Occasional vomiting is something almost all cat owners have experienced at some point during their feline’s life, and even though this symptom is considered “normal” by many, it is in fact an abnormal pathological condition, especially when it happens more than twice a month on average.
As a cat owner, it’s very important to understand the difference between occasional throwing up and chronic vomiting. Keep reading to learn how to identify and deal with chronic vomiting.
The common old excuses
Many of us, cat owners, as well as veterinarians, have accepted various explanations for chronic vomiting over the years: “your cat is suffering from hairballs”, “your cat is eating too fast”, “it’s just a case of a sensitive stomach” and the list goes on. In reality, those theories usually remain unproven and the vomiting does not seem to get any better, even when we try to address those issues by giving our cat a hairball paste on a regular basis or changing its eating habits.
In some cases, a combination of eating too fast and not crunching on the kibbles can lead to vomiting undigested food. This is relatively common in cats that suffer from severe gingivitis, and can usually be resolved by treating the gum disease and feeding them wet food instead of dry kibbles.
Unfortunately, most cases of chronic vomiting do not fall into these categories and the condition usually hides a more complicated disease that is often difficult to diagnose.
The diagnostic process and the surprising results
A recent study has shown some very surprising results on this subject: 99 out of 100 cats suffering from chronic vomiting, weight loss and diarrhoea have been found to be suffering from either inflammatory bowel disease (IBD) or lymphoma – a type of intestinal cancer. Sometimes both conditions were found in the same patient.
Those two conditions are not easy to diagnose; a definitive diagnosis usually involves an intestinal biopsy which is a very invasive procedure. An experienced ultrasound specialist can usually detect intestinal lymphoma and sometimes even IBD.
There are other conditions that can cause chronic vomiting in cats, for example pancreatitis which is also not easy to diagnose. Other common reasons for chronic vomiting include hyperthyroidism, chronic kidney failure and foreign linear body in the intestines.
My cat is a chronic puker, what can I do?
Step by step diagnosis is the key to finding the cause of the vomiting, a full history including eating habits, age and other medical conditions in the background is the first step that needs to be taken by your veterinarian, this should be followed by a thorough physical examination to try a feel some abnormalities or sensitivity in the intestines.
The different causes of vomiting are separated into two groups: gastrointestinal (GI) tract causes and non-GI (extra GI) diseases. Common examples of GI causes are: gastric parasitic or infectious disease, dietary hypersensitivity (allergy or intolerance), IBD, obstruction, gastric or intestinal neoplasia, motility disturbances. While common examples of extra GI causes are pancreatic disease (pancreatitis or exocrine pancreatic insufficiency), acute or chronic renal disease, hepatic disease or cholangitis, endocrine diseases (hyperthyroidism, diabetic ketoacidosis), systemic infectious disease (e.g., toxoplasmosis, feline infectious peritonitis, fungal).
The next steps should be a comprehensive blood test, urinalysis, an abdominal ultrasound (preferably done by a specialist), endoscopy and as a last resort an exploratory laparotomy (abdominal surgery). The last two methods will include taking several biopsies from the intestines. These biopsies will then be analysed by histopathologists and results should arrive to your veterinary clinic within a few days.
How do we treat it?
Treatment will depend on the cause of the chronic vomiting, although as an immediate relief your veterinarian will usually prescribe a special diet and an anti-emetic medication to help control the vomiting until a final diagnosis is reached. Some cats will improve on diet alone, especially those suffering from pancreatitis or IBD, others will require additional medications in order to get better.
Inflammatory bowel disease (IBD) is usually treated with low dose steroids long term in conjunction with a hypoallergenic prescription diet. Pancreatitis is also treated mainly with a change of diet and it requires medications during acute crisis of the disease (anti emetics, anti-acid meds). Lymphoma is a much more severe condition but sometimes steroids can slow down it’s progression and improve the clinical picture.
Regarding hyperthyroidism, treating the primary disease usually resolves the vomiting episodes.
Prevention and management
Although the following theory is only a speculation, it would only make sense that processed cat food, primarily dry kibble, could play a big part in most pathologies involving chronic vomiting in cats. Today’s commercial foods usually contain grains and other fillers that a cat in the wild would never choose to eat willingly.
Choosing a high-quality grain free food for cats can prove itself extremely worthwhile in the long run for both prevention and management of vomiting and bowel diseases in cats.