Affected Animals:
Any age, sex, or breed of cat.

Overview: Vomiting is one of the more common reasons why owners take their cats to the veterinarian.  Isolated episodes of vomiting rarely are a cause for concern as long as the cat still has an appetite and is bright and alert.  Most healthy cats will, on occasion, vomit whole or partially digested food, hairballs, or foamy, clear liquid.

On the other hand, excessive or chronic vomiting can be indicative of a more serious underlying condition that requires treatment.  Always seek veterinary care if a cat vomits for a period longer than one day or appears ill because dehydration can occur.

Clinical Signs:
Cats sometimes will salivate profusely due to nausea.  Some cats may vocalize or cry when feeling nauseated. Vomitus can contain food, clear liquid, yellow bile, blood, and occasionally parasites.  Depending on the cause of vomiting there can be weight loss, a good or poor appetite, diarrhea, dehydration, lipsmacking, retching,and tooth-grinding.

Symptoms:
See clinical signs.

Description: Vomiting is a reflex act where food and/or fluid are brought up from the stomach through the mouth. Vomiting occurs when the vomiting center of the brain, the chemoreceptor trigger zone, is stimulated by specific nerve impulses from the body.  Diseases and certain situations, like a car ride, can stimulate the nerves leading to the vomiting center, causing nausea and vomiting.  Many anti-vomiting medications work by blocking the signals from reaching the chemoreceptor trigger zone.

Complications of vomiting include dehydration, weight loss, and aspiration pneumonia, which occurs when vomitus gets inhaled into the lungs.

A vomiting cat should be evaluated by a veterinarian to determine the severity of the vomiting, necessary diagnostics, and the recommended course of treatment.  Chronic vomiting cases may require advanced testing procedures to diagnose the specific cause.

Diagnosis: The veterinarian will take a thorough history and perform a physical examination in order to determine the severity of the illness, how long it has been occurring, and to differentiate vomiting from regurgitation.  Although uncommon in cats, regurgitation is a passive act in which food flows back up the esophagus, the tube connecting the mouth and stomach.  Shortly after eating, at the time when this occurs, the food usually will appear undigested and shaped like a tube.  Regurgitation carries different possible diagnoses than vomiting and should be addressed accordingly.

Vomiting is a reflex action in which material is expelled from the stomach and/or intestines through the mouth.    It is usually preceded by nausea and involves retching.  Cats with acute vomiting that are not very ill may be treated symptomatically for a short time before diagnostic tests are pursued.  Testing is appropriate when the vomiting is severe, the cat seems very ill and fails to respond to appropriate therapy, or when the vomiting is chronic. 

Common tests include fecal examination, urinalysis, and routine bloodwork, such as a complete blood count and chemistry panel.  Other relevant blood tests include thyroid hormone level and viral serology for feline leukemia virus and feline immunodeficiency virus.  Abdominal x-rays commonly are needed. 

Sometimes the veterinarian may perform a barium contrast study.  Liquid barium outlines the gastrointestinal tract on x-rays and helps determine if there are any abnormalities.  Other diagnostic tools include ultrasonography, which uses high frequency sound waves to outline the details of the abdomen.  Another procedure, endoscopy, involves placing a tiny camera down the mouth and into the stomach and intestines to look for disease.  Also, tissue samples can be taken and sent to a pathologist for assessment. In other cases, exploratory surgery is needed to diagnose the problem.

Depending on the underlying cause, some cases of chronic vomiting in cats are very difficult and frustrating to diagnose and treat.  A referral to an internal medicine specialist for further diagnostics and treatment may be indicated in some cases. 

Prognosis:
The prognosis for otherwise healthy cats that vomit for only a day or two is excellent.  For animals that have been vomiting for several days or longer, the prognosis is dependent on the cause and how quickly the owner seeks veterinary attention.  Rapid medical attention offers the best prognosis by attempting to prevent damage or complications from the underlying condition.

Transmission or Cause:
There are numerous causes of vomiting. Some examples include motion sickness, drugs, and overeating. Obstruction of the gastrointestinal tract by a swallowed piece of string or other foreign body will cause vomiting. Vomiting occurs with inflammatory bowel disease and parasitic infestation in organs such as the kidney, liver, and pancreas.   A veterinarian should be consulted for questions about any potential causes of vomiting.

Treatment: For cats that have been vomiting for only a short period of time and that are not otherwise visibly sick, symptomatic treatment for one to three days is usually very beneficial and successful. Typically, food is withheld for 24 to 36 hours and injections of medications may be given to help alleviate the vomiting.  If the vomiting persists, or if the animal is visibly debilitated, the use of intravenous fluid therapy may be given to prevent dehydration.  Drugs also can be given intravenously instead of orally.

Further treatment is based on finding and correcting the underlying cause of the vomiting.   Different conditions require varying treatments.  For example, a cat that ingested a string needs to have surgery immediately to prevent the string from knotting up the intestinal loops and slicing through the intestinal wall.  A cat with hyperthyroidism needs anti-thyroid medication to get the thyroid level back in the normal range; symptomatic treatment of the vomiting until the disease is controlled will be necessary. 

Prevention:
Some causes of vomiting can be prevented, but other causes, such as cancer, can not.  Common sense is often the best medicine.  Some obvious guidelines include taking steps to secure drugs and household poisons, strings and small toys that can be swallowed, and any trash or garbage.  Other helpful measures include using a hairball preventive regularly, brushing to remove excess dead hair, and avoiding overfeeding.