Some Startling New Thoughts on Cats and Hairballs

Guest post by Fern Crist, DVM

It is always the case that we vets deal with the same problems at home that we counsel our clients about.  And not always terribly well.  I’m certainly no exception.  Years ago, I had a long-haired cat who threw up hairballs frequently, but unlike most hairball-barfing cats, she did not just hack up the offending wad and then go about her business as though nothing had happened.  Nope, she would obviously feel ill for minutes to hours afterward.  And probably beforehand, too, had I had the vision to see it. 

I tried all the time-honored remedies that I prescribed every day for my patients.  I dosed her with various brands of flavored petroleum jelly.  I fed her diets purporting to help with hairballs by the inclusion of extra fiber.  I brushed her constantly, which fortunately she loved.  None of these things helped.  Eventually I shaved her, leaving the adorable puffs on her legs and tail that made her look like a fat little old lady in tight leotard and legwarmers.  As long as I did this three or four times a year, there were no more hairballs.  Oddly enough, however, she continued to have vomiting episodes, albeit less frequently, and minus the hair.  Diagnostics revealed inflammatory bowel disease, and eventually my poor sweet girl succumbed to intestinal lymphoma. 

While rooming with a brilliant feline practitioner at a medical conference shortly after, still grieving, I confessed my frustration with the seemingly insignificant problem of hairballs.  Her answer blew me away.  There is no such thing as “just a hairball,” she says to me.  Think about it.  Cats developed stringent grooming behaviors in the course of evolution because grooming is a positive survival factor, probably through  controlling parasitism  and other diseases.  So they are going to ingest a lot of hair.  Does vomiting as a daily method for expelling this hair seem evolutionarily sound?  Stomach acid hurts the esophagus and teeth, and frequent vomiting upsets the electrolyte balance.    While vomiting as an emergency mechanism to rid oneself of the occasional nastiness seems reasonable, it seems unlikely that the daily vomiting of hairballs is the “normal” thing that the medical community has assumed it to be.

I’m hooked.  Go on, I say.  She continues.

Why would we think that “lubrication” of the gut with petroleum products would help?  A cat is not a car.  And in no way could a cat have naturally evolved to require the dosing with “lubricants” to survive or to thrive.  Likewise, cats in the wild would never eat a “high-fiber” diet, and so would seem unlikely to benefit from one.  On the contrary, it would appear logical that a cat would thrive better on what a cat has been evolved to eat – namely a mouse or a reasonable facsimile thereof – and that feeding a cat something wildly different from the diet it has evolved on is more likely to result in harm than in good.

No, she says, I think it likely that a “hairball,” far from normal, is probably a common early symptom of Inflammatory Bowel Disease.  Impaired motility of the gut would account for the balling up of hair that should pass right through, if stomach-emptying time is the 0.2 – 2 hours it is reported to be in a normal cat.  A cat shouldn’t be able to swallow enough hair fast enough to outrace normal stomach emptying time. 

This is making sense to me.  Particularly as I just lost my own cat to this.  And as I think back, I realize that “hairballs” have been in the histories of a disproportionate number of the patients I’ve treated with IBD and lymphoma.

She tells me that she’s been changing her patients over to low-fiber diets (grain-free and low carbohydrate) for a while now, and she’s seeing a precipitous drop in the whole “hairball” thing.  I can see the long-term implications of this line of reasoning:  if cat food containing an unnaturally high level of fiber and carbohydrates is associated with an increased incidence of  impaired GI motility and vomiting, and if cats fed this way are at higher risk to develop IBD and lymphoma, then a drop in hairball vomiting might mean that a cat has a lower risk of these two nasty diseases.  Sounds as though a grain-free diet might be a better way to go.

This all made sense to me.  No science to it back then, but neither was there any to support the idea that hairballs are normal.  No one had at that time asked if a carbohydrate-based diet could possibly have long-term negative consequences for cats. 

Well, they have now.   Every day, there’s more scientific evidence that these “mere” hairballs we see so often may respond, not to grease and not to fiber, not to brushing and not to shaving, but to feeding a diet that looks like what a cat was evolved to eat.

In the intervening years, I’ve changed my own cats over to grain-free, low-carb canned foods, and I’ve seen nary a hairball from anyone for a very long time.   In my esteemed colleague’s footsteps, I’ve been changing my patients over to these same diets.   I hear about fewer hairballs, and my patients  are slimmer, fitter, and healthier in many ways.  Is this a panacea?  Of course not.  There’s no one cure for everything.  But I now have serious trouble believing that a feline diet in which the calories are derived primarily from carbohydrates, which are much cheaper than proteins, is beneficial to anything other than the manufacturer’s bottom line.

So next time someone tells you that malt-flavored grease, fiber additives, brushing or shaving are the only ways to help with those annoying hairballs, think again.  Hairballs may be more than just a stinky mess for you to clean up.  They might well be a sign that your cat has a real health problem, and should see the veterinarian.  And your cat might be telling you that her gut would be happier with “mouse” than with breakfast cereal.

129 Comments on Some Startling New Thoughts on Cats and Hairballs

  1. Megan
    July 24, 2015 at 8:42 am (4 months ago)

    I’ve had my medium-haired cat on Wellness grain-free canned food for about a year now, and I brush her daily (and furminate at least once a week). Until a couple months ago she basically NEVER got hairballs. In the last couple months she had a few hairballs, but in the past two weeks she’s had four. What am I doing wrong? She seems fine otherwise.

    • Ingrid
      July 24, 2015 at 9:00 am (4 months ago)

      It’s possible that Wellness changed their formula, Megan. Maybe try a different brand of grain-free food? If the frequent hairballs continue, I would get her checked out by your vet.

    • Lizzie Medina
      October 3, 2015 at 2:47 pm (2 months ago)

      Hi Dr. Ingrid:

      Thanks for your article, it reminds me a lot about my cat’s actual case. I have a 4 year old Persian cat and since May she is having problems with hairballs and vomiting. I groom her once a month with her groomer but she grooms herself a lot. I took her to the vet, and after the regular blood tests and X Rays the vet told me that she had a congestion of hairballs in her stomach, gave her some shots to stop the vomiting, and he change her diet to Prescription Id Digestive management dry food and for the regular treatment he told me to gave her laxatone almost everyday. She seemed to have relief for a month or so, and then comes back the vomiting until it becomes a once a day event and I have to get her again to the vet. Now she is tired of the Laxatone paste and I am trying with her the treats, and she likes it. Even though she vomited, she continues to eat her regular food, her poop is normal, and she acts normally (plays, run etc)

      I am concerned that she could have instead the Inflammatory Bowel Disease, and that the vet have not made an accurate diagnosis. Now I am trying Naturvet Enzymes and Probiotic to her food to see if this improves her vomiting problems.

      I really don’t know what to do anymore for her, rather than go again to visit her vet if the enzymes and probiotics doesn’t work. My main corcerned is that I don’t want to visit the vet every 2 months or so so he can gave her some shots and be there again over and over without a long time remedy. I would appreciate your advice and feedback if there is any other remedy that you think I could try to relieve my cat (Bella).



      • Ingrid
        October 3, 2015 at 5:09 pm (2 months ago)

        I’m not a doctor, Lizzie, this article was written by Dr. Fern Crist. I think you’re getting bad advice from your vet. Your kitty probably needs additional diagnostics to determine what’s really going on, which could include an ultrasound and/or biopsies. The enzymes and probiotics are a good idea, and they may make a difference, but I would also consider a diet change to a grain-free canned diet or raw diet, rather than the dry prescription diet your vet recommended. I also don’t think daily laxatone is good for her.

        I would encourage you to find either a holistic vet or an internal medicine specialist to help you figure out what’s going on with Bella.

        • Lizzie
          October 4, 2015 at 8:09 pm (2 months ago)

          I’m so sorry for the confusion, I will take the advise to go with from now on with a grain-free food and if needed I will look for a second opinion. Thanks!

      • karen
        October 25, 2015 at 2:46 am (1 month ago)

        My cat has been on a raw diet for two years. Since then throws up hairbalks and poops on carpet about once a month. Finally took to vet. $85 later plus some petroleum hairball crap that he wont even eat. Any ideas?

    • Jan Barnett
      November 24, 2015 at 2:45 pm (3 hours ago)

      I’m dealing with a small-cell lymphoma cat right now, and this article makes perfect sense to me. Thank you. In researching foods, I quickly learned that “grain-free” is not necessarily “low-carbohydrate.” In fact, the most expensive brands of dry food still contain at best 20% carbohydrates in the form of legumes, such as chick peas and lentils. This is too high. Aim for zero carb, which can only be met with a very high quality canned food.

  2. Beth
    July 22, 2015 at 12:01 pm (4 months ago)


    Thanks for this post. It is wonderfully informative and one of the best pieces on the topic I’ve read online! I do have a question maybe you can assist me with; My husband and I have 2 cats – a 9yr old domestic medium hair, and a 6yr old domestic short hair. 4-5yrs ago our older cat had a bout of persistent vomiting post meal time and it became pretty concerning. After consulting a few vets, and doing EXTENSIVE research online we made the commitment to switch to a raw food diet. We’ve been following &’s advice/recipes verbatim and it COMPLETELY resolved the vomiting issues almost immediately. *Of note: The switch in food was followed by MASSIVE hairballs. 3-4 (between two cats) per week for about 2-3 weeks or so. Since then we’ve had a ‘normal’ amount of hairballs, 1 per month approximately (sometimes none at all) between two cats for years… until recently. It’s been HOT here in NYC and the cats have been pretty lazy, and shedding like crazy, but still acting and eating normally. We have cool areas of the apartment they can retreat too but they seem to prefer the hottest rooms possible. However, we’ve seen a huge increase in sizable hairballs – approximately 2-3 every other week or so between 2 cats. There is little to no food present in the hairballs and very little bile. They are tubular and loosely matted. They are also spitting out the hairballs without too much effort – no excessive coughing, hacking etc. They are still passing hair normally too. I do my best to brush them (I Zoom Groom and Furminate followed by a flea comb and sometimes a damp cloth) every other week or so but sometimes I feel as if that increases the likelihood of hairballs. We also normally bathe them (mostly for allergy reduction – we use very little soap, and just give them a quick rinse and a good brushing) every 6 months or so – for which they are currently overdue as I’m a bit worried about causing them undue stress and the excessive grooming that follows a bath. My questions are: how long should I wait this out before a vet visit? Could the heat/summer/shedding be causing the increase in hairballs? Do you have any thoughts about bathing and hairball reduction/promotion? Should I increase brushing? And finally, would there be merit in adding probiotics in now or waiting to see if this bout of hairballs dissipates at all?

    • Ingrid
      July 22, 2015 at 3:23 pm (4 months ago)

      I would be concerned about the increase in hairballs to 2-3 every other week, Beth, especially since they’re on a raw diet. The hot weather and excessive shedding could be the reason, but it still seems that they should be able to move the hair through their system. You could try adding a probiotic to their food to see if that helps. If bathing is stressful for them, I’d probably not do that right now. As long as they enjoy brushing, increasing that certainly can’t hurt. If you’re not seeing an improvement after adding a probiotic and/or increased brushing, I’d consult with your vet.

      • Beth
        July 22, 2015 at 3:34 pm (4 months ago)

        Thanks so much for the speedy reply Ingrid! Great advice. This is very helpful. I’m going to start by increasing the brushing immediately. Even with regular brushing I still pull a small mountain of fur out of them (mostly our medium hair cat Polaris) so perhaps I just haven’t been diligent enough. They also groom each other, so I’m guessing getting Polaris’ shedding under control will help both of them.

        • Sepo
          August 24, 2015 at 12:41 pm (3 months ago)

          I feed a raw diet, add probiotics and groom daily. This summer is also very hot here in Seattle and my cat is throwing up much more hairballs than normal, and like your some is just loose hair, I was wondering if it was the heat also, even though he is indoors and the house is generally cool we do not have AC. I was thinking of taking him off he raw chicken and trying him on a protein he has not had like turkey or duck. he alternates between chicken and rabbit now ( both raw), I feel so bad for him.

          • Beth
            August 24, 2015 at 1:04 pm (3 months ago)

            Hey Sepo, just a quick note relative to your post and an update on my current experience… I have taken Ingrid’s advice and upped the brushing of both my cats significantly (especially my medium hair tortico). I basically leave the flea comb out and grab it whenever I see a cat roaming the kitchen and give them a quick brushing. I believe this has helped SIGNIFICANTLY. I also started a ‘hairball’ log where I do my best to try and determine which cat may have been the culprit based on location, time of day, and size/type of hairball. This has eased my mind considerably as what I have catalogued shows few hairballs with more time in-between than I originally perceived. The heat has died down since I first wrote in so perhaps that has helped reduce my cats’ general discomfort but we have seen a BIG reduction in hairballs and the only thing I have changed so far is the brushing. Hope that helps.

          • Ingrid
            August 24, 2015 at 1:42 pm (3 months ago)

            I suspect that the hot weather does have something to do with the increased shedding and resulting increase in hairballs that you’re seeing, Sepo. I would brush your cats more frequently. If the vomiting continues once the weather cools off and with increased brushing, I’d have your vet take a look at your cat.

  3. Karen Moss
    June 17, 2015 at 3:49 pm (5 months ago)

    Can you please recommend a good cat food to switch to that will help with the intestinal problems problems, which are disguised as hairball problems ? I have 3 cats and do not control when they eat but I have an automatic dispenser that does control the portions it kicks out and they free feed. Unfortunately, I don’t know if one gets more than the other. I can’t give probiotics because it is difficult to medicate them, due to some of thier personalities and my health conditions. I currently feed them Science Diet RD because they are all indoor cats, older, and not as active, so a little overweight, but they all throw it up occasionally. I know they all do this because I can see each hair color.I would appreciate any suggestions on what food to switch to that is more grain free, has more protein than carb, etc. as stated in the above article. Thank You. Please send answer to my email.

    • Ingrid
      June 17, 2015 at 3:57 pm (5 months ago)

      You can find my recommendations here, Karen:

      To address some of your questions: stop feeding dry food and stop free-choice feeding. Feed two or three small meals a day (you may need to feed your cats in separate locations) so you can monitor when and how much they eat. Probiotics can be easily mixed in with canned food. Once you stop feeding dry food and switch to a premium grain-free canned or raw diet, your cats will lose weight, and your hairball problems will resolve.

      I hope this helps!

  4. Christine
    April 25, 2015 at 6:13 am (7 months ago)

    I switch over for all my pets to a grain free diet. I have one cat who still has issues vomiting hair balls, or the food at least once a week, and sometimes more. She is so skinny in my mind, but hasn’t lost weight, nor has she gained.

    I also have two cats who have never had anything but no grain food, and their feces is just liquid.

    So now I am at a loss on what to do. The vet sees nothing wrong, and I would just like for all my pets to feel good.

  5. Annie
    January 18, 2015 at 12:23 am (10 months ago)

    I’m wondering why vets don’t mention summertime heat as a cause of hairballs. The only time my girl will cough up a hairball is when the weather is warm. Even in the winter, when someone in my house cranks up the heat past 69, my cat will cough up a hairball within 24 hours every single time without fail. If I catch the thermostat on 69 or more, I know I’ll be cleaning up a hairball that night or the next day.

    Cats automatically start shedding in warm or hot temperatures so the cat can better tolerate the higher heat. Naturally when they start shedding from heat, they’re going to be ingesting a lot of extra hair and voila ! a nice gift left for mommy to clean up the next day.

    Keep your cats in air conditioning or in a room with fans to keep them cool in the summertime. Poor things have to wear a fur coat in the hot heat so please be compassionate. In the winter, keep your thermostat on 68 and no higher and you’ll probably see a significant reduction in hairballs. You’ll be healthier, too, since turning the theromostat any higher will dry out human throats and sinuses which is guaranteed to heighten the risk of colds and fly. Dry heat in the winter is BAD for people and pets.

    • Ingrid
      January 18, 2015 at 6:57 am (10 months ago)

      As you’ve seen in this article, intestinal motility is the primary cause for hairballs. I don’t think anyone has ever established a corelation between ambient temperature and frequency of hairballs.

  6. Miyoshi
    January 13, 2015 at 1:07 am (11 months ago)

    My cat is about 14 years old and I switched his food to Lotus about 4 years ago. Well about a year he started hating problems. The vet said he had colitis. While there I asked him about his hair all problem. He hacks and never coughs anything up so I asked if that can cause any problems. He just kind of shrugged it off and said no. He seemed to have no concerns about it. I tried the food he gave me. My cat wouldn’t eat it. At all. I tried raw food. He wouldn’t eat it. I tried Wellness and Lotus wet food. He wouldn’t eat it. I finally tried fancy feast and he ate it. His colitis symptoms cleared up and started doing better.

    About six months ago he started getting very thin. Gradually his appetite has gone WAY down. When he had a BM one time on the floor next to litter box, I picked it up and smashed it. It was full of hair. So when I started looking on the Internet I found this is a rare problem and surgery would be required to remove it. He’s so old now and weak I believe from not eating I don’t know if he can survive this type of surgery. I’m really worried about him and he was so healthy until recently. HELP!! What do I do???!! Any help will be appreciated. I don’t want to lose my cat to hairballs!!!!

    • Ingrid
      January 13, 2015 at 7:03 am (11 months ago)

      You need to take your kitty to a vet as soon as possible, Miyoshi. Rapid weight loss is always a concern, and could be caused by any number of conditions.

  7. Jessica
    January 6, 2015 at 5:52 pm (11 months ago)

    Hi Ingrid,

    Your post finished to convince me that we have to feed our cat a better food. 3 more weeks before moving back to the US, I am becoming very impatient, especially since it will take a few days to complete the transition (from Science Diet Hairball Control, only can besides Whiskas in Chile). I think I will choose Tiki Cat over Weruva as Tiki as more calories in a can, I would also like to try Feline’s Pride. I read many good things about probiotics, should I add it right away with the new food or should I wait and see how things go?

    In regards of hairball, my 6-years old indoor silky long hair cat has been pretty sensitive this summer, our current season, and has been vomiting very dense large hairballs once a week since Christmas. I comb him everyday but it has been very hot since the holidays and AC are rare in Santiago, so I guess he has been shedding more but this is the first time which concerns me a little. At this pace, given the details above, is it kind of safe or should I be really concerned ? Thank you.

    • Ingrid
      January 6, 2015 at 6:31 pm (11 months ago)

      I recommend a daily probiotic for all cats, Jessica. I like the Dr. Goodpet digestive enzyme and probiotic blend:

      I would a little concerned about large weekly hairballs. It’s possible that you’ll see this resolve with the diet change and the addition of a good probiotic (probiotics can help increase intestinal motility), but if it continues, I’d get him checked by a vet.

      • Jessica
        January 7, 2015 at 3:06 pm (11 months ago)

        Thank you, Ingrid. I was looking into Mercola pet probiotics and digestive enzymes but will read more about Dr. Goodpet. I really hope the high quality food and supplements will help our cat but we will have him checked anyway sometime after we arrive. That trip (planes, + 24 hours door to door) really concerns me. He did well the other way around but duration was shorter and he was younger. He was checked on late November anyways and the vet said the physical exam was great so he thought the blood test was unnecessary but we will do it anyway in the US.

        • Ingrid
          January 7, 2015 at 3:44 pm (11 months ago)

          The Mercola product is an excellent choice as well, Jessica.

          • Jessica
            January 25, 2015 at 2:00 pm (10 months ago)

            Hi Ingrid,
            So we made it through the (very stressful) trip from South America to Los Angeles. Since our cat was doing fine, I already started to give him probiotics. Mercola recommends 1/2 scoop for maintenance/wellbeing and 1 scoop for therapeutic, I have been giving him 1/2 scoop per day over several meals. He has had some burps (or something like that) since then and I found a lot of fur in his stool this morning, most of the stool was normal, part of it was soft, he also threw up a hairball this morning as well. Could it already be the probiotics working after 48 hours? Should I keep giving him 1/2 scoop or reduce and adapt slowly ?

            Also, I have started to slowly introducing him to Tiki Cat cans, the chicken versions. He seems to love it but he doesn’t eat as much since he has to chew on it and is used to licking (he was on Science Diet in SA). Should I be patient and he will end up eating more and more once he is fully on that kind of diet or there is something I can do to help him ?

          • Ingrid
            January 25, 2015 at 2:29 pm (10 months ago)

            I’m glad you made it safely to LA, Jessica! Yes, the probiotics can work that quickly. I would stick with the recommended dose. I’d also be patient on getting him used to the Tiki Cat. Do keep an eye on his weight, though. The Tiki Cat is lower in calories than other brands.

          • jessica
            February 1, 2015 at 2:36 pm (10 months ago)

            I am sorry, I don’t know why the “reply” button doesn’t appear below your last answer.

            I am puzzled and probably impatient… Our cat has now been on Tiki Cat (Koolina and Puka Puka which seem to have more calories per can now) cans only for almost a week. No more kibbles before going to bed (15 g), no more Science Diet Hairball Control. In the same time, I also started to give him probiotics (1/2 scoop for maintenance) and he has had 0.75 ml Omega 3 pet Nordic Naturals per day for a few years (flaky skin). I have found lots of fur in some of his stools so I guess the probiotics are working but he regurgitated hairballs twice over the past week. They are less dense but I am confused because he didn’t do that as often.

            It has been a week (after a very long and stressful airplane trip on the top of it) so maybe I have to be more patient and let the whole new diet and probiotics do their job a little bit more before taking him to the vet ? Maybe give him more probiotics (the container says 1 scoop for therapeutic reasons) for a few days ? He is very playful and has a gorgeous fur.

          • Ingrid
            February 1, 2015 at 3:41 pm (10 months ago)

            I would give it more time, Jessica.

          • Jessica
            February 2, 2015 at 2:28 pm (10 months ago)

            I will, Ingrid, thank you.

            Also, do you happen to know why Tiki Cat Puka Puka and Koolina Luaus now have a higher calorie content ? I have emailed and called them several times with no answer, which is quite disappointing.

          • Ingrid
            February 2, 2015 at 3:57 pm (10 months ago)

            Unfortunately, I don’t know why the calorie count might have increased, Jessica.

          • Jessica
            February 3, 2015 at 1:54 pm (10 months ago)

            I finally got a hold on someone at Petropics (Tiki Cat) but unfortunately, that person wasn’t able to answer my question and said that my email had been forwarded to a colleague who should be able to do so. I will let you know when I hear back from them as some people might be concerned about feeding Tiki because of the cost involved.

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