E924
Vomiting

Causative Agents: Some of the more common causes of vomiting include ingestion of grass, hair or other substances that are indigestible and irritating to the stomach, overeating (especially if immediately followed by heavy exercise), and motion sickness. Infectious parasites, viruses, bacteria, and some problems with the internal organs of the body may also cause a cat to vomit.

Certain drugs and toxic substances will cause vomiting if ingested. These include the following:

Insecticides
Pesticides
Cleaning agents
Antifreeze (Ethylene glycol)
Lead
Zinc
Arsenic compounds
Non-steroidal anti-inflammatory drugs (NSAIDs) -aspirin and ibuprofen

If a cat has ingested any type of poisonous substance, contact a veterinarian immediately. Inducing the cat to vomit the poisonous substance may save its life. However, it is important to note that some poisonous substances are more harmful if the animal vomits them. Never force a pet to vomit if it has consumed an acidic or alkalotic cleaning solution, a petroleum product, or it is severely lethargic or comatose.

The following can be given at home to induce vomiting in a pet:

1. Hydrogen peroxide - 1 teaspoon orally every 10 minutes, followed by gently rocking the cat back and forth or jostling the abdomen for several minutes; repeat 3-5 times if necessary.
2. Ipecac - 1 teaspoon orally per 10 lbs. of body weight.

Clinical Signs: Vomiting refers to the forceful expulsion of stomach contents through the mouth. Vomit may contain: food in various stages of digestion, bile (a brown, green, or yellow-colored, rather sticky liquid), blood, or any combination of these three. Types of vomiting that may indicate a more serious problem and would certainly warrant professional assistance include the following:

1. Regurgitation: Regurgitation is actually not true vomiting; it is more passive in nature. The food is often expelled undigested and possibly shaped like a tube or cylinder. Violent abdominal heaving is usually absent. Regurgitation can occur with a blockage in the upper digestive tract or a problem with the animal’s ability to swallow.
   
   
2. Continuous vomiting: The cat first empties its stomach of food, then begins to vomit foamy yellow or clear fluid. Vomiting which does not stop within a couple of hours is considered continuous. This situation often indicates stomach irritation.
   
   
3. Hacking/vomiting: This is a condition when vomiting is usually preceded by a coughing or hacking fit. The vomit may contain food or stomach juices. This type of vomiting may be secondary to a respiratory problem in which a coughing or hacking fit becomes severe enough to lead to vomiting. Some cats seem more susceptible to this condition than others. Please see page E122 for additional information on coughing.
   
   
4. Chronic vomiting: This is a situation where vomiting occurs now and then, is not predictable or constant, but continues over a period of weeks to months. It may or may not be associated with eating. Other symptoms of chronic illness may also be noted such as weight loss, poor appetite, and a general lack of energy. Kidney and liver disease, diabetes, and cancer are some of the more serious possible problems. Untreated parasite infections are also a possible cause of chronic vomiting.
   
   
5. Projectile vomiting: Vomiting is unusually forceful, and stomach contents are often expelled a long distance. This type of vomiting is suggestive of a complete blockage in the digestive tract such as some type of ingested object, a tumor, or scar tissue in the digestive tract lining.
   
   
6. Vomiting blood: Fresh blood in the vomit indicates that damage has occurred to the internal lining of the upper digestive tract. Bleeding ulcers, foreign objects, and tumors all have the potential to cause an animal to vomit blood. Certain types of drugs may also cause bleeding from the stomach.
   
   
7. Vomiting stool: Vomit which looks and smells like a bowel movement often indicates an extremely serious, life-threatening situation. Complete blockage of the lower intestines and/or severe trauma to the digestive tract are often suspected. Consider this symptom an emergency!
   
   
8. Vomiting in conjunction with neurologic symptoms: Vomiting in an animal experiencing frequent seizures, paralysis, or balance problems (circling, rolling, head tilting), is probably related to a neurologic problem. Correction of the primary neurologic problem will likely correct the secondary vomiting problem.

Diagnosis: Diagnosing the cause of vomiting may or may not be easy, depending on the state of the animal when presented to the veterinarian. Coupled with a physical examination, a thorough history on the cat is essential in determining the cause of vomiting. The doctor may elect to approach the situation conservatively with a temporary restriction in food and water intake. Diagnostic testing such as radiographs and bloodwork may be advised in other cases. More invasive diagnostics such as endoscopy (a camera on the end of a fiber-optic tube placed inside the animal’s digestive tract), contrast-enhanced radiography (dye placed inside the animal’s digestive tract and the progress of the dye is followed with the help of radiographs), fluoroscopy (a moving radiograph), or surgery may be necessary if the diagnosis is especially difficult to make. See Section D for additional information on many of these tests.

Treatment: Specific treatments for vomiting are based on the exact cause. Treatment of the primary cause is necessary to stop the vomiting and may include dietary changes, counter-acting poison or drug intoxication, insulin therapy, antibiotic therapy, electrolyte replacement, deworming, anti-inflammatory therapy, fluid therapy, and/or surgery. Supportive care to correct the adverse effects of vomiting include fluid therapy, anti-emetic therapy (specific drugs which stop vomiting), electrolyte replacement, and proper nourishment.