Hairball Vomiting: A sign of illness or just a fact of life for a cat?

By Erika Ball, DVM


There are many services that we perform for our feline overlords. We wait on them hand and
foot, maintain their bathroom areas to the highest standards, giving massages on demand at
regular intervals, allowing them to steal our warmth on cold nights….I could go on and on. One
of these duties that we find ourselves performing is cleaning up the occasional hairball.

Some degree of hairball vomiting is normal, even expected. However, your definition of what
constitutes a hairball may differ from mine. Just because there is hair in what your cat vomits
does not make it a hairball. Cats groom. When they do, they ingest hair. When they vomit for
any reason there is a good chance that the vomit will contain hair. When I refer to a hairball, I
am specifically referring to a tubular structure that consists of mostly hair, wadded and woven
together. From a distance it often resembles stool. This is much more common in long haired
cats, whose fur is finer and longer and much more likely to form a conglomerate that can
bounce around in the stomach, getting larger as more hair is added to it. That is not to say that
short haired cats don’t get hairballs, only that it is less common.

Most of the time hairballs are harmless. Usually you don’t know that there is any problem until
one comes up, usually on your bed or your expensive new carpeting. Occasionally, hairballs
can cause problems, even serious ones. If a large enough hairball should manage to pass into
the intestines it could cause an intestinal obstruction. It is the most common “foreign body”
obstruction I find in adult cats upon surgical exploration. On one occasion I found a giant
hairball that took up 1/3 the volume of the stomach. The cat’s only symptom was drooling. He
was still eating, and there was no vomiting. There are over-the- counter hairball “remedies” and
even diets or treats that claim a reduction in the number hairballs your cat might have. While
these products may help (I’m not convinced these are all that effective) by lubricating and
making it easier for the hair to pass into the intestines, you still run the risk of an obstruction
occurring. There is one really good way of minimizing or even eliminating hairballs, but you
might not like it. Have a groomer give your long haired cat a lion cut twice a year or so. This
will significantly cut down the hair ingested and your cat will feel GREAT! They don’t like having
all that hair to contend with either. You may even like the way it looks!

So what if the vomit is food, or liquid, even if there is a little bit of hair? This is true vomiting, not
hairball vomit. The one exception to this is that your cat is vomiting as a result of an obstructive
hairball. Either way your cat should be seen by a veterinarian. Vomiting can be caused by a
variety of illnesses, such as food intolerance or allergy, inflammatory bowel disease,
pancreatitis, a non-hairball obstruction, metabolic diseases such as hyperthyroidism or kidney
disease, parasitic infection, toxin ingestion, etc. Cats RARELY vomit because they “eat too

Your veterinarian needs to perform an exam and diagnostics to determine the cause of the
vomiting and implement the best treatment for your cat. There was a time in my career that I
accepted a certain amount of vomiting as “normal” for a cat. I now know that the single most
common cause of chronic vomiting is intestinal disease, and should not be ignored. There are
diagnostic tests that needed to narrow down the cause of the vomiting, including blood work, x-
rays, and abdominal ultrasound. Ultimately an exploratory surgery with intestinal biopsies may
be necessary to diagnose the cause of your cat’s chronic vomiting.

When is it time to consult with a veterinarian? When your cat is vomiting regularly (more than 2
times per month), severely (multiple episodes in a short period of time) with or without hairballs,
when there is a decrease in appetite, becomes lethargic, has blood in the vomitus, is losing
weight, has concurrent diarrhea, and/or is either worsening or not improving rapidly. Don’t
dismiss vomiting as a normal part of being a cat. It’s not, and your cat’s life may depend on
being seen and worked up properly by a skilled veterinarian.