Introduction
Ulcers are sores or lesions that form in the lining of a cat’s stomach or upper small intestines, known as the duodenum. They are caused by damage to the mucosa, which is the protective lining of the stomach and duodenum.
Ulcers in cats are relatively uncommon compared to other gastrointestinal issues like inflammatory bowel disease. However, they can still cause significant pain, vomiting, and loss of appetite in affected cats. If left untreated, ulcers can lead to serious complications like gastrointestinal bleeding, perforation, and peritonitis.
It’s important for cat owners to recognize potential signs of ulcers in their pets and seek veterinary care to properly diagnose and treat these painful lesions. Catching ulcers early improves the prognosis and helps prevent further deterioration of the cat’s health.
Symptoms
Ulcers in cats can cause a variety of concerning symptoms. Some of the most common symptoms of ulcers in cats include:[1]
- Loss of appetite
- Vomiting
- Weight loss
- Bad breath
- Drooling
- Lethargy or acting depressed
A loss of appetite is one of the most telling signs of ulcers in cats. Your cat may seem hungry and go to their food bowl, but end up not eating much. They may also begin vomiting, sometimes vomiting up food or bile.
Significant weight loss can occur since the cat is not eating properly. You may also notice bad breath and excessive drooling. The pain from the ulcer causes them to salivate more.
Your cat may seem lethargic or depressed. They know something is wrong and are likely in pain. Ulcers can greatly diminish a cat’s quality of life until properly treated.
Causes
The most common causes of ulcers in cats are Helicobacter pylori bacteria, NSAIDs, stress, and hyperacidity.
Helicobacter pylori is a type of bacteria that can infect a cat’s stomach lining and cause ulcers. The bacteria releases substances that damage the protective mucus of the stomach, making it vulnerable to damage from stomach acid. H. pylori infection is the leading cause of ulcers in cats.
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin can also irritate the stomach lining and make ulcers more likely to form. NSAIDs reduce production of protective prostaglandins in the stomach.
Stress is another common cause of ulcers in cats. Stress increases stomach acid production while also decreasing blood flow to the stomach. The combination of excess acid and reduced protection from blood flow allows ulcers to develop.
Hyperacidity, which is an abnormally high level of hydrochloric acid in the stomach, can directly damage the stomach lining and cause ulcer formation. Acidity increases with stress, infection, and certain medications.
Diagnosis
Diagnosing ulcers in cats involves a combination of physical examination, diagnostic testing, and procedures to identify the cause. The vet will start with a thorough physical exam, checking for signs of illness and palpating the abdomen to locate areas of tenderness or swelling. Bloodwork such as a complete blood count and biochemistry panel can look for infection, inflammation, kidney issues, and other systemic problems. Specific blood tests may be done to check for hyperthyroidism or other endocrine disorders if those are suspected.
The vet may want to analyze a small tissue sample from the stomach lining. This biopsy can be obtained via endoscopy, which allows visual examination of the stomach lining through a narrow tube with a camera on the end. Biopsy results can identify if there are Helicobacter bacteria present causing the ulcers. Endoscopy also allows collection of stomach fluid to test for excess acid production.
In some cases, the vet may order x-rays or an abdominal ultrasound to get images of the stomach and look for thickening of the walls, abnormal masses, or foreign objects that could be causing ulcers. Identifying the underlying cause is key to proper treatment and prevention of recurring ulcers.
Treatment
The primary treatment for cats with ulcers caused by a herpesvirus infection focuses on relieving symptoms and supporting healing. This often involves:
Antibiotics – Antibiotics may be prescribed to prevent or treat secondary bacterial infections. Common choices include topical gentamicin, ciprofloxacin, and oxytetracycline. Oral antibiotics like doxycycline may also be used.
Antacids – Antacids help reduce stomach acid and allow ulcers to heal. Famotidine (Pepcid) or omeprazole may be prescribed.
Diet change – Eating smaller, more frequent meals of bland, easy-to-digest food can help reduce ulcer pain. Prescription gastrointestinal food may also be recommended.
Stress reduction – Reducing stressors in the cat’s environment supports healing. Pheromones, toys, cat trees, and dedicated play time can help lower stress.
Other therapies like lysine supplements, lactoferrin, and interferon may also be used. In severe cases, surgery may be required. Healing can take 4-6 weeks, and medication may be needed long-term to prevent recurrence.
Home Care
If your cat is diagnosed with ulcers, there are some things you can do at home to help aid their recovery and prevent the ulcers from worsening:
Feed small, frequent meals – Feeding smaller, more frequent meals can help reduce the acidity in your cat’s stomach and prevent irritation of the ulcers. Feed several small meals throughout the day rather than one or two large meals.[1]
Avoid stressful situations – Stress can exacerbate ulcers in cats, so try to minimize stressors in your cat’s environment during recovery. Reduce interactions with other household pets, keep noise levels low, and stick to your cat’s normal routine as much as possible.
Give antacids as directed – If your vet prescribes antacids, be sure to give them according to instructions to help reduce stomach acid and allow the ulcers to heal. Common antacids for cats include famotidine (Pepcid) and omeprazole (Prilosec).
Prognosis
With prompt veterinary treatment, the prognosis for cats with stomach or intestinal ulcers is generally good. However, ulcers can be chronic or recurring in some cats, requiring lifelong management.
Most ulcers will heal within 2-4 weeks when treated with medications like antacids, antibiotics, and drugs to decrease stomach acid production. Dietary changes are also important for ulcer healing and prevention of recurrence. Cats may need to eat small, frequent bland or prescription low-fat meals. Once healed, cats can usually transition back to normal food over 2-4 weeks.
For severe or refractory ulcers, surgery may be required. This carries greater risks but can be curative in some cases. Even after surgery, medication and dietary management are often still needed.
Without treatment, ulcers can worsen and cause life-threatening complications like gastrointestinal bleeding, perforation, and peritonitis. However, with attentive home care and follow-up veterinary visits, most cats have an excellent recovery prognosis.
Prevention
There are a few key ways to help prevent stomach and intestinal ulcers in cats:
Avoid NSAIDs – Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can increase the risk of ulcers in cats. Avoid giving your cat any NSAIDs unless strictly necessary and prescribed by your veterinarian. Using alternatives like acetaminophen for pain relief may be an option.
Manage stress – Stress is a major risk factor for ulcers in cats. Try to minimize stressful events, changes in routine, or introductions of new cats/pets. Use calming aids like Feliway diffusers and make sure your cat feels relaxed and secure in their environment.
Annual vet exams – Have your veterinarian perform a thorough physical exam at least once a year. Bloodwork and other diagnostic tests can help identify conditions like kidney disease that may predispose a cat to ulcers. Treating underlying issues early is important.
With proactive prevention methods, stomach and intestinal ulcers can often be avoided in cats.
Cost
Treating ulcers in cats can be expensive, with the total costs varying based on the cause, severity, and treatment plan. Diagnosing the underlying cause generally costs $200-500 for tests like blood work, urinalysis, biopsies, and imaging. Once diagnosed, ongoing treatment and medication can cost $100-200 per month.
For ulcers limited to the mouth or skin, topical medications and immune-modulating drugs often cost $100-150 per month. More severe cases involving the stomach/intestines may require intravenous fluids, anti-ulcer medication, antibiotic therapy, and a special diet, with monthly costs ranging from $150-300.
In some cases, the most affordable long-term option is surgery such as full mouth extractions for stomatitis or gastropexy for stomach issues. However, surgery can cost $2,000-3,000 or more when hospitalization is included.
Pet insurance can help manage the costs of diagnosing and treating ulcers in cats. Policies with 80-100% reimbursement and low deductibles provide the most coverage for these potentially expensive conditions.
Conclusion
Feline infectious peritonitis (FIP) is a concerning viral disease in cats that can be difficult to diagnose and has a poor prognosis if left untreated. While some cats can live with mild symptoms, most cats that develop the wet form of the disease will sadly succumb to it within weeks or months. This makes prevention and early intervention critical.
If your cat is showing concerning symptoms like fever, weight loss, diarrhea, abdominal swelling, or difficulty breathing, get them evaluated by a veterinarian right away. With a combination of bloodwork, imaging, PCR testing, and possibly biopsy, vets can get to the root of what’s causing illness. Though challenging to treat, anti-viral and immunosuppressant medications may help support quality of life if caught early.
Working closely with your vet to monitor symptoms and explore all options available is extremely important, even if the prognosis seems bleak. Though FIP currently has no definitive cure, supportive care can sometimes prolong life. Ongoing research brings hope that more effective treatments will be available in the near future.
