Expert: Jessica - 10/10/2009

Question
We have an approximately 6 year old mixed breed domestic medium hair cat.  She occasionally will throw up her food, but we've got used to which foods she likes and she usually only throws up about once/month.  Over the last week, she's thrown up almost daily.  Today she vomited early in the morning, and it entirely consisted of her food.  Then after a very vocal afternoon she meowed very strangely for about a minute, and then threw up again.  This time it almost entirely consisted of clear bile.  What are your thoughts?

Thank you!
Doug

Answer
Hi Doug.  Vomiting once a month is generally not something to be concerned about with cats, but vomiting every week or more often usually is.  I’m listing some of the causes for frequent vomiting, in the order in which I have found them to be most common to least common in my own experience (this may not reflect the true order of frequency in all cat populations):

+ Parasitic worm infections - most commonly roundworms, which can be killed with a dewormer. Tapeworms are another pest that can be killed with a separate dewormer, but tapeworms don't cause vomiting as often as roundworms.

+ Protozoan infections such as coccidia and giardia, which can be controlled with prescription antibiotics.  A third protozoan germ called tritrichomonas has also been found in cats but is less common.

+ Bacterial infections.  These usually respond to metronidazole, one of the antibiotics used to treat giardia.  Many vets will also recommend to mix a probiotic into the cat's food to add in helpful bacteria, which will keep harmful bacteria in check.  Probiotics include Probiocin and FortiFlora.

+ Hairballs.  Most cats vomit these up on their own, but sometimes they need help to pass them.  You may want to consult a vet about giving her a lubricant such as Petromalt or Laxatone if hairballs are suspected after a physical exam.

+ Inflammatory Bowel Disease.  This condition isn’t well understood, but it appears to be caused by an overreaction of the immune system to an unknown stimulus (and most likely, a combination of stimuli).  Some suspected sensitivities are food ingredients, bacteria, and proteins in the lining of the gastrointestinal tract itself.  About half of cats with this disease suffer chronic vomiting.  The usual treatment is to suppress the overactive immune response with prednisone.

+ Organ function/endocrine problems.  Kidney and liver failure as well a pancreatitis can result in severe nausea.  A blood test can be run by your vet to check her kidney and liver values, and in the same panel, her pancreatic values to a lesser extent.  A thyroid test can be included to cover your bases if warranted, since an overactive thyroid can also cause nausea and vomiting.

+ Gastrointestinal cancer.  This tends to be relatively uncommon in cats this age, so hopefully this won’t be a concern!  Vets can often feel defined masses during a physical examination, and an x-ray can help confirm a suspicion.  An ultrasound is the best way to detect gastrointestinal masses.

+ Fecal impaction.  Cats who become seriously constipated will start vomiting as toxins from stool begin entering their blood stream.  If it happens that you haven’t noticed her passing much stool in the last few days, she could be suffering this life-threatening condition and needs to be seen on an emergency basis.

+ Poisoning.  Cats who nibble on certain plants, taste household cleaners or happen to swallow a pill that they found lying around the house can be in serious trouble.  Belly problems are a common reaction to many of these toxins, but worse complications may be yet to come.  If you have any suspicion that she may have eaten anything strange, she should see a vet on an emergency basis.

+ Foreign objects.  Cats can swallow sharp items such as splintered bones or needles, which can perforate the stomach or intestines and lead to this severe stomach pain and vomiting.  They also are known for swallow bits of string or dental floss.  These can get caught in the loops of the intestines as they pass through, and as the intestines move and contract, the string acts as a small saw, lacerating the tissue.  Or just as dangerously, they can cinch loops of the intestines shut, causing a blockage.  Generally, a good place to start diagnosing these problems is with an x-ray.  Surgery will be needed to correct these problems if found.  This is also an emergency.

I hope she's all better soon.  Best of luck!

Jessica