My Cat Has Vomited a Few Times but Seems Fine - Should I Worry?

Cats vomit. And an isolated episode of vomiting does not necessarily mean that something is seriously wrong. A healthy adult cat may occasionally bring up food, fluid or a hairball and then immediately go back to behaving completely normally. They may have eaten too quickly, swallowed a large amount of hair while grooming, eaten something that has mildly irritated their stomach, or simply had a transient gastrointestinal upset.

But frequent vomiting is not something I would automatically consider normal for a cat, particularly if it represents a change from their usual behaviour. As a vet, I am much less interested in a single episode of vomiting than I am in the bigger picture: How often is it happening? Is the pattern changing? And what is the rest of the cat doing?

First: Was this actual vomit?

This sounds like a strange question, but distinguishing vomiting from regurgitation can be really useful because they originate from different parts of the gastrointestinal tract and can have different underlying causes. Vomiting is an active process. Before your cat is sick, you may notice them:

• licking their lips

• swallowing repeatedly

• drooling

• appearing nauseous or unsettled

• crouching down

• retching

• contracting their abdomen before bringing something up

What they produce may contain partially digested food, fluid, bile, froth or hair.

Regurgitation is generally much more passive. Food or fluid seems to come back up without the repeated retching and abdominal contractions associated with vomiting. It often happens relatively soon after eating, and the food may appear largely undigested. Repeated regurgitation also deserves veterinary investigation, particularly if it is becoming more frequent.

If you're not sure which your cat is doing, take a video. Seeing an episode can be extremely useful to your vet.

What about hairballs?

Cats swallow hair as part of normal grooming, and occasionally bringing up a hairball isn't necessarily concerning. Long-haired cats, heavy groomers and cats that are moulting may swallow particularly large amounts of hair. However, one thing I wouldn't recommend is assuming that repeated vomiting is simply because your cat gets hairballs. If your cat is regularly retching or vomiting, particularly if little or no hair is being produced, there could be another underlying gastrointestinal or medical problem. Hairballs themselves can also occasionally contribute to gastrointestinal obstruction, so repeated unproductive retching, reduced appetite or signs of illness should never simply be dismissed as a cat “trying to get a hairball up”.

When am I less worried?

In a healthy adult cat, I'm generally less concerned if they have vomited once or perhaps a couple of times but:

• remain bright and responsive

• are behaving normally

• still want to eat

• are drinking normally

• can keep food and water down

• have no diarrhoea

• aren't showing signs of abdominal pain

• haven't lost weight

• have no other changes in their normal behaviour or routine

In that situation, careful monitoring may be reasonable. The important word, though, is monitoring. If vomiting continues, becomes more frequent or your cat develops any other symptoms, I would reassess the situation. Young kittens, elderly cats and cats with existing medical conditions deserve a little more caution because they may become unwell or dehydrated more quickly.

When might I worry?

This is where looking at the whole cat becomes so important. 

Vomiting and losing weight. 

This is one of the combinations I pay particular attention to. A cat may still appear relatively bright while gradually losing weight, and owners don't always notice weight loss immediately, especially in long-haired cats.  Chronic or intermittent vomiting accompanied by weight loss can occur with several underlying diseases, including gastrointestinal disease, hyperthyroidism, kidney disease, pancreatic disease and some cancers.

They’re eating very well but still losing weight. 

A good appetite doesn't necessarily reassure me if a cat is losing weight. In fact, a cat that is eating normally or appears unusually hungry while continuing to lose weight gives us another important clinical clue. Hyperthyroidism is a classic example, particularly in middle-aged and older cats. These cats may become hungrier, lose weight despite eating well, become more vocal or restless, drink more and develop intermittent vomiting or diarrhoea. Gastrointestinal diseases that interfere with digestion or absorption can cause a similar pattern. 

Vomiting and eating less (often with weight loss).

Reduced appetite can indicate nausea, pain or systemic illness. Cats are also a species in which prolonged inadequate food intake can cause additional problems, so I don't like cats going for significant periods without eating. If your cat is repeatedly vomiting and has stopped eating, or is eating substantially less than normal, contact your veterinary practice with more urgency.

Vomiting with increased frequency. 

Sometimes owners tell me: “My cat has always been a bit of a vomiter” and occasionally that is true. Even my Oreo will occasionally regurgitate or vomit. But I still want to know whether the pattern has changed. A cat that historically brings up the occasional hairball but has suddenly started vomiting twice a week is different from a cat whose behaviour has genuinely remained unchanged for years. Keep an eye on frequency. If you're finding yourself cleaning up vomit increasingly often, start making a note of when it happens. A simple diary on your phone can reveal a pattern that wasn't obvious before. Regular or chronic vomiting should not automatically be accepted as normal feline behaviour.

Vomiting with diarrhoea. 

Vomiting and diarrhoea together can occur with something relatively simple, such as an acute gastrointestinal upset. But they can also occur with infections, parasites, dietary problems, inflammatory gastrointestinal disease and wider systemic illness such as neoplasia. They also increase the risk of dehydration so I’d always like to see these patients although again if the cat is very bright, eating well with vomiting and diarrhoea, I am less concerned. 

I become more concerned if vomiting and diarrhoea are persistent or accompanied by:

• lethargy

• reduced appetite

• blood

• weight loss

• abdominal discomfort

• dehydration

• your cat generally appearing unwell

Vomiting with behavioural changes (lethargy, hiding etc).

If vomiting is happening alongside a noticeable change in your cat's normal routine or personality, I would want to know why.

Vomiting up water. 

This is a red flag because it can lead to dehydration. A cat that vomits once and then happily eats and drinks is very different from one that repeatedly vomits every time they drink. Persistent vomiting can quickly lead to dehydration and disturbances in the body's electrolytes. If your cat is repeatedly vomiting and unable to keep water down, I wouldn't recommend simply monitoring them at home.

Vomiting blood.  

A tiny streak of fresh blood can occasionally occur after repeated retching because the oesophagus or stomach has become irritated. But significant quantities of fresh blood, repeated blood in the vomit or dark material resembling coffee grounds warrants veterinary attention. I rarely see cats vomit blood to be honest. 

Vomiting after eating something they shouldn’t. 

This changes the situation completely! Cats, particularly younger catsc an swallow objects such as:

• string

• thread

• wool

• hair ties

• elastic bands

• small toys

• pieces of plastic

String and thread are particularly concerning in cats because they can cause serious intestinal damage.

Toxins are another consideration. Lilies, some human medications, antifreeze and numerous other substances can cause severe illness in cats. If you know or suspect your cat has swallowed a foreign object or been exposed to something toxic, don't wait for them to become unwell before contacting a vet. Oh and if you ever see string protruding from your cat's mouth or bottom, don't pull it contact your vet.

What causes vomiting in cats? 

There are many possible causes, which is why recurrent vomiting can sometimes require investigation. They range from relatively minor problems to significant underlying disease and can include:

• dietary changes or dietary indiscretion

• eating too quickly

• hair ingestion

• gastrointestinal parasites

• food-responsive gastrointestinal disease (dietary insensitivity)

• constipation

• inflammatory gastrointestinal disease (IBS)

• pancreatitis

• foreign bodies

• kidney disease

• hyperthyroidism

• liver disease

• toxin exposure

• certain medications

• gastrointestinal masses or cancer

The most common cause of vomiting I see is  hyperthyroidism and conditions of the gastrointestinal disease so inflammatory bowel disease or feline lymphoma.  

Will my vet investigate? 

The investigation depends enormously on your cat's age, history, examination and other symptoms. Sometimes the first step is simply a thorough clinical examination and discussion about exactly what has been happening.

Your vet may ask:

• How often is your cat vomiting?

• What does it look like?

• Does it happen before or after eating?

• Has their appetite changed?

• Have they lost weight?

• Are they drinking or urinating more?

• Is there diarrhoea?

• Are they indoor or outdoor?

• Could they have eaten a foreign object?

• Have there been any dietary changes?

Depending on the answers and examination findings, further investigation might include blood tests, diet trial, urine testing, faecal testing or abdominal imaging such as ultrasound. For persistent gastrointestinal disease, occasionally more advanced investigations or intestinal biopsies may be needed although I rarely biopsy intestines nowadays and get most of my information from ultrasound. 

Not every cat needs every test! 

So, should I worry? 

If my healthy adult cat vomited once or twice but remained completely bright, was eating normally, drinking normally, keeping water down and behaving exactly as usual without weight loss, I would usually monitor them rather than panic.

But I would arrange a veterinary assessment if:

• vomiting becomes frequent or persistent

• the pattern has changed

• they are losing weight

• their appetite has reduced

• they are eating well but still losing weight

• they develop diarrhoea or other gastrointestinal signs

• they're drinking or urinating more

• their behaviour or normal routine has changed

• they're unable to keep water down

• they're repeatedly retching without producing anything

• there is significant or repeated blood in the vomit

• they seem painful, lethargic, weak or generally unwell

• I suspect they have swallowed a foreign body or toxin

An isolated vomit in an otherwise completely well adult cat isn't necessarily an emergency. But repeated vomiting, particularly when combined with weight loss, appetite changes or a change in behaviour warrants a veterinary check up.