(Dr. Iulia Miha, DVM) It is normal to see or hear your cat vomiting from time to time. This usually happens when they need to eliminate a routine hairball. Occasional vomiting is not necessarily a problem, but in some cases, it can be a sign of a health issue. If your cat does suffer from a health problem, vomiting is usually not the only clinical sign that occurs with something more serious.

Other symptoms that can accompany vomiting include lack of appetite, weight loss, lethargy, and even diarrhea. A cat can vomit for many reasons, some more severe than others. For this reason, contacting the veterinarian will depend on how often your cat vomits and whether or not other clinical signs are present.

What Is Vomiting?

Vomiting is not a disease in itself but a clinical sign that can appear alone or in association with other symptoms. Vomiting is the evacuation of stomach contents which can occur in many pathologies (renal, hepatic, gastrointestinal, etc.).

How to Recognize Vomiting in Cats: Vomiting vs. Coughing vs. Regurgitation

Vomiting can often be confused with feline behaviors like coughing or regurgitation. For this reason, it is important to recognize the different signs to know when further action is needed.

Vomiting

Vomiting usually begins with nausea. In this case, your cat will lick their lips, drool more than usual, and be restless. The process of throwing up involves strong contractions of the abdominal muscles which will subject your pet to quite a lot of effort.

Coughing

Abdominal contractions caused by vomiting are different from those caused by coughing. If your cat coughs, they will expectorate a white foam which they will then swallow. Also, cats that cough usually adopt a crouched position with their neck stretched.

Regurgitation

If your cat regurgitates, it occurs quickly and without abdominal contractions. It usually occurs after your cat has recently eaten or drank water.

What Are the Causes of Vomiting in Cats?

When a cat vomits occasionally, there usually is no reason to worry because cats need to eliminate hairballs. It is absolutely normal for cats to swallow hair while grooming. In other cases, occasional vomiting may occur as a consequence of a change in diet. If your cat is vomiting often, and/or other clinical signs occur (bloating, abdominal pain, or diarrhea), change your cat’s diet and contact your veterinarian.

Other causes of vomiting in cats can be:

• Foreign bodies
• Toxins
• Parasites
• Food allergies
• Inflammatory bowel disease
• Constipation
• Ulcers
• Gastritis
• Cancer
• Liver diseases
• Kidney diseases
• Pancreatitis
• Diabetes
• Some infectious diseases
• Some neurological diseases

Vomiting can be acute (lasts 2-3 days) or chronic (lasts for a long time). Chronic cases of vomiting require more special attention from the veterinarian due to possible complications such as dehydration and electrolyte imbalance.

Additionally, cats that eat nothing or very little for 2-4 days are exposed to the risk of developing hepatic lipidosis - also known as fatty liver syndrome. Hepatic lipidosis is a liver disease that can be fatal if it is not promptly reversed.

What Does Your Cat’s Vomit Look Like?

Even though it may sound disgusting, it is important to know what your cat's vomit looks like because this will help the veterinarian diagnose the condition. Different diseases and conditions can cause your cat's vomit to have a distinct color and appearance. Here are some examples:

• Yellow/green vomit (vomiting bile) – It usually occurs in hepatobiliary diseases. For example, when your cat has been fed for the first time after not eating for 24 hours or when they are anorexic. It can also happen when your cat has repeatedly vomited and their stomach is empty.

• Bloody vomit – Bloody vomit can occur in ulcers, nosebleeds (the blood runs down your cat's throat into the stomach), or if your pet has repeatedly vomited (the lining of the esophagus and stomach has been irritated by gastric acid). Your cat can also vomit blood if they are poisoned (rat poison, antifreeze, or xylitol).

• Brown/dark liquid vomit – This type of vomit generally occurs when your cat vomits digested or old blood. Blood can come from the intestinal tract due to ulcers, foreign bodies, or even hairballs that have caused intestinal obstruction.

• White foam vomit – Foamy, white, or colorless vomit with food content indicates a gastric condition of an inflammatory or dyspeptic nature. But even some severe kidney issues (e.g., kidney failure) can give similar clinical signs.

• Watery or clear liquid vomit – This type of vomiting can occur when your cat has had too much water at once or they suffer from certain diseases that make pets consume more water (kidney disease, diabetes, hyperthyroidism, Addison's disease, etc.).

• Vomit with worms – In massive infestations with intestinal worms (especially roundworms), cats can end up vomiting the actual parasites. Although these worms are not dangerous, massive infestations can put your cat's life in danger, especially if they are a kitten or have other health problems.

• Vomit with mucus – When a cat needs to eliminate mucus, they can regurgitate it. If your cat eliminates large amounts of mucus, this may indicate that they suffer from inflammation, infection, or other diseases.

• Vomiting food – When cats eat too much and too quickly, vomiting may occur. This type of vomiting can also occur in food allergies and foreign bodies which prevent the passage of food into the small intestine.

When Should You Contact the Veterinarian?

Contacting the veterinarian will depend on how often your cat vomits and whether or not other clinical signs are present. Here are the situations in which you should contact the veterinarian immediately:

• Your cat vomits repeatedly.

• Your cat shows other clinical signs: low appetite, lethargy, and diarrhea. If diarrhea occurs, you can consider it a medical emergency because along with vomiting, this quickly leads to dehydration. Dehydration can become fatal for your cat if it is not intervened in time.

• Your cat has stopped eating and drinking water for at least 12 hours and is vomiting repeatedly.

• Your cat suffers from diabetes, kidney disease, or hyperthyroidism. In this case, contact the veterinarian as soon as possible because they can dehydrate especially quickly.

• Your cat is vomiting up intestinal worms. If the infestation reaches this stage, it means your cat is heavily infested with intestinal worms and may suffer severe complications.

How Is Vomiting in Cats Treated?

In the case of occasional vomiting, treatment may not be needed. If the vomiting is acute, it is generally treated with anti-vomiting medication. These drugs do not treat the cause that led to the onset of vomiting. As a result, in order to properly treat vomiting, the vet will have to identify the underlying cause.

In the case of mild forms, when a visit to the veterinarian is not possible, you can choose to restrict your pet's diet for 12-24 hours. Afterward, you can introduce it easily, in small and frequent amounts (you can opt for intestinal diet food). Start with 25% of your cat's normal portion. If they show no signs of vomiting, add food gradually until you reach the full portion.

Do not block your cat's access to water. If your cat drinks a lot of water at once, try to give them water in small and frequent quantities. Otherwise, vomiting may reoccur.

Conclusion

Cats groom themselves very often and swallow hair. Therefore, occasional vomiting is normal for cats because they need to eliminate hairballs. If the vomiting becomes repeated and lasts for several days, it is necessary to contact your veterinarian because this clinical sign has various causes (from mild to severe).

It is also important to know the color and consistency of your cat's vomit because these two aspects can indicate the condition your pet is suffering from and can help the veterinarian in establishing the diagnosis. Acute vomiting is usually treated by restricting the diet for a few hours and antiemetic drugs. Lastly, the vet can recommend a veterinary diet that can help manage your cat’s vomiting.

Dr. Iuliana Mihai, DVM, Masters In Small Animals And Equines Pathology

Iuliana graduated from the University of Agronomical Sciences and Veterinary Medicine in 2012, Romania. She has a Master’s degree in Small Animal and Equines Pathology and a strong affinity for Veterinary Parasitology and Laboratory. In 2013 she started her Ph.D. in epithelial cancer in dogs and cats. She volunteered at the faculty’s clinic in her 3rd year of study, and continued her career in small animal pathology and laboratory. She has one cat and eleven rats. Her interests outside of work include traveling, writing, and crafting.