Page 643 - Problem-Based Feline Medicine

30 – THE CAT WITH SIGNS OF ACUTE VOMITING 635

extra-intestinal tract diseases (such as hepatitis, renal Food intolerance is usually a cause of chronic, inter-
failure or pancreatitis, dietary indiscretion), and mittent vomiting, but kittens may present acutely with
inflammatory diseases (e.g. IBD). diarrhea when they are first introduced to new foods.
Diarrhea may result when a rapid change in food over-
Many cats vomit intermittently, and these episodes
whelms the digestive capacity. Changes in food com-
are attributed to trichobezoars (hairballs). However,
position require changes in digestive enzymes.
some of these cats may be vomiting due to dietary
indiscretion or food intolerance, gastric parasites, Ingesting a foreign substance (dietary indiscretion)
motility disturbances, pancreatitis or other acute such as lizards, beetles, moths or plants may cause
inflammatory disorders. acute vomiting. Over-eating or eating too quickly is
poorly documented as a cause of vomiting in cats.
Acute, persistent vomiting episodes that occur along
with other clinical signs such as lethargy, anorexia or
diarrhea, usually signal a more serious problem that
Clinical signs
should be investigated more thoroughly. Examples of
problems fitting this category include intussusception, Intermittent but persistent vomiting or mucoid, soft
erosions/ulcers, acute renal failure, neoplasia or inflam- feces are common signs. Poor hair coat or failure to
matory bowel disease. thrive may also be noted but this is less common.

DISEASES CAUSING SIGNS OF ACUTE Diagnosis
VOMITING There is no definitive diagnostic test for this problem
other than to observe a response to changing the diet.
FOOD INTOLERANCE OR DIETARY
INDISCRETION**
Differential diagnosis
Classical signs Intermittent but unrelenting vomiting in an otherwise
● Intermittent vomiting. healthy cat suggests possible motility disturbances,
● Large bowel diarrhea or soft, mucoid feces. antral pyloric hypertrophy, gastric parasites or early
IBD.

Pathogenesis
Treatment
Food intolerance is a non-immunologic, adverse reac-
Changing the diet to a diet that does not contain the
tion to a substance(s) present in food. This reaction
offending substance. This may be as simple as chang-
may be to a food component such as the type of protein
ing from a grocery store brand to a premium brand food
or carbohydrate, or it may be to the colorings, preserv-
(or vice versa), but also may require changing to a
atives, flavorings, etc. that are present in pet foods.
hypoallergenic food product (IVD’s Limited diets,
Natural chemicals in foods such as amines, salicylates
Hill’s d/d, Eukanuba Response formula, Waltham,
and monosodium glutamate may stimulate nerve end-
etc.). Kittens often respond to being fed exactly the
ings and have also been associated with food intoler-
same food as a sole diet for at least 3 days.
ance. Highly flavored or “rich” food has more of these
chemicals. Cats may be sensitive to more than one
food. Signs may require a “binge” or several days of Prognosis
exposure before they are evident.
Good if the appropriate food can be found, which is
The actual mechanism associated with vomiting or usually not a difficult problem. However, the cat may
diarrhea due to food intolerance is unknown. have to remain on the diet indefinitely.