Regurgitation in Cats
Overview of Regurgitation in Cats
Regurgitation is the backward flow or effortless evacuation of fluid, mucus, or undigested food from the esophagus. Unlike vomiting, it is not accompanied by nausea and does not involve forceful abdominal contractions. It is a symptom of esophageal disease and not a disorder in itself. The typical appearance of regurgitation in a cat is an undigested tube of food.
Below is an overview on Regurgitation in Cats followed by in-depth information the causes, diagnosis and treatment of this condition. It is important for your veterinarian to establish regurgitation from vomiting as they can look similar but the causes and subsequent treatment is very different.
The timing of regurgitation:
in relation to eating is determined by the location of esophageal dysfunction, degree of obstruction, and presence or absence of esophageal dilatation.
Regurgitation immediately after eating is most likely to occur with proximal esophageal lesions or esophageal obstruction.
Regurgitation may be unassociated with eating when the esophagus is dilated, because this provies a reservoir for food and fluid.
Selective retention of fluids over solid food is more likely with partial obstruction.
Causes of regurgitation in cats fall into two categories:
Esophageal structural disorders – which include foreign bodies, stricture and vascular ring anomaly
Esophageal motility disorders – which include megaesophagus
What to Watch For
Frequent regurgitation of undigested food
Care should start with a discussion with your veterinarian who will obtain a medical history about your cat. The initial differentiation between vomiting and regurgitation is important because, not only are different organs involved, but also different diagnostic techniques and therapeutics are warranted. Diagnostic tests and treatment should follow.
Diagnosis of Regurgitation in Cats
Diagnostic tests are usually needed to determine the cause of regurgitation. A thorough medical history is of paramount importance, confirming that your cat is regurgitating and not vomiting. A thorough physical examination is always necessary as well. Diagnostic tests may include:
Complete blood count (CBC)
Endocrine testing (ACTH stimulation, thyroid profile)
Thoracic (chest) radiographs (X-rays)
Acetylcholine receptor antibody test, antinuclear antibody testing
Electromyography and muscle biopsy
Esophagram (barium swallow)
Blood lead and/or organophosphate levels
Treatment of Regurgitation in Cats
Treatment of the regurgitating cat can either be supportive or specific, where the latter can be instituted when a known underlying cause is identified. Supportive therapy may consist of the following:
Gastrointestinal motility (movement) enhancing drugs
Acid blocking agents and esophageal/gastric coating agents in cases of suspect or associated esophagitis
Hospitalizing and restoring fluid and electrolyte balance and nutritional support in the severely ill patient
Antibiotic therapy in cases of pneumonia
Home care recommendations depend on the underlying cause of the problem. The following general recommendations should be considered:
Administer all prescribed medications and practice the directed feeding instructions.
Watch very closely for signs that might suggest secondary pneumonia, which include labored breathing, coughing and/or general lethargy and a poor appetite.
Pay close attention to the body condition of your pet. Maintaining an appropriate nutritional plan can sometimes be difficult in these cats.
In-depth Information on Regurgitation in Cats
There are many causes of regurgitation. It is important to understand that although there are multiple diseases of the esophagus that cause regurgitation, there are other disorders that are considered systemic (involving the whole body), that have an effect on the esophagus, and regurgitation is only one of the symptoms being exhibited. The following are the most commonly reported disorders associated with regurgitation in cats.
Megaesophagus (esophageal hypomotility) is the decreased/absent esophageal movement or peristalsis that often results in dilatation (stretching beyond normal size) of the esophagus. It may be congenital (existing from birth) or acquired (noninheritable trait that results later in life).
Esophageal inflammatory disease.
Esophagitis is an inflammation of the esophagus. It may be a primary entity or secondary to other disorders.
Myositis is an inflammatory/immune disorder that affects the muscles.
Intrathoracic extraluminal (in the chest cavity but outside of the esophagus) disease.
Vascular ring anomaly is a congenital disorder that causes an entrapment and compression of the esophagus and, in turn, a partial obstruction (blockage). Megaesophagus and regurgitation often occur secondary to this obstruction.
Intrathoracic (in the chest) tumors or masses may compress the esophagus from the outside, causing regurgitation.
A hiatal hernia is an abnormality of the diaphragm allowing part of the stomach to be displaced into the chest cavity. Regurgitation is one of the most common signs seen with this disorder.
Intraluminal (inside) esophageal obstruction.
An esophageal stricture is an abnormal narrowing of the esophagus, often secondary to either esophagitis or some inflammatory event, such as a foreign body.
Esophageal foreign bodies often cause regurgitation due to an associated esophagitis or physical blockage. Foreign bodies usually lodge at the narrowed areas if the esophagus, including the thoracic inlet, at the base of the heart, or at the hiatus of the diaphragm.
Tumors or masses can grow within the esophagus, causing obstruction and regurgitation.
An esophageal diverticulum is an out-pouching of the esophagus. It can be congenital or acquired.
Neuromuscular dysfunction resulting in megaesophagus.
Myasthenia gravis is a disorder affecting the neuromuscular (nerve and muscle)junctions often causing generalized weakness, in addition to megaesophagus/ regurgitation.
Polymyositis is a disorder associated with inflammation and weakness of the muscles, including the esophagus.
Endocrine disorders (hypothyroidism, hypoadrenocorticism) can be associated with regurgitation.
Certain toxicities (lead, organophosphate) can affect the esophagus and cause megaesophagus and regurgitation.
Systemic lupus erythematosis is an immune disorder affecting multiple systems, occasionally causing megaesophagus and regurgitation.
Polyneuritis is a disorder associated with the inflammation of multiple nerves, occasionally causing megaesophagus and
Idiopathic (unknown cause) megaesophagus is one of the most common causes of regurgitation. This is generally a diagnosis of exclusion, after all of the above diseases have been ruled out with appropriate diagnostics.