This article was contributed by esteemed Principal Veterinary Surgeon of Amber Cat Vet, Dr. Brian Loon

Almost all cat parents would have seen their cat vomit at some point, while with some cats it happens regularly but maybe not often enough for owners to be concerned, because their cat is “otherwise healthy”.

Normal or cause for alarm?

Many owners put occasional vomiting down to furballs, but it is dangerous to do so, as a wide variety of other medical conditions can also cause similar vomiting without other signs, such as pancreatitis, dietary intolerance, inflammatory bowel disease (IBD) and gastrointestinal (GI) lymphoma, a type of cancer. I often see cats eventually diagnosed with these conditions with vomiting once to twice a month as the only sign, and often owners don’t even feel the vomiting is worth mentioning till owners are specifically asked about it in consultation. If a human were to be vomiting every month, most people would be concerned enough and seek medical attention promptly. The same really applies for our feline friends.

The problem is that when these conditions are not promptly diagnosed, the disease can get more severe with time and eventually makes affected cats more sick (such as experiencing appetite loss, weight loss, diarrhoea/soft stools), and one disease can even progress to another, such as IBD transforming to GI lymphoma. Yet when these conditions are promptly diagnosed, they can be effectively managed to reduce the risk of further progression, stop the vomiting signs and progression to more severe signs as well, thus improving the quality of kitty’s life.

What happens when you take your vomiting cat to the vet

When a cat is vomiting, veterinarians will perform a thorough history review with owners, including asking about diet, lifestyle and any other occasional signs that may appear. A thorough physical examination is then performed, before then discussing with the owner if any further diagnostic tests are recommended. This is crucial as the list of causes for vomiting is very long, from gastrointestinal causes such as those mentioned above, foreign body obstruction and bacterial/viral/parasitic gastroenteritis (such as from food that is not well cooked), to extra-gastrointestinal causes such as kidney disease, liver disease, diabetes mellitus and various non-gastrointestinal cancers.

In addition, regurgitation (passive reflux of material from the oesophagus or food pipe) can often be confused with vomiting (forceful expelling of material from the stomach).

After the more likely list of differentials have been considered based on the history and physical examination, initial diagnostics tests that your veterinarian may recommend to investigate the above include blood, urine and stool tests, x-rays and/or ultrasound. Sometimes initial trial treatment may be recommended by your veterinarian for mild cases in younger cats such as antibiotics for bacterial gastroenteritis, anti-parasitics for GI parasites, a veterinarian-recommended elimination diet trial and probiotics.

What if your cat is still vomiting after the initial treatment?

If the signs persist after trial treatment is completed, when the cat is senior (7 years or older), or when there are pre-existing disease conditions, it is then essential to investigate further to determine the root cause rather than trial various treatments which may not be effective. This can be done with minimally invasive techniques such as upper and lower GI endoscopy and exploratory laparoscopy (aka keyhole surgery).

With GI endoscopy, a long tube with a magnified camera at the end is used to examine the inner lining of the oesophagus, stomach, the early to middle sections of the small intestines and the large intestines. Subtle changes in the GI tract lining can be seen with the magnified camera, and importantly biopsy samples can be obtained along the GI tract to send for histopathology.

With exploratory laparoscopy, two to three tiny 0.5-1 cm incisions at the abdomen allow for magnified cameras and instruments to be used to visualise the abdominal organs and obtain necessary biopsy samples for histopathology. Histopathology (analysing cells of organs under the microscope) is important as it often leads to a definitive diagnosis and avoids further guesswork, then allowing the veterinarian to work with owners with a targeted long term management plan specifically for your cat.

Also, these procedures are minimally invasive, so for most cats it is a day procedure and they go home eating and behaving as they were before the procedure without pain.

Final words

If your cat has been vomiting occasionally but regularly (e.g. once to twice a month or more), or if there are also other signs such as weight change, appetite change, soft stools/ diarrhoea or change in energy levels, please seek help from your veterinarian early, as with these cases early management often leads to a healthier and happy feline, and is also less costly in the long term compared to managing a condition only when it has progressed to a severe stage.