Fur Balls

Fur balls are a common complaint among cat owners. If you have ever known a long haired cat, you have probably had the unfortunate experience of cleaning up after fur balls. For many owners they are considered a normal part of owning a cat. As Veterinarians we view them as bit differently. For us any fur ball is still a vomit and any cat that is vomiting (fur balls, food or anything else) is a concern. It is true that, as can happen in humans and other species, there may be one off, or infrequent vomits that do not always raise the alarm bells. Defining infrequent can be tricky, but we often consider any vomiting that happens more often than twice a month to be abnormal and concerning.

There are many causes of vomiting in cats. Cats that tend to eat grass or other hard to-digest plants may frequently vomit. Restricting them from access to grass may solve the problem. However often the vomiting can be due to a more serious underlying disease which needs to be diagnosed in order to treat it specifically.

Chronic Vomiting

Cats who vomit semi-frequently, over long periods of time, but are otherwise well are often called chronic vomiters. There any many causes of chronic vomiting, the most commonly diagnosed include:

• Hyperthyroidism
• Dietary intolerance and dietary hypersensitivity (These cats will generally respond to a strict hypoallergenic or elimination diet.)
• Inflammatory bowel disease
• Chronic gastritis
• Gastric and intestinal obstructions
• Gastric and intestinal cancer (lymphoma, adenocarcinoma, mast cell tumours)
• Intestinal polyps
• Fur balls – Although it is thought that cats who suffer from severe fur balls are likely to have an underlying intestinal disorder that affects the motility of the gut
• Parasites such as intestinal worms (This is a very uncommon cause of vomiting in adult cats.)

Acute Vomiting

In other cases, cats may suddenly start to have frequent vomits, over a shorter period of time. In these cats the concern for more urgent, even life threatening disease arises. The most urgent cause for a cat to vomit can be an intestinal obstruction, which if left untreated can be deadly. Other causes of acute vomiting can include pancreatitis, renal disease, liver disease, toxin ingestion, and sometimes diabetes. In most cases, cats will be unwell and often off their food. These cats need to be seen quickly and have further testing done to determine the cause of the vomiting.

Hero’s Big Hairball

“Hero” and his brother Ziggy are both fluffy adorable Snowshoe cats who stay with us frequently. On the Sunday before they were to go home, our nursing team noted that Hero has several small vomits in his condo. He was bright, smoochy and still seemed interested in his dinner, so they determined after a big clean up, he would be okay to wait the night. They booked him for a vet check with Dr Martine for early Monday morning so he could be assessed before going back home.

When the staff came to work the next day, more vomits were found, and he seemed a bit more quiet than usual. On assessment he was mildly dehydrated and had some very mild discomfort in the front of his abdomen. Dr Martine ran a full blood profile including a blood gas and a Feline Pancreatic Lipase test for Pancreatitis. Hero’s bloodwork confirmed his dehydration, and showed some mild changes associated with vomiting, but his kidney and liver enzymes appeared to be within normal limits. His pancreatitis test was normal, and his blood gas showed some mild electrolyte changes associated with vomiting. Given his mild bloodwork changes, he was started on intravenous fluids to correct his dehydration, given some anti-nausea mediation and pain relief. This was continued overnight to help support him and monitor for any further vomits.

The next morning, Hero vomited again, this time, a few small flecks of blood were noted. He did not seem to have improved much even with the fluids and supportive care overnight, so it was decided to take some abdominal X-rays (radiographs) to screen him for a possible intestinal obstruction. Hero was sedated and then lightly anaesthetised to obtain the X-ray images. The x-rays did not show an obvious mass or cause for obstruction, but several loops of small intestine were quite dilated and the stomach was severely dilated with fluid and gas, all of which can indicate a possible obstruction. Dr Martine used the ultrasound to perform an AFAST (abdominal focused ultrasound assessment) to screen him further, noting there was no free fluid, but many loops of intestine seemed very dilated and hyper-motile. The decision was made to go ahead with surgery to try and find the cause of the possible obstruction.

Dr Sabine and Dr Kayleigh worked together to perform Hero’s surgery where a large fur ball of 6cm in length, and horseshoe shaped was found in his distal small intestines. There were also two areas where the intestines were very inflamed, thickened and had increased blood flow. These areas appeared to have be sites of previous obstruction, where the fur ball had been stopped, acting like and obstruction but then moved on. Given that fur balls have the potential to be caused by underlying abnormal intestinal motility or structure, biopsy samples were taken from several sites within the intestines (that appeared more normal) and a local lymph node for assessment by a pathologist.

Hero recovered well from his surgery, but given the length and extent of the procedure, he was sent for overnight care and monitoring at Perth Veterinary Emergency. The next day he came back to the Cat Hospital and was already much brighter and happier. He ate well, and bounced back quickly and went home that afternoon.

We waited patiently, and his biopsies have since come back as just inflammation likely caused by the obstructing, big fur ball. This is all very good news for Hero, who is now on the mend, back to playing with his brother and keeping his family warm with his cuddles. We will continue to monitor Hero for further fur balls and hopefully they will not grow quite so large to irritate his stomach and intestines again.

If your cat is having vomits or fur balls, it is best to have it checked with a veterinarian. For many cats fur balls are the only signs of underlying intestinal or stomach disease and often indicate for some investigation to assess for one of the many underlying causes discussed above. In some cases diseases like inflammatory bowel disease can transform or mutate into cancer. Catching these diseases early can help reduce this risk and help ensure a longer happier life for your cat.

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