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.Continue Reading
Far too many cat parents accept occasional or even chronic vomiting and diarrhea as a fact of life with cats. “He just eats too fast.” “She has a sensitive stomach.” “It’s just a hairball.” The truth is that chronic vomiting and/or diarrhea can be an indicator of serious diseases of the small intestine, including inflammatory bowel disease (IBD) and intestinal lymphoma.Continue Reading
Today is National Hairball Awareness Day. The fact that someone decided it was a good idea to have a “holiday” named after hairballs is probably more of a marketing ploy to sell ineffective remedies and diets than anything else, but it’s also testament to the fact that hairballs are far too common in cats. And contrary to some of the information you may see around the web today, they are not a normal part of a cat’s digestive process.
What is a hairball?
Traditionally it has been thought that hairballs develop because of how cats groom themselves. As cats lick their fur, the tongue’s tiny barbs pull off excess hair. Inevitably, some hair gets swallowed in the process. Ideally, it passes through the body and ends up in stools, but hairballs form when hair wads up in the stomach instead.Continue Reading
Chronic diarrhea is probably one of the most frustrating conditions, both for the affected cat, and for her guardian. Diarrhea is considered chronic if symptoms persist for longer than three weeks, but any time your cat has diarrhea for more than a day or two, a visit to your veterinarian is indicated, especially if your cat is not eating or drinking water and/or is vomiting as well. Chronic vomiting and diarrhea can lead to dehydration, and, if left untreated, can become life threatening.
Common Causes of Chronic Gastrointestinal Disease in Cats
Causes for chronic intestinal disease can vary, and include
Diabetes, arthritis, kidney disease, heart disease, low immunity, even cancer – all of these diseases are ultimately caused by chronic inflammation. Inflammation is the body’s natural response to healing by bringing an increased immune response to the site of an injury or infection, but when inflammation becomes chronic, it damages the body and causes illness.Continue Reading
Hairballs are often the topic of jokes and cartoons, but there is nothing funny about a cat who gets frequent hairballs. While the occasional, isolated hairball may be nothing to worry about, there really is no such thing as “just a hairball.”
What is a hairball?
Traditionally it has been thought that hairballs develop because of how cats groom themselves. As cats lick their fur, the tongue’s tiny barbs pull off excess hair. Inevitably, some hair gets swallowed in the process. Ideally, it passes through the body and ends up in stools, but hairballs form when hair wads up in the stomach instead.
However, more recent findings show that hairballs also form because the affected cat’s intestinal motility (the movement of food content from the stomach to the intestines) is impaired, something that most commonly occurs secondary to inflammatory bowel disease, which in turn is caused in almost epidemic proportions by grain-based diets and their adverse effect on the gut flora.Continue Reading
One of the best things you can do for your cat’s health is to stop feeding dry food. Dry food is the equivalent of junk food for cats. Many of the degenerative diseases we’re seeing in cats, including diabetes, urinary tract disease, kidney disease, and inflammatory bowel disease, may be directly linked to these foods.
Cats need meat and moisture
Cats are obligate carnivores. This means they need meat to survive. They cannot get enough nutritional support from plant-based proteins such as grains and vegetables, because, unlike humans and dogs, they lack the specific enzyme that processes plant-based proteins metabolically. They need few to no carbohydrates in their diet.
Cats also need moisture in their diets. They do not have a strong thirst drive when compared to other animals, and this can lead to chronic low-level dehydration when the cat’s main diet is a dry one. Even if your cat drinks water, it won’t be enough if she only eats dry food. A cat’s natural diet (prey) contains about 75% water. Dry food only contains 7-10%. Canned food contains somewhere around 75% (depending on the brand). Even though a cat on only dry food will drink more water than a cat who is eating canned food, when you add up the water they drink and the water that occurs in their diet, water intake still falls short for the cat on dry food. Considering how common urinary tract and kidney problems are in cats, this in itself should make a convincing argument against dry food.
Meal-feeding, not free-choice feeding
Many pet owners feed dry food because it can be left out during the day without spoiling while the cat is left at home alone. This method of free choice feeding is one of the leading contributors to obesity in cats. Cats, by nature, are hunters, and it doesn’t make sense that they should need access to food 24 hours a day. Meal feeding twice a day mimics their natural hunting behavior much closer, and by feeding controlled portion sizes twice a day rather than leaving food out all day long, calorie intake, and weight can be controlled much better.
Dry food does not clean teeth
The myth that dry food helps clean cats’ teeth is one of the most persistent beliefs when it comes to pet food, and it is simply not true. Most cats don’t chew their kibble long enough, if at all, for any of the scraping action that is the theory behind this myth to kick in. What little they do chew shatters into small pieces.
Some pet food manufacturers offer a “dental diet” that is made up of larger than normal-sized kibble to encourage the chewing longer, but many cats swallow even those larger size pieces whole. Additionally, dry food leaves a carbohydrate residue in the cat’s mouth that actually encourages growth of tartar and plaque. And seriously, if it was true that dry kibble cleans teeth, wouldn’t human dentists recommend that we eat dry cereal to keep our teeth clean?
The 6 Ways to Transition Your Cat from Dry to Wet Food
Some cats will transition easily. The first time you feed them grain-free canned or raw food, they’ll start eating it right away, and I’m guessing what goes through their minds at that point is something along the lines of “finally, the humans have figured out what I’m supposed to be eating!”
Others can present more of a challenge. This is in no small part due to what pet food manufacturers do to make these dry food so enticing to cats. As part of the production process, the baked or extruded kibble is sprayed with animal digest (and yes, it’s pretty much as disgusting as it sounds: digest is material that results from chemical and/or enzymatic hydrolysis of clean and undecomposed animal tissue.) Cats love the taste of these digests; for some cats, it’s like kitty crack and actually causes them to be addicted. Some cats also love the texture of dry food and may resist the drastic change in texture from dry to grain-free canned or raw food.
1. Go slow, and be patient
The key to transitioning these hard-core dry food addicts is to go slow and be patient. And you may need a few tricks up your sleeve. For some cats, it may take several months. I’ve heard of one cat whose human would put down a small amount of canned food next to his dry food every day for several weeks. He refused to touch it, so she wound up throwing it out each time. Then one day, several weeks into the transition, he gobbled up the raw food and never touched his dry food again!
2. Stop free choice feeding
If your cat is eating only dry food, and you leave food out at all times, stop this practice immediately. This step is critical. Feed twice a day, at set meal times, and take up what the cat doesn’t eat within about half an hour. She gets no other food until the next meal time. Your cat will not try anything new if you keep his bowl filled with the old, familiar food 24/7.
Be prepared that your cat will make you feel like you’re letting him starve. This phase of the process can be much harder on the human than it is on the cat. Persistence is key. A little hunger at meal times can be a powerful motivator to get a cat to accept the new food.
3. Gradually increase the amount of canned or raw food
If your cat is already getting a small amount of canned food or raw food as a special treat, she will probably be much more receptive to being transitioned to all canned food or even raw food. All you have to do is gradually increase the amount of canned or raw food, and decrease the amount of dry food, until you’re only feeding canned or raw.
4. Add some incentives to tempt finicky eaters
Some hard-core dry food addicts can be convinced to try canned or raw food by sprinkling freeze-dried chicken or salmon on top of the food. A little bit of tuna or clam juice drizzled over the canned or raw food can also help. Other “bribes” can include cooked meat, cut in small pieces, a spoonful of meat-based baby food (make sure it doesn’t contain onion powder), or, as a last resort, a small amount of crushed kibble.
5. Never let your cat go without food for more than 24 hours
Be patient and persistent during the transition period, but never let your cat go without eating for more than 24 hours. Allowing a cat to go without food, especially one who is overweight, can result in a life-threatening condition called hepatic lipidosis.
6. Minimize intestinal upset
Most people recommend transitioning to a new food gradually, by reducing the amount of the old food and increasing the amount of the new food over a number of days to avoid upset stomach and soft stools. I’ve found that when transitioning to grain-free food, this is usually not an issue.
I do recommend adding a good probiotic every day. I actually recommend this not just during the transition period, but as a lifelong immune system booster. Probiotics come in unflavored powders and can be mixed in with the food. I use Dr. Goodpet’s Feline Digestive Enzymes, a mix of enzymes and probiotics.
Cat parents who have weaned their cats off of dry food are usually amazed at the difference. Overweight cats who have been unable to lose weight are starting to lose fat and build muscle. Haircoats look sleeker and shinier. Stools decrease in volume and smell. And most importantly, cats are healthier.
Far too many cat parents accept occasional, or even chronic, vomiting and diarrhea as a fact of life with cats. Cats just do that sometimes, don’t they? Well, no. Healthy cats don’t vomit on a regular basis, nor do they have diarrhea. Chronic vomiting and diarrhea can lead to dehydration, and, if left untreated, can become life threatening.
The most common cause of gastrointestinal problems for cats is Inflammatory Bowel Disease. Although cats of all ages can be affected, it is typically seen in middle-aged or older cats. The term IBD is used for a number of chronic gastrointestinal disorders. Physiologically, it is characterized by an infiltration of inflammatory cells into the lining of the digestive tract. The location of the inflammation can help determine the specific type of IBD.
Symptoms of IBD
Symptoms most typically include chronic vomiting and diarrhea, but sometimes, constipation can also be a problem. Some cats present with weight loss as the only clinical sign.
Diagnosis of IBD
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 IBD is through biopsies of small samples of the intestinal lining. These samples can be obtained through endoscopy or abdominal surgery. These procedures require general anesthesia.
IBD 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. However, steroid therapy carries serious longterm side-effects.
The Diet Connection
There are commercially manufactured diets available for the treatment of IBD, most of them containing so-called “novel proteins,” ie., proteins that the cat may not have been exposed to before such as rabbit, venison, and duck. (We used to call them the “Disney diets” when I still worked at a veterinary clinic – Thumper, Bambi and Donald…).
However, 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.
Vomiting and diarrhea are not something you, and your cat, should learn to live with. Take your cat to a veterinarian for a thorough physical exam. After ruling out other conditions or diseases as causes, the solution might just be something as simple as changing your cat’s diet.
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.
Dr. Slack graduated from the College of Veterinary Medicine at the University of Georgia, and has been working exclusively with cats since 1993. She is the owner of Uniquely Cats Veterinary Center in Boulder, CO.