# Hairballs - are they normal?



## Ceiling Kitty (Mar 7, 2010)

I know hairballs/furballs have traditionally been considered a normal part of cat physiology. However, nowadays that idea has pretty much gone out the window. As far as I am concerned, personally, frequent hairball vomiting is a sign of a digestive tract problem until proven otherwise.

*Is it hairballs?*

If your cat brings up a clump of hair, that's a hairball.
If they bring up food or bile with a few strands of hair, or no strands at all, that's not a hairball. That's just vomiting. They are very unlikely to be trying to bring up a hairball.
If they are coughing or wheezing, I'd be more concerned about feline asthma and they need to see a vet; they are very unlikely to be trying to bring up a hairball.

Cats do not 'cough up' hairballs from their lungs; they vomit them up from their stomachs, and usually the hair only comes up by coincidence. The cause of the underlying vomiting needs to be addressed.

*What's normal?*

Cats spend 25% of their waking time grooming. The little barbs on their tongue catch a lot of hair, so overall a lot can get swallowed. This is usually passed out in the faeces and, although large amounts of hair can irritate the bowel and result in colitis, this is generally considered normal.

*Are hairballs ever normal?*

Cats are not birds of prey, and bringing up hair on a frequent basis is not really normal. Cats have evolved to ingest large amounts of hair through grooming, not to mention that they are able to handle small furry creatures such as mice.

There have been no large studies on the incidence of hairballs in domestic cats. Small surveys have suggested that around 10% of short-haired cats suffer with the frequent elimination of hairballs; this figure doubles for long-haired cats. Whether or not these cats are normal and healthy is open for debate, but I guess it stands to reason that long-haired cats should bring up more hairballs than short-haired cats.

Some specialists consider all hairballs to be abnormal. A prominent American feline medicine specialist says that they will allow a cat 'one or two hairballs a year', and that anything more than that warrants investigation.

Studies in big cats and feral cats are similarly lacking. One 1980 study of fourteen dockyard cats revealed that only 29% of them had any hair in their stomachs at post-mortem, and that only one cat had enough to form an actual hairball. Conversely, 22 out of 23 faecal samples from the same cats contained hair. Hair in poo is normal; hair in vomit is not.

*So, what can cause hairballs?*

There are two main causes:

1. Ingesting too much hair
- fleas
- itchy skin conditions
- overgrooming, for example due to stress

2. Abnormal movement of the upper digestive tract
- unsuitable diet
- IBD
- bowel cancer
- chronic pain or stress

Generally, when we see cats who bring up a lot of hairballs, we're thinking of chronic gastro-intestinal (GI) disease as the first thing to rule out.

*
What are the consequences of hairballs?*

Normally, hair in the stomach is passed out through the intestine and ends up in the poo. If there is too much hair in there, the ball becomes too big to pass and it is vomited back instead. Too much hair will gather in the stomach if it is ingested in large amounts, or if the stomach isn't contracting properly to push it through.

Occasionally, a hairball can be vomited up into the back of the nose and lodge there. This results in nasal discharge, sneezing, retching and foul breath.

If a hairball becomes so large that it cannot physically be vomited up, it will sit in the stomach or intestine indefinitely. This can obviously cause an intestinal obstruction. Hairballs that are present in the digestive tract for long periods can eventually become mineralised - ie calcium is deposited in the fibres and the hairball turns hard. Mineralised hairballs are even harder to pass or vomit and cause more severe symptoms.

*What to do next if your cat brings up a lot of hairballs?*

Speak to your vet. As mentioned above, frequent hairball vomiting points to GI disease until proven otherwise; investigations and/or treatment may be necessary.

The diagnostic work-up for chronic GI issues often begins with blood tests - a routine blood screen may be followed by more specific tests such as vitamin B12 and folate levels, pancreatic lipase etc. Poo tests, ultrasound scans and biopsies may also be recommended. Diet trials or medication trials may also help reach a diagnosis.

Vets will often recommend trialling a bland diet first. Diet-responsive GI disease is COMMON COMMON COMMON in cats. Swapping to an exclusion diet may reduce hairballs.

*What about hairball diets?*

Hairball Control diets contain high levels of insoluble fibre, to improve stomach motility and enhance the emptying of the stomach. This should make it easier for hairballs to pass. There is also belief that the larger kibble size with these diets is associated with increasing the chances of hairballs exiting the stomach.

There are no studies into the effectiveness of Hairball Control diets, but anecdotally they seem to work. However, switching blindly to one of these risks missing any underlying issues, plus a lot of them are dry food and may not be the best thing for cats.

It is interesting to note when considering a Hairball Control diet that raw diets are also (anecdotally) associated with reduction in hairballs, and that at least one prominent feline specialist recommends low carb, high protein wet food for the condition.

*What else can be done?*

Daily grooming to remove loose hair (especially in long-haired cats) is important. Severe cases may require a full lion clip to reduce the coat to a length that better represents what the cat's digestive tract evolved to handle.

Small, frequent meals encourage better emptying of the stomach, hopefully passing hairballs through.

Lubricants (such as Katalax or plain old liquid paraffin) are a controversial suggestion. Many have argued that hairballs in cats are not caused by a grease deficiency, and thus why would giving a lubricant help matters? Fact is, they may be worth a try; they are odourless and tasteless so often go down well in food.* There are (theoretical) concerns that liquid paraffin can affect the absorption of the fat-soluble vitamins (A, D, E and K); if using it long-term, it might be better to leave one meal per day 'untreated' to counteract this.

_*IMPORTANT: please never syringe liquid paraffin into your cat's mouth. Aspiration into the lungs is a real risk and extremely dangerous if it occurs. Always give it mixed in with food._

There are medications available that increase stomach motility. Speak to your vet about these.


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## moggie14 (Sep 11, 2013)

Thanks Shosh for another informative post 
Must admit none of my moggies have ever had this problem in the past ... except Dexter one of my current boys who very occasionally (once a month perhaps?) brings up a hair ball and he is a short haired Tonk cross 
I would be concerned if this was a regular occurance


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## rose (Apr 29, 2009)

I have 3 cats, a siamese, siamese mix and a birman. The birman has brought up hair balls that look like sausages as far as I know 3 or 4 times a year. The others never. I have only ever had a long haired cat once before ( another birman 36 years ago) he used to bring up similar hair balls without any other problems and died in his sleep aged 16. Assumed hair balls were part and parcel of being long haired?


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## nicolaa123 (Mar 30, 2012)

And just to add 

Some Startling New Thoughts on Cats and Hairballs


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## Ceiling Kitty (Mar 7, 2010)

nicolaa123 said:


> And just to add
> 
> Some Startling New Thoughts on Cats and Hairballs


That's an awesome article, thanks!


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## nicolaa123 (Mar 30, 2012)

Shoshannah said:


> That's an awesome article, thanks!


What you have written makes so much sense..plus months and months of research into ibd, throws (excuse the pun) a lot up about the link between hairballs and ibd and the like.


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## GingerNinja (Mar 23, 2014)

My Basil was semi-long haired and suffered with hairballs. He died from cancer in his stomach/intestines (I did not have investigations done) and was sure that there was some link. 

I suppose now that the problem caused the hairballs rather than the other way round 

Still miss my gorgeous boy


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## chillminx (Nov 22, 2010)

Many thanks Shoshannah for that useful, & interesting information.

And many thanks Nicola for the link to the interesting article


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## urbantigers (Apr 13, 2014)

Interesting. One of my cats (semi longhaired) does bring up hairballs (definitely hairballs as they are clumps of hair just accompanied by a small amount of stomach contents) from time to time but my short haired cat has never had a problem. I think I could help by grooming him more often and getting rid of loose hair but he hates it and does a good job himself of making sure he has no knots.


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## korrok (Sep 4, 2013)

None of the cats I owned when I was young (5 of them) nor my current two bring up hairballs or anything that remotely looks like it, including the one who was longhaired...I've always wondered why some cats do and some don't. Very informative!


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## ForeverHome (Jan 14, 2014)

This is very interesting and ought to be pinned really.

However just to add a comment on the normality of hairballs in wild animals, Big Cat Rescue who house upward of 100 various big cats and smaller big cats seem to think it's quite normal. Here's an ocelot, one of my favourite cats, not filmed at the prettiest time but relevant -


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## Jannor (Oct 26, 2013)

Great articles Shosh and Nicola.

Just to add - I did think originally my NFC was vomiting because of hairballs but he turned out to be hyperthyroid.


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## Cookieandme (Dec 29, 2011)

I was starting to think my two were odd as they have never had a hairball and lots of people talk about them.


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## chillminx (Nov 22, 2010)

Aren't your two shorthaired CandM? It is very rare for any of my shorthaired cats to vomit hairballs - in fact none of my current shorthaired cats have ever done so (at least none I have witnessed). 

My longhaired cat is different - if he is not thoroughly groomed every day (all year round, not just in moulting season) he will vomit hairballs.


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## ForeverHome (Jan 14, 2014)

chillminx said:


> Aren't your two shorthaired CandM? It is very rare for any of my shorthaired cats to vomit hairballs - in fact none of my current shorthaired cats have ever done so (at least none I have witnessed).
> 
> My longhaired cat is different - if he is not thoroughly groomed every day (all year round, not just in moulting season) he will vomit hairballs.


Misha was technically a shorthair though long for a shorthair ie not proper short like a Burmese - and she produced them at the rate of a couple a week her whole life. She was not brushable, even at 7 or 8 weeks old she shredded hands if we tried. My current two produce enough for me to know whose hairball it is if I didn't see them do it.


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## nicolaa123 (Mar 30, 2012)

The thing that really sticks out for me is the fact cats have groomed for years and years and years. Being sick is quite a process and a stress for a cat, so why would that be the only way to get rid of excessive fur when it can cause discomfort and pain to a cat. The "normal" way is for the fur to pass through the body rather than vomit it. Makes sense to me that if the only way is to make themselves sick to rid the excess hair there must be an issue..


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## Cookieandme (Dec 29, 2011)

Yes both BSH although Cookie's coat is twice the thickness of April's, April doesn't like being brushed but Cookie sheds all the time.


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## ForeverHome (Jan 14, 2014)

nicolaa123 said:


> The thing that really sticks out for me is the fact cats have groomed for years and years and years. Being sick is quite a process and a stress for a cat, so why would that be the only way to get rid of excessive fur when it can cause discomfort and pain to a cat. The "normal" way is for the fur to pass through the body rather than vomit it. Makes sense to me that if the only way is to make themselves sick to rid the excess hair there must be an issue..


Yes, that's why I took the trouble to post the thoughts of a big cat rescue organisation who seem to think it's perfectly normal in wild animals.


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> Yes, that's why I took the trouble to post the thoughts of a big cat rescue organisation who seem to think it's perfectly normal in wild animals.


I actually found the link quite disturbing especially as it's titled as being funny 

Did not look funny to me in the slightest


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## chillminx (Nov 22, 2010)

nicolaa123 said:


> I actually found the link quite disturbing especially as it's titled as being funny
> 
> Did not look funny to me in the slightest


Nicola - I completely agree with you, I thought the same

Foreverhome - but they are not wild animals living in the wild, they're in a sanctuary for rescued big cats.

I would think their diet is similar to that which is provided in safari parks for big cats - hunks of raw meat on the bone, but not an entire prey animal such as a deer, so there'd be less roughage in the diet.

Who knows what difference that would make in terms of smooth passage of ingested fur through the digestive tract.


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## ForeverHome (Jan 14, 2014)

Ok you carry on. I'm quite sure it _can_ be indicative of underlying problems in some cases, just the same as a headache or coughing can be in humans, but personally I don't subscribe to the idea that every sniffle has to be checked out and treated.

Hairballs and IBD - a hairball that comes up the way it went down hasn't been anywhere near the bowel, it's only been as far as the stomach. So it might make sense to find a link between a lot of difficult hairballs and something being amiss in the stomach, which might also have effects further along the intestinal tract, but there's got to be a lot more to it than hairballs being symptomatic of IBD. A missing link in the chain, so to speak.

Always good to be vigilant and aware of your cat's health, but in the interests of people being able to make informed decisions on their pets' health and welfare I thought (perhaps wrongly) that an alternative point of view might be of value.

Here's a question - do raw fed cats that don't have IBD never get furballs?


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> Ok you carry on. I'm quite sure it _can_ be indicative of underlying problems in some cases, just the same as a headache or coughing can be in humans, but personally I don't subscribe to the idea that every sniffle has to be checked out and treated.
> 
> Hairballs and IBD - a hairball that comes up the way it went down hasn't been anywhere near the bowel, it's only been as far as the stomach. So it might make sense to find a link between a lot of difficult hairballs and something being amiss in the stomach, which might also have effects further along the intestinal tract, but there's got to be a lot more to it than hairballs being symptomatic of IBD. A missing link in the chain, so to speak.
> 
> Always good to be vigilant and aware of your cat's health, but in the interests of people being able to make informed decisions on their pets' health and welfare I thought (perhaps wrongly) that an alternative point of view might be of value.


Hairballs are not always a symptom of ibd at all could be a whole number of other issues going on, which was listed in the first article. Yes the article I linked to did mention ibd as I have a cat with ibd and my research has bought up the subject many times. However the new studies being done (which makes a lot of sense) is if you have a cat vomiting on a regular basis then you should get it checked out rather than just put it down to hairballs.

I feel you are being a little over sensitive about it. Absolutely we all need to be vigilant with out cats health and yes an alternative point if view is always good to read. What I didn't like was the fact the you tube clip was titled funny. Not my sense of humour at all. Plus there was not information I could see on that page that stated it was "normal" please correct me if I am wrong.

Oh and I would always suggest people contact their vet or do their own research rather than just believe what they read ie make their own informed decision.


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## nicolaa123 (Mar 30, 2012)

To answer your edited question. No idea if raw fed non ibd cats get hairballs. Oh and ibd is not just food related there can be a whole load of other factors going on that can cause ibd. If the problems stop with a raw diet or diet manipulation then the ibd is put down to food sensitivities.

However some cats with ibd do not respond to diet adjustment (true ibd) 

My ibd cat never never had hairballs. However now if he does have one I can also tell that he will then have a flare up.


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## JaimeandBree (Jan 28, 2014)

Shoshannah, what would you consider to be "frequent" i.e. too many hairballs?

Just interested because coincidentally one of mine (not sure which as I found it on the spare room carpet when I got up this morning, bleurgh!) brought up a hairball for the first time since I've had them today. I've had them 3 months. It was definitely a hairball as it was a large clump of hair covered in bits of food, lovely to wake up to


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## chillminx (Nov 22, 2010)

ForeverHome said:


> in the interests of people being able to make informed decisions on their pets' health and welfare I thought (perhaps wrongly) that an alternative point of view might be of value.


Of course, why wouldn't it  All comments here are part of a friendly discussion aren't they Sorry I didn't like the content of your link, but it was no reflection on you. 



> Here's a question - do raw fed cats that don't have IBD never get furballs?


I should think it's an individual thing, even on a raw diet. Coat length would be a factor too.

IBD can in some cases cause inflammation of the whole gut, not just the bowel. e.g. gastritis in the stomach. This _might_ possibly be a relevant factor I don't know.


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## ForeverHome (Jan 14, 2014)

nicolaa123 said:


> Hairballs are not always a symptom of ibd at all could be a whole number of other issues going on, which was listed in the first article. Yes the article I linked to did mention ibd as I have a cat with ibd and my research has bought up the subject many times. However the new studies being done (which makes a lot of sense) is if you have a cat vomiting on a regular basis then you should get it checked out rather than just put it down to hairballs.
> 
> I feel you are being a little over sensitive about it. Absolutely we all need to be vigilant with out cats health and yes an alternative point if view is always good to read. What I didn't like was the fact the you tube clip was titled funny. Not my sense of humour at all. Plus there was not information I could see on that page that stated it was "normal" please correct me if I am wrong.
> 
> Oh and I would always suggest people contact their vet or do their own research rather than just believe what they read ie make their own informed decision.


If a cat vomits a lot yes they should be checked out. That's not the same as a cat that brings up a lot of hairballs. I don't know about anyone else but I've never seen any food with the hairballs, just frothy saliva. They don't seem to bring it up in the same way, either. It's a hairball or the food coming back up, never both together, not with any of my 6 past and present anyway.

I thought some degree of normality was implied in the opening phrase "A lot of cats means a lot of hairballs".

No it's not my sense of humour either but I did feel it was relevant in the matter of whether hairballs are natural or not, to see that a big cat sanctuary sees so many of them they consider it perfectly natural. I mentioned it because until that point it looked a little bit like we should be whisking the cat to the vet's every time it brings up a hairball. Forgive me for being touchy about that, yes I admit I do get irritated with discussion forums where only one opinion is permitted, no matter what any alternative is backed up with.

eta Thanks Chillminx


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> If a cat vomits a lot yes they should be checked out. That's not the same as a cat that brings up a lot of hairballs. I don't know about anyone else but I've never seen any food with the hairballs, just frothy saliva. They don't seem to bring it up in the same way, either. It's a hairball or the food coming back up, never both together, not with any of my 6 past and present anyway.
> 
> I thought some degree of normality was implied in the opening phrase "A lot of cats means a lot of hairballs".
> 
> ...


I haven't seen anywhere on this thread that has stated only one opinion is allowed!

Back to the video yes that was implied but that is no real evidence that it is normal behaviour. If I remember I will ask tomorrow at the wildlife park that is next to where I volunteer at the hedgehog hospital. One of the volunteers is actually one of the cat keepers I will ask her as she spends a lot of time with them.

We all make decisions about our cats health and well being and what's right for one isn't always right for the other. Only we can make that call.


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## ljs85 (Jun 2, 2012)

Now that it's been said, it does seem obvious that vomiting up hairballs isn't really the best way of removing hair......

Thankfully only one of my three (Tiberius) is prone to hairballs, and even then it's only every couple of months or more.

He's a Maine coon so semi long haired, but Ezri (another mc) has never had them. I think it's because that while they are both semi long haired, Tiberius seems to have a lot more loose hair and is prone to matting whilst Ezri rarely has matts.


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## Ceiling Kitty (Mar 7, 2010)

Shine a light.

I don't think that a cat should be taken to the vet for producing one hairball. Or even two. Or even a few a year.

But cats who bring up hairballs frequently - I don't think we can put an exact figure on it, but let's for argument's sake say a couple of times a month - should be checked out.

Coughing in cats is NOT caused by hairballs and should always be checked.

IBD is NOT the only cause of hairballs. In a young cat, dietary intolerances can be a common reason for abnormal gastric motility. The idea that hairballs are a normal part of feline physiology has been bandied around for so long that many people DO know no different; all I want is to spread the word so that owners whose cats are barfing hair all the time consider that maybe something could be amiss and get them checked out.

As for big cats - as I said my first post, studies are lacking. I have contacted a friend of my stepfather's (he's a cryptozoologist and has many, many contacts in the zoology world) who is an expert in big cats to see what he says, and I will let you know.


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## catfan (Feb 1, 2014)

Whilst this makes sense to me there are always some oddities I think. I saw on an American forum that a cat started getting hairballs _after_ they had been switched to a raw diet (and on it a while) when they never did before! (not that that makes me think switching to raw is a bad idea in any way).


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## nicolaa123 (Mar 30, 2012)

Shoshannah said:


> Shine a light.
> 
> I don't think that a cat should be taken to the vet for producing one hairball. Or even two. Or even a few a year.
> 
> ...


I didn't get chance today to ask at the the wildlife park today as was a busy day, some poorly hogs and one DOA very sad poor little one.

Be interesting in what you find out about the big cats..


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## catfan (Feb 1, 2014)

> dietary intolerances can be a common reason for abnormal gastric motility


What is going on in the digestive system when this happens? (and when stress causes the same problem?) - don't worry if it's too complicated or time consuming to explain but was just wondering.


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## Ceiling Kitty (Mar 7, 2010)

The physiology of gastric motility is pretty complex - at least I think it is - but I shall do my best to summarise it. 

When the stomach empties after eating, the liquid empties first followed by the solid material (which includes food and hair). These are called 'liquid-phase' and 'solid-phase' emptying, and their rates are highly dependent on diet.

Studies have shown that average solid-phase emptying in cats fed on wet food is four hours; in dry-fed cats it is 14-16 hours. Interestingly, there is conflicting evidence on whether or not water intake affects gastric emptying time, as some papers have found it does and others have found it doesn't.

Dry food-wise, they've found that triangular kibbles are emptied more slowly from the stomach than round ones. Don't ask me why!

From this, we could conclude that feeding dry food slows down gastric emptying time, possibly making the vomiting of hairballs more likely as they sit in the stomach for longer.

In cats, it has been suggested that the normal contractions of the stomach are absent or reduced in the interdigestive period - that is, the fasting time between meals. In most species, special contractions called IMMCs (interdigestive migrating motor complexes) maintain gastrointestinal motility even when there's no food in there. These IMMCs are responsible for moving indigestible material from the stomach into the large intestine.

It has been proposed that cats differ. They don't appear to have traditional IMMCs. Instead, they have MSCs (migrating spike complexes), which seem to be absent in the stomach and only present further down the bowel. This delays gastric emptying time during fasting. These findings have not been proven in any actual live cats, but it seems to make sense. I guess more research is needed to prove it either way.

If this is true - also bearing in mind that larger meals have been found to slow down solid-phase emptying - it could be deduced that feeding smaller, frequent meals may help hair pass more easily than large, infrequent ones.

Diet-responsive gastrointestinal disease is common in cats. Symptoms include vomiting and/or diarrhoea, and when vomiting occurs frequently any hair that normally would have passed out of the stomach is brought back, hence the hairballs.

Anything that causes inflammation of the bowel - IBD, dietary sensitivity - will affect its motility, because the contractility of the smooth muscle in the gut wall is reduced by the inflammation. The mechanism is way too complex for me - it involves muscarinic receptors, ion channels and stuff. Human papers report that the reduced motility results in changes in the normal bacterial flora, which then aggravates the inflammation and creates a perpetual spiral of problems. 

Hope this clears things up and hasn't made it worse. :lol:


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## catfan (Feb 1, 2014)

That does help. Thank you for taking the time to answer.


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## ForeverHome (Jan 14, 2014)

That is helpful I think but I'm not sure I understand it properly. 

Liquid phase and solid phase makes sense, if a cat chucks up soon after eating it's normally very liquid, if it's later then it's normally more solid (in my experience anyway). I take it emptying happens a bit at a time of increasingly solid material? That could explain my observation that furballs never come up with much food, if any. 

Solid phase emptying takes nearly a day in dry fed cats - I don't get this bit. If a cat has a dry meal then 6 hours later a wet meal, presumably it all mixes, so does that mean the dry slows down evacuation of the wet? Dry and more hairballs makes sense though. 

If smaller more frequent meals should result in fewer hair balls, this runs counter to the raw/dry argument, as dry fed cats are more likely to be nibbling all day while unless I'm much mistaken a raw fed cat is more likely to get 1 or 2 meals a day? So thinking logically (possibly wrongly) that could account for raw-fed hairballers and dry-fed non-hairballers ... have I read that all wrong?

If the same is true of big cats who may eat a huge meal every couple of days, by this they ought to get lots of hairballs? And not all their own hair if they eat the skin of their prey. 

But why would hair sit in the stomach while pieces of bone pass on through?

Bobby coughs. More in the days running up to a furball. He's been checked over, nothing found. 

Now - gastric emptying slowing down during fasting, I'm intrigued. It would be a marvellous bit of evolutionary design to slow down the energy release from your food while you don't have much of it! But is that another reason why furballs form? If so that would seem to be an added reason to free-feed rather than fixed set meals. 

And I'm thinking, bear with me on this, say on day one a cat is hungry and eats more than it needs, then day two is not hungry so eats less than it needs, the food it does eat would go through more slowly so it wouldn't feel hungry, but by the next day it hasn't had enough so it's hungry again? 

And finally, is hepatic lipidosis more common and faster onset in cats compared to other animals? And would that indicate, together with the lots of small meals preventing furballs, that they are not designed to cope with an empty stomach? Or on the contrary should the stomach get a break from working?


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## Ceiling Kitty (Mar 7, 2010)

Interesting post, ForeverHome, I don't know the answers to some of the questions. I _will_ answer a bit later when I'm feeling a bit better. xxx


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## chillminx (Nov 22, 2010)

ForeverHome said:


> if a cat chucks up soon after eating it's normally very liquid, if it's later then it's normally more solid (in my experience anyway).


What happens during the digestion process is : once the food is in the cat's stomach the gastric juices in the stomach start protein digestion. The juices consist mainly of hydrochloric acid and pepsin. There is also mucous present to protect the lining of the stomach from the digestive juices.

At the same time as the chemical process of protein digestion takes place, mechanical mixing is going on by means of peristalsis, which causes waves of contractions along the stomach wall, enabling the mass of food to mix with the digestive enzymes.

After 3-4 hours in the stomach of a domestic cat the food has been turned into a thick liquid called 'chyme' (so the more liquid a cat's vomit the longer the food has been in the stomach being processed).

Next stage of digestion is when the pyloric sphincter valve opens, and the chyme enters the duodenum where it mixes with digestive enzymes from the pancreas, then passes through the small intestine in which digestion continues. 95% of nutrient absorption takes place in the small intestine.

When the chyme is fully digested it is absorbed into the blood. Water & minerals are reabsorbed into the body in the colon. Some vitamins e.g. biotin and vit K, are produced by bacteria in the colon and these too are absorbed into the blood in the large intestine.

Bone is hard for the cat's stomach to break down and some of it (not sure what %) will pass through the system almost unchanged, providing fibre.

There will of course always be some hair in the stomach of a cat. When a cat vomits there will be hair in the vomit, and the presence of hair itself may not always be the cause of the vomiting.

The stomach of a short haired domestic cat in good health, will cope fine with processing the amount of hair the cat swallows from normal grooming. It is the longer haired cats who may have a problem.

A short haired cat who vomits regularly is likely to be doing so due to inflammation of the gut (especially the pancreas) which in turn is interfering with normal peristalsis and as a result causing a partial blockage in the gut.

Gut inflammation in cats is commonly due to dietary sensitivity, or may be due to bacterial causes etc.

Hope some of that might be of interest.


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## ForeverHome (Jan 14, 2014)

Thanks CM, all the general description I remember from school. Hair present seems logically normal, that long-haired should have more of it is also logical. But a hairball as such is a lot more hair than just one or two days, is it not? So it must be staying in the stomach while the stomach is emptying, several times, to build up to the big sausages I get on my carpet. It follows that the stomach is not fully emptying, does it not?

Shosh - re your cough videos on the other thread, the first is exactly what Bobby does but he does it for longer. With his past career he's been tested for lots of things and the vet checked his upper and lower respiratory tract and listened to his heart, and said all was normal. It hasn't got any better or worse in 14 months and he has no other symptoms - but I think dry central heating can be ruled out. He often does it on waking and tends to do it more in the few days before a big fur ball. He also snores. Hardly surprising as he has one of those run-into-the-window faces.

Edit: He also 'huffs' when he's had a run-around, doesn't breathe heavy but just gives a 'huff' as soon as he stops.


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## jaycee05 (Sep 24, 2012)

Thank you for all the above posts, one of my cats has colitis, and used to bring hairballs up quite a lot, just recently they have come out the other end, not sure why, as i thought hairballs just came up from the stomach, and wouldnt pass through she gets really bad stomach cramps and tries, to get to the tray,[doesnt always manage it] or vomits,or both,
My vet says there is nothing they can give her, except an inflammatory injection about once a month,i hate seeing her in pain,as she really cries out in pain


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## chillminx (Nov 22, 2010)

ForeverHome said:


> a hairball as such is a lot more hair than just one or two days, is it not? So it must be staying in the stomach while the stomach is emptying, several times, to build up to the big sausages I get on my carpet. It follows that the stomach is not fully emptying, does it not?


I agree it seems hair is remaining in the stomach whilst the stomach empties of its other contents (chyme) several times over. Not sure why this would be - could it be there is too much hair in the stomach for it to be broken down adequately by the hydrochloric acid sufficiently to pass through the pyloric sphincter?

How well does hydrochloric acid break down hair anyway? (hair does contain keratin protein) - I don't know.


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## ForeverHome (Jan 14, 2014)

chillminx said:


> I agree it seems hair is remaining in the stomach whilst the stomach empties of its other contents (chyme) several times over. Not sure why this would be - could it be there is too much hair in the stomach for it to be broken down adequately by the hydrochloric acid sufficiently to pass through the pyloric sphincter?
> 
> How well does hydrochloric acid break down hair anyway? (hair does contain keratin protein) - I don't know.


I believe it doesn't, and hair also takes a very long time to break down post mortem too. As a matter of fact I've seen my own long hairs come out the back end of a cat, usually in the form of a dangly klingon waving around as the cat walks ...

What I have always believed about hairballs is that some hair will pass through with the food but if there's more it can form a clump in the stomach with is not normal to pass as a ball through the intestine but is supposed to come up periodically as a furball. Don't ask me where I get this from, it's what I've always understood to be the system.

Following on from this and with years of observation, I believe grass helps the hair to pass normally if it's an oily smooth grass, however the rough lawn grasses (like the ones you can use to whistle in your hands) are an irritant and can provoke the hairball back up again. Whether that's planned on the cat's part or not, no idea.

There is one thing that makes sense about vomiting hairballs as being the right way to dispose of hair. Chyme as it travels through the convolutions of the gut is soft and malleable and isn't going to get stuck. However a sausage of matted hair is pretty stiff, and that would be more likely to cause a blockage. So if the cat were to have evolved to let individual hairs pass through the gut but to collect hair deliberately in the stomach until the ball is big enough to make it worth chucking up, that would help avoid blockages. Furthermore I put it to the court that hairballs always seem to be sausage shaped, not a random rounded mass, which I put it to you might indicate it's a deliberate evolutionary strategy. Otherwise, a sausage would pass easily through a sausage shaped gut, so why doesn't it?

I'd like to stress I have no veterinary knowledge on this matter but these are observations and logical deductions.

As for being indicative of other bowel problems, maybe there is a causal link (either way) between an irritable gut and very little hair passing through it, hence more hairballs. Maybe not enough hair passing through irritates the gut, or maybe because the gut is irritated the cat retains more hair in its stomach to form sausages?

ETA a blockage would be fatal, whereas stomach acid coming into contact with the teeth most likely would not, certainly not at reproductive age, so the lesser of the two evils would survive to pass on their genes ...


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## Satori (Apr 7, 2013)

chillminx said:


> How well does hydrochloric acid break down hair anyway? (hair does contain keratin protein) - I don't know.


Like FH, I would assume not at all. If you look at the concentrations needed to break down the hair in your drains, the conditions in a mammals stomach wouldn't touch it.


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## nicolaa123 (Mar 30, 2012)

Then that poses the question why do some cats never experience hairballs?


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## ForeverHome (Jan 14, 2014)

nicolaa123 said:


> Then that poses the question why do some cats never experience hairballs?


Maybe in some there is less hair ingested or more of the ingested hair passes through and isn't retained? No hairballs at all is just another point on the scale from none to weekly or daily, isn't it?

I don't know, I'm just chewing it over. It would be really helpful to know more about wild cats though, if they have a similar hairball rate to an average domestic shorthair, it could be normal. If they have very few or none, it might be the result of something we're doing wrong.


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## Jonescat (Feb 5, 2012)

I sort of assumed that the sausage shape was because the oesophagus is a tube and the hair ball would have to be squashed in to a sausage in order to get out.


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> Maybe in some there is less hair ingested or more of the ingested hair passes through and isn't retained? No hairballs at all is just another point on the scale from none to weekly or daily, isn't it?
> 
> I don't know, I'm just chewing it over. It would be really helpful to know more about wild cats though, if they have a similar hairball rate to an average domestic shorthair, it could be normal. If they have very few or none, it might be the result of something we're doing wrong.


But if they are all made the same way surely then they would all deal with the hair in the same way? Same as humans built the same way digest food, yet some have problems with digestion even tho we are made the same way, just some of us have underlying problems.

Plus with wild cats are you talking about captive or wild as I would think a completely different answer would be obtained.


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## nicolaa123 (Mar 30, 2012)

Jonescat said:


> I sort of assumed that the sausage shape was because the oesophagus is a tube and the hair ball would have to be squashed in to a sausage in order to get out.


I have read similar..let me find the quote

According to Joanna Guglielmino, DVM, they are generally similar in appearance to a cigar or sausage, an elongated shape imparted by the narrow food tube (esophagus) through which a hairball passes on its adventurous journey from the cat's stomach to the outside world.


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## Ceiling Kitty (Mar 7, 2010)

ForeverHome said:


> Thanks CM, all the general description I remember from school. Hair present seems logically normal, that long-haired should have more of it is also logical. But a hairball as such is a lot more hair than just one or two days, is it not? So it must be staying in the stomach while the stomach is emptying, several times, to build up to the big sausages I get on my carpet. It follows that the stomach is not fully emptying, does it not?


Sorry if I've lost track of this thread and am repeating what others - or even I, for that matter - have said. I have read all the posts. I would imagine that the reason the hair is coming up is exactly that - the stomach isn't emptying fully and the hair isn't being passed through into the duodenum. The question is, why is that happening?

The feline medicine bods believe that it shouldn't happen and is a sign that something is wrong. The other argument is that it can be a normal phenonemon in feline gastric physiology. I buy into the former, personally, but opinions are opinions and not facts. 



ForeverHome said:


> Shosh - re your cough videos on the other thread, the first is exactly what Bobby does but he does it for longer. With his past career he's been tested for lots of things and the vet checked his upper and lower respiratory tract and listened to his heart, and said all was normal. It hasn't got any better or worse in 14 months and he has no other symptoms - but I think dry central heating can be ruled out. He often does it on waking and tends to do it more in the few days before a big fur ball. He also snores. Hardly surprising as he has one of those run-into-the-window faces.


It's obviously difficult for me to comment on a specific case and nor should I, really (as I'm sure you can appreciate), because I have never seen Bobby. Can it be ascertained in his case that he definitely isn't coughing, starting to gag then bringing up hair as a 'side effect' of the coughing?

Hair comes from the stomach, not the respiratory tract, so coughing should not be linked to hairball vomition directly.

I think if he's been checked over by the vet and both you and the vet are happy with him, then that's all good.  The purpose of my original post is to ensure that people whose cats barf up hairballs all the time get them checked out to make sure nothing else is underlying, seeing as popular culture and belief has portrayed hairballs as 'normal' when, in many cases, they are not.


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## Ceiling Kitty (Mar 7, 2010)

Oh bloody hell, I just stated in my previous post that I'd read the whole thread but I didn't even see the next page of posts!   What a technologically incompetent moron I am. :thumbdown:

Sorry, reading the rest now.


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## Ceiling Kitty (Mar 7, 2010)

Jonescat said:


> I sort of assumed that the sausage shape was because the oesophagus is a tube and the hair ball would have to be squashed in to a sausage in order to get out.


Correct, I would say.

Regurgitation is NOT vomiting, but as an example, regurgitated food etc comes out as a sausage because of the oesophageal lumen.


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## Ceiling Kitty (Mar 7, 2010)

I haven't heard anything back from big cat man yet.

I have another contact I've asked (he he makes me sound like I'm a gangster or something). He's an eminent zoologist in Denmark who is also an expert on animal hair. I'll see what he says.

I suppose, to deepen the confusion further, we need to consider whether or not there is a difference between the big cats and the small wild cats. Species from the _Panthera_ and _Felis_ genera could vary. It would be great to know if the Pallas's cat produces hairballs, being the only long-haired wild cat.


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## Jonescat (Feb 5, 2012)

Shame thatsafunnylookingcat isn't around so much now - they might have had some interesting info to share.


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## Ceiling Kitty (Mar 7, 2010)

This is what Lars has said:

_Wild cats (big and small) do produce hairballs, but in far smaller quantities than domestic cats. So it is in a sense natural - but wild cats typically has far shorter hairs than many domestic types, so more of the hairs naturally pass straight through and never gets a chance to become entangled and make balls, whereas longhaired domestics - well you know._

And when I asked him about Pallas's cat:

_Its such a rare cat, and equally rare in captivity so there is hardly any information on it. Fact is, that it does happen in nature. I have for instance found a a hairball in Kenya at a much used resting place for lions - it was the size of a tennisball - so it does happen. But usually the hairs go out the "proper" way. It is a rare occurence. In olden time these kind of hairballs, which you can also find in other animals, were knows a bezoars, and all kinds of strange capabilities where assigned to them._


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## ForeverHome (Jan 14, 2014)

So fair to say some hairballs are perfectly normal, a lot of hairballs might indicate a problem. If the longer the hair the more hairballs, domestic shorthairs should have more than wild cats and longhairs more than shorthairs - in general. So far so good, and then excessive hairballs can point to a problem. Ok. 

The sausage shape being formed as it comes through the oeosophagus - I am unconvinced. Put on a pair of rubber gloves next time your kitty presets you with one and play with it, see if it can be re-formed to a different shape. They are pretty stiff, hence my thoughts earlier on the viability of getting one through the convolutions of the intestinal tract. 

Thank you S for your comments on Bobby, of course I didn't think you'd be able to diagnose him for me  but the hairball doesn't immediately follow the cough. Of course airway and foodway are separate. But increased coughing in the week leading up to a hairball is odd. Anyway ...


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> So fair to say some hairballs are perfectly normal, a lot of hairballs might indicate a problem. If the longer the hair the more hairballs, domestic shorthairs should have more than wild cats and longhairs more than shorthairs - in general. So far so good, and then excessive hairballs can point to a problem. Ok.
> 
> The sausage shape being formed as it comes through the oeosophagus - I am unconvinced. Put on a pair of rubber gloves next time your kitty presets you with one and play with it, see if it can be re-formed to a different shape. They are pretty stiff, hence my thoughts earlier on the viability of getting one through the convolutions of the intestinal tract.
> 
> Thank you S for your comments on Bobby, of course I didn't think you'd be able to diagnose him for me  but the hairball doesn't immediately follow the cough. Of course airway and foodway are separate. But increased coughing in the week leading up to a hairball is odd. Anyway ...


With regards to the hairball when I've experienced a fresh one I have found I can squish and pull apart (didn't even use gloves) when it's not been fresh ie I've not been home or found under the bed then yes it's harder but still able to reform the shape


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## Ceiling Kitty (Mar 7, 2010)

ForeverHome said:


> The sausage shape being formed as it comes through the oeosophagus - I am unconvinced. Put on a pair of rubber gloves next time your kitty presets you with one and play with it, see if it can be re-formed to a different shape. They are pretty stiff, hence my thoughts earlier on the viability of getting one through the convolutions of the intestinal tract.


Will have to see if Bagpuss produces any - Orange never produced a single one in 15 years. If he does oblige, I shall have a poke!


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## ForeverHome (Jan 14, 2014)

nicolaa123 said:


> With regards to the hairball when I've experienced a fresh one I have found I can squish and pull apart (didn't even use gloves) when it's not been fresh ie I've not been home or found under the bed then yes it's harder but still able to reform the shape


I suggested gloves for the squeamish  I haven't deliberately pulled one apart yet but whenever I've picked up with a piece of bog roll it's been a lot firmer than a goo of partially digested food.


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> I suggested gloves for the squeamish  I haven't deliberately pulled one apart yet but whenever I've picked up with a piece of bog roll it's been a lot firmer than a goo of partially digested food.


Ah maybe you havn't fully examined a fresh one. Next time maybe try and reform one, you could be surprised


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## ForeverHome (Jan 14, 2014)

nicolaa123 said:


> Ah maybe you havn't fully examined a fresh one. Next time maybe try and reform one, you could be surprised


Bobby hadn't even finished expelling the froth when I picked one up yesterday morning. Not hard by any means, but a lot less malleable than soggy half-digested food. Much like others I've picked up immediately for the past 27 years.


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## nicolaa123 (Mar 30, 2012)

Picking up with tissue will give a different feeling. Maybe next time don't use tissue


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## ForeverHome (Jan 14, 2014)

nicolaa123 said:


> Picking up with tissue will give a different feeling. Maybe next time don't use tissue


Ok. And if it falls apart like a slop of half digested food, I'll eat it.


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## Ceiling Kitty (Mar 7, 2010)

ForeverHome said:


> Ok. And if it falls apart like a slop of half digested food, I'll eat it.


Ew... :eek6:


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> Ok. And if it falls apart like a slop of half digested food, I'll eat it.


I don't think you need to eat them but I guess it's another way to judge consistency, not sure even I would go as far as eating one


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## ForeverHome (Jan 14, 2014)

nicolaa123 said:


> I don't think you need to eat them but I guess it's another way to judge consistency, not sure even I would go as far as eating one


Oh dear - figure of speech, as I don't have a spare hat.


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## nicolaa123 (Mar 30, 2012)

ForeverHome said:


> Oh dear - figure of speech, as I don't have a spare hat.


Now I'm even more confused I thought we were talking about hairballs not hats 

Be interesting tho if cats have various consistency to their hair balls wonder what that could mean?


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## Jonescat (Feb 5, 2012)

I came across this - which says hairballs are differently made up but no explanation as to why:
http://docsdrive.com/pdfs/medwelljournals/javaa/2004/833-841.pdf

It might give a little justification to Cosma Thai fruits chicken and pineapple though!

Also have come across the fact that bezoars (trichobezoar) can be made up of either hair or vegetable matter (phytobezoar) so I wonder if you can get combinations, giving different degrees of mushiness?

Also loads of stuff about how motility is affected by practically everything from diet and stress through the a-z of disease, so suffering cats may not have the same problem, just the same symptom


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## Paddypaws (May 4, 2010)

Bezo Pet Lubricant Paste For Cats And Dogs 70g Tube - Animed Direct
I have no idea if this is of any use, or is better/worse than Katalax etc but it caught my eye in view of this discussion.
I do remember reading an article which stated that stubborn hairballs are actually hair bound together with undigested fat....and therefore adding lecithin to the cat's diet (naturally in egg yolk) could help break down those fats and help the problem.


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## koekemakranka (Aug 2, 2010)

I always thought hairballs were normal. Nunu is a longhaired cat, but although he is groomed daily, he does still vomit up hairballs, I would say about once a month. He hates the taste of the petroleum pastes and gags if I try to get some into him (I sometimes sneak some onto his paw when he is alseep). I must say, since I have moved him to a wet food diet, the hairballs have decreased. I wonder if it has to do with moisture content of the food. The other two cats, both shorthaired, have never vomited up a hairball. Flea did once, but it was not her hair, it was Nunu's (she had been grooming him ). I wonder also if modern longhaired cats have "unnatural" coats due to the way they have been bred? Most wild cats are shorthaired as was mentioned earlier.
This is a very informative thread, thank you OP


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## Aeth (Mar 31, 2014)

I was having some problems with River bringing up hairballs when she was new to the household a few months ago. Reading through this, I wonder if an element of the hairball problem was caused by her having a bit of diarrhoea/soft poo for 2-3 weeks, caused by stress from the move. 

The hairballs started about two weeks in, there were two, after which I started giving her Whiskas anti-hairball treats. She then had a really nasty episode of very watery diarrhoea, which meant I had to take her to the vet. He treated it with a multi-pronged approach as there's a look of giardia around here just now apparently, and recommended malt paste in the future. I waited for a week for her tummy to settle down (another hairball in the meantime, but a smaller one), and since I've started giving her the malt paste she's had no more problems.

I just wonder if the couple of weeks of abnormal gut function might have caused her hairballs.


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## chillminx (Nov 22, 2010)

Aeth said:


> Aeth, it could well have done, as her gut was probably inflamed, and inflammation of the gut interferes with normal peristalsis. i.e. normal movement of gut contents is hampered, and can cause temporary partial blockages. This could include hair not being able to pass through the gut as it should, thus forming hairballs which had to come up as they could not go down.


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## jaycee05 (Sep 24, 2012)

chillminx said:


> Aeth, it could well have done, as her gut was probably inflamed, and inflammation of the gut interferes with normal peristalsis. i.e. normal movement of gut contents is hampered, and can cause temporary partial blockages. This could include hair not being able to pass through the gut as it should, thus forming hairballs which had to come up as they could not go down.


My cat has had hairballs come out of both ends, so must be able to go down too


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## Ceiling Kitty (Mar 7, 2010)

jaycee05 said:


> My cat has had hairballs come out of both ends, so must be able to go down too


It is normal for them to go down.  The debate remains as to how normal it is for them to come up. :blink:


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## MerlinsMum (Aug 2, 2009)

Shoshannah said:


> It is normal for them to go down.


So obvious when you think about it. Cats eat rats, mice, birds, rabbits, fur and all. The fur obviously passes through the other end, so why would we think it normal for their *own* fur to come up a different way?

Always fascinated when my dogs eat whole game - even feathers come out looking a bit like fur in the poop, as the quills must be digestible but the strands of feather aren't.


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## ForeverHome (Jan 14, 2014)

Seems we don't even have a consensus on whether bits of fur and feather should come up or go down. Some cats pluck and some eat it all. Some cats bring it up and some cats send it down. So would it be reasonable to suppose that their own fur should also have two possible routes, in whatever proportion? 

Another difference between wild and domestic is thta the house cat has the benefit of a warm winter indoors and therefore can happily moult all year round, which a wild animal is less likely to do. For sure we have bred thick coated long haired cats so maybe it makes sense to get more furballs than would be normal for a cat. 

I am slightly disappointed at the virtually nil response to the idea that the convolutions of the intestine could make passing a furball hazardous. We do hear of cats getting blockages due to large furballs, whereas I've never heard of a cat getting into a life-threatening situation bring up a furball. Surely the idea merits a little more thought than it's been given here.


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## Britt (May 18, 2014)

Great article.

I give my Pooh Intense Hairball from Royal Canin and 10 Whiskas Temptations anti Hairball daily.


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## buffie (May 31, 2010)

ForeverHome said:


> *I am slightly disappointed at the virtually nil response to the idea that the convolutions of the intestine could make passing a furball hazardous. We do hear of cats getting blockages due to large furballs, whereas I've never heard of a cat getting into a life-threatening situation bring up a furball*. Surely the idea merits a little more thought than it's been given here.


When I had a discussion with Meeko's vet about hairballs he said that in all his years in veterinary practice he has only seen one cat with a blockage caused by a hairball.
With regards life-threatening situation bringing up a hairball I don't think that is what is being said,the suggestion being put forward is that in a cat that is healthy and doesn't have any/show any possible signs of digestive issues 
should not vomit hairballs very often.


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## Ceiling Kitty (Mar 7, 2010)

Sorry ForeverHome, I missed your last post. 



ForeverHome said:


> Seems we don't even have a consensus on whether bits of fur and feather should come up or go down. Some cats pluck and some eat it all. Some cats bring it up and some cats send it down. So would it be reasonable to suppose that their own fur should also have two possible routes, in whatever proportion?


Yes.... but, I still do not see vomiting as a physiological process that nature would intend to happen on a regular basis, in the absence of something underlying. Obviously vomiting is a protective mechanism, but it is accompanied by the expulsion of hydrochloric acid which, we know, can damage the oesophageal and oral mucosae, plus the enamel on teeth, if it happens frequently.

This is in contrast to regurgitation, which happens by a different mechanism and does not involve stomach acid because, in mammals, it does not involve the stomach. Regurgitated material originates from the oesophagus and does not tend to pass the cardiac sphincter into the stomach per se.

It would make more sense for anything 'normal' that is consumed - food, hair, whatever - to pass through the gut and into the faeces, rather than come up in a pool of acid. To me, vomiting has always been a mechanism of ejecting something potentially harmful (such as a foreign body that cannot pass through, or a toxin), or an unfortunate side effect of disease.

I guess it comes down to whether you count hair to be normal, or a foreign body. :blink:



ForeverHome said:


> Another difference between wild and domestic is thta the house cat has the benefit of a warm winter indoors and therefore can happily moult all year round, which a wild animal is less likely to do. For sure we have bred thick coated long haired cats so maybe it makes sense to get more furballs than would be normal for a cat.


I agree. This is one crucial difference between domestic cats and wild/feral cats.



ForeverHome said:


> I am slightly disappointed at the virtually nil response to the idea that the convolutions of the intestine could make passing a furball hazardous. We do hear of cats getting blockages due to large furballs, whereas I've never heard of a cat getting into a life-threatening situation bring up a furball. Surely the idea merits a little more thought than it's been given here.


We do hear of it. I personally have never seen an intestinal blockage due to a bezoar. In fact, thinking back now, the only intestinal blockage I have ever operated on in a cat was caused by consumed cat litter, which resulted from pica, in a cat who had underlying alimentary lymphoma. Her bowel disease had caused the pica, and the litter got trapped at the level of the tumour.

In long-haired cats, more frequent vomiting of hairballs probably is normal, compared to short-haired cats. The vast majority of wild cats are short-haired. Long-haired domestic cats probably ingest more hair when grooming than nature intended them to, so vomiting hairballs probably occurs more often. But I still don't believe it is normal full-stop.

Whack 'cat hairballs normal' into Google and you'll get a bunch of stuff stating that it is. It doesn't really seem to question it, and there's no real explanation behind it. Maybe these sites are correct. I'm not saying they definitely aren't, just that I _believe_ they aren't.

Whack 'cat hairballs normal' into a VIN (Veterinary Information Network) search, searching the opinions of veterinary surgeons worldwide (albeit mostly in the US), and you'll get a very different story. Searching the opinions of feline medicine specialists almost invariably turns up the view that frequent vomiting of hairballs is abnormal.

Some examples:

*Dr. Jane Brunt, a former president of the American Association of Feline Practitioners:*

_The bottom line about hairballs is they are not normal," says Dr. Jane Brunt, a feline veterinarian and executive director of the CATalyst Council. "The cat has developed a digestive tract that can handle normal amounts of fur without a problem. Even long-haired cats should not develop more than one or two hairballs a year._

*Martha Cannon, an RCVS recognised Specialist in Feline Medicine, published this excellent article in JFMS in 2013:*

*Hair Balls in Cats: A normal nuisance or a sign that something is wrong? J Feline Med Surg. January 2013;15(1):21-9. 
*
Her findings were a little more open-minded, and included:

_Vomiting of hair balls is common in domestic cats and is often an indication of excessive fur ingestion or of altered gastrointestinal motility.

Owner surveys conducted in the authors practice suggest that around 10% of otherwise healthy shorthaired cats regularly bring up hair balls (two or more per year) and that the incidence in longhaired cats is around twice that in shorthaired cats.

Diet-responsive gastrointestinal disease is a common cause of hair ball vomiting in otherwise healthy shorthaired cats._

But she summarised the problem as such:

_Vomiting of hair balls is a common problem in domestic cats, to the extent that it is considered by many owners and veterinarians to be a normal feline behaviour. Whether this is ever the case remains unclear but in most shorthaired cats the frequent elimination of hair balls is an indicator of an underlying chronic disease that is causing increased ingestion of fur or altered gastrointestinal motility._

*Dr. Gary Norsworthy, a certified feline specialist and editor of six commonly used feline veterinary textbooks:*

*Diagnosis of chronic small bowel disease in cats: 100 cases (20082012) JAVMA (2013) 243: 1455-1461*

_... notable finding in this study is that vomiting of hairballs is really not as normal as we have thought. _

_I hypothesize that formation and vomiting of hairballs are due primarily to hypomotility of the small bowel. Instead of moving aborally at the normal speed, hair moves slowly, resulting in hairball formation.

I am convinced that the vomiting of hairballs is a sign of chronic small bowel disease if it occurs twice a month or more in any cat; or if it occurs once every two months or more in shorthaired cats; or if it occurs in cats that are not fastidious groomers, i.e., presented with many mats in their hair coats or with heavy dandruff._

But TBH, these comments and other similar ones were rather quickly talked down.  The latter comment above came from a vet who then worked up her own cat who vomited weekly, to find it had hyperthyroidism and IBD. And this is discussion between vets - there's not always agreement of opinions in the veterinary world, but there is now a clear consensus emerging that frequent hairballs are abnormal.

My personal view is that hairballs, brought up frequently (more than a couple of times per month) are not normal. My own cat with IBD still NEVER brought up a single hairball.

But... that's my opinion, and opinions are not always correct.


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## CoCoTrio (Jan 3, 2013)

I've just caught up with this thread and it's really interesting. Thanks to all esp Shosh for all the insights. Mr T has only ever given us two hairballs, so about one every 12 months. The latest was day before yesterday. Just seems odd if something is 'normal' that it should happen so very infrequently.  

What's the average size of a ball? Mr T's was about 2" long. Yuk.


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## ForeverHome (Jan 14, 2014)

Thanks S for that very informative and helpful stuff. I've been wondering (as I cleaned long fine cobweb-like hairs out of a hire car where their owner has never been) about the structural differences of long and short hairs. The shorts I've known have a relatively straight hair that bounces back to straight-ish if bent. This long-hair has, well strands of cobweb is the best description I can think of. That would alter how the hair is dealt with perhaps?

Also that I very rarely see a furball with food, yet it must take time to form in the stomach. But they seem to be brought up separately. I'm still obstinately thinking there has to be some mechanism we don't yet understand for that to happen. One stomach - bring up breakfast but leave the hairball in place, and bring up the hairball on its own later? I think they are doing something clever with their hairballs.


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## CoCoTrio (Jan 3, 2013)

ForeverHome said:


> I think they are doing something clever with their hairballs.


 Cats are full of mysteries!

Our recent hairball was sitting in a puddle of watery puke, but no food. I think you're right, maybe they can wait until the food's passed out of the stomach before expelling the ball.


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## ForeverHome (Jan 14, 2014)

Sorry to "bring this up" again, blame what Molly brought up this morning! 

One hairballs, sausage shaped ... but folded in half. Folded in half and pressed, so no not just loosely folded as it landed on the carpet. When I saw it that reminded me it's not the first time I've seen this. 

Does that not suggest the mat has formed in the stomach, and has not become sausage-shaped as a result of passing through the oeosophagus? I knew there was a reason I believed they formed in the stomach, I'd forgotten what the reason was. Thanks Molly.


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## Ceiling Kitty (Mar 7, 2010)

They do form in the stomach??? :huh:


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## ForeverHome (Jan 14, 2014)

Shoshannah said:


> They do form in the stomach??? :huh:


Don't they??


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## Ceiling Kitty (Mar 7, 2010)

ForeverHome said:


> Don't they??


Yes, they do. I'm confused!


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## ForeverHome (Jan 14, 2014)

Shoshannah said:


> Yes, they do. I'm confused!


Ah I understand the confusion now.

Earlier it was suggested that the elongated shape of a furball was due to its passage through the oeosophagus. For some reason I don't believe that but I couldn't remember the reason. I now remember it's because I've occasionally seen them long and then folded over.


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## Ceiling Kitty (Mar 7, 2010)

ForeverHome said:


> Ah I understand the confusion now.
> 
> Earlier it was suggested that the elongated shape of a furball was due to its passage through the oeosophagus. For some reason I don't believe that but I couldn't remember the reason. I now remember it's because I've occasionally seen them long and then folded over.


It's my understanding that the elongation IS due to the oesophageal passage.  This is what we see with food that has been regurgitated as opposed to vomited. It's tube shaped.

Incidentally, I recently heard a report of a cat who died after vomiting a hairball which got caught in the oesophagus. Made me think of this thread!  :lol:


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## ForeverHome (Jan 14, 2014)

I can't 'like' that how awful. 

How do you explain folding over then?


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## Ceiling Kitty (Mar 7, 2010)

ForeverHome said:


> I can't 'like' that how awful.
> 
> How do you explain folding over then?


Yeah... I've just looked it up a bit more and have found a few reports now of cats presenting with hairballs wedged in their oesophagus.  I've never seen one, touch wood! 

I very much doubt a hairball in the stomach is completely spherical. The stomach has a somewhat tubular shape, albeit very wide. I imagine a non-spherical clump of hair being pushed through the oesophagus makes it completely tubular. I don't see any reason why it couldn't enter the oesophagus slightly folded and be pushed up that way.

It's an interesting subject - someone should do a study!


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## Citrineblue (Sep 28, 2012)

Having only just seen this thread.... Interesting......

We have five cats and no hair balls at all. Two are shorthair BSHs, one shorthair curly selkirk, one longhaired curly Selkirk and one longhaired variant Selkirk so a range of hair types and lengths. The only thing similar is their diet of RAW mince and Chunks and whole prey. All are in full spring moult and no hair balls. I know anecdotally they say RAW helps prevent hair balls but it does seem to correlate here.


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## ForeverHome (Jan 14, 2014)

Certainly is, even on here we've raised more than enough ideas for a dissertation. 

Another observation - cat eats increased amounts of grass over a period of a few days, keeping it down. Then eats an even larger amount for a couple of days which it brings back up - on its own. Then suddenly without warning brings up a furball on its own with no grass. 

So does the grass really help the cat to bring up the furball at all?


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## oliviarussian (Sep 2, 2010)

My Rosso gets quite poorly the day before he brings up a hairball, goes very quiet and withdrawn and gets diarrhoea...As soon as he has brought it up he's as right as rain, I thought it was just coincidental the first couple of times but it happens like clockwork!


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## bluecordelia (Jan 5, 2014)

This has got me pondering. Blue doesn't have hairballs she hacks up but on occasion we get a few small 0.3-5 cm little cylindrical hairballs in faeces. She is a sensitive tum and i try to avoid grain.


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