Vomiting is the act of forceful contraction of the abdominal muscles leading to the ejection of ingested material through the mouth.
• Vomiting in cats is often accompanied by increased salivation, excessive swallowing, restlessness, and vocalization
• In young, otherwise healthy indoor cats, mild acute vomiting is usually the result of eating something unusual or poorly tolerated
• If vomiting continues for longer than 24 hours, veterinary attention is warranted
• Vomiting is caused by a wide array of underlying conditions that range from minor to life-threatening
• Indicated diagnostic tests include blood work, fecal analysis, urinalysis, diagnostic imaging, endoscopy, biposies, and surgery
• In cases of long-term or severe vomiting, the underlying cause must be identified to determine treatment
Mild, occasional vomiting, occurring no more than once a month, is common in cats and is usually not an emergency. In the case of acute vomiting (no longer than 1-2 days), the underlying cause may not be established, and health generally improves fairly rapidly with symptomatic treatment. If a cat vomits more than once a month or presents secondary symptoms, such as lethargy, weakness, or decreased appetite, professional attention is warranted. The need for more urgent or emergency veterinary care is determined based on the severity of other associated symptoms.
Vomiting can be either acute or chronic:
Acute vomiting: lasts no longer than two days. In the case of an acute upset stomach due to eating something unusual or poorly tolerated, the animal's health generally improves spontaneously or with symptomatic treatment.
Chronic vomiting: does not resolve over the course of two days and usually persists for more than two weeks. It may or may not be accompanied by other symptoms.
Vomiting is characterized as severe when it is relentless and is accompanied by other symptoms like distress, lethargy, appetite loss, weakness, collapse, and seizures.
Forceful retching can damage the lining of the esophagus, so a few streaks of red blood in the vomit does not necessarily indicate an emergency. Vomiting large quantities of digested blood, which appears like coffee grounds, is a clear indicator of an emergency.
Potential causes of vomiting cats include, but are not limited to:
• Dietary indiscretion • Eating too much or too quickly • Infectious diseases (viral, bacterial) • Food allergy
• Toxic ingestion (e.g. chocolate, onion, antifreeze, or mothball poisoning) • Liver disease • Kidney disease
• Diabetes mellitus • Inflammatory bowel disease • Gastrointestinal parasites • Gastrointestinal obstruction
• Tumors and cancer
A note about hairballs: While grooming, cats ingest some of their loose hair. Hair is not digestible, but healthy cats usually manage to pass hair uneventfully in stool. Sometimes cats throw up hairballs. This is not alarming when it occurs rarely, but medical investigation to pursue the underlying cause is warranted if it occurs more than once a month. Chronic vomiting of hairballs is not normal.
The number of times a cat throws up during a bout of vomiting is not usually significant. Once the stomach is upset, a cat is expected to throw up as many times as it takes until the upper digestive tract is empty. Instead, the primary indicators of severity with respect to vomiting are the duration of the vomiting and the presence of associated symptoms.
Vomiting is a more significant concern for cats with previously diagnosed conditions. Vomiting has the potential to be more serious for cats with pre-existing conditions like diabetes mellitus or chronic kidney disease. Some conditions associated with vomiting are life-threatening and not all are treatable.
If further investigation of vomiting is indicated, strategies to determine the root cause may include:
• Physical examination • Blood test • Fecal analysis • Urinalysis • Diagnostic imaging • Endoscopy • Biopsy
• Laparotomy (exploratory surgery)
Symptomatic support of vomiting includes:
• Withholding food (GI rest) • Special diets • Probiotics and digestive supplements • Antiemetics • Fluid therapy
Specific therapy depends on the underlying diagnosis and ranges widely.
General guidelines to ensure optimal gut health and reduce occurrences of vomiting in cats include:
• Diligent and frequent brushing to reduce the amount of loose hair which helps control hairballs
• Keeping up to date with vaccinations and annual veterinarian visits are crucial in preventing and/or early detection of conditions that may cause vomiting
• Healthy diet and proper disposal of food scraps can prevent food intolerance or ingestion of toxins
• Keeping cats indoors minimizes the likelihood of exposure to many underlying causes of vomiting
Vomiting can be mistaken for regurgitation, which is the passive expulsion of food and or fluid from the esophagus and does not involve abdominal contractions.
Depending on the underlying cause, a number of symptoms are associated with vomiting, including:
• Nausea • Diarrhea • Constipation • Weakness • Lethargy • Dehydration• Weight loss • Decreased appetite
• Abdominal pain
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