groomers and long-haired breeds are
prone to swallowing more hair, especially during shedding season.
While most of these hairs pass
through your cat’s digestive tract and
are eliminated in the feces, some of it
remains in the stomach. As more hair
accumulates in the stomach, it begins
to form a clump that we know as a
A hairball can become dangerous if
the mass passes from the stomach to
the intestine rather than being vomited, according to the Cornell Feline
Health Center. In fact, this would be
a medical emergency, because the
hairball could create a life-threatening
blockage, which requires surgical removal. If your cat tries
but does not produce a bowel
movement, vomits frequently
or refuses to eat, take her to
the vet right away.
sign of disease?
Brushing your cat and removing loose hairs prevents your cat from
swallowing too much hair, which keeps
hairballs from forming. Hairball diets,
which are high in insoluble fiber, fiber
supplements and GI lubricants like
Laxatone are effective at moving swallowed hair through the digestive tract
so that it passes through the stool.
While these remedies work at preventing hairballs, new research shows
that we might just be treating symptoms and ignoring underlying disease.
We may think of vomiting hairballs
as a normal part of being a cat, but
perhaps we should be asking why
our cats are having problems moving
swallowed hairs from the stomach
through the rest of the digestive tract
and expelling them through the feces
in the first place.
Decreased digestive motility, or
hypomotility, could indicate some-
thing more serious. Chronic vomiting,
whether or not a hairball is expelled,
could be a symptom that warrants fur-
ther examination. So, before starting a
hairball remedy, take your cat to your
veterinarian to confirm that the hairball
vomiting is just about the hairball.
“The problem with covering up
vomiting with hairball diets, fiber
supplements or GI lubricants is that it
delays getting a diagnosis,” said Gary D.
Norsworthy, D.V.M., a board-certified
feline specialist and owner of the Alamo
Feline Health Center in San Antonio.
Dr. Norsworthy explained that chronic
vomiting might be a symptom of small
bowel, or small intestinal, disease. Small
bowel disease starts with mild inflamma-
tion in the intestines and progresses to
severe inflammation, a condition known
as inflammatory bowel disease (IBD). In
some cats, IBD progresses to lymphoma.
“It is much easier to treat IBD than
lymphoma,” Dr. Norsworthy said. “Sadly,
many of the chronically vomiting cats I
diagnose are already at the lymphoma
stage.” Assuming that chronic vomiting
is normal or treating the symptoms
without an accurate diagnosis can allow
disease to progress, he warned.
“Vomiting two times per month or
more for several consecutive months
is abnormal and justifies an ultrasound
study,” Dr. Norsworthy said. “If the ultra-
sound study is abnormal, biopsies of
the small intestine (and sometimes the
stomach) are justified. The presence or
absence of hair is not significant.”
In their groundbreaking studies of 100
cats (from 2008 to 2012) and 300 cats
(from 2008 to 2013), Dr. Norsworthy
and his colleagues examined cats who
had been patients at the Alamo Feline
Health Center and showed clinical signs
of chronic vomiting, diarrhea, weight
loss or some combination of these. Both
studies were published in the Journal
of the American Veterinary Medical
Association (2013/2015). They continue
their research and, to date, have studied
more than 500 cats.
“Based on our experience with over
500 cats taken to surgery, there is a 96
percent chance that the cat will either
have IBD, a food allergy/intolerance
(that can lead to IBD) or lymphoma,”
Dr. Norsworthy said. “Fifty percent
of those have IBD and 45 percent
have lymphoma. The other 5
percent have a food allergy/
What does this mean for those
of us who live with cats? Bottom
line: Don’t dismiss chronic vomit-
ing as normal.
“Chronically vomiting cats
(even hairballs) need an ultra-
sound study and most likely
biopsies of the small intestine,” Dr.
Norsworthy said. What surprised him
was how many chronically vomiting
cats there are and how many of them
have intestinal lymphoma. In fact, only
one of the first 100 cats studied had
a normal biopsy, necessitating further
examination for all chronically vomit-
With so many cats afflicted with
chronic vomiting, it’s no wonder that
we accept it as normal. “Where there
are cats, there are hairballs” might be
an axiom we accept as part of life
with cats. But Dr. Norsworthy and his
colleagues refuse to accept that, and
neither should the rest of us.
Hairball = Undigested hair + digestive fluids ( (
O The former editor of Cat
Fancy magazine, Susan
specialized in pet and
veterinary topics for near-
ly 20 years. She and her
husband are the proud, adoring parents of
two 9-year-old tabbies.