Vomiting describes the active expulsion of food from the stomach. Vomiting may be caused by disorders of the stomach but is a clinical sign that can occur with many diseases and problems.
"It is not a specific disease or diagnosis itself."
It is not a specific disease or diagnosis itself. Cats vomit quite readily and occasional vomiting in an otherwise healthy cat may not indicate anything abnormal. This is particularly true if the vomited material consists largely of hair. It is considered a normal process for cats to swallow hair while they are grooming themselves, and they will vomit hairballs periodically.
If it is normal, then how serious can vomiting be?
It depends on the cause of vomiting. Most cases of acute vomiting, when vomiting has been present for less than two to three days, resolve readily with simple treatment, without the underlying cause being diagnosed. Severe or chronic vomiting is more serious. It can lead to secondary problems, particularly dehydration and disturbances in the levels of electrolytes such as sodium.
Vomiting can be caused by minor intestinal upset, as from eating spoiled food or foul-tasting things such as certain insects. However, vomiting can also be a symptom of a more serious illness, such as bacterial or viral infection, intestinal obstruction from foreign bodies, urinary tract obstruction, liver disease, or cancer. Left untreated, these illnesses can lead to serious complications, including death.
How do I recognize vomiting?
Vomiting may begin with a stage of nausea, in which the cat appears restless, and possibly apprehensive. The cat may lick its lips, salivate and repeatedly swallow. Vomiting itself involves forceful contractions of the abdominal muscles, leading to expulsion of fluid, froth or food. The severe effort associated with vomiting may be distressing to the cat.
It is important to differentiate this from the abdominal contractions associated with coughing. Cats may cough up some froth or foamy material that they subsequently swallow. Cats usually crouch down on all four legs when coughing with the neck stretched out.
"It is also important to differentiate vomiting from regurgitation..."
It is also important to differentiate vomiting from regurgitation, which is usually associated with problems affecting the esophagus and is a more passive process. Features that help to differentiate vomiting from regurgitation include:
- Whether return of food involves abdominal contractions and effort
- Whether the returned food is in the shape of a sausage
- Whether the returned food is re-eaten
- The relationship to eating or drinking
What does acute vomiting mean?
Acute vomiting is vomiting that has been present for no more than two to three days. Most cases will respond quickly to simple symptomatic treatment. The cause of such cases is often never established and may be due to relatively trivial factors such as eating spoiled food. In a minority of cases of acute vomiting, usually because the vomiting is severe and leads to complications such as dehydration, or because a more serious underlying cause is suspected, further tests, specific treatment and aggressive supportive care will be required.
What is the symptomatic treatment for acute vomiting?
Non-specific symptomatic treatment is often prescribed initially in mild cases of acute vomiting. Your veterinarian may advise you to withhold food for a time ranging between six and twenty-four hours. After this time, you will usually be advised to feed your cat an easily digested, bland diet in small quantities given frequently. A diet based on boiled chicken and boiled rice is often recommended. It is important that the cat does not receive any other foods during this period.
"Water should be freely available and is important to prevent dehydration."
Water should be freely available and is important to prevent dehydration. If the cat is progressing well, the quantity of food offered at any one time can gradually be increased back to a normal quantity and then the cat's normal diet can be reintroduced gradually over several days.
In some cases, your veterinarian may prescribe medication to control vomiting or relieve inflammation. This approach allows the body's healing mechanisms to correct the problem.
If your cat does not improve with symptomatic treatment, your veterinarian may make a change in medication or perform further tests to evaluate the problem more thoroughly.
How will my veterinarian decide what type of testing and treatment is necessary?
Features that you may be able to identify that will help the veterinarian decide whether symptomatic treatment or further investigations are appropriate include:
- If the cat is depressed, lethargic or has a fever
- If the cat is eating
- If there has been weight loss
- If there has been any blood in the vomit (a few specks of fresh blood may not be abnormal but more copious or persistent bleeding is significant)
- If there is any pain or distress, particularly affecting the abdomen
- Whether normal feces are being passed, or if the cat has diarrhea or constipation
- What is the frequency and amount of vomiting
- What is the relationship of vomiting to feeding
- Whether there is any offensive odor or abnormal color to the vomit
- What the cat has been fed and if there has been a recent change in diet
- Whether the cat has any access to other foods or other substances
- Whether any treatment or supplements have been given recently
- Whether any other cats in the household are affected
What other treatment or diagnostic testing may be required?
"If the vomiting is severe...more aggressive treatment may be required."
If the vomiting is severe or if your veterinarian suspects a serious underlying problem, such as kidney or liver disease, more aggressive treatment may be required. It may be necessary to hospitalize your cat for intravenous fluids therapy to combat dehydration and correct any imbalances in the levels of electrolytes. In some cases, it may be necessary to administer injections to control the vomiting. In less severe cases, you may be able to treat your cat at home. You may be asked to administer fluids and special solutions at home, and if this is the case, you will be shown how to do this. You must be patient, giving only small quantities at frequent intervals. If your cat becomes unduly distressed by home treatment, contact your veterinarian for further instructions.
Additional diagnostic tests may be required in cases of chronic vomiting, or when the cat has been vomiting for more than two to three weeks, even though the vomiting may be intermittent and the cat may appear otherwise well. In these cases, the underlying cause must be determined in order to treat the problem appropriately. Some of the more commonly used tests are:
Blood tests may show evidence of infections, kidney and liver problems, thyroid disease, or diabetes and may provide other clues leading to the diagnosis.
X-rays may show abnormalities of the esophagus or stomach. It may be necessary to give barium to help identify any obstructions, tumors, ulcers, foreign bodies, etc.
Endoscopy, which is viewing the inside of the stomach directly through an endoscope, a flexible viewing tube, may provide a diagnosis in some cases or the procedure can be used to obtain biopsy samples. Endoscopy requires a general anesthetic.
Laparotomy or an exploratory surgery is necessary in some cases, particularly if some obstruction or blockage is suspected or if biopsy samples are required. Laparotomy can be both a diagnostic and a treatment procedure.
Once the diagnosis is known, treatment may include special diets, medications, or surgery.
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