Possible Causes for Your Cat Vomiting Clear Liquid

Vomiting is not normal in cats, and when your cat vomits clear liquid, it can be a sign of a serious illness. Vomiting itself is what is considered to be a nonspecific symptom. It could be associated with an array of health concerns. Some of these can include things like hairballs, internal obstructions, pancreatitis, eating too quickly, constipation, indigestion, parasitic infections, poisoning, stress, depression, or even anxiety.

Possible Causes for Your Cat Vomiting Clear Liquid

Hairballs

Cats are naturally meticulously clean animals and groom themselves for a large part of their day. As your cat grooms themselves, tiny hook-like structures on their tongue catch loose and dead hair, which is then swallowed. The majority of the hair passes all the way through the digestive tract with no problems, but sometimes the hair stays in the stomach and forms a hairball.

Commonly, cats will vomit up clear liquid prior to a hairball. Although, a cat vomiting up clear liquid with a hairball occasionally can be normal and not a concern, it is important to note that hairballs should not be frequent, painful, or difficult for your cat to pass. Some commercial cat diets and treats are formulated to help prevent formation of hairballs. Adopting a regular brushing schedule and getting your cat comfortable with brushing can also help get rid of any loose fur in your cat's coat that they may otherwise ingest when grooming themselves.

Food and Dietary Changes

When there is a change in your cats feeding schedule, if your cat misses a meal or eats later than normal, your cat may vomit up clear liquid.

In addition, you may have switched your cat’s food too quickly. When changing your cat to a new diet, it is recommended to do it gradually over a one to two-week period gradually decreasing the amount of current cat food while increasing the amount of new cat food.

Your cat may eat too quickly, and this can cause clear vomit or clear vomit with food present. If you cat is a habitual 'scarf and barf' cat or if they have intestinal sensitivities, that may be causing them to vomit up partially digested or undigested food. If your vet has ruled out other medical issues and thinks that what your cat is vomiting up is actually food, they may want you to try a food for sensitive stomachs with your cat. If your cat is still struggling with vomiting food on this special diet, they may then want to put your cat on a strict, hydrolyzed protein diet.

Your vet may also suggest food puzzles for your cat. Food puzzles are a great source of both play and enrichment for your cat. There are more and more manufactured food puzzles available on the market that stimulate both of your cat's predatory and foraging instincts. The added benefit of food puzzles for a cat that chronically vomits their food, though, is that it slows down the chow time so that a cat cannot eat too quickly and then get sick from it.

Indigestion

Just like in people, a cat's stomach produces various gastric juices as well as hydrochloric acid to digest their food. If, however, a cat skips a meal for some reason, or if they are not fed on time, that buildup of juice and acid can irritate the stomach and cause your cat to vomit. Cats with indigestion may vomit yellow foam in addition to white foam. If you and your vet suspect your cat's vomiting is from indigestion, your vet may suggest feeding small, frequent meals at the same time throughout the day so as to alleviate any buildup of stomach acid.

Gastritis

If your cat is one to get into things they shouldn't, it is possible that they have irritated their stomach with something that they have eaten. When this happens, you may see vomiting clear liquid in addition to vomiting blood and/or bile. Your cat may also be exhibiting a decrease in appetite, a depressed attitude, lethargy, or dehydration. Your vet will know just what to do if your cat is vomiting because of gastritis.

Some other causes can include:

• Parasites

• Constipation

• An obstruction of foreign material in the intestinal tract

• Ingesting a toxin

• Metabolic disorders such as diabetes, kidney disease, and hyperthyroidism

What Should I Do if My Cat Is Vomiting Clear Liquid?

Some cat owners may describe their cat as 'puke-y' but it should be noted that frequent vomiting is never normal for a cat. Vomiting more than once a week is definitely a sign of issues. If your cat is vomiting clear liquid several times and/or in conjunction with other symptoms such as lack of appetite, weight loss, lethargy, or diarrhea, you should make an appointment with your vet right away. Your vet will want to start with a physical exam, checking your cat's vital signs and palpating your cat's abdomen. After a thorough examination, your vet may also want to run some tests, including blood work and x-rays. Blood work will check your cat's organ function, making sure that there are no signs of liver disease or kidney disease, as well as your cat's red blood cell and platelet levels. An x-ray study will check for any fluid in the abdomen that could potentially be blood and it may also show intestinal gas patterns that could be indicative of a blockage.

Depending on what your doctor finds, your cat may require hospitalization for fluid therapy and supportive care, or they may just need outpatient treatments and oral medications to go home on. If your vet suspects your cat has an intestinal blockage your cat may require surgery to remove whatever the blockage is.

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Diabetes Ketoacidosis (DKA) - A Complication of Diabetes in Cats and Dogs

Unfortunately, as veterinarians, we are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). You're probably wondering if you just had a dog or cat diagnosed with diabetes mellitus—what do you do? First, we encourage you to take a look at these articles for an explanation of the disease:

• Diabetes in Cats

• Diabetes in Dogs

This article will teach you about life-threatening complications that can occur as a result of the disease; specifically, a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it.

What is DKA?

When diabetes goes undiagnosed or difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells — resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body.

Symptoms of DKA

Clinical signs of DKA include the following:

• Weakness

• Not moving (in cats, hanging out by the water bowl)

• Not eating or complete anorexia

• Vomiting

• Excessive thirst and urination (clear, dilute urine)

• Large urinary clumps in the litter box (anything bigger than a tennis ball is abnormal)

• Weight loss (most commonly over the back), despite an overweight body condition

• Obesity

• Flaky skin coat

• Excessively dry or oily skin coat

• Abnormal breath (typically a sweet “ketotic” odor)

• Diarrhea
  

In severe cases DKA can also result in more significant signs:

• Abnormal breathing pattern

• Jaundice

• Abdominal pain (sometimes due to the secondary problem of pancreatitis)

• Tremors or seizures

• Coma

• Death

What can cause DKA?

When DKA occurs, it’s often triggered by an underlying medical problem such as an infection or metabolic (organ) problem. Some common problems that we see with DKA include the following:

• Pancreatitis

• Urinary tract infection

• Chronic kidney failure

• Endocrine diseases (e.g., hyperadrenocorticism [when the body makes too much steroid], or hyperthyroidism [an overactive thyroid gland])

• Lung disease (such as pneumonia)

• Heart disease (such as congestive heart failure)

• Liver disease (such as fatty changes to the liver)

• Cancer

Diagnosing DKA

While diagnosing DKA is simple, by looking at the blood sugar levels of dogs and cats and by measuring the presence of these fat breakdown products in the urine or blood, treatment can be costly (running between $3-5000). A battery of tests and diagnostics need to be performed, to look for underlying problems listed above, and treatment typically requires aggressive therapy and 24/7 hospitalization.

Treatment of DKA

Treatment, typically, is required for 3-7 days, and includes the following:

• A special intravenous catheter called a “central line” (placed to aid in frequent blood draws)

• Aggressive intravenous fluids

• Electrolyte supplementation and monitoring

• Blood sugar monitoring

• A fast acting or ultra fast acting insulin, regular or Lispro, typically given intravenously or in the muscle

• Blood pressure monitoring

• Nutritional support (often in the form of a temporary feeding tube)

• Anti-vomiting or anti-nausea medication

• Antibiotics

• Long-term blood sugar monitoring and a transition to a longer-acting insulin

Thankfully, with aggressive supportive care, many patients with DKA do well as long as pet parents are prepared for the long-term commitment (including twice-a-day insulin, frequent veterinary visits to monitor the blood sugar, and the ongoing costs of insulin, syringes, etc.).

Preventing DKA

By following your veterinarian’s guidelines and recommendations you can help regulate and control your pet’s diabetic state better and monitor your pet carefully for clinical signs. For example, if your pet is still excessively thirsty or urinating frequently despite insulin therapy, they are likely poorly controlled and need an adjustment of their insulin dose (of course, never adjust your pet’s insulin or medications without consulting your veterinarian).

When in doubt remember that the sooner you detect a problem in your dog or cat, the less expensive that problem is to treat. If you notice any clinical signs of diabetes mellitus or DKA, seek immediate veterinary attention. Most importantly, blood glucose curves (when a veterinarian measures your pet’s response to their insulin level) often need to be done multiple times per year (especially in the beginning stages of diabetes mellitus).

If you have any questions or concerns, you should always visit or call your veterinarian.

Related reading:

• Diabetes in Cats

• Diabetes in Dogs

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