Expert: Jessica - 8/25/2009

Question
QUESTION: My cat Roxy vomits bile occasionally, usually once a month.  This month, she has vomited twice, approximately 2 weeks apart.  There has been no change in her food.  Though she vomits, she always continues to eat and drink, and is as playful and energetic as normal.  There is never food in the bile; rarely, a few hairs are present.  She has never hacked up a hairball, and I have her on Laxatone, in addition to grooming her everyday.

What are some possibilities for the vomiting?

ANSWER: Hi Amy.  Is your kitty free fed, or do you feed her scheduled meals?  If she’s fed scheduled meals, you may want to consider free feeding or purchasing a timed feeder so that she can eat every few hours.  Cats frequently vomit bile when they go too long between meals.  

However, there are certainly other reasons.  You probably would have noticed roundworms in her vomit if she was infected, but these are still a possibility and are one of the most common causes of vomiting in cats.  If you have an established relationship with a vet, the easiest way to treat roundworms is to pick up some Revolution, a topical medication that is applied between the shoulder blades.  It protects against fleas, ticks and heartworm and also will kill roundworms.  Oral medications are available if you schedule an appointment with your vet.  There are some roundworm treatments available over-the-counter at pet stores, but I find them ineffective, and they tend to cause more side effects than those that vets provide.  

More serious causes of vomiting include kidney failure, pancreatitis, liver disease and inflammatory bowel disease.  Even an overactive thyroid can cause vomiting.  However, vomiting is very often seen at least once or twice a week with these conditions.  Cats have sensitive stomachs by nature, so to find vomit every couple of weeks may not necessarily be of great concern.  Nevertheless, it may not be a bad idea to visit the vet and have a blood work up done.  This will check all of her organ function (thyroid tests can be added if deemed appropriate) to give you an idea of her overall health.  


---------- FOLLOW-UP ----------

QUESTION: Hi Jessica,

Thank you so much for your reply.  I feed Roxy meals twice a day, because she is voracious about eating and will eat everything in sight (and a whole day's worth of dry food at once) if allowed to do so.  I have her on Wellness canned food, because I want to keep her well hydrated.  

Roxy is currently on Revolution as a preventative.  Is it necessary to apply it between the shoulder blades?  When I do that, she licks it off, so I apply it just behind her head, so she can't reach it.

I have mentioned the vomiting to my vet, and he said once-a-month vomiting was nothing to worry about as long as she seemed normal otherwise.  

Why do cats vomit when they are hungry?  Can stress be another cause of vomiting?  A housemate and a new cat moved in last week, and Roxy hates the new cat.  The other cat is mostly confined in her room, but when she comes out to play, Roxy is very displeased.  I try to reassure Roxy that all of my attention is still hers.

Answer
Cats tend to vomit when their stomachs are empty because their stomach acid has nothing to digest, so it irritates the stomach lining and can lead to vomiting.  Ideally, it's best to feed cats with sensitive bellies 5 smaller meals each day instead of 2 or 3 larger ones, so their bellies aren't empty for long periods.  It's a little bit of an investment, but there are timed feeders equipped with ice packs that would allow you to continue to feed her canned food in measured portions throughout the day if the vomiting seems to be a real concern.  The 8 day feeder by Ergo is one example.  http://www.autopetfeeder.com/  There are less sophistocated ones as well.

Stress can, indeed, be a cause of stomach upset.  Since the vomiting has gone on for a while, I would imagine the new housemates are not to blame for her belly problems, but potentially, any time she's felt extreme anxiety about something, it could make her stomach sick.  I do like a product called Feliway for this sort of stress, and I think it would be beneficial for her during this time of change, even if it doesn't solve the vomiting.  It's always good to use when there are any big changes in the home.  I use the plug-in diffusers in my own home to reduce anxiety associated with new cats (I foster).  You can learn more at www.feliway.com  It's available at pet stores and online.  The original set up seems to be least expensive at amazon.com as far as I have found.

Applying Revolution to the fatty layer between the shoulders ensures that the medication will be quickly absorbed and distributed for the fastest and most efficient results.  But I, too, apply Revolution more on the back of the neck rather than between the shoulders to avoid having my cats lick it off.  It may take a little longer to be effective against a bad flea infestation (if you'd had one), but it should give your kitty the same protection once absorbed into the bloodstream.