Chronic vomiting in cats: It's not hairballs!

Does this sound familiar? "My cat has vomited all its life. The vomiting was occasional for months to years. Then it became once or twice a month. Now it's daily. Otherwise, my cat feels good and eats well."

The greatest of all feline myths is that vomiting is normal, says Gary D. Norsworthy, DVM, DABVP (feline practice). We've been accepting chronic vomiting in cats as normal, which it really isn't, says Dr. Norsworthy. In fact, most chronic vomiting in cats originates from the small bowel. The differential diagnoses in these patients are inflammatory bowel disease, neoplasia without mass formation, food intolerance/allergy, and miscellaneous and infectious causes.

Speaking at the CVC in San Diego, Dr. Norsworthy, owner of Alamo Feline Health Center, a feline-only practice in San Antonio, Texas, describes his workup in feline patients with chronic vomiting.

The workup begins with abdominal ultrasonography to look for intestinal wall thickening, with clients present. If wall abnormalities are identified, he discusses the need for a laparotomy with full-thickness intestinal biopsies.

In many of these patients, inflammatory bowel disease or intestinal lymphoma is confirmed histologically. And in general the prognoses with treatment are good.

The take-home message from Dr. Norsworthy: "Quit treating these cats for hairballs, and get a real diagnosis."