Vomiting is the main symptom of gastrointestinal diseases in cats, probably because cats have a highly developed vomiting center. Many cats' vomiting is caused by gastrointestinal diseases, but not all cats do. Table 1 lists some possible main causes of vomiting. Vomiting can be simply divided into acute vomiting and chronic vomiting, which need to be diagnosed and treated by different methods. Generally speaking, as long as the symptoms of vomiting appear, it can be diagnosed as acute vomiting and support therapy can be taken. For chronic vomiting, we must use special diagnostic methods to diagnose it, and then we can choose the appropriate treatment. In addition, some cats vomit is a normal physiological phenomenon.

Causes of cat vomiting:

1, stomach trouble

Chronic gastritis, pyloric obstruction, tumor, parasitic diseases (wasp, wolverine), improper diet or overeating, eating grass or indoor plants, eating hairballs.

2. Abdominal diseases

Inflammatory bowel disease, pancreatitis (chronic), peritonitis, liver disease (bile duct hepatitis, hepatic fatty deposition), intestinal obstruction (complete or partial obstruction caused by linear foreign bodies), tumor (stomach, pancreas or intestine), colon disease (colitis, Hirschsprung's disease), parasite.

3. Systemic or metabolic diseases

Uremia, drug or toxin effects, such as paracetamol, tetracycline, adriamycin, digoxin, ketosis, filariasis, hyperthyroidism.

Preliminary diagnosis method

The approximate diagnosis method of cat chronic vomiting refers to the road map given in Figure 1. This includes a complete medical history investigation and a thorough physical examination.

Medical history:

Time of onset

Vomiting frequency

The nature of vomit (food, mucus, blood, bile, fur or grass)

Relationship with eating habits. Did you eat too fast?

Precursor symptoms (restless animals, pacing, howling and drooling)

How is your appetite?

Past onset, development and improvement

Physical examination:

General posture and appearance

Physical condition (thin/fat, coat condition)

Vital signs (temperature, pulse, breathing)

Mucosal condition (pallor, congestion, jaundice)

Oral examination (whether there are fine lines under the tongue)

Carefully palpate the abdomen (whether there is a lump, the thickness of the intestine, whether the edge of the liver is neat, whether the lymph nodes are swollen, whether there is pain and fluid exudation)

Differential diagnosis was made according to the medical history and physical examination results (table 1). Only about 15% cats with pancreatitis will have vomiting symptoms. The most common disease in medical history is loss of appetite. About half of cats with inflammatory liver disease and fatty deposits in the liver will have vomiting symptoms.

Other checks:

Hematology and plasma biochemical examination

If the metabolic enzymes in the liver are abnormal, a liver function test (bile acid) is needed.

Fairf and FIV test.

T4 was found to be hyperthyroidism.

Abdominal x-ray. If accompanied by respiratory symptoms, the shooting site should include the chest.

Abdominal ultrasound examination. The lesions were found and the intestinal wall thickness was evaluated. Check the liver and pancreas carefully.

Endoscopy, gastric and small intestinal mucosa biopsy.

If there are symptoms of diarrhea and/or weight loss, the intestinal function should be examined (fTLI, B 12, fPli).

When the plasma biochemical examination shows that the liver has diseases, liver biopsy is needed.

If there are masses or other lesions, laparotomy is needed. At the same time do a biopsy.

Alternative treatment:

Determine the treatment plan according to the possible complications. Pyloric obstruction is not common in cats and can usually be treated by surgery. Although some foreign bodies can be removed by endoscope (Figure 2 and Figure 3), in most cases, surgery is still needed to remove foreign bodies in the gastrointestinal tract after appropriate supportive treatment. The treatment of gastrointestinal tumors should take into account different types of tumors on the basis of the above methods. Gastrointestinal adenocarcinoma in cats can be removed by surgery, and the growth rate of adenocarcinoma after surgery is mostly slow, which can greatly prolong the life of animals.

Intestinal lymphoma can be treated by various chemical methods. Intragastric hairballs are related to abnormal gastric peristalsis, and most cases may be accompanied by inflammatory bowel disease, so complications must be treated by surgery or endoscopic removal of hairballs.

Inflammatory bowel disease (IBD) is the most common cause of chronic vomiting in cats. Prednisone (1-2 ㎎ twice a day per kilogram of body weight) can be taken orally for two to three weeks, and then the dose once every two weeks is halved on the basis of the last time, and finally reduced to once every other day.

Severe cases need to be treated with azathioprine (kg weight 0.3㎎, once a day or once every other day). If you take medicine every day, you must monitor the white blood cell count of animals. Some cats need long-term immunosuppressive treatment. For severe inflammatory bowel disease, we can consider using cyclosporine or chlorambucil (anti-tumor drug) with stronger curative effect. It is also effective to inject corticosteroids into some seriously ill cats. Changing the type of protein in diet is also very helpful for treatment, especially for cats with vomiting and diarrhea.

Cats often vomit when they have liver disease. Food-induced liver fat deposition can generally be solved by gastrostomy or nasoesophageal intubation. Bile duct hepatitis should be treated with prednisone and antibiotics such as enrofloxacin and metronidazole. Synthetic bile acids and ursodeoxycholic acid have anti-inflammatory and bile excretion promoting effects. Antioxidants vitamin E and S- adenosylmethionine also have certain effects on treating liver diseases in cats.

Be sure to remember.

Some cats need long-term immunosuppressants to treat inflammatory bowel disease.

If the endoscopic diagnosis results are inconsistent with the clinical symptoms, open exploration and full-thickness organ biopsy can be considered.