Hairballs in cats: Symptoms, causes and treatment

Summary

What are hairballs in cats?

A hairball, more formally known as a trichobezoar, is a long cylindrical mass of hair that forms in the stomach. Cats groom themselves with their rough tongues, which have tiny hook-like barbs that catch the loose hair and foreign bodies in their coats, much like a brush. Swallowing of hair in cats from grooming is normal and typically the hairball should pass through the gastrointestinal tract and be expelled in the faeces.

Are hairballs normal?

While it is widely considered normal for a cat to vomit up the occasional hairball, it is generally an indicator that there is excessive hair consumption (often the case in longer haired cats) or indicative of an abnormality in the gastrointestinal tract. Hairballs are a common cause of vomiting in cats. It can be distressing for owners to observe their cat produce a hairball, and rather unpleasant to clean it up.

Ongoing production of hairballs can be indicative of an underlying issue that should be addressed, as they can cause gastrointestinal obstructions which require surgical intervention.

Expert advice from Dr Felicia:

Hairballs, while often seeming innocuous, are a helpful prompt to evaluate whether your cat is grooming excessively, needs additional grooming help or has an underlying gastrointestinal issue.

 What are the signs of a hairball in cats?

The most common signs seen by owners are:

• Vomiting of hairballs, food, mucus
• Retching, gagging or hacking, prior to vomiting
• Reduction of appetite
• Constipation

In severe situations, the hairball is not vomited up but remains in the stomach and hardens into a dense mass, which can irritate the stomach or even cause an intestinal blockage. Long-haired breeds have a greater risk of this occurrence due to their intake of larger quantities of hair, and these breeds should always have some supplementary grooming performed to reduce their hair intake.

What are the signs of a hairball obstruction?

Blockage of the intestines by a hairball may have the following symptoms:

• Repeated vomiting, often large volumes of undigested food and water
• Ongoing retching, gagging or hacking without producing a hairball
• Abdominal pain and discomfort
• Lethargy
• Constipation

Expert advice from Dr Felicia:

Hairball obstruction can affect cats of any age. Their signs of illness may be quite non-specific, such as reduced appetite, hiding and just not seeming themselves.

What causes frequent hairballs in cats?

Hairballs can result from a combination of different factors, which in most cases relate to the quantity of hair consumed and/or the passage of the hair through the digestive tract:

• Increased grooming due to skin disease or irritation
• Excessive or compulsive grooming due to behavioural causes
• Seasonal changes – additional hair is shed
• Indoor / sedentary lifestyle – physical inactivity can slow the passage of food and hair through the digestive tract
• Breed – Long-haired breeds, such as Persians and Maine Coons, tend to have more hairballs unless they are groomed to reduce hair consumption
• Motility disorders or the presence of “retention” pockets in the digestive tract, which affect the movement of food through the digestive tract
• Inflammatory bowel disease
• Obstruction from a foreign body, cancer, parasites

In the latter cases, the hairball should be seen as a symptom of an underlying problem, rather than the primary problem, and the underlying problem needs to be detected and treated, rather than the hairball itself.

Expert advice from Dr Felicia:

Given the wide ranges of potential hairball causes, Investigations for hairball may vary at least initially. Considerations include whether the cat is unwell or losing weight, the frequency of hairball elimination and what is currently being done at home in terms of regular brushing/whether other husbandry factors such as diet change have been attempted.

Hairball or cough: How can you tell?

Coughing and trying to bring up a hairball can look very similar in cats. When vomiting a hairball, a cat will usually retch with noticeable contractions of the abdomen and may eventually bring up fluid, food or a cylindrical mass of hair. A coughing cat may crouch low with its neck extended and produce repeated dry, harsh or wheezing sounds without bringing anything up.

Persistent coughing should not be assumed to be a hairball, as it may be associated with asthma or another respiratory condition. Record a video of the episode to show your vet, as this can help distinguish coughing from vomiting. Arrange a veterinary examination if the episodes recur, and seek urgent care if your cat is breathing rapidly, struggling to breathe or breathing with its mouth open.

When should you see a vet about hairballs?

Arrange a veterinary appointment if your cat is producing hairballs more frequently than usual, has started vomiting hairballs for the first time later in life, or also has weight loss, diarrhoea, constipation, reduced appetite, excessive grooming or skin changes.

Seek urgent veterinary attention if your cat repeatedly retches or vomits without producing a hairball, cannot keep food or water down, has stopped passing faeces, appears painful or unusually lethargic, has a swollen abdomen or is having difficulty breathing. Repeated hacking can sometimes be caused by asthma or another respiratory condition rather than a hairball.

How are hairball problems diagnosed?

The occasional hairball vomited up by a long haired cat who despises grooming is probably not unexpected, though not ideal. However, it is important to visit the vet in the following situations:

• Hairballs are occurring frequently
• Hairballs are occurring repeatedly for more than 24 hours
• If you cat is vomiting and coughing without bringing up a hairball
• If your cat is in obvious pain and discomfort
• If it is a new occurrence in an older cat

Diagnostic tests in more serious cases of hairballs may include:

• A complete blood cell count – to evaluate red and white blood cell counts and morphology
• A blood chemistry profile – to evaluate kidney and liver function, serum electrolytes (e.g. sodium, calcium, phosphorus), blood protein levels and blood glucose levels
• Thyroid screening – a total T4 test
• Urinalysis – to further evaluate kidney and function and urinary tract function
• Faecal examination – to check for intestinal parasites

Other diagnostic tests for imaging of the gastrointestinal tract may be recommended, depending on the results of the above tests, for example:

• Abdominal x-ray and / or ultrasound
• Endoscopic examination of the intestinal tract

Expert advice from Dr Felicia:

Imaging, typically x-ray or ultrasound is required for a definitive diagnosis of trichobezoar, with bloodwork and other screening tests performed to exclude other causes of vomiting/malaise. For other diseases endoscopic biopsies may be recommended to confirm a diagnosis of inflammatory bowel disease.

How are hairballs treated?

There is no treatment that will completely prevent the occurrence of hairballs, and more commonly where medical causes have been excluded there may be some adjustments to be made at home to reduce their incidence. There are a few different remedies that may reduce the number or frequency of hairballs. These may work for some cats but are not effective in all cases.

Common treatments and preventative measures for hairballs include:

Medications / laxatives

Mineral oil, paraffin oil and petroleum-based treatments may be prescribed (use these products only on veterinary advice). Usually given weekly, the underlying supposition is that a lubricated hairball will pass more easily out of the stomach and through the intestinal tract.

“Hairball formula” cat food

Certain commercial cat foods and treats are available tha claim to prevent and / or control hairballs. These are typically high in fibre, which is assumed to help bind the hair and stimulate the gastrointestinal tract to move the hairball along.

Dietary modification

Trialling different diets for sensitive stomachs may be beneficial for cats that vomit frequently, and may be advised by your vet. Often a wet food diet can be beneficial as cats tend to have insufficient water intake to supplement a dry food diet.

Grooming

Regular brushing and combing of your cat and using a de-shedding tool can help reduce the amount of hair that is swallowed. Removal of loose hair before your cat has the chance to ingest it will reduce the amount of ingested hair and lower the number of hairballs produced.

Seek out behavioural triggers for over-grooming, including boredom, and provide distractions and other enjoyable activities instead, and/or discuss the possibility of behavioural medication with your vet where appropriate.

Surgery

Enterotomy on the ileum (small intestine) may be performed in extreme cases to remove a hairball.

If an underlying or contributing cause has been detected, such as parasites, bacterial overgrowth or inflammatory bowel disease, treatment for these conditions will be prescribed.

Expert advice from Dr Felicia:

Some of these interventions can be tried in the absence of a definitive diagnosis in a otherwise healthy cat to see if it helps to improve the frequency of trichobezoars, however if there is limited improvement or deterioration additional testing is needed to seek the underlying cause.

How can you help prevent hairballs?

Regular brushing is one of the best ways to reduce hairballs because it removes loose fur before your cat can swallow it. Brush long-haired cats and heavy shedders frequently—ideally every day—and increase grooming during seasonal shedding. Keeping your cat’s flea prevention up to date and checking for skin irritation can also help, as itching may lead to excessive grooming and greater hair ingestion.

If your cat is producing hairballs regularly, speak to your vet. Frequent hairballs can sometimes be associated with allergies, skin disease, stress or an underlying gastrointestinal condition. Your vet may recommend a specially formulated hairball diet, paste or other treatment where appropriate. Do not give human laxatives, oils or home remedies unless specifically directed by your vet.

In a nutshell

Hairballs or trichobezoars are cylindrical masses of ingested hair that commonly occur in cats. They may result from a combination of factors including hair length, shedding patterns, dietary factors and digestive issues. Recurrent hairballs in an apparently healthy cat may indicate an underlying problem that should be investigated by your vet.

Sources

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