What to Feed a Cat With a Sensitive Stomach

By Liz Bales, DVM

 

Does your cat have a sensitive stomach? Do they consistently vomit or cough up hairballs? Believe it or not, hairballs aren’t normal for cats; their bodies are made to pass the hair that they ingest from grooming.

So these could be signs that your cat is sensitive to something in their food.

Gastrointestinal (GI) disturbances are commonly caused by poorly digestible foods, food allergies or food additives/flavorings/preservatives.

Many times, a diet that’s formulated to address your cat’s sensitive stomach can ease and even resolve the problem. But it’s important to not immediately jump to changing your cat’s diet without getting your vet’s input.

Here’s what you should do if your cat has a sensitive stomach and how you can help them find the right diet.

Talk With Your Veterinarian to Rule Out Other Medical Issues

Vomiting can be a sign of many different illnesses, not just a sensitivity to food. And coughing up a hairball can look very similar to general coughing and sneezing in a cat—which could actually be signs of feline asthma.

If your cat is vomiting food or hairballs once a month or more, or is also losing weight, a veterinary visit is recommended.

You should also try to get a video of your cat when they are exhibiting these behaviors so that your veterinarian can see what you see at home.

At the vet’s office, your veterinarian will check for clues as to what is causing the stomach upset. They may recommend diagnostic tests like blood work, X-rays or an ultrasound to find the cause of the GI upset.

By ruling out other medical issues, you can make sure they get right medical treatments for any underlying issues.

How to Find the Best Food for Your Cat’s Sensitive Stomach

Once you’ve dealt with any other health issues, you can work with your vet to figure out the best food for your cat’s sensitive stomach.

Your vet will be able to guide you towards foods that fit your cat’s nutritional requirements, while you can narrow it down by your cat’s food preferences to find the perfect match.

Here are some options your vet might suggest for finding a food for your cat’s sensitive stomach.

Start With a Diet Trial

Once your cat gets a clean bill of health from the veterinarian, a diet trial is the logical next step. Diet trials are a way to narrow down your cat’s food options until you find a food that suits their sensitive stomach.

There is no “one-size-fits-all” diet for every cat. Your cat will have an individual response to each diet. So, work with your veterinarian to find the most suitable food for your cat’s needs.

It can take up to three or four months for your cat to clear the old diet from their system so that you can completely evaluate the new diet.

What to Look For in the New Diet

The best foods for a cat with a sensitive stomach will be highly digestible and contain no irritating ingredients. Highly digestible diets have moderate to low fat, moderate protein and moderate carbohydrates.

Many of these diets have additives that improve intestinal health, like soluble fiber, omega-3 fatty acids and increased levels of antioxidant vitamins, and they contain no gluten, lactose, food coloring or preservatives.

Try a Hypoallergenic Diet

Cats can experience food allergies that cause gastrointestinal upset. Of all the components of the diet, the protein source is the most likely to cause food allergies.

Your cat can be allergic to any protein that they have been exposed to. For example, rabbit and chicken may both cause a food allergy. But, if your cat has never eaten rabbit before, their immune system hasn’t been sensitized to it, and they are unlikely to be allergic to it.

Some studies show that beef, chicken and fish are the most likely to cause allergies. The best cat food for helping cats dealing with food sensitivities for certain protein allergies are hypoallergenic diets.

Types of Hypoallergenic Diets for Cats

There are three main types of hypoallergenic diets:

  • Limited ingredient
  • Veterinary prescription food with a novel protein
  • Hydrolyzed protein

Limited ingredient diets typically contain only one protein source and one carbohydrate source, and they can be purchased without a prescription, like Natural Balance L.I.D. Chicken & Green Pea Formula grain-free canned cat food. However, these diets are not regulated to ensure that they don’t have cross-contamination.

For more highly allergic cats, veterinary prescription diets with novel animal proteins contain a single-source protein and are produced in a facility that prevents cross-contamination.

Hydrolyzed protein diets, which also require a veterinary prescription, break down the protein to a size that’s less likely to be recognized by the immune system, like Royal Canin Veterinary Diet Hydrolyzed Protein HP dry cat food.

Try Simply Changing the Form of Cat Food

Your cat’s stomach sensitivity may improve by just changing the type of food that you feed.

For example, if your cat is experiencing stomach sensitivity on dry food, it is reasonable to try a low-carb, higher-protein canned food diet, like Royal Canin Royal Canin Veterinary Diet Gastrointestinal Moderate Calorie canned cat food or Purina Pro Plan Veterinary Diets EN Gastroenteric Formula canned cat food.

Likewise, if you are feeding wet food, you may do a trial of a dry food diet with a dry food like Royal Canin Sensitive Digestion dry cat food.

Try a Different Feeding Routine

Cats that eat large meals are more likely to vomit very soon after eating—tongue-in-cheek, we call this “scarf and barf.”

With a stomach the size of a ping-pong ball, cats, in particular, are physiologically and anatomically designed to eat small, frequent meals. They are designed to hunt, catch and play with many small meals a day. Eating one large bowl of food a day can lead to frequent regurgitation.

In general, small, frequent meals are best. This results in less gastric retention of food and increases the amount of food that is digested and absorbed.

You can recreate this natural feeding behavior with the award-winning, veterinary recommended Doc & Phoebe’s indoor hunting cat feeder kit.

Instead of filling the bowl twice a day, use the portion filler to put the food into each of the three mice and hide them around the house. This natural feeding style provides portion control, activity and stress reduction that has shown to decrease or eliminate vomiting.

By: Dr. Elizabeth Bales, DVM

 

Chronic vomiting in cats

Chronic vomiting in cats

By Dr. Karen Shaw Becker

Chronic vomiting in cats is unfortunately so common that many pet parents and even some veterinarians view it as “normal” behavior. However, in my professional opinion, chronic vomiting, even in kitties with hairballs, is a sign something’s wrong and needs to be investigated. After all, big cats in the wild don’t routinely vomit.

Wild cats also don’t have hairball issues, which is why I believe recurrent hairballs in housecats is also a sign that something’s amiss. Other common causes of persistent vomiting in cats include a poor diet, food intolerances, eating too fast and too much time in between meals.

Other causes include enzyme deficiencies, gastrointestinal (GI) problems that result in hairballs, toxin ingestion and underlying medical conditions like kidney disease and GI cancer.

Problem: Hairballs

If your kitty is vomiting hairballs, you’ll see cylindrical wads of hair and debris, probably some undigested bits of food, and usually a little phlegm to hold the disgusting little mess together.

Long-haired cats and cats who are really into grooming themselves — and often all the other cats (and dogs, and even people) in the house — typically have more hairball issues than normal. Cats eating dry food don’t get enough moisture in their diet, so their organs tend not to function as efficiently as they should. And unlike dogs, kitties don’t make up the deficiency by drinking lots of water, so they often end up chronically mildly dehydrated.

A GI tract that is moisture-depleted is less able to transport a hairball than the digestive tract of a well-hydrated cat eating a species-appropriate diet. Cats in the wild pass hair in their feces on a regular basis. Felines have tiny bristles on their tongues and are designed to process swallowed hair. Recurrent hairballs are abnormal.

What to do: Brush your cat and feed a moisture-rich diet. To help prevent your cat from swallowing so much hair that it forms hairballs in his GI tract, you’ll need to brush him regularly. If he’s grooming everyone in a multi-cat household, you’ll also need to brush the other kitties.

If your cat is eating exclusively dry food and you can’t or aren’t willing to switch to a different diet, I recommend adding bone broth to his dry food and a bit of fiber to each meal, or a petroleum-free hairball remedy, or even a dab of coconut oil on his front paw. I also recommend fiber and coconut oil together. Kibble fed cats definitely need additional GI lubrication to help ingested hair pass through the digestive tract.

Problem: An Underlying Medical Condition

Many cats today have inflammatory bowel disease (IBD), or irritable bowel syndrome (IBS), which causes intermittent vomiting. IBD can progress to GI lymphoma in cats, which is another reason that chronic vomiting in any kitty should be investigated medically.

In addition to lymphoma, other types of GI cancers can also cause vomiting, as can metabolic disorders like hyperthyroidism, which is a very common disease diagnosed in older kitties. Organ disease or a malfunction of the organs of detoxification, including the liver and the kidneys, will also cause vomiting.

What to do: Make an appointment with your veterinarian. Your vet should first rule out all potential medical reasons for vomiting, for example kidney failure, liver failure, hyperthyroidism or GI cancer.

If all those problems are ruled out and your veterinarian is concerned about potential IBD or IBS, I recommend submitting a blood sample to the GI lab at Texas A&M University for a functional GI test. That test can determine if your cat is dealing with malabsorption and maldigestion, or a disease of the small intestine or pancreas.

Many cats have a reduced number of hairballs and vomiting episodes when their unbalanced microbiome is addressed by switching to a species-appropriate diet, or at a minimum, have probiotics added to their food.

Problem: Poor-Quality Cat Food

Cats fed processed diets containing rendered ingredients may vomit due to poor-quality, biologically inappropriate ingredients. Rendered ingredients that wind up in pet food are leftovers from the human food industry, and can include animal pieces and parts like bird feathers, snouts, beaks, eyes, hooves and nails.

These are very low-quality ingredients with low-to-no bioavailability that are difficult for cats to digest, which can cause GI upset. Cats tend to have upper GI issues, so they vomit. Dogs typically have lower GI issues, and are more apt to develop diarrhea.

Since the introduction of processed pet food, many cats have been fed diets that are not species-appropriate, which has led to the development of food intolerances and allergies — a very common reason for intermittent vomiting over a period of months or years.

If your kitty is at a healthy weight with a normal energy level, but just throws up occasionally, food sensitivity could be the culprit. Food sensitivities develop when the same foods are fed over and over, which happens a lot with cats because they get addicted to certain foods and refuse to eat anything else.

Feeding the same type of protein, even if it’s excellent human-grade quality, can over time create GI inflammation and food sensitivities. So it’s not just about feeding good-quality protein, but also switching proteins frequently. I recommend transitioning cats with GI upset to human-grade cat food (which unfortunately can be very difficult to find), and then to a fresh food diet.

What to do: Upgrade your cat’s diet. I prefer a raw diet for cats who will eat it, but even gently cooked fresh food is a huge improvement over processed pet food. I also recommend rotating proteins every three to four months to avoid hypersensitivity reactions.

If you believe your cat may have a food hypersensitivity or allergy, I recommend Dr. Jean Dodd’s Nutriscan saliva test, which can provide help in choosing a diet that’s less reactive for your kitty. The good news is I’ve found that correcting food sensitivities, removing noxious or unnecessary ingredients from a cat’s diet, as well as transitioning to a species-appropriate, fresh food, natural diet eliminates most of the common causes of vomiting in cats.

If you feed your cat treats, be sure to offer only high-quality treats. You don’t want to spend money upgrading your kitty’s diet and then feed junky treats that can create GI inflammation and vomiting. So if you feed treats, it’s important to offer the highest quality you can afford. Or better yet, make homemade cat treats.

In store-bought treats, you should look carefully at the label and avoid anything containing propylene glycol, FD&C red #4, ethoxyquin, chemical dyes, emulsifiers, surfactants and other questionable ingredients. All those additives, preservatives and other chemicals can cause GI inflammation and vomiting.

It’s also important to note that contrary to what many people think, cats don’t need milk. Animals are only suited to digest and process milk from their own species. Drinking the milk of a different species past weaning can cause or exacerbate GI inflammation. If your cat can’t tolerate cow’s milk, it can cause vomiting, so if you’re giving him milk, I recommend you stop offering it.

Problem: Enzyme Deficiencies

Sometimes a kitty’s pancreas doesn’t produce enough digestive enzymes, such as lipase, protease and amylase, which can result in acute or chronic pancreatitis. Pancreatitis (inflammation of the pancreas), is very common in cats, and even if there are no other obvious symptoms, can be an underlying cause of intermittent vomiting.

What to do: Supplement with digestive enzymes. Cats evolved to eat an entirely fresh food diet, primarily mice, which is a very rich source of digestive enzymes that is entirely missing from processed cat food. That’s why I recommend adding a digestive enzyme to your cat’s diet.

If your kitty’s pancreas is producing adequate enzymes, adding additional enzymes to her food won’t cause any problems. However, if her pancreas is not secreting sufficient enzymes, supplementing ensures she’ll have what her body needs to process her food. Providing a high-quality digestive enzyme can help reduce vomiting as well as the potential for pancreatitis.

Problem: Speed Eating

Another very common reason cats throw up is from eating too fast. Your cat’s esophagus is horizontal and flat. Everything he eats has to travel horizontally before it moves into the stomach.

In cats with a tendency to wolf their meals, the food can back up in the esophagus and push against the lower esophageal sphincter. This can result in regurgitation of part or all of the meal, undigested, within moments of swallowing. This seems to be a special problem in multi-cat households in which all the kitties are fed in the same area at the same time, which can spark competition.

There’s usually at least one gobbler in the group, and when the food bowls hit the floor, he scarfs his own meal in a flash and then visits everyone else’s bowl to see about leftovers. He’s such a little glutton that he often ends up returning all that hastily eaten food to the floor.

What to do: Provide separate eating areas in multi-cat households. If you have a scarfer in the house, you need to feed your kitties in separate areas so they can’t see or hear the others eat. It’s best if you can close the door behind each cat, because it won’t take long for your gobbler to figure out where the rest of the bowls are if he can still get to them.

Give them about 20 minutes of solitude to eat their food slowly and uninterrupted, then remove the bowls. This may slow down your gobbler, reduce or eliminate the vomiting, and keep him from getting fat. It also allows your slower-eating kitties to relax while they dine.

If you have just one cat but she’s a gobbler, you may need to split her meals into smaller portions and feed her more often so the food doesn’t come right back up. You can also use a mini-muffin tin to slow her down. Just put a bit of food in each individual muffin cup. Moving from cup to cup will naturally slow her down.

If you don’t own a mini muffin tin, you can also try spreading the food out over a large cookie or baking sheet. If you prefer something more high-tech, there are slow-feed bowls you can purchase that provide essentially the same benefit.

Problem: Too Much Time Between Meals

Cats fed on a regular schedule, for example, at 7:00 AM and 5:00 PM each day, tend to start looking for their meal an hour or so earlier because their bodies know it’s getting to be that time.

Around the same time, your cat’s stomach begins releasing digestive substances like hydrochloric acid, gastric juices and bile in anticipation of the upcoming meal. If you’re late with her meal, she may throw up a white foamy liquid mixed with a bit of yellow bile.

This is because the digestive substances irritate the lining of the stomach when there’s nothing in there for them to work on, so your cat’s body gets rid of some of the acid to prevent further irritation.

What to do: Offer a pre-meal snack. If this scenario is occurring with your cat, give her a little something to snack on before you feed her, like a treat or a small bite of her meal. This will give her stomach juices something to digest and should alleviate the vomiting.

Problem: Toxin Ingestion

Rarely, poisoning can also be the cause of acute vomiting in kitties. It’s rare, but it happens. If you have a cat who is otherwise healthy, especially an indoor-outdoor kitty, and he suddenly starts vomiting, you should be concerned he has ingested something toxic.

Even if your cat is indoors only, unfortunately, many types of houseplants are poisonous for cats — and many cats like to sample houseplants. It’s important to make sure you’re not bringing anything into your home that could potentially poison your feline family member.

It’s important to note that since cats are designed to eat fresh food, they’ll nibble on anything fresh in your house if they’re not provided a fresh food diet. Since felines don’t have a biological requirement for plants, it’s a good bet most house-plant sampling cats are trying to supplement a processed diet with living foods.

What to do: Offer safe greens to your cat, and safely store all household chemicals out of reach. If you have kitties that like to snack on your houseplants, I recommend providing them roughage that is more palatable and safer than houseplants. You can do this in the form of cat grass, which is wheatgrass, or by offering fresh sunflower sprouts.

Any pesticides, herbicides or household cleaners that are stamped “call poison control” need to be safely stored out of the way of cats. You should assume that any cleaner you’re using in your house will ultimately be ingested by your cat, because kitties lay on surfaces, and they’re fastidious groomers.

All your household cleaners should be cat-friendly. I can’t emphasize enough that if you are still using traditional toxic household cleaners, if you have cats, one of the best gifts you can give them is to switch to nontoxic household cleaners.

 

 

Hair Balls and Cats

By W. Jean Dodds, DVM Hemopet / NutriScan

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Pet caregivers seem to have become accustomed to thinking that hairballs are the status quo for cats. It is true that many cats spend several hours per day grooming themselves and that can lead to a build-up of indigestible keratin (the insoluble protein in hair). Veterinarians may only become concerned when the situation is a clinically significant issue or emergency marked by lethargy, unproductive retching and inappetence, which can indicate a potential hair blockage in the small intestine. Other veterinarians are not only concerned about the acute emergency, but also are worried that frequent hairball vomiting is an indicator of chronic small bowel disease.

The frequency number is a matter of debate about when we, as veterinarians, should be more proactive in pursuing a more definitive diagnosis. Some experts say hairball vomiting every week or two is perfectly within normal range. However, Dr. Gary Norsworthy, a feline medicine expert, says that frequency of vomiting is way too often. In fact, he puts greater restrictions on it: not more often than every two months or more, in otherwise healthy shorthaired cats; or, cats that are not fastidious groomers. I agree.

Landmark Study

In 2014, Dr. Norsworthy released what I consider one of the landmark veterinary studies of current time. Landmark is an impressive word but he took cat vomiting – which is still widely accepted as a normal biological function – and proved that it is not.

His journey to discovery is one for the history books. Veterinarians were all convinced that cat vomiting was due to a stomach issue. So, Dr. Norsworthy was employing endoscopy – the technique of inserting a tube with a camera into the esophagus and stomach for observation – but the results were clinically insignificant. Then he would lump everything as inflammatory bowel disease (IBD) and prescribe corticosteroids, anti-vomiting medications, a special diet and hairball lubricants. But, none of these treatment options had much impact on fixing the issues.  Eventually, Dr. Norsworthy and his team opted for ultrasound to view the stomach and the small intestine. (Endoscopy cannot enter the small intestine.)

Time and again, the stomach looked fairly normal but the small intestine was always inflamed. Eureka! Biopsy then confirmed that the walls of the small intestine were indeed thickened and that it was the cause of chronic cat vomiting.

Study Results:

  • 100 cats – Sample size
  • 1 cat – normal biopsy findings
  • 49 cats – diagnosed with chronic enteritis (usually IBD)
  • 46 cats – diagnosed with small cell lymphoma (cancer); which can be caused by untreated or undiagnosed chronic enteritis
  • 3 cats – mast cell disease
  • 1 cat – adenocarcinoma

You are probably wondering how an inflamed small intestine causes vomiting, if vomitus originates in the stomach. The explanation is that the whole gastrointestinal system is “backed up” because of hypomotility, which means that hair and food move through the bowel at subnormal speed. When more hair or food is ingested, the full bowel results in reflux vomiting.

Preventative Tips

Our goal should be to prevent the onset of IBD, because otherwise there is no cure and the current non-specific treatment measures are less than effective or desirable.

I also emphatically stress that cat caregivers need to be even more prevention vigilant as compared to dog caregivers. Why? Because cats are more finicky and become set in their ways, so you need to acclimate them to these tips at the earliest age possible. If you adopt a senior cat, please keep trying.

Food Special prescription foods for hairballs, sensitivities and urinary tract infections exist. However, they are generally cereal-based kibble and possibly have ingredients that are not only questionable, but also can inflame the bowel. This is the opposite of what we want to achieve. But, workarounds are available.

Food rotation is a key component with cats. Many cats will lock onto one type of protein because of repeatedly being fed it. We should not permit this. So, rotation from the beginning helps cats get used to the taste and consistency of many proteins. In fact, I would rotate the diet every few days or at least weekly.

The bigger problem is that we should not assault the bowel with foods that cause inflammation. So, we need to figure out which foods are causing the sensitivity or intolerance in an individual cat. Veterinarians often suggest food elimination diets, but it is difficult to ascertain which foods are causing the inflammation with this method, it takes too long (weeks), and compliance by the client or cat is difficult to maintain.  I suggest instead performing the NutriScan Food Sensitivity & Intolerance Test that I and the team at Hemopet developed. It takes out the guesswork. Once we do this, we have identified specific proteins that a cat will want to and can safely eat.

Kibble is by nature contradictory to a cat’s needs since it only contains about 10% moisture. Cats never drink enough water because they are descended from the African Wildcat. Observations have demonstrated that the African Wildcat only derives 10% of his moisture needs from freshwater sources and 90% from prey. Even though cats started the domestication process over 10,000 years ago, their primary purpose was to curb rodent populations so they continued to receive moisture through prey. So, I clearly want all cats on a moisture-rich diet that could be canned, dehydrated and moistened, or raw. At Hemopet, we feed Saucy, the feral cat that stays around our clinic canned food.

Grooming I would not be surprised if ingested hair also contributes to IBD. However, we cannot stop the hair ingestion. The best solution is investing in several of the right brushes and combs for cats. Definitely do your research about the type of hair and talk to grooming experts. Then, set aside a few minutes a day to brush your cat thoroughly or as much as you can. Many cats need to become acclimated to it but be unwavering in your commitment. In fact, some cats begin to love it so much not only for the feeling but also for the devoted affection.

Omega-3 Supplements   Omega-3 fatty acids can help improve the condition of your cat’s skin and fur, as well as the ability of his digestive system to manage the hair and debris he swallows while grooming himself. The source of omega-3’s is generally from fish, so you need to make sure your cat does not have a sensitivity to the type of fish or its oils.

Hairball Remedy Granted, not all hairballs can be stopped but, again, we want to decrease their frequency. When they do occur, many veterinarians suggest a petroleum-based hairball remedy. If you think about it, petroleum beds come from fossil fuels (e.g. dead dinosaurs) and is a little counterintuitive. Petroleum-free and all-natural options are available. They are usually made with slippery elm, papaya or marshmallow. Dab it on the tip of your cat’s nose. Your kitty will lick the jelly and swallow it. This allows the hair to pass more easily through the GI tract.

Fiber Fiber helps keep things moving. With cats, you can try pumpkin, wheatgrass, coconut fiber or psyllium seed husk powder.