Why Does My Cat Keep Throwing Up? Understanding Vomiting in Cats

It’s a distressing sight for any cat owner: your beloved feline suddenly retching and throwing up. Occasional vomiting in cats might seem somewhat normal, perhaps after eating too fast or a hairball incident. However, when your cat keeps throwing up, it’s a clear sign that something isn’t right and warrants your attention. Understanding why your cat is repeatedly vomiting is the first step in getting them the help they need and ensuring their long-term health and well-being. This guide will walk you through the potential causes of frequent vomiting in cats, what you can learn from the vomit itself, and the diagnostic and treatment options your veterinarian might recommend.

Understanding Cat Vomit: What Can It Tell You?

While the appearance of your cat’s vomit isn’t a definitive diagnosis in itself, it can offer valuable clues for you and your veterinarian. Observing the color and consistency can provide a starting point in understanding the potential underlying issues.

Decoding Vomit Colors and Types

• Yellow Vomit: Yellow vomit typically indicates the presence of bile, a digestive fluid produced by the liver. This can sometimes point to liver issues, but more commonly, it occurs when a cat vomits on an empty stomach. It can also simply mean your cat ingested something yellow.

• Clear Vomit: Clear vomit can be tricky. It might be regurgitation, originating from the esophagus, which is often a passive process distinct from active vomiting. Alternatively, it could be stomach secretions expelled from an empty stomach.

• White, Foamy Vomit: Similar to clear vomit, white, foamy vomit is often associated with regurgitation from the esophagus or vomiting from an empty stomach. The foamy texture comes from air mixing with stomach or esophageal fluids.

• Blood in the Vomit: The presence of blood in vomit, medically known as hematemesis, is always a cause for concern. The blood can originate from various points along the upper digestive tract, including the mouth, esophagus, or stomach lining. Bright red blood usually indicates fresh bleeding, while darker blood might suggest bleeding that occurred further up the digestive tract and has been partially digested.

• Coffee-Ground Appearance to the Vomit: Vomit with a “coffee-ground” appearance is a significant indicator of bleeding in the stomach. This appearance is due to blood that has been digested and broken down in the stomach, often associated with stomach ulcers or other forms of gastric bleeding.

• Brown, Smelly Vomit: Brown, smelly vomit can have several causes. It might indicate bleeding in the upper gastrointestinal tract where the blood has been digested, giving it a brown color and altered smell. However, it can also be as simple as your cat having eaten something brown and, well, smelly! Distinguishing between these possibilities requires further investigation.

• Undigested Food in the Vomit: Vomiting undigested food means that the food hasn’t had time to move out of the stomach and into the intestines. This can be a sign of food intolerances or allergies, gastrointestinal obstructions preventing food from passing, or general irritation of the upper digestive tract. Noting when your cat last ate is crucial here. For example, vomiting undigested food a day after eating strongly suggests a blockage or a motility disorder preventing normal stomach emptying.

Questions Your Vet Will Ask About Your Cat’s Vomiting

When you take your cat to the veterinarian because of persistent vomiting, be prepared to answer detailed questions. These questions help your vet narrow down the possible causes and decide on the most appropriate diagnostic steps. Thinking about these questions beforehand can make your vet visit more efficient and helpful:

• Was the cat exposed to plants or other toxins? Consider any household plants, cleaning products, medications, or chemicals your cat might have access to. Many common household items are toxic to cats.

• When did the vomiting start? Knowing the onset and duration of the vomiting helps determine if it’s an acute (sudden) or chronic (long-term) issue.

• What is the cat’s normal diet? Details about your cat’s regular food, treats, and any recent dietary changes are important, as food sensitivities or allergies can be a cause of vomiting.

• Does the cat go outside, and if so, does the cat hunt? Outdoor cats have more exposure to parasites, infections, and potential toxins. Hunting habits can also indicate ingestion of prey that might carry parasites or be contaminated.

• What is in the vomit? As discussed earlier, describe the color, consistency, and contents of the vomit (food, bile, blood, etc.).

• Is the cat on medication? Certain medications can have vomiting as a side effect.

• Is there also diarrhea? The presence of diarrhea alongside vomiting can suggest a broader gastrointestinal issue or systemic illness.

• Is the cat eating? Changes in appetite, such as decreased or absent eating, are significant signs of illness.

• When does the vomiting occur (in relation to eating or other activities)? Note if vomiting happens right after eating, hours later, in the morning, or after specific activities. This timing can provide clues about the location and nature of the problem.

• Is the cat losing weight? Unexplained weight loss is a general sign of illness and can be associated with chronic vomiting.

• Is the cat drinking a lot or urinating a lot? Increased thirst and urination can indicate underlying conditions like kidney disease, diabetes, or hyperthyroidism, which can sometimes cause vomiting.

• Does the cat play with string or small objects? Cats who play with and potentially ingest string, yarn, or small toys are at risk of gastrointestinal obstructions, a common cause of vomiting.

Veterinary Examination and Diagnostic Tests for Cat Vomiting

Following your detailed history, your veterinarian will conduct a thorough physical examination of your cat. This hands-on assessment is crucial in identifying potential clues and guiding further diagnostic steps.

Physical Examination

During the physical exam, your veterinarian will check for:

• Abdominal pain: Palpating the abdomen can reveal tenderness or pain, indicating inflammation or discomfort in the digestive organs.
• Masses in the abdomen: The vet will feel for any abnormal lumps or masses that could be tumors, enlarged organs, or foreign bodies.
• Obvious foreign body: Sometimes, a foreign body like a string can be visible under the tongue or in the mouth.
• Evidence of weight loss: Assessing body condition and muscle mass can confirm weight loss.
• Heart murmur: Heart conditions can sometimes be associated with vomiting.
• Enlarged thyroid gland: Hyperthyroidism, a common condition in older cats, can cause vomiting.
• Fever: Fever is a general sign of infection or inflammation.

The findings from the physical exam, combined with your cat’s history, will help your veterinarian decide which, if any, diagnostic tests are necessary.

Initial Diagnostic Tests: X-rays and Blood Work

If further investigation is warranted, the initial tests usually involve abdominal radiographs (X-rays) and blood work with a urinalysis.

• Abdominal X-rays: X-rays are invaluable for visualizing the internal organs. They can reveal:

  • Abnormalities in organ size and shape: Enlarged or shrunken organs can indicate disease.
  • Foreign bodies: Radiopaque (dense) foreign objects can often be seen on X-rays.
  • Tumors: Large masses may be visible.
  • Constipation: Severe constipation can be identified.
  • Other abnormalities: X-rays can reveal fluid buildup or gas patterns that suggest problems.

• Blood work with Urinalysis: Blood tests provide a wealth of information about organ function and overall health. They can detect:

  • Organ dysfunction: Elevated liver or kidney values can indicate organ disease.
  • Endocrine disorders: Blood tests can diagnose conditions like diabetes and hyperthyroidism.
  • Exposure to toxins: While not always definitive, blood work can sometimes suggest exposure to certain toxins like antifreeze.
  • Urinalysis: Analyzing urine alongside blood work is crucial for diagnosing conditions like diabetes, kidney disease, and urinary tract infections.

Advanced Diagnostic Imaging and Procedures

If initial tests are inconclusive, or if a more detailed investigation is needed, your vet might recommend more advanced procedures:

• Barium Study: A barium study involves giving the cat barium, a contrast agent, orally or rectally, and then taking a series of X-rays over time. This helps visualize the movement of barium through the digestive tract, identifying:

  • Foreign objects in the intestines: Barium can outline obstructions.
  • Motility issues: Abnormal movement of barium can indicate problems with intestinal function.

• Ultrasound: Abdominal ultrasound uses sound waves to create detailed images of the internal organs. It’s excellent for assessing:

  • Organ architecture: Ultrasound can visualize the internal structure of organs like the liver, pancreas, and kidneys, detecting abnormalities not seen on X-rays.
  • Fluid collections: Fluid buildup in the abdomen can be identified.
  • Guided biopsies: Ultrasound can guide needle biopsies to collect samples from specific organs for diagnosis.

• Endoscopy: Endoscopy involves inserting a flexible tube with a camera and light source (endoscope) into the digestive tract. It allows direct visualization of:

  • Stomach, upper intestines, or colon lining: Endoscopy can detect inflammation, ulcers, tumors, and foreign bodies that might not be visible on X-rays.
  • Foreign object retrieval: Small foreign objects in the stomach or upper intestines can sometimes be removed endoscopically, avoiding surgery.
  • Biopsy collection: Endoscopy allows for targeted biopsies of the stomach and intestinal lining to diagnose conditions like inflammatory bowel disease (IBD) or cancer. Endoscopy is generally less invasive than surgery.

• Exploratory Surgery: In cases of persistent vomiting where other diagnostics are inconclusive, or when a foreign body is strongly suspected but not confirmed by other means, exploratory surgery might be necessary.

  • Diagnosis and Treatment: Surgery can both diagnose and treat conditions like foreign body obstructions.
  • Biopsies: If no foreign body is found, surgery allows for biopsies of the entire intestinal tract, stomach, liver, pancreas, lymph nodes, and any other visible abnormalities. This is particularly useful for diagnosing IBD or intestinal cancer.
  • Full Thickness Biopsies: Surgery allows for larger, full-thickness biopsies of the intestinal wall, which can be more diagnostically informative than endoscopic biopsies.

While exploratory surgery offers a comprehensive view and the ability to obtain larger biopsies, it’s more invasive, expensive, and requires a longer recovery time compared to endoscopy. The choice between endoscopy and surgery depends on the individual cat’s situation, the suspected causes of vomiting, and the owner’s preferences and financial considerations.

Because advanced diagnostics like endoscopy and exploratory surgery can be costly, it’s important to have an open discussion with your veterinarian about the benefits, risks, and costs of each option. In some cases, symptomatic treatment might be considered without a definitive diagnosis, but this approach requires careful communication and understanding of the potential risks involved.

Treatment Options for Cat Vomiting

Treatment for vomiting in cats is highly dependent on the underlying cause. While addressing every specific cause is beyond the scope of this article, we can discuss general treatment strategies.

Supportive Care: Fluids and Anti-emetics

Regardless of the underlying cause, supportive care is often a cornerstone of treatment for vomiting cats.

• Fluids: Vomiting leads to fluid loss and dehydration. Fluid therapy is crucial to:

  • Rehydrate the cat: Replacing lost fluids is essential.
  • Flush the system: Fluids can help eliminate toxins or irritants.
  • Maintain hydration: Even if not severely dehydrated, fluids prevent further dehydration.
  • Subcutaneous Fluids: For mild to moderate dehydration, fluids can be administered subcutaneously (under the skin).
  • Intravenous Fluids (IV): For severe dehydration or weakness, IV fluids are more effective. IV fluids are delivered directly into the bloodstream via a catheter, allowing for rapid rehydration and higher volumes of fluid administration. However, IV fluids are more expensive and require hospitalization.

• Anti-emetic Medication: Anti-emetics are medications specifically designed to stop vomiting. They work by:

  • Reducing vomiting frequency: This helps prevent further fluid loss and electrolyte imbalances.
  • Relieving abdominal discomfort: Vomiting can be painful; anti-emetics can alleviate this.
  • Encouraging appetite: By controlling nausea and vomiting, anti-emetics can help the cat feel more like eating.

• Stomach Protectants: Medications like Pepcid (famotidine) or sucralfate are sometimes used as stomach protectants. Their effectiveness in treating vomiting is debated, but they are generally considered safe and may provide some benefit by reducing stomach acid or coating irritated stomach lining.

• Pain Medication: If anti-emetics alone don’t adequately control abdominal pain, additional pain medication might be prescribed.

Dietary Changes for Vomiting Cats

Diet plays a significant role in managing both acute and chronic vomiting in cats.

• Acute Vomiting: For sudden onset vomiting, temporary dietary changes to easily digestible foods are often recommended. These include:

  • Prescription Diets: Veterinary diets specifically formulated for gastrointestinal issues, such as Royal Canin Gastrointestinal High Energy, or Hill’s Prescription Diet i/d.
  • Bland Human Food: Plain, cooked, meat-flavored baby food (ensure no onion or garlic powder is added) or boiled, skinless, boneless chicken can be offered in small amounts. Important Note: These bland options are not nutritionally complete and should only be used for a few days under veterinary guidance.

• Chronic Vomiting: For cats with long-term or recurring vomiting, dietary changes can be both therapeutic and diagnostic.

  • Diet Trials: Switching to a novel protein or hydrolyzed protein diet can help identify food sensitivities or allergies.
  • Prescription Diets: Veterinary prescription diets are often recommended for long-term management.
  • Limited-Ingredient Diets: Diets with a limited number of ingredients can help pinpoint food allergens.
  • Duration: Diet trials for chronic vomiting require patience. It can take several weeks on the new diet to see if it effectively controls the vomiting. It’s crucial to use a complete and balanced diet, especially for long-term feeding.

Prednisone for Inflammatory Bowel Disease (IBD)

In some cats, chronic vomiting is caused by inflammatory bowel disease (IBD). Prednisone, a corticosteroid medication, is often used to treat IBD by suppressing the overactive immune response in the intestinal tract.

• Prednisone Therapy: Prednisone can be effective in reducing inflammation and controlling vomiting associated with IBD.
• Important Considerations: Prednisone has potential side effects, including increased thirst and urination, increased appetite, immune system suppression, and muscle weakness. It can also worsen certain conditions like pancreatitis, diabetes, and kidney disease.
• Veterinary Supervision: Prednisone should never be given to your cat without veterinary diagnosis and supervision. It’s typically considered only after basic diagnostic tests (blood work, X-rays) have been performed, and after discussing the risks and benefits with your veterinarian.

Ultimately, understanding why your cat keeps throwing up involves careful observation, detailed communication with your veterinarian, and potentially a range of diagnostic tests. With proper diagnosis and treatment, you can help your feline companion get back to their happy, healthy selves. If your cat is experiencing persistent vomiting, don’t hesitate to schedule a consultation with your veterinarian to get them the care they need.