Conscious Cat

April 28, 2010 106 Comments

Some Startling New Thoughts on Cats and Hairballs

Posted by Ingrid

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.


106 comments to “Some Startling New Thoughts on Cats and Hairballs”

  1. Carla Bennett says:

    After spending years smearing petroleum jelly on my cat’s foreleg because she would get constantly plugged with hairballs, a wonderful Pussy & Pooch pet shop person sold me some Vet’s Best Hairball Relief. Directions are one pill broken up in the morning and one in the evening, but my cat does well with 1/2 in a.m. and 1/2 in p.m. I break the half-pills up in her treat dish and she loves them, snarfs them right down. This holistic medicine is wonderful! I have never seen such fabulous poop :). Occasionally, if there’s no poop in the litterbox, I give her a few extra crumbs. I love the vet who “invented” this stuff!!! It’s cheaper on than in the pet shops, but heck, either way it saves on vet bills, which can be scarier than dental bills!

  2. Clare says:

    We have a 4 year old tuxedo cat and have had him only a year. The previous owner said he threw a hair ball every 2 weeks or so., but its more frequent than that. I hate to see him do this, he also rushes to eat some grass to help him throw it up. I had him on dry food and wet morning and evening. I read your article and have switched him to wet grain free. I give it twice or three times a day, more if I am home all day. About a teaspoon each time. he loves the grain free wet.
    I also switched the dry food to grain free and am breaking him in on that, still not at 100% on that. I was wondering how long it will take to see a difference, and a reduction in hairballs. he threw up a small one 2 days after the switch over, but as I said he is not 100% on the grain free dry yet.
    I realize the author of the article prefers 100% wet, but my worry is when we are at work and if he has to eat wet only in the am and pm, hikes to pick on the dry early morning around 4am.

    when should we expect to see a change in hairballs and overall health ?

    • Ingrid says:

      I would eliminate the dry food completely. If he eats a full meal at breakfast and dinner, he’s not going to need more food around while you’re at work. Some people see changes immediately after switching to grain-free canned or raw food, for other cats, it may take longer. If he continues to throw up frequently even after the changeover, I’d get him checked out by your veterinarian to rule out other issues.

  3. Datdamwuf says:

    I am so sorry about your cat, it is so hard to lose our family.

    I hope you are still willing to answer questions on this post. History: I started out feeding my 2 Maine Coons a raw diet, the second cat just would not adjust and so I switched to canned Wellness with other grain free canned foods occasionally. When they were about 1.5 yrs old, my (now) ex began giving them Canin dry food, the second cat got addicted to it and started fatting up so I switched them to Evo dry food. I allow the dry to run out every other day. At 2 years old I started giving both cats a modified “Lion Cut” year round because I couldn’t keep up combing both of them and they matted up (they love to play in water). I have also always given them living wheat grass and catnip regularly. The wheat grass never caused/causes any vomiting at all. When they eat the sharp edged grasses outside it does cause vomiting. I believe they eat grass because it tastes good to them and the wheat grass has no sharp edges, so no vomiting.

    Presently they are both about 7 years old. My silky haired meticulous cat threw up a small hairball after I’d let the Lion Cut lapse a bit long, and I thought nothing of it because maybe once a year this happens.

    However, a week later he began vomiting minutes after eating or drinking. After 2 days I took him to the emergency vet fearing dehydration. His xray showed a small hairball mass and blood work showed no issues. The vet wanted to hospitalize and do surgery, this seemed precipitous to me so I refused and took him home. They put him on Cerenia and Lactulose, after 2 days he wouldn’t eat even though he was not vomiting. I looked up Lactulose and discontinued it due to the side effects. Next morning I took him to my regular vet who put him on Pepcid AC and Laxatone, she also had me switch him to Fancy Feast to help with appetite. He began eating/drinking again by the next day and vomiting stopped. I could see a lot of hair in his stools, he eventually did vomit again, he choked up a large hairball. After a 10 days I got him back on Wellness with Laxatone every 3 days.

    Then I had to travel, when I returned I found my cat sitter had not given the Laxatone or monitored food intake well, my cat began the exact same symptoms. I had to give the Cerenia one day to bring the vomiting under control, then did Pepcid AC & Vaseline every day for one week. I also got the groomer to do the Lion Cut, hoping to end the cycle, the vomiting resolved. He has not vomited for 2 weeks and is finally “himself” again.

    Now I’m giving him a small amount of Vaseline once or twice a week and he is back on Wellness mostly. This cat is a long silky haired meticulous groomer and he cleans the other cat. The other cat never vomits, his hair is shorter and courser. Both of these cats have always been on a grain free diet for their entire lives.

    The only explanation I can come up with is that I let the Lion Cuts grow out twice in a row and so the cat who grooms alot got hairballs. But even this makes no sense, I have let the Lion Cut lapse before in winter with no issues.

    My question is; should I have a complete blood workup done to be sure there is no underlying issue? Is there any thing else I should test to make sure these episodes are not a symptom of something much worse that might be recognized before it becomes more serious? Any other suggestions? (I am not concerned with cost, only with ensuring my cat is OK)

    thank you for any help or response with this!

    • Ingrid says:

      I would pursue further diagnostics, just to rule out anything more serious. Perhaps Dr. Crist will chime in with more information, but to me, the fact that this is a recurring problem would be enough to make me want to look a little deeper.

    • Fern Crist, DVM says:

      First, I’d like to applaud you for doing such a great job educating yourself on proper feline nutrition. As a cat vet, I’m always delighted with a client who has taken care of that part for me!

      And how frustrating is it, when you’ve done all that homework and STILL your cat has hairballs?!!

      The most important take home for you today is that hairballs are not normal. Neither is a head cold or diarrhea, but having a minor ailment like that once in a while IS normal. So while the occasional hairball (once or twice a year) is not a trouble signal, a pattern of more frequent or more severe hairballs is.

      Hair should go through right through the gut, from mouth to anus, without tangling up. All self-grooming hairy-coated animals MUST be able to pass hair every day. Hairballs only form when the motility of the gut is impaired in some way, slowing down hair passage, which then allows the “tangling” to occur. Again, once in a blue moon is just a quirk. A pattern or a severe incident bears looking into.

      As you no doubt already know, hairballs are the most common symptom of IBD in cats. They are, however, caused by a myriad of other intestinal issues as well – ANY intestinal disorder that affects motility can cause hairballs. And you know how many intestinal disorders affect motility? ALL of them. And you should also keep in mind that IBD, while strongly associated with carb-heavy diets in cats, can appear for other reasons.

      You said, “I let the Lion Cut lapse before with no issues.” To me, that signals a change in pattern and a reason to look further.

      Bloodwork is definitely indicated, but might well turn out to be insufficient. There are a whole host of GI disorders that are not diagnosable without other types of tests, ranging from the less invasive (radiographs, fecal analyses etc) to the more invasive (exploratory surgery with biopsies) and tons of stuff in between.

      What tests are actually indicated can only be determined by you and your feline vet after a good physical exam and an extensive, thorough history-taking. And I encourage you to pursue that as soon as possible!

      Meanwhile, keep up the good work with the low-carb, grain-free diets!

      • Datdamwuf says:

        Thanks for the response Dr. Crist. I’ll get with my vet again to determine what tests we can perform that are not invasive. At this point he seems fully recovered and normal, I’m back to saying to him “obnoxious cat is obnoxious” while I cater to his demands. I’m very happy he is his old demanding and kingly self.

        The only change since I posted is that I’m letting him outside again and he is eating grass but NOT vomiting other than once and it was just grass (they go out an hour a day in fenced yard). Also, I’ve been giving him the new Greenies for hairballs each day even though I cannot find any info on whether they really help and my vet’s only response was that they work for some of her clients, she had no other opinion.

      • Datdamwuf says:

        Wanted to follow up with diagnoses. My cat has chronic pancreatitus according to blood tests, the vet thinks that was contributing to the sudden vomiting immediately after eating/drinking, that he was having an acute attack. He was put on prednizone and it currently on .5 ml once a week. I’ve completely done away with dry food except a half cup mid day (who can deal with insane cat demanding his treat? not me). He continues to throw up hairballs on an intermittent basis. Example; he threw up 3 days in a row in the morning before breakfast, but he hadn’t done so in a month prior. This is a pattern now and I have no idea what to do beyond going back to the vaseline twice a week to help the hair pass. Any ideas are welcome!

        • Sepo says:

          I use Sentry Hairball in the food, and it appears to work well, my cat does not like the taste or smell of some of the malt flavored hairball treatments, but this one he is fine with it. I also add feline probiotics to his food. I purchased the one Ingrid recommended in another post. I also add extra water to his wet food, and i give him no dry food at all. As i long as i stay on that regime my cat can pass the hair. I used to have a sitter come by to feed him when i was away, but found having him board at my vets is a better fit for my cat, with the sitter coming for 30 min a day he was alone too long and was bored and groomed too much, at the vets he is more active and is not alone so he does not get into excessive grooming. I am also assured that he is fed on a regular schedule and they add the Sentry to his food. I also have his belly shaved as that is the area he does not like me to groom, but he loves to groom the belly

        • Ingrid says:

          You may want to consider replacing the mid-day dry food snack with freeze dried chicken.

          • Datdamwuf says:

            I had forgotten that for a long time I was sprinkling a purina probiotic on their food so Ghost would eat and I stopped once the appetite returned, so I will start that again. I’m not sure now if the dry food is an issue (it’s mostly chicken and very expensive so I cuss at the cats when they insist upon it). Ghost won’t eat freeze dried unless I hold it for him to bite chunks off, the other cat will snatch it all if I put any down so that’s no good. Yes, Ghost is a weird cat.

            The one thing that has changed large is that his once a week pred is in an oil based fomula because the refrigerated concoction only lasts one month. Could the oil change the action of the pred? I’m considering switching back and getting smaller amounts.

          • Ingrid says:

            I’m not sure whether the oil could affect the efficacy of the pred – that would be a good question to ask your vet, or the compounding pharmacy.

  4. All For Rusty says:

    I cannot thank you enough for posting this information. Thank you, Ingrid! Thank you Dr. Crist! After years of 5-10 “hairballs” per week, and 3 different vets telling us it was “normal”, we switched Rusty to a wet food diet based on your suggestions above. It has been over a week and he has not thrown up. Not even once. We are very excited about this and he seems to be feeling much better. Again- I cannot thank you enough. This has been life changing for all of us.

  5. Derek says:

    I have my 2 cats on a grain free diet (mix between dry and wet of same brand). My elder cat has been vomiting large hairball on a daily basis. I’ve tried every possible remedy, but with no success. I may try shaving him again to see if that helps though.

    I’m also dealing with my cats being ultra finicky, and as of late, not wanting to eat the food they’ve been on for months. It seems this happens every time I’ve switched brands. They eat it for a while and then play the whining/starving game even when a full fresh dish is put out for them.

    I’ve spent thousands of dollars this year alone on my cat, and am getting pretty upset that he’s still having issues. Any suggestions would be helpful.

  6. Sarah says:

    So my 7 yo tabby had a few hairballs from Sept – May each each but always has more during the hot summer months. We live in Texas and I’m starting to realize after stepping on two hairballs the past few days (yuck!) that I think I have more time to brush her during the school year (I’m a teacher). I just ordered a bag of Soulistic (thank you amazon prime!). I’m hoping this will really help her. I will definitely be taking her into the vet soon but I think from your posts I’ve been able to get a much better handle on the situation.

    Thanks so much for sharing your experience and knowledge!

  7. Derek says:

    I bought some probiotics made specifically for cats (on Amazon). It seems to be helping my cats. For those with sick furry ones, maybe give it a try. I also try to brush them more…less for them to consume.

    • Ingrid says:

      Probiotics are a good idea for cats in general, and since they promote a healthy gut, they can also help improve motility and prevent hairballs.

  8. Derek says:

    I should mention to those with sick puking cats…..My cat’s puking problem went from 4 times a day to practically none. The solution was regulating his thyroid via a “radio – iodine” procedure. You may want to check and see if your cat has an underactive or overactive thyroid. If so, do not keep them on medication as this is what my vet had me do and this is what will slowly kill your cat. If they have a thyroid issue, this radio-iodine treatment seems to be the only thing that will actually regulate it and keep your cat from getting more ill.

  9. Jancee says:

    Hi, I have a fluffy spayed female dilute calico 5 yrs. old. We had her shaved twice of her 5 yrs. on recommendation by another who had hairball puking cats. We moved from a warm climate where the vet recommended ID intestinal formula sold in their clinic. Kitty did pretty good on this, but still some puking. She has always been indoor! Now we live Pacific Northwest and I still feel I should have her shaved. She will allow me to brush and comb her…for a short time. She eats purina indoor formula. Shall we have her shaved? We tried to do it ourselves but seems impossible. Diet suggestions?

  10. Athena says:

    I give my crew of 7 a little of the Sentry hairball relief stuff once a week, and have very few hairballs. I feed them all dry Iams for “adult indoor weight and hairball care.” i’ve been hearing that grain-free wet food is better, and even that ANY wet food is better than even the best dry. But I can’t afford to switch right now. I feel like i’m doing them a disservice being unable to give them the best food. If I didn’t have as many, I could afford more expensive food. But they might also have grown up either in a cage in the shelter, or in a rescue with 60 others, instead of just 6 if I hadn’t taken them home. Sigh. I don’t know what to do.

    • Ingrid says:

      Feed the best quality canned food you can afford. You are absolutely right that ANY wet food is better than dry. Eliminating dry food is the best thing you can do for your cats’ health.

  11. Jessica says:

    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 says:

      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 says:

        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 says:

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

          • Jessica says:

            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 says:

            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.

  12. Miyoshi says:

    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 says:

      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.

  13. Annie says:

    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 says:

      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.

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