Page 639 - Problem-Based Feline Medicine

30 – THE CAT WITH SIGNS OF ACUTE VOMITING 631

MECHANICAL
● Gastrointestinal foreign bodies (obstruction)** (p 636)
Acute onset of vomiting that may be projectile if the obstruction is at the pylorus. Vomiting may
be intermittent if object is not causing a complete obstruction. Linear foreign bodies (e.g. string)
may be evident wrapped around the base of the tongue.
● Intussusception* (p 643)
Acute onset of vomiting, anorexia and lethargy and occurs more often in kittens. The obstruction
may be palpated in some cats.
● Motility disturbances (ileus, gastroesophageal reflux)* (p 647)
Vomiting is not associated with eating and usually is bile stained due to presence of duodenal
content.

● Antral pyloric hypertrophy/stenosis (p 660)
Vomiting of partially or completely digested food usually several hours after eating, and may be
projectile in nature. Siamese cats may be predisposed. Vomiting may appear to be acute in onset in
the congenital form, as the vomiting occurs when the kitten begins to eat solid food.
METABOLIC
● Hepatopathies (hepatic lipidosis, cholangitis, drug-induced hepatopathy)** (p 638)
Anorexia, lethargy and vomiting are persistent. Cat may or may not be icteric.
● Diabetes mellitus* (p 643)
Acute onset of vomiting, lethargy, anorexia associated with uncontrolled diabetes mellitus. Cats
are usually older, in poor body condition and may be severely dehydrated or in shock if owner
does not recognize the condition until late.
● Acute renal failure/pyelonephritis* (p 645)
Acute renal failure is associated with an acute onset of vomiting and depression (may be primary,
e.g. ischemic, hypovolemic, or secondary, e.g. post renal obstruction). Other signs include tachyp-
nea, oliguria or anuria, hypothermia. Pyelonephritis causes intermittent vomiting, pain over the
sublumbar region, decreased appetite, occasionally fever and polyuria.
● Hypercalcemia (p 652)
There are many causes of hypercalcemia, but the clinical signs most commonly seen are anorexia,
vomiting, weight loss and lethargy or weakness.
NEOPLASTIC

● Gastric or small intestinal neoplasia* (p 641)
The most common tumor of the feline digestive system is alimentary lymphoma. Other tumors that
occur in the stomach and small intestine are adenocarcinomas (second), and mast cell tumors
(third), with fibrosarcomas, leiomyosarcomas and carcinoids occurring rarely. The primary site of
gastric tumors is the pylorus. With the exception of lymphoma, which can occur at any age, most
tumors occur in old cats. The clinical signs most often observed are anorexia, weight loss and vom-
iting, which may occur as acute vomiting when the tumor causes a GI obstruction.
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