Gagging, or retching, describes muscular contraction of the throat that appears similar to the initial stages of vomiting or coughing, but is distinct from both these processes.
• Causes of gagging include hairballs, eating excessively fast, nausea, inflammation of the throat or the esophagus, physical blockages in the mouth, throat, and stomach, respiratory disease, poisoning, nasopharyngeal polyps, and tumors
• Investigation of gagging involves physical examination, blood work, and diagnostic imaging such as x-rays, endoscopy, fluoroscopy, and ultrasound scans
• Treatment options depend on the underlying disease process but includes medication such as antiinflammatories, antibiotics, anti-nausea medication, and surgery in some cases
• Prognosis varies: some cases are easily resolved with changes in feeding practices, other cases require urgent attention but carry a good prognosis
• Severe cases involving tumors of the mouth or throat are often fatal
Gagging is a common presentation in cats but most cases are temporary and involve uncomplicated conditions such as hairballs or eating too quickly. Prognosis in these cases is excellent.
Some cases are associated with airway obstruction, presenting alongside breathing difficulties, blue tinged gums or tongue, and collapse. Cats presenting with gagging alongside possible airway obstruction require emergency treatment.
There are many potential causes of nausea in cats, which can induce gagging. Signs of nausea that resolve on their own and are not recurring are not cause for concern. A cat that has not eaten in over 24 hours, or who is gagging, vomiting or has diarrhea for over 24 hours requires emergency treatment.
Prognosis due to underlying serious medical conditions varies based on the condition and severity of symptoms.
There are numerous diseases that have gagging as a possible symptom. Different triggers include:
• Eating too quickly
• Tumors - oral, laryngeal, tracheal, esophageal, gastric
Gagging may also be due to nausea. Nausea is associated with
• Motion sickness • Anxiety • Kidney disease
• Liver disease • Cancer • Pancreatitis • Toxin ingestion
• Intestinal foreign body • Inflammatory Bowel Disease
The severity of gagging varies significantly depending on the trigger.
Gagging from hairballs is often sudden onset, moderate to severe, but self-limiting once the hairball has been expelled. Gagging from nausea may be mild to severe depending on the extent of the nausea but often responds to treatment. Gagging caused by obstruction such as a slow growing tumor is often progressive and is unlikely to resolve with medication. Gagging associated with airway obstruction is usually severe, and sometimes fatal without emergency treatment.
Diagnosis of the underlying cause of gagging involves:
• Physical examination
• Blood work
• Bacterial culture
• Viral isolation
• Diagnostic imaging
Treatment varies depending on the underlying cause but options include:
Lifestyle changes such as
• Slow feeding bowls
• Regular grooming to reduce ingestion of hair
• Anti-hairball supplements
Medications such as
• Anti inflammatories
• Steroids - oral or inhaled
In some cases, surgery may be required, such as foreign body or tumor removal.
Gagging is sometimes mistaken for coughing, vomiting, and regurgitation. Coughing in cats appears very similar to gagging. Cats with respiratory disease such as asthma, or heart disease may appear to be gagging, but may actually be coughing.
Gagging is usually found alongside other symptoms which vary depending on the underlying disease process. Common examples include:
• Poor appetite
• Bringing up hairballs
• Abdominal pain
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