At one time or another your cat may have about
of vomiting. Usually he’ll have eaten something
disagreeable, eaten too much or too fast, played too soon
after eating or any number of non-serious conditions. Vomiting
may be a sign of a very minor problem. Or it may be a sign of
something very serious.
Vomiting (emesis) is the act of expelling contents from the
stomach through the mouth. It’s a reflex act, involving a
triggering stimulus (such as inflammation of the stomach), the
central nervous system and abdominal muscles that work
together to expel the contents from the stomach. There are
multiple causes of vomiting. An occasional, infrequent
isolated episode of vomiting is usually normal.
Vomiting is a symptom that can be caused by
disorders of the gastrointestinal system (stomach and/or
intestines) or it can be secondary to a disease from a
different system (such as from cancer, kidney failure,
diabetes, or infectious diseases). This can make the diagnosis
of the cause of the vomiting a challenge.
Vomiting can be defined as acute (sudden onset) or chronic
(longer duration of one to two weeks). The severity or
concurrence of other signs will determine the recommendation
of specific diagnostic tests. Important considerations include
monitoring the duration and frequency of the vomiting. If your
pet vomits once then eats normally with no further vomiting,
has a normal bowel movement and is acting playful, then the
problem may resolve on its own. If the vomiting continues
after your pet eats or if your pet acts lethargic, or
doesn’t want to eat, then medical attention is warranted.
What To Watch For
Dehydration – persistent vomiting leading to
dehydration
Abnormal behavior or physical abnormalities associated
with prolonged vomiting – the presence of lethargy
(reluctance to move), diarrhea, weight loss, blood in the
vomit, or other physical abnormalities
Diagnosis
Optimal therapy of any serious or persistent medical condition
depends on establishing the correct diagnosis. There are
numerous potential causes of vomiting and before any treatment
can be recommended, it is important to identify the underlying
cause. Initial therapy should be aimed at the underlying
cause. Tests may include:
Complete medical history and physical examination,
including abdominal palpation. Medical history will most
likely include questions regarding the following:
vaccination history; diet; appetite; general health;
character of vomitus (frequency, progression, presence of
blood duration of vomiting); weight loss; past medical
problems; medication history and presence of other
gastrointestinal signs (such as diarrhea).
Your veterinarian may recommend a number of laboratory
tests. These can include a complete blood count (CBC), a
serum biochemical panel, and a urinalysis.
Fecal examination (to determine presence of parasites or
blood).
Plain radiography (X-rays) or contrast X-rays (X-rays
performed with a contrast material such as barium or
aqueous iodine), can help to determine the cause of the
vomiting.
Ultrasonography is an imaging technique that allows
visualization of abdominal structures by recording
reflection (or echo’s).
Endoscopy – may be useful to diagnosis or remove
certain foreign bodies that are in the stomach. Endoscopy
can also be used for examination of the stomach and a
portion of the intestine (and potentially obtain biopsies
of abnormal areas).
Laparotomy - This is an exploratory surgery that
involves the looking into the abdomen for evaluation of
abnormalities.
Treatment
Treatments for vomiting may include one or more of the
following:
Eliminate predisposing cause (change in diet, eating
plants, etc).
An acute episode of vomiting in a playful pet, in the
absence of other physical abnormalities, may be treated
symptomatically without hospitalization (outpatient
treatment). Outpatient treatment may consist of
subcutaneous fluids, injectable antiemetics (drugs used to
control nausea and vomiting) and a follow-up appointment
if the symptoms are not resolved immediately.
Pets that have abdominal pain, diarrhea and act
lethargic or have any other physical abnormality, may be
treated with hospitalization. Hospital therapy may include
intravenous fluid administration, 24-hour monitoring, and
drug therapy. This is often combined with diagnostic
testing to determine the cause of the vomiting.
Sick pets may require referral to an emergency or 24
hour hospital that offers around-the-clock care.
Home Care and Prevention
Follow-up with your veterinarian for re-examinations of your
pet as recommended and administer any veterinary prescribed
medications. If your pet experiences inadequate response to
prior measures, a further workup may be indicated to determine
the underlying cause of the vomiting.
Treatments of vomiting are dependent on the cause. Symptomatic
therapy of an episode of vomiting includes withholding food
and water for three to four hours. If your pet has not vomited
by the end of this time, offer small amounts of water (a few
tablespoons at a time). Continue to offer small amounts of
water ever 20 minutes or so.
After the small increments of water are offered, gradually
offer a bland diet. Small frequent feedings of a bland
digestible diet such as: Hill’s prescription diet I/D, Iams
Recovery Diet, Purina EN or Waltham Low Fat, are usually
recommended. Homemade diets can be made of boiled rice or
potatoes (as the carbohydrate source) and lean hamburger,
skinless chicken or low-fat cottage cheese (as the protein
source).
Return to regular cat food should be gradual over one to two
days. If vomiting continues at any time or the onset of other
symptoms are noted, call your veterinarian promptly.
If your pet is not eating, acts lethargic, the vomiting
continues or any other physical abnormalities mentioned above
begins, it is important to see your veterinarian. Your pet
needs your help and the professional care your veterinarian
can provide. If your pet is having the clinical signs
mentioned above expect your veterinarian to perform some
diagnostic tests and make treatment recommendations.
Prevention is aimed at minimizing your pet’s exposure to
foreign material (strings, etc) or toxins. Keep your cat
indoors to minimize exposure to foreign material that may be
located outside. Monitor your pet’s appetite and general
health, as well.
Vomiting may be caused by a number of disorders. A single
episode of vomiting is seldom cause for concern but prolonged
or excessive vomiting may be a sign of a serious underlying
problem. Have your pet examined by a veterinarian if he is
vomiting before he becomes seriously dehydrated or
debilitated.
Different diseases will be considered as potential causes of
vomiting by your veterinarian depending on your pet’s
medical history and physical examination. If the vomiting has
been occurring for three months in an 8-year-old cat with a
history of weight loss, then laboratory work and radiographs
(X-rays) may be the diagnostic tests of choice. Since vomiting
can be a symptom of many different diseases, numerous
diagnostic tests may be needed to determine the cause of your
pet’s problem. The extent of the work-up should be discussed
with your veterinarian.
Treatment
Optimal therapy of any serious or persistent medical condition
depends on establishing the correct diagnosis. There are
numerous potential causes of vomiting and before any treatment
can be recommended, it is important to identify the underlying
cause. Initial therapy should be aimed at the underlying
cause.
Diagnosis In-depth
Certain diagnostic tests must be performed to confirm the
causes of vomiting. Your veterinarian may recommend a number
of laboratory tests for your pet.
A complete blood count (CBC) may be needed to evaluate
your pet for infections, inflammation, parasitic infection
or anemia. A serum biochemical panel may reveal the cause
of vomiting (such as diabetes, liver disease or kidney
failure) or demonstrate complications of vomiting (such as
abnormal blood potassium).
Other tests that may be recommended include: 1) a serum
amylase and lipase – to evaluate for evidence of
pancreatitis; 2) urinalysis – to evaluate kidney
function and look for signs of infection; and/or 3) fecal
examination to determine presence of parasites or blood.
Radiography – Plain radiography (X-rays) can help to
determine if the following are present: some foreign
bodies (string, etc); tumors; intussusception (where one
piece of intestine prolapses into and becomes trapped in
another); gastric or intestinal obstruction; and
abnormalities of the kidney and liver. Contrast X-rays
(X-rays performed after a contrast material such as barium
or aqueous iodine has been ingested by the animal or fed
via a stomach tube or given intravenously) can help in the
diagnosis of some foreign bodies, show whether food
empties from the stomach normally, and determine whether
the urinary tract (kidneys, ureter, bladder and urethra)
are normal. Aqueous iodine is preferred over barium if
perforation of the stomach or intestines is suspected due
to the potentially irritating effects of barium when it
leaks into the abdomen.
Ultrasonography – an imaging technique that allows
visualization of abdominal structures by recording
reflection (or echos). This is a non-invasive tool that
can be used for evaluation of abdominal contents.
Endoscopy – may be useful to diagnosis or remove
certain foreign bodies that are in the stomach or to
perform an examination of the stomach and a portion of the
intestine. It can also be used to obtain biopsies of
abnormal areas. A specialist may perform this procedure
for which general anesthesia is usually required. The
benefit of this procedure is that it is less invasive than
surgery. Basically a fiberoptic tube is inserted into the
mouth and advanced through the esophagus and into the
stomach and upper small intestine. A disadvantage of
endoscopy over surgery is that endoscopy only allows
visualization of a small portion of the gastrointestinal
tract and only partial thickness biopsies of the bowel can
be taken.
Laparotomy – an exploratory surgery that involves
opening the abdomen to look for abnormalities such as
foreign bodies, tumors, intestinal obstruction or to
obtain biopsies of abnormal tissues. The disadvantage of
this procedure is that it requires that an abdominal
incision be made. The advantage of this procedure is that
all of the abdominal organ contents can be visualized and
it allows some abnormalities to be repaired (for example,
removal of intestinal foreign bodies). It also allows full
thickness biopsies of tissues to be taken for microscopic
evaluation.
Treatment In-depth
There are numerous potential causes of vomiting; therefore,
before any treatment can be recommended it is important to
identify the underlying cause. The intensity of the treatment
will be determined by your pet’s condition. Treatment often
includes withholding food and water while giving fluids and
electrolytes intravenously and administering drugs for control
of vomiting and/or gastrointestinal protectants.
Potential symptomatic treatments may include:
Giving no food or water until vomiting has stopped for
12 to 24 hours. This is usually done in conjunction with
fluid and electrolyte therapy. Water is then initiated
after 12 to 24 hour period. Small increments of water are
offered and gradually a bland diet is started. Small
frequent feedings of a bland digestible diet such as
Hill’s prescription diet i/d, Iams Recovery Diet, Purina
EN or Waltham Low Fat are usually recommended. Homemade
diets can be made of boiled rice or potatoes (as the
carbohydrate source) and lean hamburger, skinless chicken
or low-fat cottage cheese (as the protein source). The
return to regular cat food should be gradual over three to
four days.
Fluid therapy is indicated if your pet is dehydrated or
actively vomiting and/or having diarrhea. For severe
cases, IV (intravenous) fluid therapy is important.
Balanced electrolyte solution with potassium supplemented
may be recommended. Occasionally, bicarbonate
supplementation may be required (which will be determined
by serum biochemistry lab testing). Dextrose may also be
added to the IV fluids. Mild cases can be treated with
subcutaneous fluid therapy where fluid is given under the
skin. Subcutaneous fluids are slowly absorbed. Intavenous
fluids are important for survival of animals that are
seriously dehydrated or debilitated.
Antiemetics are drugs that are used to control vomiting.
Common drugs used include:
Metoclopramide (Reglan®)
Chlorpromazine (Thorazine®)
Prochlorperazine (Compazine®)
Common gastrointestinal protectants include:
Famotidine (Pepcid®)
Cimetidine (Tagamet®)
Sucralfate (Carafate®)
These drugs are given after vomiting is controlled.
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