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Chronic Vomiting In Cats

As a board-certified veterinary internist, I often ask clients, “If you were vomiting once a week, would you consider this normal?” Certainly, most people would not. Yet veterinarians frequently hear clients speak of their cats vomiting “all the time” or “whenever he eats too fast,” often with the added disclaimer, “that’s just what he does.”

The fact is, with the exception of an occasional hair ball, our feline companions should not routinely vomit. Cats vomit for many reasons. To start down the path to a diagnosis, veterinarians first try to decide whether the problem originated in the gastrointestinal (GI) tract, is a result of an underlying metabolic (organ function disease), or if the cause began in the small intestines.

1. Gastrointestinal (GI) Tract

Diseases that originate in the GI tract can include:

  • Underlying Motility Disorders
    • Abnormal emptying of the stomach or chronic constipation
  • Dietary Indiscretion
    • Eating irritating plants or other foreign materials
  • Infectious Causes
    • Parasites and changes to the normal flora in the GI tract along with others
  • Food Intolerance
    • Often due to the protein source in the pet’s diet

2. Underlying Metabolic Disease

To diagnose, lab work and imaging (x-rays and ultrasound) are often necessary.

Examples of underlying metabolic diseases include:

  • Kidney Disease
  • Liver Disease
  • Pancreatic Disease
  • Thyroid Disease

3. Small Intestine

Many of my chronic vomiting patients, especially those that also have an intermittent lack of appetite and poor weight gain, have some form of inflammatory bowel disease. A subset of these patients may have true food intolerance, but many have developed alterations in their local immune system that have led to changes in the intestine. These changes result in impaired digestion and absorption of their food which manifests as vomiting and weight loss. Finally, one of the most serious causes of chronic vomiting and weight loss in cats is intestinal cancer (lymphoma being the most common).

If your feline friend is vomiting frequently, especially if the vomitus is food or fluid (not just fur) or if the vomiting is associated with weight loss and behavior changes, please see your family veterinarian to work on determining a diagnosis. He or she will discuss with you:

  • Your cat’s lifestyle
  • Diet
  • Details of Cat’s Vomitus (contents, volume, timing relative to eating, etc.)

A thorough comprehensive examination, review of weight trends, complete lab work, and imaging are often the initial steps of a diagnostic work-up. Many patients will be trialed with a new diet and symptomatic medications may be used. If these initial steps are not helpful in resolving the problem, then your family vet may choose to do further imaging of the GI tract. An abdominal ultrasound can be very helpful in identifying patients that may be at risk for more significant causes of vomiting including inflammatory bowel disease and lymphoma. Some cats will require biopsies for definitive diagnosis.

The good news is that many cats with chronic vomiting can be treated and their symptoms are well-managed. However, identifying the underlying cause early is often key to treatment success. If you have questions or concerns about the health of your cat, contact your family veterinarian.


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