THE HAIRY TRUTH ABOUT HAIRBALLS AND OTHER ISSUES Dr. William Fortney, DVM

Not So Pretty Part of Cat Life

Hairballs, also known as 'Furballs' or trichobezoars (their scientific name), are a very common problem in cats - especially long-haired varieties. Up to 80% of cat owners report their cats produce hairballs at least monthly.  These disgusting furry sausages are accumulations of hair, fat and undigested food in the cat’s stomach that are eventually vomited up because they are too large to pass into the intestines.

 The top of a cat’s tongue contains numerous hard, tiny backward-facing barbs or spikes.  These spikes are great for cleaning and grooming, however, instead of spitting out the loose hair that accumulates on the tongue “brush”, they swallow it.

Normally the non-digestible hair swallowed passes through the stomach into the intestines and is expelled in the cat’s stool.  Problems occur when the swallowed hair combines with fat (and sometimes food) forming a dense “hairball” that usually stays in the stomach because of its size.

For most cats, this ingested hair passes through their system without any issues. However, some cats can accumulate so much hair in their digestive tracts that it leads to an obstruction, which may be expelled as a hairball. This buildup often results from excessive grooming due to skin conditions, pain, or stress, or from difficulties moving hair through the digestive system, which can occur with gastrointestinal diseases or certain medications.

Normally the non-digestible hair swallowed passes through the stomach into the intestines and is expelled in the cat's stool. Problems occur when the swallowed hair combines with fat (and sometimes food) forming a dense "hairball" that usually stays in the stomach because of its size.

The “hacking" you may notice when your cat is bringing up a hairball is the gagging or retching of trying to vomit. Besides the unpleasant hacking associated with hairball elimination, hairballs can also create a mess on floors, carpets or furniture. If you are a person who finds hairballs intolerable, you may even want to consider a hairless breed.

Hairballs are one of the most common reasons that cats vomit. While it is normal for a cat to have them occasionally, large hairballs can be dangerous.

Fortunately, most hairballs are eventually "coughed up" before they pass into the intestines and cause a serious digestive tract obstruction. Signs of a major hairball problem and possible obstruction are persistent retching/vomiting without producing the hairball, inability to defecate, diarrhea and/or loss of appetite.

To reduce the frequency of regurgitated hairballs at its source, you should regularly comb or brush your cat. Longhaired cats and cats with thick coats particularly benefit from regular combing. I remember at least one owner who routinely shaved her Persian cat in a drastic attempt to eliminate the problem.

If your cat still has problems even with frequent brushing, ask your veterinarian to recommend a hairball-management product. Most of these commercial compounds are composed of flavored non-digestible white petroleum that works by lubricating the cat’s digestive tract to help the hair pass more easily.

However, some cats will collect so much hair in their digestive tracts that it causes an obstruction which can be expelled in the form of a hairball. These hairballs are often caused by ingesting excess amounts of hair through overgrooming (common with skin conditions, painful areas, or stress) or by having trouble moving the hair through their system (which can occur with gastrointestinal diseases or certain medications).

.

An easier long-term solution to hairball problems involves switching to a hairball-control formula diet. Historically, veterinarians used a high-fiber diet to help with a chronic hairball problem. The fiber can help move the excess hair through the cat's digestive system. As hairballs are composed of up to 30% fat, a new dietary technology uses a natural soy lecithin emulsifier in combination with fiber. The emulsifier helps break down existing hairballs, allowing them to pass more easily through a cat's digestive tract. Even better, the compound minimizes the formation of new hairballs. You may want to ask your veterinarian about the newer hairball control formula diets for your cat.

Compared to relatively benign hairballs, swallowing a string-like object, medically termed a 'linear foreign body,' can have potentially fatal consequences. Being imaginative creatures, cats love to play with 'string-like' objects such as shoelaces, sewing thread, yarn, dental floss, curtain pulls, fishing lines, rubber bands, string, and audiotape. Holidays have an additional set of temptations with tree tinsel (the plastic variety), ribbons and balloon strings.                          

Unless it balls up, the digestive tract has a hard time moving a long string-like object through, especially if one end is wrapped around the base of the tongue. The stretched-out linear object causes the intestine to bunch up around it in a wavy accordion shape as the far end of the 'string' is pulled along by the intestine, which is attempting to move it out of the cat. But the near end of the string (closer to the mouth) may be anchored at the tongue or moving more slowly.

As the intestine continues to pull on one end of the string, the string becomes tense, like the rope in a tug-of-war. This increasing tension causes the string to 'saw' through the intestines with fatal complications if not surgically removed in a timely fashion. Obviously, the earlier the surgery, the better the outcome.

Signs of a 'linear foreign body' can include gagging, vomiting, diarrhea, anorexia, lethargy, a painful abdomen, and perhaps a fever. You might even see a string-like object protruding from your pet's rectum or mouth. Call your veterinarian immediately, but don't jeopardize your cat's health by attempting to pull the “string” out.

Despite the dangers posed by string, this is a fairly rare problem and most cats can live long and healthy lives playing with these types of things since most pass without hanging up and damaging the intestines. However, the best prevention is to eliminate as many linear objects as possible (especially loose objects that aren't attached to anything) from your cat's environment.

Maintaining Digestive System Health

Maintaining a healthy digestive system is very important to your cat's overall health. Here are some easy things you can do to keep the digestive system as healthy as possible:

* Keep your pet free of intestinal parasites such as worms. Have your veterinarian perform routine fecal examinations.

* Feed a high quality, highly digestible diet.

* If hairballs are a persistent problem, feed a hairball-control formula diet.

* If giving snacks or treats, make sure they are not more than 5% of the total diet.

* Avoid feeding fatty snacks that can upset the digestive system.

* Don't tempt your pet by placing 'goodies' (especially chocolate) in easily accessible areas of the house.

* Keep your cat's environment free of 'string-like' objects.

* If you suspect your cat may have a linear foreign body, do not delay in seeking veterinary care and don’t attempt to treat the problem yourself.

CONFUSING HAIRBALLS WITH VOMIT

Many owners often confuse hairballs with other types of vomit, and it's easy to understand why this mix-up occurs. When cats vomit, they typically exhibit a distinct body language that signals what’s about to happen. They adopt a recognizable crouched position, lowering their bodies while extending their necks forward. This posture not only prepares their body for expulsion but also serves as a clear signal to attentive owners. Alongside this physical cue, cats make various “expulsive” sounds—grunting, retching, or heaving—that can be alarming yet memorable for any cat owner.

It’s an experience that many cat owners would rather avoid, but once endured, it certainly imprints in one’s memory. In the moment, the combination of sounds, the cat’s position, and the sight of vomit can lead to a visceral reaction, prompting owners to rush to their pets’ sides in concern.

However, it's essential for cat owners to understand that this vomiting behavior isn't exclusive to hairballs. When a cat vomits for any number of reasons—such as dietary indiscretion, illness, or gastrointestinal irritation—they will exhibit the same crouched posture and expulsion sounds. As many cats groom themselves frequently, it’s almost inevitable that some hair will be mixed in with any vomit they produce, regardless of the underlying cause.

Despite this intertwining of hair and vomit, the mere presence of hair does not automatically classify the vomit as a hairball. A hairball, by definition, is a specific type of vomit that usually consists primarily of a compact mass of hair, along with some digestive fluid. In contrast, regular vomit may contain a mix of food, bile, and hair, and is often liquid or semi-solid rather than a cohesive mass.

This distinction is crucial for understanding your cat's health. Regular vomit, especially if it occurs frequently or is accompanied by other symptoms such as lethargy, diarrhea, weight loss, or changes in appetite, may indicate an underlying health issue that requires veterinary attention. Conditions such as a food intolerance, gastrointestinal obstruction, or infections can lead to repeated vomiting episodes and should not be overlooked.

In contrast, hairballs, while often considered a nuisance, may indicate that a cat is grooming more than usual, possibly due to stress, skin problems, or other factors that warrant examination. Monitoring your cat's vomiting behavior and the nature of what they are expelling can provide important insights into their health and well-being.

Ultimately, being able to distinguish between hairballs and other types of vomit can help cat owners respond appropriately and seek veterinary advice when necessary, ensuring their feline companions get the care they need to thrive and remain healthy.

How can I tell the difference between a hairball and other kinds of vomit?

Differentiating between a hairball and other types of vomit can be achieved through careful observation and attention to specific characteristics. The primary way to discern the two is by examining the ratio of hair to other materials present in the expulsion.

A hairball typically takes on a distinctive cigar-shaped form that consists mainly of densely packed hair fibers. This shape is a result of the way the hair accumulates in the cat's stomach, forming a coherent mass that the cat eventually expels. When a hairball is ejected, you may notice that it is often surrounded by a small amount of digestive fluid, which may include mucus or bile, but the predominant component is the hair itself. The density and compactness of the hairball can make it seem more solid compared to other types of vomit, and it may have a somewhat dry texture due to the concentration of hair.

In contrast, when a cat vomits due to other underlying issues—such as dietary indiscretion, illness, or gastrointestinal disturbance—the contents are usually very different in appearance and consistency. A typical vomit will be primarily composed of various fluids, including gastric juices and bile, combined with undigested food particles and other materials. In these instances, the amount of hair present in the vomit will be relatively minimal compared to the overall volume of the liquid and solid materials. The vomit might have a soupy or semi-liquid consistency, making it easy to distinguish from a hairball.

In addition to the content, the timing and context of the vomiting can provide additional clues. If your cat has been grooming excessively or you notice them retching in a manner consistent with producing a hairball, it's more likely that the expulsion is indeed a hairball. On the other hand, if your cat exhibits signs of distress, lethargy, or if the vomit occurs unexpectedly after eating, it could indicate an issue that requires further investigation.

Another factor to consider is the frequency of vomiting. If a cat is frequently vomiting primarily hairballs but shows no other signs of distress—such as weight loss, diarrhea, or changes in appetite—then this is somewhat normal for some cats, particularly long-haired breeds. However, if there is a significant increase in the frequency of hairballs or if the cat transitions from producing hairballs to more liquid vomit, it's crucial to consult a veterinarian. An increase in vomiting frequency can signify health concerns, including gastrointestinal blockage, pancreatitis, or infections that need immediate attention.

Confusing “Coughing’ with “Trying to Cough Up a Hairball”

Speaking of vomit, what many people don’t realize is that cats assume almost identical positions – and make almost identical sounds – when they cough and when they vomit.

Unfortunately, this leads many owners to ignore coughing in their cat, because they see it as “oh Fluffy’s just trying to cough up another hairball.” This can be problematic to ignore, as the coughing could be a symptom of a more serious medical issue, such as respiratory disease.

One thing to remember is that cats are very efficient vomiters. So, if they have something in their stomachs that they need to get out, they will. So, if nothing is coming out, they’re more likely coughing than “trying” to throw something up.

Confusing Acid Indigestion with Hairballs

Another common experience that many people confuse with hairballs is a cat’s early morning ritual of making retching sounds, and then spitting out puddles of liquid containing small tangles of hair.

This tends to happen most often in the early morning when cats start to become active, are thinking about eating, and have an almost empty stomach. And while this may contain liquid and hair, in many cases, cats that do this are suffering from acid indigestion, hyper-acidity, or bilious (nauseous) vomiting, and would need to be treated as such.

Should I Be Concerned about my Cat’s Hairballs?

If your cat is having actual hairballs every couple weeks, but is doing well otherwise, it is probably not something to be terribly concerned about. However, if it is happening more often (for example, a few times per week or more often) there may be an underlying medical issue, and you should see your local cat veterinarian for an exam. (While rare, some hairballs can become lodged in the intestine and require surgery)

If your cat passes a hairball and seems to be doing well otherwise, no treatment is really needed. In this situation, the best treatment is taking the steps above to prevent hairballs from happening again.

However, if your cat is having more regular hairballs, it’s best to consult  your cat’s veterinarian for a personalized treatment plan.