Jan 10, 2012 1:05 PM by Bonnie Markoff

It's Not a Hairball

One of my favorite scenes in any movie is from Shrek 2: Puss In Boots hacking up a hairball. Wouldn't you love to see the actual footage of Antonio Banderas as he voiced over that scene?! Those of you with vomiting cats would surely rather watch the movie version than see your own cat vomiting, yet again, on your freshly cleaned carpet.

Last week Stan asked about his cat, Hoot, who vomits every other day and is only 3 years old! Stan has done an excellent job with Hoot. Lab work has been performed as well as deworming. He has tried several diets to no avail and has also paid attention to better grooming so Hoot sheds less, thus ruling out hairballs. I know many of you can relate to this and I know it can be VERY frustrating.

Cats vomit for many reasons. Most causes of vomiting will make the cat sick - poor appetite, low energy, diarrhea, weight loss or some other sign of illness. These other signs really help us to find the cause of the vomiting. However, I think I see a cat like Hoot almost every day - an otherwise healthy and happy cat that just keeps vomiting. Most of these cats have some form of what we often term "Inflammatory Bowel Disease" or IBD. IBD encompasses a number of different syndromes all related to the stomach, intestines or colon and is often associated with pancreas and liver disease. Many cats with IBD show no signs aside from vomiting. Other cats can become severely ill and even die.

Most cats with IBD will have normal blood work, urine, x-rays and physical exams. The only way to definitively diagnose IBD is to obtain biopsies of the stomach, intestines and colon. This requires full anesthesia for either surgical biopsies or endoscopy/colonoscopy - clearly an expensive and uncomfortable proposition that is hard to justify in an otherwise healthy cat. There are a few tests we can run and treatments we can try that can suggest IBD, and this is where we usually start.

Our approach to most cats suspected of having IBD is to run a test called a TLI/PLI/B12/folate. This helps us to look at pancreatic function and inflammation along with the intestines ability to absorb and manage two B vitamins. Many cats with IBD have low vitamin B12 levels and can be managed by simply giving B12 injections. If the budget allows, we also recommend an abdominal ultrasound performed by a Board Certified Radiologist. Ultrasound allows us to look at the lining of the stomach and intestine in pretty good detail and it allows a very nice look at the pancreas and liver.

Treatment of IBD can include probiotics, antibiotics, antinausea drugs, diet changes and immunosuppressive drugs. We often start with the drugs with lowest potential side effects: probiotics, an antibiotic called metronidazole, vitamin B12 and in some cases an anti-nausea drug. Potential prescription diets include those with proteins that are new to the patient (duck, kangaroo, etc) or diets in which the proteins have been broken down to amino acids so they are less likely to illicit an immune response. We find that the vast majority of cats respond to the above therapy and can be managed long term on diet alone. Some patients will require immunosuppression, which is usually in the form of prednisone or cyclosporine. Whenever financially feasible, it is best to get an actual biopsy before instituting these medications.

If you have a vomiting cat, or any pet with a chronic problem, come see us at Animal Care Clinic where our focus is on Family Veterinary Practice. We would love to help.



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