It was Lulu’s first visit to VCA San Carlos Animal Hospital -- and her owner, Casey, had a long list of concerns about her 11-year-old cat. 

“She was concerned about eye discharge, weight loss, broken hairs, dehydration, excessive vocalizing, and a few other, minor things,” said Jenn Mattson, assistant hospital manager. “We expected a long medical history, given the age of the cat, but what we found was quite surprising.”

“She hadn’t been to a veterinarian in several years,” said Dr. Kim Haddad, “And we were definitely able to help her with so many of her concerns. The cat was hyperthyroid, which is not uncommon in senior cats, but manifests itself with a number of clinical symptoms. But what we found was not one of the usual symptoms.”

“Casey hadn’t mentioned any abdominal discomfort. And Lulu had a really large, really uncomfortable abdominal bulge.”

“And then, Casey said ‘oh yeah, you know, she really grooms herself -- a lot.’”

Anxiety was mentioned, but only as a lesser health concern. As Dr. Kim Haddad began her baseline exam, she realized that Lulu was in serious trouble. She called in Dr. Maren Stauber to confirm what she was feeling in Lulu’s abdomen.

“Everyone was able to feel this really unusual mass,” said Dr. Haddad, medical director at VCA San Carlos. “We determined it was the size of a small grapefruit. For a skinny cat like Lulu, this was a very pronounced problem – and potentially life-threatening situation.” 

This discovery led to a very long discussion between doctor and client. “Dr. Haddad explained the situation to the owner in detail,” said Jenn, “while the owner shared day-to-day details of Lulu’s routines and rhythms.”

“We recommended X-rays as a starting point, to get a better idea of what was going on,” said Dr. Haddad. “We also checked to see if her excessive grooming was the result of allergies. While the owner agreed with us completely, Lulu was not so cooperative. We had to keep her with us, and keep her calm and comfortable, while we reviewed the diagnostics.”

“Personally, I was concerned that we would see evidence of cancer, based on the size of the mass and Lulu’s age,” said Dr. Haddad. “But the X-rays showed that the mass was contained entirely within the stomach.”

Dr. Haddad started to wonder: Lulu is a long-haired cat.  

Could this mass be…one massive hairball?

Rallying for the right thing to do

“As soon as the hairball question came up, the entire conversation changed,” said Jenn. “We had a lot of questions for the owner about the grooming behaviors she mentioned earlier. She revealed that grooming had become excessive over time. She also mentioned that while Lulu had regularly coughed up hairballs – every other day, on average – it had been a long time since she’d last done so.”

At that point, Dr. Haddad recommended surgery. But Lulu’s owner was still in shock. She thought she was coming to a routine appointment. She wasn’t prepared for this unexpected financial commitment. At the same time, taking Lulu elsewhere for care was not an option. 

“She had no idea there was a mass,” said Dr. Haddad. “So we had to break the news. We had to try to take her from this position, where she thought it was just allergies, to understanding the urgent risks of this diagnosis. That’s where the work really began. It was a process, a journey, a transition.”

“I really have to say, hats off to Jen,” said Dr. Haddad. “She did a lot of heavy lifting, as well as communication, and the effort was just quite remarkable. Her job was as difficult, if not more, than removing the mass surgically. And it had such a great outcome!”

“The owner was very distraught,” said Jen, “and we were just as upset as she was. She really just wanted to get her cat the care she needed. Lulu was otherwise a healthy cat -- with a lot of life ahead of her.”

Working with VCA Charities, the hospital was able to connect Lulu with HOPE Funds, a program to assist with life-threatening emergencies for income-qualifying clients. While waiting for approval, the care team moved forward with Plan B.  

“Whether we were approved for HOPE Funds or not, we were going to find a way,” said Jen. “We discussed payment arrangements that the client could afford, and proceeded with Plan B while hoping for Plan A to work out.”

“We had some uncomfortable conversations, for sure,” said Jen, “but it was all in the interest of figuring out how we made this surgery happen quickly. Everything we were doing was for Lulu.”

“The owner was very distraught,” said Jen, “and we were just as upset as she was. She really just wanted to get her cat the care she needed. Lulu was otherwise a healthy cat -- with a lot of life ahead of her.”

Removing an unwanted guest

The next morning, the team got good news while gathering for surgery: Lulu had been approved for the highest allowed HOPE Fund, which covered most, but not all of the surgery. The program also allowed VCA San Carlos to apply additional discounts. In the end, the client was left with some payments, but far less than she was originally expecting.

“Surgery was very routine,” said Dr. Haddad. “Everything went so smoothly. Lulu remained stable with no hiccups of any kind. And then we saw what we were working with.”

To remove the object from Lulu’s stomach, the team had to make an abdominal incision while she was under anesthesia. They found a trichobezoar, or mass of undigested hair, in her stomach – measuring 5”x3” and weighing one-third of a pound!

“It was like an alien being removed from her stomach,” said Jen. “I couldn’t believe this object came out of her little body. It was one of the most amazing things I’d ever seen.”

While recovering from surgery, Lulu enjoyed a beauty treatment. Since she was excessively grooming, the longhair cat received a “lion cut” that was the talk of the hospital.

“She looked so cute,” said Jen. “She’s not the most cooperative cat, so we couldn’t get a glamour shot. The haircut was more than just cosmetic. We wanted to break the bad habit of excessive grooming and prevent another blockage.”

“Lulu was effectively starving to death,” said Dr. Haddad. “She was not getting nutrients of any kind. Her entire stomach was filled with this massive hairball. Nothing was getting through her digestive system.”

Two weeks after surgery, Lulu was thriving. She’s started a new medication for her thyroid condition, and she’d even gained two pounds. For an 11-year-old, her outlook is brighter than ever.

“Lulu is not a mean cat, but she’s definitely sassy,” said Jen. “And we’ve all been humbled by her remarkable experience at VCA San Carlos.”

What should cat owners know?

“Cats groom all the time,” said Dr. Haddad. “It’s part of being a cat! But if your cat is grooming obsessively, you should talk to your veterinarian.”

“Vomiting of hairballs is the first symptom of a problem,” said Dr. Haddad. “This is also your first indicator that a hairball diet might be needed.”

Long-haired cats will always be prone to hairballs. There’s nothing unusual about the occasional ejection, but all cat owners can minimize hairball risks with simple lifestyle changes:

  • Regular grooming can reduce the likelihood of hair obstruction by eliminating excessive hair
  • Supplements and special diets can improve hairball digestion.

If your cat is older, be sure to talk to your veterinarian about hyperthyroidism. If your cat’s thyroid gland is overproducing, the metabolic thermostat of their body is affected, and calories are burning too quickly. If left unmanaged, hyperthyroidism can lead to liver and kidney issues, constricted blood flow, and hypertension. Fortunately, routine screenings at annual appointments will catch this condition – and new transdermal options make treatment more manageable for pets and owners.

“We see this more frequently in senior cats,” said Dr. Haddad, “and the initial signs are so subtle. Watch for appetite and weight imbalances. The cat may be eating well but losing weight. The appetite might seem voracious, but the cat isn’t gaining weight. You may see softer stools or constipation. The cat might seem more agitated: vocalizing more at night, more anxious, more grooming.”

“All of those behaviors are telling a story,” said Dr. Haddad, “and your cat hopes you’re listening.”

When you donate to VCA Charities during online or on-site checkout, your dollars support programs like HOPE Funds. Visit our website to learn more!