Regular cat vomiting episodes: Once a month for an 8-hour period


I have a 15-year old tabby who is a few pounds heavier than he should be. Back in 2008, I took him to the vet regarding lethargy, and he was diagnosed as having a heart condition. He was put on Enalapril, 1/2 pill twice a day. In July 2010, he was increased to 1 pill, twice a day, and about a month ago, decreased back to a half pill, twice a day.

In June 2010, I began taking note of the fact that he started having vomiting spells, which would last about 8 hours before he felt like eating food again. This happens once a month, consistently. He usually vomits maybe 5 times during this 8 hour period. It starts out as food being brought up (undigested), and on about the 3rd or 4th episode, he'll vomit up a pink liquid. At around the 5th or 6th hour of the 8-hour time-frame, he'll usually sleep, but if he tries to eat before the 8 hours is up, he'll vomit up the food or treats.

He's on Lasix now, one pill (12.5 mg) a day. I've tried to find a common denominator to his once a month episodes, but have found nothing concrete. He's using Scoop Away (unscented) cat litter. Once, I thought the scented variety made him sick, because he got sick a day later when I bought the scented variety. But he still gets sick, even with the 'unscented' litter. Also, I never leave any uneaten food out after 3 hours of sitting in his bowl. I've considered the carpet in the house, which hasn't been steam cleaned since 2007, but I'm not sure at all about that. I've considered the warm temperature in the house as maybe being an issue, but I can't be sure of that either.

My cat was having diarrhea problems over a month ago, and the vet put him on Metronidazole for 10 days, and he didn't get sick until about 6 weeks afterward (this past Sunday). I was out of the house for an extended number of hours this past Sunday, and when I came back, he had vomited a small pool of saliva, and shortly after that, he couldn't keep any food down. He got sick again at around 4:00 am this morning, and he was able to eat again until around noon.

Have you ever encountered this type of condition? The veterinarian doesn't seem to have an answer, and my friends with cats don't have any answers either.

Vomiting episodes in cats are very common, and once a month vomiting would typically not be reason for concern.
However, considering your cat’s age and heart condition, these episodes should be explored further by a veterinarian. Unfortunately, the list of possible causes and treatments for cat vomiting is quite long, but I would be happy to provide some basic recommendations for you.

First, I would like to point out that one of the main side effects of your cat’s medication, Enalapril, is vomiting. Is this feline heart disease medication always being given on an empty stomach? Unless you were told otherwise because of your cat’s particular condition, Enalapril should be given on an empty stomach. If there is inconsistency in his medication and feeding schedule enough so that he may be getting this medication while his stomach is not empty, the pill could certainly be contributing to the vomiting.

Similarly, although I know you have tried quite hard to determine any kind of pattern of possible triggers, have you considered how easily his medication goes down or who gives his medication immediately before the onset of the vomiting episodes? For instance, if someone other than the person who gives him his pill most of the time gives it, he may be getting a taste of the pill, causing nausea.

Since you are treating your kitty with Lasix for any breathing difficulties he may have, it should also be noted that any fluid retention in the lungs can cause vomiting as well. Even though he is on Lasix, it is possible that your kitty is still retaining some fluid in his lungs, and this possibility should be explored with your veterinarian.

Aside from the conditions your kitty has already been diagnosed with, there are many other things that should be explored with your veterinarian to find possible causes for your cat’s vomiting. If he has not had full bloodwork recently, I would strongly recommend you bring him to your veterinarian to do so. Feline hyperthyroidism can cause vomiting, and if left untreated, could make his heart condition significantly worse. Also, conditions such as cat diabetes and feline kidney disease could cause vomiting, and bloodwork would be the best way to diagnose any of these conditions.

Your kitty could also be suffering from occasional bouts of feline inflammatory bowel disease. The fact that his vomiting episodes decreased, or at least there was more time between instances, when he was on Metronidazole suggests that an inflammatory condition may be causing his vomiting spells. A longer period of Metronidazole treatment should be discussed with your veterinarian as well.

Your cat should also have a fecal examination to check for parasites. A very wise and successful veterinarian once told me that every vomiting cat should be given a general, broad-spectrum deworming, even if the fecal exam results come back negative, so discussing this option with your veterinarian would also be advised.

Hairballs could also be causing your cat’s vomiting. All cats ingest some hair while grooming themselves, and even if you aren’t seeing fur in your kitty’s vomit, he could still be becoming nauseous from hairballs. If you aren’t doing so already, you may want to consider brushing your cat with one of FURminator’s cat grooming tools. The FURminator brushes actually remove the undercoat of your cat’s fur, greatly reducing the amount of hair that your kitty ingests.

All-in-all, I would strongly recommend that you do some diagnostic testing with your veterinarian. As I said before, once monthly vomiting spells would not normally be a reason for concern, but considering your kitty’s age and health conditions, I would worry that if he wasn’t eating due to nausea and if his appetite did not return after the episode had passed, he would be at risk for dehydration. If you decide to not explore the various tests and treatments with your veterinarian, please take your kitty to a veterinarian immediately if his appetite does not return quickly or if he becomes lethargic during one of these episodes.

Wishing you all the best,
Dr. Neely

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