Caitlin UltimoHealth / Symptoms & Solutions

Vomiting in Senior Cats

Just as with humans, aging brings about some less-than-desirable changes in the way a senior cat’s body works. It also ushers in certain diseases that are not seen in young cats. Vomiting can be symptoms of these diseases.

Chronic Small Intestinal Disease

The most common cause of vomiting in older cats (cats 11 years old and up) is chronic small intestinal disease. This disease is due to two primary causes:

  1. Chronic inflammation, most often due to Inflammatory Bowel Disease (IBD)
  2. Cancer, most often due to lymphoma

Both result in vomiting anywhere from twice per month to even daily. After several months to years, most cats experience weight loss. Although often attributed to aging, weight loss occurs because the intestinal wall loses its ability to absorb the digested nutrients from the cat’s food. An interesting result of this form of weight loss is an increase in appetite. My clients often tell me their cats have “really good appetites.”

Because chronic vomiting is so common in adult and older cats, we, meaning cat owners and veterinarians, have largely accepted chronic vomiting as a strange form of “normal.” We accept it with the excuse, “My cat is just a puker,” as one of my clients told me one day. We don’t try to understand it or stop the vomiting because it is just going to happen.

Other excuses include:

  1. My cat eats too fast.
  2. My cat has a sensitive stomach.
  3. My cat throws up hair or hairballs and “that is really normal.”

The reality is that none of these excuses do anything more than cause us to accept chronic vomiting and/or spend many dollars trying to fix the problem with special diets (hairballs, sensitive stomach) and hairball remedies. In addition, we often get creative in ways to slow the eating process by putting large marbles or smooth stones into the cat bowl.

So, what should you do if your cat is “just a puker?”

Have your veterinarian examine your cat and be honest about the frequency of vomiting. Don’t tell your veterinarian that your cat vomits “occasionally” or “pretty often.” Keep a log for a month or two, and tell your vet exactly how many times your cat vomited. Tell your vet you want some answers, and, if needed, refer him or her to a study on the subject that I helped author 1. There is mounting evidence that IBD may transform to lymphoma in some cats. Ignoring the problem will not make it go away, and it might allow it to get worse.

Hyperthyroidism and Your Cat

Hyperthyroidism is a senior cat disease that may result in chronic vomiting. It’s caused by a tumor in the thyroid gland, which is the body’s metabolism regulator. The tumor makes too much thyroid hormone so metabolism speeds up greatly. This results in weight loss as well as a cascade of other symptoms, because thyroid hormone affects literally nearly every organ in the body. The heart races, the blood pressure spikes, and the muscles in the intestinal wall become overactive. They send food traversing down the intestinal tract too rapidly, causing diarrhea. They also cause some reverse food movements that cause vomiting.

Your veterinarian can diagnose this disease rather easily. In the vast majority of cats, he or she can run a blood test called a total T4 that checks for the level of thyroid hormone. In some cats, other tests are needed for confirmation.

Treatment is very successful because we have four good options: diet, oral medication, surgery and radioactive iodine treatment. The first two will control the disease, but long-term treatment is necessary. In most cases, the last two can cure it. After your vet examines your cat and performs some blood tests, he or she can advise you as to the best options for your cat.

We expect these older cats to gain their weight back, have a normal heart rate and blood pressure, and enjoy life again. It’s always very rewarding for veterinarians to see the spring return to the cat’s step and the smile to return to your face.

Kidney Failure in Older Cats

Vomiting can be a part of kidney failure. After working 24/7 for 12-plus years, the kidneys begin to wear out. For most cats that live 15 years or more, kidney failure writes the last chapter in the cat’s medical history.

The kidney’s job is not to make urine; it is to get rid of waste products that are in the blood. When the waste products exceed the high end of the accepted normal range, we say the cat is in “kidney failure.”

To measure kidney function, we often look at two waste products in the blood: creatinine and the blood urea nitrogen. When they become elevated, the cat has lost about 75 percent of kidney function. That is the bad news. The good news is that cats are not small dogs. When dogs lose 75 percent of kidney function, we use the term “kidney failure.” These poor creatures are in real trouble and usually do not live more than a few months. However, cats are tougher than dogs. They can live quite well when the kidney values are mildly elevated.

The key is to find the cat in kidney insufficiency, so measures can be taken to prolong kidney function. Kidney insufficiency is a stage of life in which normal kidney function has passed but in which kidney failure does not exist. The cat’s annual physical examination should include blood tests for kidney function (and thyroid function).

There are several measures taken to help the cat in kidney insufficiency. A special diet, often called a kidney diet, is fed. Traditional kidney diets have restricted protein levels to reduce workload on the kidneys. However, the winds of change are blowing and suggesting the raising protein levels may be better. This debate will continue for a few years among feline specialists and academicians, so stay tuned. There are several drugs that can also prolong kidney function, including some to keep the electrolytes potassium and phosphorus at their optimum levels. After examining your cat and seeing her lab tests, your veterinarian can tailor a treatment program to give your cat many extra years of quality life.

Other Causes

Less likely causes of vomiting in senior cats include foreign objects, parasites and viruses. Sometimes cats swallow objects or plants and then throw them up. While common in young cats, senior cats are generally well past the curious stage in their lives, so this is quite uncommon. Worms and infections that cause vomiting are rare in senior cats so we do not list them as common causes. Reference 1. Norsworthy GD, Estep JS, Kiupel M, Olson JC, Gassler LN. Diagnosis of chronic small bowel disease in cats: 100 cases (2008–2012). 2013;243(10):1455-1461.


By: Dr. Gary D. Norsworthy

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