This is one of the most common concerns that owners of cats bring to me. It’s such a common problem that Merriam-Webster’s Collegiate Thesaurus lists “cat” as a synonym for vomit – honest!

I wish that there was an easy answer for every cat that presents with the problem of intermittent vomiting, but like most problems, including medical ones, there is rarely an easy answer for a complex issue. Many people start with the assumption that the problem is simply hairballs, and hairballs can cause problems, including intestinal obstruction in some cases. In case you missed it, April 29 was National Hairball Awareness Day – honest! If you need planning details for next year’s event as well as scads of other cat tips visit www.cattipper.com.

Hairballs are caused by excessive shedding, which a cat then ingests as they groom themselves. The hair can then cause irritation of the stomach and GI tract resulting in vomiting. The most effective way to help reduce the problem is to comb your cat on a daily basis. Most cats learn to enjoy the sensation. I recommend a metal flea comb, which gets down to the skin and does a good job of removing dead hair and stimulating the skin, but there are a number of commercial products on the market as well. Another thing to consider is adding fish oil or other oils high in omega 3 and 6 fatty acids to help improve your cat’s hair coat. These fatty acids are also heart healthy and promote normal joint health as well so they are a great nutritional supplement to consider in any cat. There are a number of hairball diets and over-the-counter hairball remedies that can be used, but usually grooming and fatty acid supplementation are all that is necessary. If not, then the vomiting may be related to another issue.

Once people get beyond hairballs they almost always think next of food allergies or food sensitivities and so begin switching foods in an effort to find something that will keep their cat from vomiting. Food allergy is a problem in cats. The most common ingredients that cats can become allergic to are beef, chicken, fish, eggs and milk.

The common symptoms of cats with food allergies are related to the skin (ear infections, severe itching with scabs and secondary infections). Vomiting is NOT a common symptom of food allergy. The only way to determine if your cat has a food allergy is to do a food trial for 8 to 12 weeks using a hypoallergenic diet that contains ingredients which your cat has never been exposed to. The bad news is that after you spend the time and effort to find out what your cat is allergic to they can go on and develop new food allergies over time.

After considering hairballs and food allergy we are left with the many medical conditions for which vomiting IS a common symptom. One condition that has been linked to chronic intermittent vomiting is obesity. Some of these cats are food obsessive and eat their food so quickly that they regurgitate it fairly undigested. One strategy to help these cats is to either feed them small amounts at regular intervals or to place some large, smooth, clean rocks in their food bowl so they have to slow down and pick their food out to eat it.

As we continue up the ladder of complexity other medical conditions that need to be considered include liver and kidney disease, cancers of the stomach and GI tract as well as a number of autoimmune-like problems such as inflammatory bowel disease (IBD), lymphocytic-plasmacytic enteritis, and eosinophilic gastroenteritis. Often these medical conditions are also accompanied by weight loss in addition to the vomiting. Once you start considering these conditions your cat will need to undergo some diagnostic testing to help to get to an accurate diagnosis.

Vomiting in cats is a common problem. Finding the reason why your cat is vomiting is not always easy and I would recommend enlisting the help of your cat’s veterinarian to help find out the cause.

Dr. Kiel is the U.S. Army veterinarian currently supporting NAS Whidbey Island and Naval Station Everett. His columns appear the first and third Friday of each month. Please send questions or comments to Dr. Kiel at joseph.kiel@navy.mil.