My cat has been vomiting for several days and I have noticed what looks like blood in it. What could cause this?
You need to take your cat to your veterinarian right away. When an animal vomits blood, a serious disease process is underway.
Hematemesis, or the vomiting of blood, has a number of causes. It should be distinguished from hemoptysis, which is the coughing or spitting up of blood. Hemoptysis is associated with bleeding from the respiratory tract. Hematemesis arises from the upper gastrointestinal tract, including the esophagus, the stomach, and duodenum (upper part of the small intestine). Additionally, bleeding from the oral cavity is not usually considered hematemesis.
Hematemesis may result from ulceration or erosion of the internal lining (mucosa) of the upper GI tract. Blood clotting disorders may also produce the vomiting of blood, but such disorders are not common causes of it.
Conditions underlying bleeding upper GI mucosal lesions include tumors, environmental stress, shock, and corticosteroid and nonsteroidal anti-inflammatory medications. Certain organ system disorders, such as liver, kidney, and adrenal disease (Addison's disease) may cause it as well. Infectious and inflammatory diseases like gastritis, hemorrhagic gastroenteritis, inflammatory bowel disease, and
Helicobacter infection are important causes of hematemesis.
Clinically the vomited blood will have a variable appearance. It may look like small bloody spots, clotted drops, or like coffee-ground bits of digested blood. To some extent the appearance of the vomited blood correlates with the location of the source of the bleeding. Generally, the fresher looking the blood, the higher up in the gastrointestinal tract the producing lesion is situated.
The veterinarian may conduct bloodwork, including complete blood count, clotting tests, and a blood chemistry panel and urinalysis to establish a diagnosis of the underlying cause of the hematemesis. Fecal tests for occult blood are sometimes required. Radiographs (x-rays) and diagnostic ultrasound studies may reveal tumors and foreign objects when present. Biopsy or fine-needle aspirate tissue samples may be obtained for examination by a pathologist. The veterinarian may perform endoscopy to visualize ulcers, erosions and other lesions; to retrieve foreign objects; or to collect biopsy specimens.
Treatment of ulcers and erosive lesions involves temporary dietary modification, and the administration, as appropriate, of medications to block stomach acid release and to protect the cells at the ulcer site, of antibiotics, and anti-nausea agents. Treatment of anemia with blood transfusions and fluid replacement may be needed. Patients with chronic bleeding may be iron deficient and require supplemental iron. If tumors are present or if GI obstruction or ulcer perforation occurs, surgery may be required to save the patient's life.
Prognosis for recovery depends on the nature of the gastrointestinal lesion.
08/22/03
