Pistachio Shells

by Mila

My 2.5 yr old female cat ate a handful of pistachio shells back in October. She began to vomit up the shells, so I rushed her to my work (I work at a pet hospital). We did radiographs and IV fluids. The x-rays showed a few shells in her intestinal tract, but no blockage. The Dr. said she'd be fine. Since then, she has thrown up a few shells. The last time she vomited was today, and there were 3 shells in the vomit. She's eating and passing stool. Any suggestions?

Dear Mila,

Thank you for writing in about your kitty. I'm sorry to hear that you have had all of this worry for the last few months.

It sounds as though the shells are too large to be passed through the intestinal tract and not easily digested within her stomach. I believe you have two options going forward for dealing with the remaining shells:

The first approach is the conservative one. As long as she's eating and acting okay and continues to pass stool regularly, you could allow her to continue to vomit up the shells. There is a possible risk that, due to the sharp nature of the shells, she may damage her esophagus when vomiting. If you choose to allow her to continue to vomit the shells, please watch carefully for any signs of blood in the vomit.

The second approach is more aggressive. An exploratory surgery to remove any remaining shells would have the benefit of preventing any internal abrasions in the stomach or intestines or the risk of tears in the esophagus. Additionally, surgery will provide an immediate solution to the problem and make her more comfortable.

If her appetite, behavior, or litter box habits change, if there is evidence of blood in her stool or vomit, or if she begins to vomit more frequently, surgery should be done to remove the shells immediately.

Regardless of which route you choose to take, I would recommend repeating the x-rays to be aware of the number of pistachio shells remaining and their location in her system. Additionally, if you choose the more conservative approach, periodic x-rays to monitor these factors should be done.

Best wishes,
Dr. Neely

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