Introduction
Throwing up is a common occurrence for cats, but can be concerning when a cat seems otherwise normal and healthy. Vomiting refers to the forceful ejection of food or liquid from the stomach out through the mouth. Regurgitation, on the other hand, is the passive movement of food or liquid from the throat or esophagus back into the mouth. While cats may occasionally regurgitate their food shortly after eating, frequent and recurrent vomiting in cats is abnormal and usually indicative of an underlying health issue.
There are a wide range of potential causes behind a cat vomiting frequently while acting normal otherwise. Broadly, these causes can be split into dietary causes like eating spoiled food or ingesting hairballs, infections from parasites, viruses or bacteria, obstruction from foreign objects lodged in the digestive tract, inflammation or disease of organs like the stomach, intestines, pancreas or liver, toxin exposure, or metabolic diseases like kidney failure or diabetes. Identifying the specific cause will require an examination from a veterinarian, along with testing as needed.
Dietary Causes
One of the most common reasons for a cat vomiting but otherwise acting normal is dietary issues. Eating too fast can cause cats to vomit soon after eating. Cats are known to be greedy eaters and will often scarf down their food. This can lead to indigestion, irritation of the stomach lining, and vomiting. Placing large cat food kibbles in a puzzle feeder or feeding smaller meal portions can slow down eating and prevent vomiting from overeating too quickly (Zoran, 2017).
Food allergies or intolerances are another source of vomiting in cats. Just like humans, cats can develop adverse reactions to ingredients in their food. Common allergens for cats include beef, dairy products, chicken, fish, corn, wheat, and soy. Switching to a hypoallergenic diet with a novel protein and carbohydrate source can help determine if food allergies are the culprit. Over 10% of vomiting in cats is caused by adverse food reactions (Marks, 2014).
Hairballs
Hairballs are a common cause of vomiting in cats. Cats groom themselves frequently, ingesting loose hair in the process. Over time, the ingested hair can accumulate into hairballs in the stomach or intestines.
Hairballs can cause vomiting when they partially obstruct the gastrointestinal tract. Cats may retch and cough as they try to bring up the hairball. They may vomit up the hairball or pass it in their stool.
Long-haired cats are more prone to hairballs since they ingest more hair from grooming. But even short-haired cats can get hairballs. Young cats are curious and tend to groom more as kittens. Older cats groom less efficiently and ingest more hair.
To prevent hairballs:
- Brush or comb your cat regularly to remove loose hair.
- Consider trimming long-haired cats to minimize excess hair.
- Feed hairball prevention cat food or treats.
- Consider hairball remedy pastes or gels.
- Schedule regular veterinary wellness exams to monitor for hairballs.
Parasites
Parasites like roundworms and tapeworms are common causes of vomiting in cats. Roundworms are intestinal parasites that kittens often get from their mother’s milk. Adult cats can pick up roundworms by ingesting feces or prey infected with roundworm larvae.1 Roundworms live in the small intestine and can cause vomiting as they irritate the intestinal lining. Tapeworms are another intestinal parasite that cats get from ingesting fleas or prey infected with tapeworm larvae. The tapeworm segments will break off and be passed in the feces or vomit and may be visible to the naked eye.2
In addition to vomiting, other symptoms of intestinal parasites can include diarrhea, weight loss, dull hair coat, and a pot-bellied appearance. However, many cats with parasites show no signs at all. The only way to diagnose parasites is through a fecal exam performed by your veterinarian. Parasites are treated with oral deworming medication prescribed by your vet.
Foreign Body Obstruction
Foreign body obstructions occur when a cat ingests something that gets stuck in their gastrointestinal tract, blocking the passage of food and causing vomiting. Common foreign objects that cause obstructions include string, rubber bands, plastic, bones, needles, and more. Cats are curious animals and may swallow foreign objects while playing or exploring their environment.
Signs of a foreign body obstruction include vomiting, loss of appetite, lethargy, and sometimes diarrhea or constipation. Vomiting is often the first noticeable sign. A cat may try to vomit but nothing comes up if the obstruction is blocking the esophagus. According to VCA Hospitals, obstructions most often occur in the esophagus, stomach or at the ileocecocolic junction where the small intestine joins the large intestine [1].
To diagnose a foreign body obstruction, the vet will do a physical exam and palpate the abdomen to feel for obstructions. Imaging tests like x-rays or an ultrasound may be done to identify the location and determine what type of object is causing the blockage. Bloodwork will also be done to assess organ function.
The main treatment for foreign body obstructions is surgical removal. The vet will make an incision into the obstructed area of the GI tract and carefully remove the object causing the blockage. If any tissue was damaged, it will be repaired during surgery. The cat will likely need to stay at the vet clinic for a few days after surgery for observation and pain management. Prognosis is generally good if treated promptly before sepsis or peritonitis can occur [2].
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder in cats characterized by persistent or recurrent vomiting, diarrhea, weight loss, and sometimes appetite loss. The exact cause of IBD is unknown, but it is believed to be the result of an inappropriate inflammatory response to intestinal bacteria and food antigens (1).
Diagnosis of IBD involves ruling out other causes through blood work, fecal analysis, abdominal imaging, and intestinal biopsies. Treatment consists of anti-inflammatory therapy such as corticosteroids to reduce inflammation, antibiotics for secondary infections, and prescription diets that are highly digestible. Symptoms can often be managed long-term, but there is no known cure for feline IBD (2).
Cats of any age can develop IBD, but it most often occurs in middle-aged to older cats around 9 years or older. Purebred cats may be at higher risk. The chronic inflammation damages the lining of the GI tract, which impairs its ability to properly digest food and absorb nutrients (3). This leads to the common symptoms of vomiting, diarrhea, appetite loss, and weight loss.
Sources:
(1) https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/inflammatory-bowel-disease
(2) https://www.vin.com/doc/?id=4252743
(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080598/
Pancreatitis
Pancreatitis, or inflammation of the pancreas, is another common cause of vomiting in cats that are otherwise acting normally. The pancreas is responsible for releasing enzymes that aid in digestion. When the pancreas becomes inflamed, it can release these enzymes prematurely, causing digestion issues that lead to vomiting.
Some common causes of pancreatitis in cats include:[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105028/]
- Obesity
- High-fat diets
- Some medications
- Trauma
- Infections
- Cancer
The main symptoms of pancreatitis are vomiting, abdominal pain, and loss of appetite. Diagnosis typically involves bloodwork to check the feline pancreatic lipase level, as well as imaging such as x-rays or ultrasound to evaluate the pancreas.[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995362/] Treatment involves resting the pancreas by withholding food for a day or two, providing anti-nausea medication, pain relief, and supportive care with IV fluids. The long-term management focuses on a low-fat diet.
Toxins
Cats can be susceptible to poisoning from common household toxins like cleaners, pesticides, plants, and medications. According to the Cornell Feline Health Center, products such as bleach, detergents, and disinfectants can cause severe gastrointestinal and respiratory tract distress if ingested (source). Heavy metals like lead and zinc are also toxic. Cats tend to be curious and can unintentionally ingest toxins by licking their paws after walking on contaminated surfaces.
To prevent toxicity, keep all household chemicals, cleaners, medications, and toxic plants out of reach of cats. Carefully read labels and follow instructions for proper use and storage. Clean up any chemical spills immediately. Use child-proof latches on cabinets containing hazardous substances. Avoid using pesticides and rodenticides, especially near food, water, or areas accessible to pets. If poisoning is suspected, call your veterinarian or animal poison control immediately.
When to See the Vet
While occasional vomiting is normal in cats, you should contact your veterinarian if vomiting becomes frequent or is accompanied by concerning symptoms. Red flags that warrant veterinary attention include:
- Vomiting more than 2-3 times in one day
- Vomit that is bloody, yellow or looks like coffee grounds
- Signs of discomfort like crying out or straining to vomit
- Lethargy, depression, or lack of appetite
- Diarrhea or abnormal stools
- Unexplained weight loss
- Excessive drooling or retching
- Difficulty swallowing
Diagnostic tests the vet may perform include:
- Physical exam to check for signs of dehydration, abdominal pain, or obstruction
- Blood work to look for infection, kidney issues, diabetes, etc.
- Fecal exam to check for parasites
- Urinalysis to assess kidney function
- Abdominal ultrasound or X-rays to visualize the GI tract
- Endoscopy to examine the upper GI tract
Early veterinary care for vomiting can help identify any serious underlying illness and prevent dangerous complications like dehydration, electrolyte imbalances, or a life-threatening condition called hepatic lipidosis. When in doubt, it’s always better to err on the side of caution and have your cat seen if vomiting persists or worsens.
Prevention
There are several steps cat owners can take to help prevent episodes of vomiting:
Dietary Changes: Transitions to new foods should be gradual, mixing small amounts of the new food with the previous food over the course of a week. Feed small meals frequently instead of one or two large meals. Avoid cheap cat foods with fillers and by-products. Choose a high quality diet appropriate for your cat’s age and health status. Provide plenty of fresh water.
Hairball Control: Regular brushing helps remove loose hair and prevents hairballs. Consider using hairball control cat foods or treats. Hairball remedy pastes can also help cats pass hairballs already formed in their digestive tract.
Toxin Avoidance: Keep household toxins locked away and out of reach. Houseplants should be cat-safe varieties. Limit access to string, ribbon, rubber bands, or other items that could cause an intestinal blockage if swallowed. Keep the litter box clean and away from food and water bowls.
