The sound usually comes first, before you are properly awake: a low, rhythmic hacking from somewhere near the rug. By the time you find the spot, your cat is sitting by the food bowl, washing a paw as if nothing happened, and on the floor is a small damp wad of fur.
Most mornings like this end with a paper towel. The trick is knowing which mornings are different.
An occasional hairball or a single bout of vomiting in a cat that is otherwise eating, playing and behaving normally is usually not an emergency. The Cornell Feline Health Center notes that even the healthiest cat vomits now and then, and that bringing up a hairball every week or two is common. Vomiting more than once a week, or vomiting with lethargy, poor appetite, blood, or changes in thirst or urination, is a reason to see a veterinarian promptly.
The sections below help you recognize warning signs, cut down on hairballs and prepare for an appointment. Working out the cause is a job for your vet.
- An occasional hairball is common. Cornell calls one every week or two common; VCA Animal Hospitals suggests calling the vet if hairballs come more than once a month. A change in your own cat’s pattern matters most.
- Vomiting more than once a week deserves a vet visit, according to Cornell, even in a cat that seems well.
- Some signs cannot wait, including repeated retching with nothing coming up, blood, refusing food, lethargy, or a possibly swallowed string.
- Never pull a string from a cat’s mouth. The Merck Veterinary Manual warns that pulling can injure the gut.
- Brushing is the main way to reduce hairballs. International Cat Care recommends daily grooming for longhaired cats.
Contact your vet or an emergency animal hospital promptly if your cat:
- Retches or gags again and again without bringing anything up
- Vomits blood, or material that looks like dark coffee grounds
- Has stopped eating, or cannot keep food or water down
- Seems lethargic, weak or in pain, especially with a tender belly
- Might have swallowed string, thread, yarn, ribbon, tinsel or dental floss, or has a string hanging from the mouth or under the tail
- Might have eaten a toxic plant, a medicine or another poison
- Is a young kitten or an elderly cat, or has a known illness such as kidney or heart disease, and is vomiting
Do not pull on any string, and do not try to make your cat vomit.
Hairball, vomiting or regurgitation: what you are seeing
A cat can bring things up in three different ways, and telling your vet which one you saw helps narrow the search.
A hairball is a clump of swallowed fur. The Cornell Feline Health Center explains that hair is mostly keratin, which cats cannot digest; most of it passes in the stool, but some collects in the stomach. A hairball that comes back up is usually slender and tube shaped rather than round, about an inch long, and roughly the color of the cat’s coat.
Vomiting is the forceful emptying of the stomach and upper small intestine. The Merck Veterinary Manual says vomiting usually starts with drooling, repeated swallowing and retching, and VCA adds that a cat about to vomit may seem restless and lick its lips. Strong heaving of the belly is the giveaway, and the material is often partly digested food, liquid or bile.
Regurgitation looks similar but is more passive. VCA describes regurgitation as happening soon after eating or drinking, without the heaving belly, and Merck notes that regurgitated food is typically undigested and may keep the tube shape of the esophagus.
Coughing can also be mistaken for a hairball. Cornell points out that frequent hacking may come from a breathing problem such as asthma, and VCA suggests filming the episode, because a short video lets the vet tell coughing, vomiting and regurgitation apart.
How often is too often?
Sources draw the line in slightly different places, so the safest rule is to treat any increase as worth a call.
For hairballs, the Cornell Feline Health Center says that one every week or two is common and usually causes no lasting problems, while VCA Animal Hospitals advises contacting a vet if hairballs happen more than once a month. The Feline Veterinary Medical Association (formerly the AAFP) goes further and says it remains unclear whether frequent hairballs are ever normal. A cat whose hairballs are becoming more frequent is better examined than watched.
For vomiting of food or liquid, Cornell’s threshold is clearer: more often than once a week calls for a prompt vet visit. The Merck Veterinary Manual adds that vomiting more than once or twice in a day, or vomiting that goes on for a long time, needs a detailed examination, because long-term vomiting can lead to weight loss, dehydration and electrolyte imbalances.
A single episode in an otherwise bright cat is different. PDSA notes that a cat does not need to see a vet every time it vomits; an otherwise well cat can be watched closely with fresh water available, and the vet called if the vomiting returns or the cat seems unwell. VCA adds that a cat that seems well but keeps vomiting for more than one to two days should be seen.
Warning signs that need a vet soon
A cat’s general condition says more than the vomit itself, so look at the whole cat, not only the mess on the floor. Beyond the signs in the box above, the Merck Veterinary Manual adds fever and weight loss, and Cornell adds increased thirst and urinating more or less than usual.
Hairballs carry their own risk. Cornell explains that a hairball can occasionally lodge in the intestine, which is rare but serious, and that a cat with lethargy, refusal of food for more than a day or two, repeated unproductive retching or true vomiting should be examined without delay.
Older cats deserve a lower threshold. Cornell lists kidney disease and an overactive thyroid among the causes of vomiting, and PDSA notes that an overactive thyroid is most common in senior cats. Our guide to caring for a senior cat covers other changes worth reporting.
String, thread and other swallowed objects
String is one of the few causes of vomiting where an owner’s quick action really matters.
The Merck Veterinary Manual notes that cats often swallow string, yarn and dental floss while playing, and that one end can stay anchored around the base of the tongue while the rest travels on into the gut. Merck lists loss of appetite, vomiting, regurgitation, diarrhea and lethargy among the signs of a blockage, and warns that a string anchored in the mouth must never be pulled, because pulling can perforate the gut where the string is embedded.
If you see thread hanging from your cat’s mouth or under the tail, leave it in place and go to your vet or an emergency animal hospital. Do not try to make your cat vomit. Cornell also lists rubber bands, paper clips, poisonous plants, spoiled food, human medicines and some human foods among the things that make cats vomit, so tell the vet about anything your cat could have reached.
Keeping risky items out of reach
Sewing thread, hair ties, gift ribbon, tinsel, dental floss and the string from a roast are the kinds of items that end up in cats’ stomachs. Wand toys with long cords are good for play but are best shut in a drawer afterwards.
Plants and food are the other common hazards. Our list of plants toxic to cats covers what to keep out of the house, what cats can and cannot eat covers the kitchen, and our guide to cat treats explains how to keep extras to a small share of the diet.
Why does my cat throw up after eating?
A cat that brings up food soon after a meal may be vomiting or regurgitating, and frequent episodes of either deserve a vet visit rather than guesswork.
The Cornell Feline Health Center says that frequent vomiting of recently eaten food is a reason to see a veterinarian, because the possible causes range from parasites and food problems to inflammatory bowel disease and metabolic illness. A vet works through those causes with a history, an examination and often blood and stool tests. While you wait for the appointment, keep the food the same: PDSA lists a change of diet among the common causes of vomiting, and switching back and forth makes the picture harder to read.
How to reduce hairballs
Brushing is the simplest and best supported way to cut down on hairballs, because every hair caught in the brush is a hair the cat does not swallow.
International Cat Care says grooming can help prevent or reduce hairballs, that daily brushing during moulting season removes more loose hair, and that longhaired cats need grooming at least once a day. The Cornell Feline Health Center also recommends daily brushing or combing, and notes that longhaired breeds such as Persians and Maine Coons, and adult cats that groom more than kittens, are at greater risk.
Short, pleasant sessions work better than long battles. International Cat Care advises building up a cat’s tolerance gradually, stopping at signs of discomfort such as twitching skin, a swishing tail or flicking ears, and ending with praise or a treat. A cat should always be free to walk away.
Overgrooming, water and remedies
Watch for overgrooming. A cat that licks until the fur thins or the skin looks sore swallows far more hair than usual. International Cat Care explains that overgrooming can come from itchy skin (often a flea allergy), from pain such as bladder discomfort, or from stress, and advises contacting your vet as soon as you notice it.
Keep water easy to reach. VCA notes that good hydration helps hair move through the gut and suggests fresh water in several places around the home.
Ask before using remedies. The Cornell Feline Health Center advises never giving a cat a laxative without a veterinarian’s approval and supervision, and says the same about commercial diets that claim to prevent or relieve blockages.
What to note before the vet visit
A few simple notes save your vet time, because the history is where every vomiting workup begins.
- How often: the date and time of each episode over the past week or two
- Timing: how long after a meal, and what the cat was doing just before
- What came up: hair, whole food, partly digested food, clear, yellow or green liquid, or anything like blood or coffee grounds
- A photo of the vomit, and if possible a short video of an episode
- Appetite, drinking and weight: eating less, drinking more, or looking thinner
- The litter box: diarrhea, constipation, or more or less urine than usual
- Possible access to string, plants, medicines, human food, or a new food or treat
For other emergencies, our pet first aid guide covers the trip to the clinic, and the cat hub gathers our other cat care pages.
Back to the rug
Most of the time, that early morning hacking really is just a hairball, and a few minutes with a brush each day will make those mornings rarer. Knowing what normal looks like for your own cat is what lets you spot, calmly and quickly, the morning that is different.
Frequently asked questions
Is it normal for a cat to throw up hairballs?
An occasional hairball is common. The Cornell Feline Health Center describes one every week or two as common, while VCA Animal Hospitals suggests calling your vet if hairballs happen more than once a month. Hairballs that become more frequent, or come with other signs, should be checked.
How often is it normal for a cat to vomit?
Occasional vomiting in an otherwise well cat is not unusual. The Cornell Feline Health Center advises a prompt vet visit for a cat that vomits more than once a week, or that also seems lethargic, eats less, drinks more or has blood in the vomit.
My cat is gagging but nothing comes up. What should I do?
Repeated retching without producing a hairball is a warning sign. The Cornell Feline Health Center says a cat with repeated unproductive retching should be seen by a vet without delay, since a blockage or a breathing problem such as asthma are possible. A short video helps the vet.
What is the difference between vomiting and regurgitation in cats?
Vomiting is active, with strong heaving of the belly, and brings up partly digested material. Regurgitation is passive, usually happens soon after eating, and brings up undigested food that may keep a tube shape. Tell your vet which one you saw.
My cat swallowed string. Should I pull it out?
No. The Merck Veterinary Manual warns that a string anchored in a cat’s mouth must never be pulled, because pulling can perforate the gut. Leave the string in place and take your cat to a vet or emergency animal hospital straight away.
Sources
- Cornell Feline Health Center: Vomiting
- Cornell Feline Health Center: The Danger of Hairballs
- Merck Veterinary Manual (Cat Owners): Vomiting in Cats
- Merck Veterinary Manual: Gastrointestinal Obstruction in Small Animals
- VCA Animal Hospitals: Vomiting in Cats
- VCA Animal Hospitals: Hairball Remedies for Cats
- International Cat Care: Grooming your cat
- International Cat Care: Over-grooming in cats
- PDSA: Vomiting in cats
- Feline Veterinary Medical Association (formerly AAFP): Hair Balls in Cats
This guide is general information and not a substitute for veterinary advice. If your cat is vomiting repeatedly or shows any of the warning signs above, contact a veterinarian.