During every routine annual exam we veterinarians do, there is a question we ask: have you noticed any vomiting or diarrhea? Often for our feline patients, we hear “Well, they’ve always been a vomiter” or “two to three times a week, but that’s normal for them”. So, how much vomiting is too much? When does that puddle of vomit stop being just an annoyance and turn into a concern?

Long-haired cats may produce a hairball one to two times a month. Short haired cats should vomit less than once every two months. Any higher frequency then this can be an early indicator of underlying disease and should be mentioned to your veterinarian during a regular exam. Any sudden or noticeable increase in vomiting frequency, diarrhea, or concerns of weight loss should indicate a need for a more immediate examination.

Vomiting or Regurgitation

Your vet will start by asking a lot of questions: firstly to determine whether your cat is vomiting or regurgitating. Vomiting and regurgitation can look very similar in pets, but are actually very different processes. Vomiting involves nausea: you may see drooling, lip-licking, vocalizing prior to the actual vomit. Once it starts, look for abdominal contractions and often rather loud sound effects. Regurgitation is often very passive in comparison: the animal will simply open its mouth and almost spit out water or food in varying states of digestion. Regurgitation does not always happen immediately after eating.

Once that is determined, the focus turns to whether the vomiting is because of a primary gastrointestinal issue or secondary to illness elsewhere in the body. To help with this, your veterinarian will perform a thorough exam including an abdominal palpation. This often looks like an unusual upside down belly massage, but they’re actually isolating different organs in the abdomen and feeling for abnormalities. They will compare the size and texture of the kidneys. They will even feel along loops of intestines, feeling for subtle thickening or “ropiness”.

Testing For Disease

Common diagnostics will include a fecal sample to assess for parasites such as roundworms. Your veterinarian may recommend trying a special diet to address dietary allergies and intolerances. A blood panel will help assess for kidney and liver function and determine the likelihood of more subtle endocrine disease such as hyperthyroidism. A urine sample will also provide essential information about kidney function. If these are inconclusive, imaging such as an abdominal ultrasound may be recommended to look for subtle inflammation in the gastrointestinal tract, which can be a sign of inflammatory bowel disease or alimentary lymphoma. And remember, early identification of disease often enables more effective treatment and management!

By Liz Spencer, BSc, BVMS
Seattle Veterinary Associates