is considered a normal process for cats to retain hair and vomit hairballs periodically.
How serious is vomiting?
Most cases of acute vomiting, when vomiting has been present for less than two to three days, resolve readily with simple treatment, without the underlying cause being diagnosed. Severe or chronic vomiting is more serious. It can lead to secondary problems, particularly dehydration and disturbances in the levels of electrolytes such as sodium. It is important to investigate such cases to identify the underlying cause so that effective treatment can be given.
How do I recognize vomiting?
Vomiting may begin with a stage of nausea, in which the cat appears restless, and possibly apprehensive. The cat may lick its lips, salivate and repeatedly swallow. Vomiting itself involves contractions of the abdominal muscles, which may be repeated, leading to expulsion of fluid, froth or food. The severe effort associated with vomiting may be distressing to the cat.
It is important to differentiate this from the abdominal contractions associated with coughing. Cats may cough up some froth which they subsequently swallow. Cats usually crouch down on all four legs when coughing with the neck stretched out.
It is also helpful to differentiate vomiting from regurgitation, which is usually associated with problems affecting the esophagus or gullet. Features which help to differentiate vomiting from regurgitation include:
• Whether return of food involves abdominal contractions and effort
• Whether the returned food is in the shape of a sausage
• Whether the returned food is re-eaten
• The relationship to eating or drinking
Acute vomiting is vomiting that has been present for no more than two to three days. Most cases will respond quickly to simple treatment. The cause of such cases is often never established and may be due to relatively trivial factors such as eating spoiled food. In a minority of acute cases of vomiting, usually because the vomiting is severe and leads to complications such as dehydration or because a more serious underlying cause is suspected, further tests, specific treatment and aggressive supportive care will be required. Features that you may be able to identify that will help the veterinarian decide whether simple treatment or further investigations are appropriate would be:
• If the cat appears otherwise well or ill – depressed, lethargic or has any other specific signs
• If the cat is eating
• If there has been weight loss
• If there has been any blood in the vomit (a few specks of fresh blood may not be abnormal but more copious or persistent bleeding is significant)
• Any pain or distress, particularly affecting the abdomen
• Whether normal feces are being passed
• The frequency and volume of vomiting• The relationship of vomiting to feeding – particularly if there is a long delay
• Any offensive odor or abnormal color to the vomitus
• What the cat has been fed
• Any recent change of diet
• Any possible access to other foods or other substances
• Any treatment given recently
• Whether other cats in the household are affected
Symptomatic treatment for vomiting
Symptomatic treatment is usually tried initially in mild cases of vomiting. It may involve a number of measures:
Withholding of food for six to eight hours or as directed by your veterinarian.
Provision of an easily digested, bland diet.
A simple, easily digestible diet will normally be offered in small quantities. A diet based on boiled chicken or sometimes fish with rice is often used. It is important that the cat does not receive any other foods during this period. Water should be freely available and is important to combat dehydration. If the cat is progressing well, the quantity of food offered can be gradually increased back to normal over several days and then the cat’s normal diet can be reintroduced gradually over several days.
Drugs – certain medications are available to control vomiting and your veterinarian may advise the use of these.
Further investigation of vomiting
If the vomiting is severe or the veterinarian suspects a serious underlying problem, other treatments and diagnostic tests may be required. It may be necessary to hospitalize your cat so that intravenous fluids can be given to combat dehydration and correct any imbalances in the levels of electrolytes. In some cases, it is necessary to administer injections to control the vomiting. In less severe cases you may be asked to administer fluids and special solutions at home. You may be given a syringe to help you do this. You must be patient, giving only small quantities at frequent intervals. If your cat becomes unduly distressed, contact your veterinarian for further instructions.
Additional diagnostic tests may be required in cases of chronic vomiting, or when the cat has been vomiting for more than two to three weeks, even though the vomiting may be intermittent and the cat may appear otherwise well. Such cases can often not be successfully treated until the underlying cause has been determined. Some of the more commonly used tests are:
Blood tests – to check for infections, kidney and liver problems, thyroid disease, diabetes and provide other clues to the diagnosis.
X-rays – may show abnormalities of the esophagus or stomach. It may be necessary to give barium to help identify any blockages, tumors, ulcers, foreign bodies, etc.
Endoscopy – in some cases a diagnosis can be made by viewing the inside of the stomach directly through an endoscope, a flexible viewing tube, which is passed through the mouth under a general anesthetic.
Laparotomy – in some cases an exploratory operation is necessary, particularly if some obstruction or blockage is suspected. This may also allow surgical treatment of the problem.