Vomiting in cats is not normal. Far too many cat parents rationalize occasional, or even chronic, vomiting with explanations such as “he just eats too fast,” “she has a sensitive stomach,” or “it’s just a hairball.” Chronic vomiting can be an indicator of serious diseases of the small intestine, including inflammatory bowel disease and intestinal lymphoma.

Study of 300 cats with chronic vomiting

Dr. Gary Norsworthy, a feline veterinarian and owner of the Alamo Feline Health Center in San Antonio, TX, conducted a study on 300 cats who showed one or more of the following clinical signs:

  • vomiting 3 times or more a month for at least 3 months
  • diarrhea for 3 weeks or more
  • weight loss of 1 pound or more within six weeks
  • ultrasonographic evidence of small intestinal thickening

53% of the cats were male, 47% female. Median age of the cats in the study was 11  years.

Out of the 300 cats, 288 (96%) had abnormalities where 150 (50%) had chronic enteritis, 124 (41%) lymphoma, 11(4%) non-lymphoid neoplasia and 3 had other conditions. The remaining 12 (4%) were normal.” The results of the study were published  in the Journal of the American Veterinary Medical Association.

These findings are staggering and make it abundantly clear that cat parents and veterinarians must stop diminishing the seriousness of chronic vomiting and/or diarrhea.

Proper diagnosis is critical

To rule out other causes of gastrointestinal problems, your veterinarian will perform diagnostic tests that may include complete blood cell counts, blood chemistry, thyroid function tests, urinalysis, fecal analysis, abdominal x-rays, and ultrasound.  The most definitive way to diagnose inflammatory bowel disease or intestinal lymphoma is through biopsies of small samples of the intestinal lining.  Unfortunately, many veterinarians will use endoscopy to obtain these biopsies, which, while less invasive than surgical biopsy, will not always reach the abnormal sections of the intestine. Dr. Norsworthy found that the only way to definitively distinguish between inflammatory bowel disease and intestinal cancer was by obtaining full thickness biopsies surgically.

Intestinal disease is very treatable

Inflammatory bowel disease is usually treated with a combination of medical and dietary therapy.  Corticosteroids are used for their anti-inflammatory and immunosuppressant properties, and they can also serve as an appetite stimulant.  Unfortunately, steroid therapy carries potentially serious longterm side-effects.

There is mounting evidence that treating the disease in its early stages will likely prevent a progression to lymphoma. The most common form of intestinal lymphoma, small cell lymphoma, is also very treatable.

It should be noted that dietary treatment may work for some cat with frequent vomiting and/or diarrhea if the symptoms are caused by food allergies or insensitivities. Increasingly, holistically oriented veterinarians are seeing a connection between diet and IBD.  These vets believe that commercial pet foods, especially dry foods, are a contributing factor to the large numbers of cats with chronic IBD.  They also discovered that many cats improve by simply changing their diets to a balanced grain-free raw meat diet.  Similar results may be achieved with a grain-free canned diet, but a raw diet seems to lead to quicker and better results.

Don’t ignore chronic vomiting or hairballs

Cat parents need to realize that hairballs are not normal. Yes, cats will vomit up the occasional hairball, but “normal” is an occasional hairball. Anything more than that could be cause for concern.

This article was first published March 19, 2014 and has been updated.

Photo by Lindsey Turner, Flickr Creatide Commons

New Dr. Goodpet banner

37 Comments on Chronic Vomiting In Cats Is Not Normal

  1. Hello, I very much appreciate the information provided and frequently reference the IBD biopsies article to clients and colleagues to bring light to the “Vomiting in cats” discussion. I have always been a vet that hopes all cat owners and vets stop considering vomiting as “normal” for cats. I would just disagree with the raw food aspect of the article as someone who has worked in a holistic clinic with a lot of cats on raw food diets, most of whom continued to vomit frequently because they were either not yet on the right protein and/or not on steroids (yet). I have also seen several of them get sick while on the raw diets and always have to worry about the concern with secondary bacterial infections with an already compromised immune system. I continue to stay up to date on nutritionist research that over and over again does not support any health benefits to feeding a raw vs a balanced, cooked diet. I really hope that more limited ingredient, canned food & vet-researched fresh-made limited ingredient options like Just food for dogs become available for our deserving cat patients.

  2. Ingrid, I was disappointed to see that, although this article was updated March 2, 2020, it still has a glaring error which should be corrected as soon as possible.
    The paragraph at fault: “Out of the 300 cats, only one had normal test results. 49 had chronic inflammation in the small intesting [sic], and 50 had some form of cancer in the small intestine. 46 of the cancer group had lymphoma.”
    Obviously that adds up to only 100 cats.
    For the 300-cat study: “Overall, 288 (96%) had abnormalities where 150 (50%) had chronic enteritis, 124 (41%) lymphoma, 11(4%) non-lymphoid neoplasia and 3 had other conditions. The remaining 12 (4%) were normal.”
    Still, an alarming finding. My quotation is from the Veterinary Specialty Center website because I have access only to the abstract of the Norsworthy et al paper, in which the breakdown was not so detailed.

  3. Omg, Going through this right now with my 8-10yr old Blu. He started out sneezing everywhere like it was allergies n now he is vomiting before he even eats. Took him to vet n had X-rays n Ultra sound n they think it is IBD but cannot tell for sure without doing a biopsy. We have him on a can allergy food which I am not fond with the brand-Royal Canin Selected protein diet. He was already on wet n dry food. took him off the dry completely. He is also on Prilosec-1/4 tab twice a day. Also, I have a indoor-outdoor cat that started sneezing n hacking n then my old Vera started it too n stop eating. Too k both of them to the vet n they gave them Convenia antibiotic shot for Respiratory infection. Vera is back eating thankfully for hse has renal disease. Blu started back eating in the even but he vomit 3 times this AM before having breakfast so he didn’t eat until later. Ug. I may have to take him back to put him on prednisone temporarily. He has lost weight too. Ug!! The vet bill is getting expensive too.

  4. Don’t ever let someone tell you vomiting is normal! Our cat was vomiting immediately after eating, still showing signs of hunger, still playing and acting normal but couldn’t keep her food down. A friend of ours who is a vet tech told us “vomiting is normal in cats” I disagreed. She wasn’t coughing up a hairball (she rarely does that anyway), she was projectile vomiting everything she consumed except water. We took her to our vet who did some exams. By the grace of God we caught that she has kidney failure. I was told it’s rare to discover that in a 4 yr old cat, that normally it doesn’t happen until they are 7 or 8 and their kidneys are in much worse condition. We discovered the vomiting was gastritis, and some anti-nausea meds allowed her gi tract to calm down so she could eat normally within a few doses. Had we listened to those who say “vomiting is normal” we wouldn’t have caught the kidney failure. Her life expectancy is greater because we were able to catch it early.

    • Just found this article since the vet thinks my 12 YO girl may have IBD.

      He put her on an appetite stimulant when she stopped eating … then she finally had a dental cleaning (after delaying while we dealt with her hypercalcemia) and he had to pull 3 teeth (no wonder she didn’t want to eat!) Now I’m giving her B12 shots once a week for IBD.

      I tried stopping the dry food before (she gets half wet, half dry) but now with teeth pulled I’m stopping dry food. She wouldn’t eat raw before, but wonder if she will now if her teeth aren’t hurting.

      I also found this stuff online and wondered if anyone’s tried it?

      Also considering a holistic vet who may be more knowlegeable than my regular vet on food suggestions and possible allergy testing.

      Sorry for blathering on … thanks for any feedback!

      • Stopping the dry food completely should make a difference, Carol. Raw may be a good option for her. I’m not familiar with the Vitality Science product. A holistic vet may be your best next step, as he/she can also advise yon on supplements, diet, etc.

    • I am so glad to finally come across your post. I have been searching for something that describes what my cat does. In about the last year she has started this frequent vomiting and yes most recently it is literally “projectile” in some instances. It also seems that no matter how or what I feed her she is constantly hungry. Also I have two other cats and one is longhaired and my vomiting one is constantly cleaning her and also the brother cat (he is shorthaired). I am figuring because of this behavior she hacks up hairballs more frequently than she should. It does not seem to matter how fast or slowly she eats she often has no more than finished her food before she vomits. I started feeding her moist food because it seems like if/when she eats the dry (and it is the sensitive systems kind) she really throws it up fast. I just had her to the vet about 2 weeks ago and she had lost a pound since I last had her there and that has been about 6 months ago. She is 7 and has always been small but she now only weighs about 10 pounds. Like your cat she still is playful and and shows no other signs of distress. I am thinking on starting to give her a probiotic to see if that helps before we go back to the vet. If you or anyone else can think of anything else I should be watching for I’d appreciate an email. Thanks so much for your post

  5. What a great post! The information provided is informative. I have two cats, ages 5 and 7. The younger one, Max has IBD. We changed both of their diets from kibble to raw a month ago and they love it. Great results, however, last week we changed brands and type of raw food: duck to rabbit and Max has started throwing up again. The ingredient in the new food seems to have lots of vegetables; organic seeds, celery, quinoa, kelp, cilantro, squash….wonder if this is the problem?

    • I think it’s quite possible that all the veggies in the new food are causing a flare up of Max’s IBD. I’d go with a brand that doesn’t use veggies. Darwin’s and Radcat are two great ones.

  6. Our cat has been vomiting daily, up to 5 times a day, for about 2 years, it started about 5 years ago and has gotten increasingly worse. We go to a holistic vet after being dismissed by the other idiot vets who didn’t care at all and have tried more remedies than I can remember. We didn’t want to go straight to drugs so have been trying so many things, but she’s on prednisone now, which I hate, but it’s suppressing it as long as she gets it every day. She still vomits even with it sometimes. She eats a dehydrated raw organic food, the closest we can get her to raw because she won’t touch actual meat. She is perfectly healthy otherwise and is skinny but she always has been. She had an ultrasound that found she has intenstinal inflammation but nothing else. It’s totally impossible to live with her in the house with that much vomit. She has covered every piece of furniture and sometimes projectile vomited on carpets and hard floors multiple times a day. It’s the most frustrating thing in the world and I can’t understand why nothing has worked. I’m trying cannabis oil and colloidal silver now, hoping against hope that something will finally click. I’m terrified she’s going to develop cancer if she hasn’t already. My vet is sure it’s from over vaccination, which I believe after looking into the research, and it makes me angry that so many vets are just pushing drugs and vaccinations that are harmful and not needed. I Was fooled by them for years and didn’t know these things unfortunately.

    • What a frustrating situation, Sarah. It sounds like the only thing you haven’t done is full thickness biopsies, which would give you a definitive diagnosis.

    • Sarah, please let me know how all this works out. My cat just started doing this at age 11 years. He is an in and out cat but about 1-2x a month I find a pile of hair and bile in the morning. He’s been on raw for about three years now which saved his life from a urinary/bladder problem. Probiotics has been recommended which I have not tried yet. Did you try that?
      I hate to hear predisone. It causes so many other problems and what I think led to the death o our dog years ago. Another story.

      I know this is so frustrating.

      • I’ve been giving her probiotics and yogurt for awhile, she’s on those and enzymes regularly. She’s developed a chronic yeast infection in her ears now, probably because of the prednisone. I’m going to bring her in again soon, but she has had dozens of appointments and the vet just doesn’t know what it is. She’s also getting cannabis oil twice a day again, I’m hoping that can make something happen.

        • I started him on probiotics about three weeks ago. Ladt week found he pooped on carpet. Part solid, part liquid.

  7. I am confused. You say take the cat to the vet. Yet the vets all say vomiting is normal. IT.IS.NOT. NORMAL for my cat. He started this at 10 years old. He vomits up bile and hair about 1-2 times a month. I do not want to give him the vaseline the Dr gave me or start him on prescriptions this and that which come with their own risks. Any healthy treatments for this? If he does have IBD or cancer what could I do anyway? I do not have him on a probiotic but will start that.

    Thanks, appreciate these comments

    • It sounds like you need to find a new vet, Karen. Your cat may need additional diagnostics to determine why he’s vomiting so frequently. If he has IBD or lymphoma, he’ll need treatment. There are plenty of treatment options for either of these two diseases, and yes, all treatments come risks, but they also come with benefits. I urge you to find a vet who will take this seriously.

      • Thank you for your quick response. And this site. It is most valuable. Yes, I do need to find a different vet. My favorite one retired and the one at the clinic who replaced her is terrible. I took him in because I was concerned about the vomiting, paid a lot of money for nothing. So here, I am hearing that this late onset of vomit could be IBD or cancer. If it is IBD would the probiotics help? If it is cancer what can be done? Other wise he looks and acts fine. His coat is good, he is playful and active. Thanks

  8. 3 years ago I switched my cat to a home made raw diet food. I found the recipe online to help with his urinary crystals. This solved the crystal problem, but the past few months he has been vomiting up hairballs at least 2x a week. I thought this was normal until reading your article. I am wondering if you think this could be due to being on the same raw food diet for 3 years. I did switch him from a chicken to a quail diet for a little while, which he did okay on. Still he was vomiting as much as when on his chicken. I am hesitant to put any fish or red meat in his diet bc of what I’ve read about fish and his bad reaction (projectile vomiting) to beef. Is there something else I should be feeding to mix up the protein? Or put in his diet? I am going to take him in to the vet for the vomiting, but I am wondering what other changes I can make to his raw diet that might help him? What are some things that he should have in his raw diet to help with IBD that I might be missing? I really like my vet, but she is not a raw diet fan, so any advice would be very much appreciated!! If it turns out he has IBD, I would like to avoid putting him on a IBD commercial diet if possible. I would appreciate any advice/help. Thanks! Sara

    • I doubt that the raw diet is causing the hairballs. I think you need to take him to your vet to pursue diagnostics to see what might be going on. And I’m with you on avoiding prescription diets, even if it turns out that he has IBD. I would recommend working with a holistic veterinarian who is well-versed in nutrition, including raw diets. Some do remote consultations if you can’t find anyone in your area.

      One thing that I recommend for all cats is giving a good probiotic every day. It’s a great immune system booster, and it promotes gut health in general. I like the Dr. Goodpet brand, which is a combination of probiotics and digestive enzymes, but there are other good ones out there.

      • Ingrid, thanks so much for your advice! I will try the probiotic and see if that helps. I have found a couple of holistic vets, but I’m going to call to see if they are experienced with nutrition, especially raw diets.

        Thank you again!

    • Sra
      I am here for the same reason. Put my cat on a raw for the crystals ( bloody urine and spraying) Diet fixed that but instead he poops and or leaves a hairball on the carpet about once a month or so. He is an in and out at so I do not know how often he throws up hairballs outside. The vet was useless. She wormed him even though he has no worms and gave me petroleum jelly that is loaded with carbs. Let me know what you find out about your cat.

  9. This article is confusing. The article was about chronic vomiting, but the study included cats with chronic vomiting and/or diarrhea and/or weight loss. I don’t see how you can conclude much from that population.

    Need to see a study on cats with only one symptom – vomiting – so we can say something about vomiting.

  10. Not happy about this post. For all the years I’ve lived with kitties in my home, they have all vomited on occasion, some more than others. I thought it was natural to have to clean puke when cats were around. My Zoe goes through periods of vomiting bile or regurgitating food maybe every few months for a day or so. Now I will have to take her to the vet next time this happens? She’s 15 and hates the car and going to the vet, although I do take her once a year for her check up and NYS mandatory rabies shot. I don’t know if the stress she will go through is worth it. It will be a tough decision. 🙁

  11. Thanks for this post. I was always told it was normal too with the hairballs. They are learning so many things now.

  12. Excellent article. We have a cat who is “sensitive stomach” and she has been on a suitable – dried – diet for many years; it seems to suit her – and from her own choice she eats nothing but that, although it’s not essential according to the vet. Despite the somewhat worrying “throwing up” a lot of the time when she was a very young cat, she has appeared to be a healthy and fit cat for all of her 14 years and remains so…. and each time she goes to the vet (which isn’t often!) he comments on her wonderful teeth and beautiful coat.

    For Ella a suitable diet seems to work – but it shows doesn’t it we should never get complacent about our cats.

    • I don’t recommend feeding dry food to cats, especially not cats with IBD, but since it’s clearly working for Ella, I’d say stick with it, Margaret!

  13. Great post! I have a cat with IBD. Thankfully he doesn’t get sick too often. I have to be careful with how much food he eats at a time and if he is moving his bowels like he should.

  14. Over his 15-year life span, no fewer than four different vets told me that Mischa’s chronic vomiting was “normal for cats” or “nothing to worry about, he has a sensitive stomach.” While he had a good long life, it ended suddenly when he developed hepatic lipidosis. Through the research I did, I am convinced that he had some form of IBD.

    I am so happy to see you putting this information out there. Even though I have had cats since childhood, until Mischa’s illness, I was entirely unfamiliar with feline IBD. Thank you for helping to educate others about this! It seems that most vets are equally ignorant and cat guardians have to take it upon themselves to become educated.

    • I think the findings of Dr. Norsworthy’s study came as a surprise to many vets, and will go a long way toward the veterinary profession taking a different view of vomiting in cats.

Leave a Reply

Your email address will not be published.