By Dr. Becker
One of the most common feline health issues is a tendency to vomit. Many kitties throw up on a more-or-less routine basis. It happens so frequently, in fact, that their humans and even some veterinarians assume chronic vomiting is completely normal for cats.
Typical excuses vets and cat guardians offer for regular episodes of vomiting include: "He eats too fast," "She has a sensitive stomach" or "Maybe it's just hairballs." I've even had clients say, "Oh he's just a puker. He barfs a lot and it's not a big deal."
Unless you're a vulture, vomiting a lot is not normal. My position has always been that chronic vomiting, even in kitties with hairballs, is not standard behavior and should be thoroughly investigated. It's important to remember that big cats in the wild don't routinely vomit.
Wild cats also don't have hairball issues, which is why I believe recurrent hairballs in housecats is also a sign that something is wrong. There's no need to panic, of course, but I would definitely recommend investigating what's going on with a kitty who is regularly coughing up hairballs.
Common causes of persistent vomiting in cats include a poor diet, food intolerances, eating too fast and too much time in between meals.
Other causes include enzyme deficiencies, gastrointestinal (GI) problems that manifest as hairballs, toxin ingestion and underlying medical conditions like kidney disease and GI cancer.
Reason No. 1: Poor Diet
If your kitty is eating a processed cat food that contains rendered ingredients, it could be contributing to vomiting. Rendered ingredients are leftovers from the human food industry, and can include animal pieces and parts like bird feathers, snouts, beaks, eyes, hooves and nails.
These are very poor-quality ingredients with low-to-no bioavailability that are difficult to impossible for cats to digest, and can cause GI upset. Cats tend to have upper GI issues, so they vomit. Dogs typically have lower GI issues, and are more inclined to develop diarrhea.
For the last hundred years, many cats have been fed diets that are not species-appropriate, which has led to the development of food sensitivities and allergies — a very common reason for intermittent vomiting over a period of months or years.
If your kitty has a healthy weight and has a normal energy level, but just throws up occasionally, food sensitivity could be the culprit. Food sensitivities develop when the same foods are fed over and over, which happens a lot with cats because they get addicted to certain foods and refuse to eat anything else.
I know lots of kitties who are seafood and poultry junkies. If they're offered another protein source, they go on a hunger strike. But feeding the same type of protein, even if it's excellent human-grade quality, can over time create GI inflammation and food sensitivities.
So it's not just about the quality of the protein, but also about switching proteins frequently. I recommend transitioning cats with GI upset to human-grade cat food, which unfortunately can be very difficult to find, and then to a fresh food diet.
I prefer a raw diet for cats who will eat it, but even gently cooked fresh food is a huge improvement over processed pet food. I also recommend rotating proteins every three to four months to avoid hypersensitivity reactions.
If you feed your cat treats, be sure to offer only high-quality treats. You don't want to spend money on excellent-quality food and then feed junky treats that can create GI inflammation and vomiting.
If you feed treats, it's important to offer the highest quality you can afford. Or better yet, make them yourself.
In store-bought treats, you should look carefully at the label and avoid anything containing propylene glycol, FDC red #4, ethoxyquin, chemical dyes, emulsifiers, surfactants and other questionable ingredients.
All those additives, preservatives and other chemicals can cause GI inflammation and vomiting.
It's also a myth that kitties need to have milk. I was raised with that myth. My parents gave our cats milk every morning, and every afternoon they threw up, but my folks never made the connection. Animals are only suited to digest and process milk from their own species.
Drinking the milk of a different species past weaning can cause or exacerbate GI inflammation. If your cat can't tolerate cow's milk, it can cause vomiting, so if you're giving him milk, I recommend you stop offering it.
Reason No. 2: Eating Too Fast
Another very common reason cats throw up is they eat too fast. Your cat's esophagus is horizontal and flat. Everything he eats has to travel horizontally before it moves into the stomach.
In cats with a tendency to gobble, the food sort of backs up in the esophagus and pushes against the lower esophageal sphincter. This can result in regurgitation of part or all of the meal, undigested, within moments of swallowing. This seems to be a special problem in multi-cat households in which all the kitties are fed in the same area at the same time, which can spark competition.
There's usually at least one gobbler in the group, and when the food bowls hit the floor, he scarfs his own meal in a flash and then visits everyone else's bowl to see about leftovers. He's such a little glutton that he often ends up regurgitating all that hastily eaten food on the floor.
If this is happening at your house, you need to feed your kitties in separate areas so they can't see or hear the others eat. It's best if you can close the door behind each cat, because it won't take long for your gobbler to figure out where the rest of the bowls are if he can still get to them.
Give them about 20 minutes of solitude to eat their food slowly and uninterrupted, then remove the bowls. This may slow down your gobbler, reduce or eliminate the vomiting and keep him from getting fat. It also allows your slower-eating kitties to relax while they dine.
If you have just one cat but she's a gobbler, you may need to split her meals into smaller portions and feed her more often so the food doesn't come right back up.
Reason No. 3: Too Much Time Between Meals
Cats fed on a regular schedule, say, at 6:00 AM and 6:00 PM each day, tend to start looking for their meal an hour or so earlier because their bodies know it's getting to be that time. (That's why I often awake with my cats on my head around 5:00 AM — they're letting me know it's time to eat!)
Around that same time, your cat's stomach will start releasing digestive substances like hydrochloric acid, gastric juices and bile, in anticipation of the upcoming meal. If you're late with her breakfast or dinner, there's a good chance kitty will throw up a white foamy liquid mixed with a bit of yellow bile.
This is because the digestive substances irritate the lining of the stomach when there's nothing in there for them to work on, so your cat's body gets rid of some of the acid to prevent further irritation. If this scenario is occurring with your kitty, it's best to give her a little something to snack on before you feed her, like a treat or a small bite of her meal. This will give her stomach juices something to digest and should alleviate the vomiting.
Reason No. 4: Enzyme Deficiencies
In some cats, the pancreas doesn't produce enough digestive enzymes, such as lipase, protease and amylase, which can result in acute or chronic pancreatitis. Pancreatitis, which is inflammation of the pancreas, is very common in cats, and even if there are no other observable symptoms, can be an underlying cause of intermittent vomiting.
Cats evolved to eat an entirely fresh food diet, primarily mice, which is a very rich source of digestive enzymes that is entirely missing from processed cat food. That's why I recommend adding a digestive enzyme to your cat's diet. It's sort of like buying insurance — you may never need it, but it's always good to have.
If your kitty's pancreas is producing adequate enzymes, adding additional enzymes to her food won't cause any problems. However, if her pancreas is not secreting sufficient enzymes, supplementing insures she'll have what her body needs to process her food. Providing a high-quality digestive enzyme can help reduce vomiting as well as the potential for pancreatitis.
Reason No. 5: Hairballs
If your kitty is vomiting hairballs, you'll see cylindrical wads of hair and debris, probably some undigested bits of food, and usually a little phlegm to bind the mess together. Sometimes hairballs can look like feces, so if you find a mess some distance away from the litterbox, it's probably a hairball and not poop. The smell (or lack of it) is also a clue.
Long-haired cats and cats who are really into grooming themselves — and often every other cat in the house — typically have more hairball issues than normal. To help prevent her from swallowing so much hair that it forms hairballs in her GI tract, you'll need to brush your cat regularly. If she's the designated hairdresser in a multi-cat household, you'll also need to brush the other kitties.
Cats eating dry food don't get enough moisture in their diet, so their organs tend not to function as efficiently as they should. And unlike dogs, kitties don't make up the deficiency by drinking lots of water, so they often end up chronically mildly dehydrated.
A GI tract that is moisture-depleted is less able to transport a hairball than the digestive tract of a well-hydrated cat eating a species-appropriate diet. Cats in the wild pass hair in their feces on a regular basis. Felines have tiny bristles on their tongues and are designed to process swallowed hair. Recurrent hairballs are abnormal.
If your cat is eating exclusively dry food and you can't or aren't willing to switch to a different diet, I recommend adding bone broth to her dry food and a bit of fiber to each meal, or a petroleum-free hairball remedy, or even a dab of coconut oil on her front paw or near her bowl. I also recommend fiber and coconut oil together. Kibble fed cats need additional GI lubrication to help ingested hair pass through the digestive tract.
Reason No. 6: Toxin Ingestion
Sadly, poisoning is also a cause of acute vomiting in kitties. It's rare, but it happens. If you have a cat who is otherwise healthy, especially an indoor-outdoor kitty, and he suddenly starts vomiting, you should be concerned he has ingested something toxic.
Even if your cat is indoors only, unfortunately, many types of houseplants are poisonous for cats — and many cats like to sample houseplants. I have a lot of houseplants and I also have cats, but all my plants are non-toxic. It's important to make sure you're not bringing anything into your home that could potentially poison your feline family member.
It's important to note that since cats are designed to eat fresh food, they'll nibble on anything fresh in your house if they're not provided a fresh food diet. Since felines don't have a biological requirement for plants, it's a good bet most of these cats are trying to supplement a processed diet with living foods.
If you have cats that like to sample your houseplants, I recommend providing them roughage that is more palatable and safer than houseplants. You can do this in the form of cat grass, which is wheatgrass, or by offering fresh sunflower sprouts.
Any pesticides, herbicides or household cleaners that are stamped "call poison control" need to be safely stored out of the way of cats. You should assume that any cleaner you're using in your house will ultimately be ingested by your cat, because kitties lay on surfaces, and they're fastidious groomers.
All your household cleaners should be cat-friendly. I can't emphasize enough that if you are still using traditional toxic household cleaners, if you have cats, one of the best gifts you can give them is to switch to non-toxic organic household cleaners.
Reason No. 7: Underlying Medical Conditions
Many cats today have inflammatory bowel disease (IBD), or irritable bowel syndrome (IBS), which causes intermittent vomiting. IBD can progress to GI lymphoma in cats, which is another reason that chronic vomiting in any kitty should be investigated medically.
In addition to lymphoma, other types of GI cancers can also cause vomiting, as can metabolic disorders like hyperthyroidism, which is a very common disease diagnosed in older kitties. Organ disease or a malfunction of the organs of detoxification, including the liver and the kidneys, will also cause vomiting.
Where to Seek Help for a Vomiting Cat
To summarize, it's important to know that chronic vomiting is not normal for cats. It's a sign of a problem that needs to be diagnosed and treated. Your veterinarian should first rule out all the scariest reasons for vomiting, for example kidney failure, liver failure, hyperthyroidism or GI cancer.
If all those problems are ruled out and your veterinarian is concerned about potential IBD or IBS, I recommend submitting a blood sample to the GI lab at Texas A&M University for a functional GI test. That test can determine if your cat is dealing with malabsorption and maldigestion, or a disease of the small intestine or pancreas.
If you believe your cat may have a food hypersensitivity or allergy, I recommend Dr. Jean Dodd's Nutriscan saliva test, which can provide help in choosing a diet that's less reactive for your kitty. The good news is I've found that correcting food sensitivities, removing noxious or unnecessary ingredients from a cat's diet, as well as transitioning to a species-appropriate, fresh food, natural diet eliminates most of the common causes of vomiting in cats.