A Surprising Reason Why Your Cat May Be Vomiting
It can be alarming to find out that your pet's dry hacking cough or 'vomiting' isn't due to hairballs - or may not even be routine vomiting. Especially if you notice these other signs, such as wheezing or difficulty breathing, see your veterinarian immediately.
Reviewed by Dr. Becker
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STORY AT-A-GLANCE
- The dry hacking cough in feline asthma is often mistaken for vomiting or coughing up hairballs, with the result that some pet parents are caught by surprise by a diagnosis of asthma
- Beyond a dry hacking cough, other common symptoms of asthma include wheezing, labored breathing, and exercise intolerance; the symptoms of asthma in cats are also seen in several other serious diseases, so a quick and accurate diagnosis is crucial
- The condition can be triggered by irritants inhaled both indoors (e.g., cat litter dust) and outside (e.g., grass, tree and weed pollen)
- Eliminating triggers, cleaning up your cat’s environment and diet, and a natural healing protocol can improve symptoms and potentially reduce the need for drugs to effectively manage your pet’s asthma
Editor's Note: This article is a reprint. It was originally published November 30, 2021.
Unfortunately, routine vomiting and/or coughing up hairballs — both of which should be investigated by a veterinarian — are all too common in cats these days.
The sounds a kitty makes when throwing up are easy to identify, but what many pet parents don't realize is they are also very similar to the sounds of feline asthma. More than a few cat owners have been shocked to learn their "vomiting" feline family member actually has a condition that inhibits her ability to breathe normally.
Asthma, either acute or chronic, affects an estimated 1% to 5% of cats in the U.S. The condition is also referred to as bronchial asthma, allergic bronchitis, and chronic bronchitis.1
In kitties with asthma, the airways (bronchi) — two thin tubes that run from the trachea to the lungs — become inflamed and swollen in response to the immune system's overreaction to the presence of an allergen. This leads to spasms of the muscles of the airways, which causes them to constrict (narrow), making it difficult to move air into and out of the lungs.
Symptoms of Feline Asthma
Cats with asthma can't draw a deep breath, but the problem isn't always immediately obvious as a breathing difficulty. That's because asthmatic kitties often develop a dry hack that sounds like gagging or retching, which is why it's not uncommon for them to be diagnosed initially with hairballs.
Wheezing, which can sound like a high-pitched sigh or whistle, is another classic symptom, along with noticeably labored breathing and exercise intolerance.
Even if your cat has a dry cough as her only symptom, it's not necessarily a measure of the severity of the condition. Kitties can have quite serious asthma but very few symptoms. Some cats have no symptoms at all until suddenly they can't breathe. An acute asthma attack can be life-threatening.
Sudden airway constriction can occur for no apparent reason, or it can result from an allergic reaction to inhaled triggers (see below). Veterinarian Dr. Richard Goldstein, associate professor of small animal medicine at Cornell University's College of Veterinary Medicine, describes the typical onset of an asthma attack:
"The cat is at rest, not doing anything at all, or else it's playing and suddenly stops. Its breathing becomes more rapid, and the cat starts trying to take in air with its mouth open. Its chest and abdomen move up and down abnormally, the breathing is shallow and rapid. And if you listen closely you may be able to detect a wheezing sound as the cat exhales."2
Open-mouthed breathing or panting in cats is a definite red flag for asthma. Brachycephalic cats with pushed in faces, such as Persians and Himalayans, are especially susceptible to breathing problems, including asthma.
Common Asthma Triggers
Suspected triggers for asthma in cats include:
- Tobacco smoke
- Dust mites
- Cat litter dust
- Fireplace and candle smoke
- Vapors from household cleaning products, aerosol sprays, and air-scenting products
- Flame retardant chemicals on carpets and furniture
- Grass, tree, and weed pollen
- Off-gassing from upholstery (stain-resistant chemicals)
- Mold and mildew
- Certain foods
Asthma affects young, old, male, and female cats equally. There may or may not be a genetic component to the disorder. I firmly believe, even if there is a genetic predisposition, that airborne and environmental contaminants and allergens are what trigger the condition.
How Feline Asthma Is Diagnosed
Symptoms of asthma in kitties are seen in other diseases as well, so it's extremely important to get an accurate diagnosis, especially since cats are often misdiagnosed with asthma when they actually have heart disease.
Sometimes it's obvious just by looking at a kitty that she's making an excessive effort to breathe. Often the breaths are rapid and shallow, the abdomen is working extra hard to push the air back out, and/or she's breathing through an open mouth or panting.
A chest x-ray should be taken if the cat can hold still without too much respiratory distress. An x-ray can help make an accurate diagnosis, however, lung changes aren't always visible with this type of imaging, so sometimes further diagnostics are required. A procedure called a transtracheal wash retrieves cells from the lower airways and can be helpful in diagnosing asthma in symptomatic cats with normal x-rays.
Another diagnostic test is the bronchoscopy, which involves passing a tiny camera down the bronchi to get a look at the interior of the lungs.
Other conditions that can mimic asthma symptoms are systemic allergies, including food allergies, and also heartworm infection. Lungworm is another common reason for asthma-like symptoms in cats. The severity of feline asthma falls into one of four categories:
- Mild asthma, in which the symptoms occur intermittently, but not daily, and they don't interfere with the cat's quality of life
- Moderate asthma, in which the symptoms don't occur daily, but are more severe and debilitating when they do occur
- Severe asthma, in which symptoms are significantly debilitating and occur daily
- Life-threatening asthma, in which airway constriction can result in a complete inability to breathe, resulting in oxygen deprivation
Obviously, if your cat is at stage 4, you should seek immediate medical care at either your veterinarian's office or the nearest emergency animal hospital. But even if your kitty's condition is mild, it's important to work with your veterinarian to prevent progression to a more severe stage, which can happen rapidly.
Treatment Options
If your cat is in crisis, your veterinarian or emergency animal clinic staff will give a small dose of epinephrine that can resolve an asthma attack in as little as 15 minutes. Pure oxygen is usually administered at the same time.
In some acute situations, a corticosteroid injection or inhalation treatment via nebulizer is required. These drugs, like all drugs, have side effects, especially the powerful ones like steroids. Once your cat is stabilized and no longer critical, it's important to work with your veterinarian to determine why the crisis occurred.
Feline asthma is a chronic, progressive disease that in most cases can be managed, but unfortunately, not cured. The goal of treatment is to prevent airway constriction and reduce the frequency and severity of asthma attacks.
The most important thing you can do for an asthmatic cat is to determine what triggers in her immediate environment are contributing to her symptoms. Does she sit beside you in the bathroom when you use hairspray? Did you recently remodel and have chemical off-gassing from new carpet, paint, or furniture? Was the exterminator just at your house? Using plug-ins to scent your home? I have seen all these examples trigger asthma in my feline patients.
I recommend talking with a wellness veterinarian about an integrative protocol to control lung inflammation and promote respiratory health in your cat, after removing triggers. I find naturally extracted plant sterols and sterolins (from a holistic compounding pharmacy) to be beneficial for these patients, as well as anti-inflammatory nutraceuticals. Nebulization therapy can also be very beneficial.
I also encourage you to consider acupuncture, which can help reduce systemic inflammation in your kitty's body as well as the frequency and intensity of asthmatic episodes.
There are a variety of drugs used to treat feline asthma, including bronchodilators and specially designed steroid inhalers. Veterinarians often start with one or several medications to manage a severe case of feline asthma. If your cat is taking drugs to control asthma but you have not identified root causes or are unable to reduce drug doses over time, my advice is to work with an integrative vet who can help you with next steps.
Some kitties with respiratory disease can be managed without using drugs, but unfortunately, in many situations cats with life-threatening asthma symptoms require at least some drugs to reduce the intensity of attacks and keep them alive but do great with a blended protocol of natural and pharmaceutical agents.
How to Help Your Asthmatic Cat at Home
- Give up smoking around your pet and don't let others smoke around him. Second-hand smoke is a major asthma trigger for sensitive cats, and it has also been linked to certain feline cancers.
- Consider not lighting your fireplace, since the smoke settles in the low areas of your home, which is where your cat hangs out.
- Address water damage and black mold issues in the home.
- Reduce or eliminate all household sprays, including anything that is aerosolized. Make sure kitty isn't in the same room with anyone spraying anything from a bottle or can.
- Get rid of scented plug-ins, candles, incense, heated potpourri — anything that gives off an aroma. Products that emit a strong scent can be a trigger for sensitive cats and people as well.
- Switch from chemical household cleaners to natural cleaners.
- Gradually switch to an unscented, low dust cat litter. Mix the new litter with the litter your cat is used to, and gradually phase out the old stuff. Also, never use bleach to disinfect the box, especially if it has a hood. Use only dish soap or vinegar and rinse with warm water.
- If you have pet pest problems, use an all-natural, safe pest repellent for flea and tick control.
- Opt for vaccine antibody titer tests in place of unnecessary vaccines.
- Invest in a room air purifier (in addition to a whole house option) and replace your HVAC air filters regularly.
- Replace old pet beds with organic or natural fiber beds and cover synthetic beds with an organic dust mite cover.
- If your cat is overweight, slim her down to a healthy size very gradually. Obesity makes lungs work a lot harder.
- Make sure your cat's daily routine stays very consistent. Kitties don't do well with changes in their environment, and any type of stress can be a potential trigger for asthma.
- Feed a nutritionally optimal, species-specific fresh food diet. Asthma is caused by inflammation of the airways in the lungs, and pro-inflammatory foods like carbohydrates can worsen any inflammatory condition in the body. I recommend not feeding your kitty any type of food containing corn, wheat, rice, or millet. Storage mites can exacerbate inflammation. Avoid grains and starches altogether. Choose food with no synthetic dyes.
- Consider gradually switching your cat first to a canned food diet, then to a raw food diet and a new or novel protein source. If your pet's asthma is a respiratory manifestation of a systemic allergic response, just switching away from the poultry or seafood your cat seems addicted to can make a big difference.
If you're committed to eliminating potential asthma triggers for your kitty, you're attending to her environment (which includes her diet), and you're partnering with an integrative veterinarian to create a natural healing protocol, you can often reduce both the frequency and severity of your cat's asthma symptoms, and also the number of drugs she requires.
