Tails of Truth: The Truth about Veterinary Medicine

Your Cat's Vomiting Isn't Normal: Let's Chat About IBD

• Dr. Angie Krause, DVM CVA CCRT • Episode 5

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Summary 

In this episode of Tails of Truth, Dr. Angie and JoJo chat about a common concern—vomiting in cats. They debunk the myth that it’s “normal,” and explain how it often points to inflammatory bowel disease (IBD). They walk listeners througha holistic approach to diagnostics, including how to tell IBD from lymphoma, when to consider steroids, and how diet and personalized care can make a big difference. They also get real about poop (yes, photos are welcome) and why documenting symptoms is a game-changer at the vet’s office. 

Takeaways

  • Vomiting is common in cats—but it’s never normal.
  • IBD is often the root issue, not just a “sensitive stomach.”
  • Lymphoma sounds scary, but most cases start as IBD.
  • Endoscopy can help confirm a diagnosis.
  • Steroids can help but should be discussed thoroughly.
  • Diet matters—a lot. And every cat is different.
  • You don’t have to rely only on prescription diets.
  • Personalized, holistic care can reduce symptoms and stress.
  • Poop tracking (and photos!) helps vets diagnose and treat.
  • Dr. Angie offers a free course for cats with vomiting and diarrhea.

Please subscribe and review! xoxo Dr. Angie & JoJo


Dr. Angie (00:01.117)
Welcome back to Tails of Truth where we tell the truth about veterinary medicine. I'm Dr. Angie and this is my veterinary nurse, JoJo. And, today we're going to be talking about vomiting cats and more specifically cats with inflammatory bowel disease. And this is one of my favorite things to talk about. One of my favorite types of patients is the vomiting cat and just equally the cat with diarrhea, but usually they're

And so I just say, vomiting kitties.

JoJo Smith (00:33.23)
But vomiting cats is normal, Dr. Angie 

Dr. Angie (00:35.713)
Jojo.

JoJo Smith (00:41.056)
It's a belief that so many of us have had or do have.

Dr. Angie (00:45.277)
It well, right. the, the veterinarians I grew up seeing, you know, for my cats when I was young would say things like, a vomiting cat is normal. And I think what they wanted to say is that a vomiting cat is common, but it's never normal. If your cat is vomiting with any regularity, I mean, if your cat vomits once a year, I'm okay with it. But if your cat is like vomiting once a month, once a week, a couple times a week,

JoJo Smith (01:02.19)
Mmm.

Dr. Angie (01:14.974)
There is a problem and your kitty needs some

So that's my party line.

JoJo Smith (01:21.742)
And it is your sweet spot. We do see a lot of kitties with IBD or a lot of people that are scheduling video consultations for IBD, meaning inflammatory bowel disease, kitties, because they are not getting the support they need.

Dr. Angie (01:26.802)
A ton.

Dr. Angie (01:35.53)
Yes.

Dr. Angie (01:40.321)
No, most cats are not eating an appropriate diet. So we can talk about that. All of my thoughts about diet and where they came from, which was from traditional medicine and my traditional medicine training. And we can talk about steroids. We can talk about lymphoma. I know we can talk about all the scary things. Okay.

JoJo Smith (01:58.894)
scary word.

JoJo Smith (02:03.982)
Let's talk about the scary things. Yeah, that word, lymphoma, is really scary. You want to start there?

Dr. Angie (02:08.83)
Yes. Yes. So when your cat is diagnosed with inflammatory bowel disease, it's usually diagnosed one in an abdominal ultrasound. And the radiologist is going to say, you know, your cat's bowel loops are thickened and it's either due to inflammatory bowel disease or lymphoma.

And so that's really scary for so many people. And unfortunately, this cannot rule out lymphoma will follow you along throughout your cat's life. And so I always tell people relax, just kind of get used to it. And we'll always be checking your cat for lymphoma because unfortunately untreated or chronic inflammatory bowel disease.

can lead to lymphoma, but it doesn't always. But it is the scary thing that follows people around, including me. My last cat also had inflammatory bowel disease, and I was always checking to see, do you have lymphoma now? What about now? And not all cats get lymphoma.

JoJo Smith (03:25.11)
or start with lymphoma. Like I would say the smaller percentage of those initial abdominal ultrasound reports are IBD, a larger percentage are IBD versus lymphoma. I feel like we rarely see lymphoma from the jump.

Dr. Angie (03:26.887)
or star.

Dr. Angie (03:36.808)
Most.

Dr. Angie (03:41.513)
So rare do we see lymphoma. Yeah, from the get-go. Most cats have inflammatory bowel disease to start with. And so you can know common things happen commonly and the chances are, and now it really depends on the findings of the ultrasound, but most of the time it's not lymphoma and there's no need to panic unless...

JoJo Smith (03:55.182)
Hmph.

Dr. Angie (04:09.802)
The radiologist says, I'm very suspicious of lymphoma or your veterinarian's very suspicious of lymphoma. And then the next step to see if it's actually lymphoma is to go and do an endoscopy, which is a very noninvasive procedure where your cat swallows a camera. They're asleep, light sedation, and they can go in with a camera and take some biopsies and they can get a better idea if your cat has lymphoma.

it's just inflammatory bowel disease. And that happened with my kitty. He lost so much weight that I was so sure that he had lymphoma. So I sent him for an endoscopy and he just had really severe inflammatory bowel disease. So I think if you have the funds to do the endoscopy, it's worth doing.

JoJo Smith (04:55.81)
I was just going to say that. That sounds really expensive for a definitive diagnosis, which can bring us two things. First, I was going to talk about your cat Simba. Who was a vomiter? This kitty, I would randomly step and vomit, know, sometimes, which is what probably people at home are experiencing, you know, just because that's, that's goes along with the IBD.

Dr. Angie (05:00.217)
Yes!

Dr. Angie (05:07.125)
Yes.

Dr. Angie (05:19.014)
Yes!

JoJo Smith (05:25.774)
So I can understand why you're like, is this sweet as kitty ever? So I'm thinking along the lines of, so diagnostics in terms of getting an endoscopy, what is that defining symptom or that defining clue where their veterinarian might go, hey, I think this is lymphoma versus IBD. Like what is the characteristic difference?

Dr. Angie (05:29.386)
Yes.

Dr. Angie (05:54.475)
So there are certain findings on ultrasound, maybe just a small segment that's very thickened of the intestines instead of diffuse thickening. So that might be one, although obviously it can be diffuse thickening too. So that's why the lymphoma word never goes away. Or cats that aren't responding to treatment and maybe they're not responding to steroids or they're not responding.

to bigger of bigger gun immunosuppressants, then we think, I wonder if this has turned in to lymphoma.

JoJo Smith (06:32.45)
Hmm. So then let's talk about that. other scary word for a lot of people in our subset or our community is steroids. Nobody wants to say yes to steroids.

Dr. Angie (06:43.341)
steroids. I know if you want to talk about steroids, I, first of all, we're going to talk about it here, but if you want to talk about steroids for your cat and the application for your kitty, you can book a consultation with me, go to boulder holistic vet.com or natural cat vet vet.com and you can book a consultation. And I can tell you if I think your cat is ready for steroids.

Unfortunately, I see so many pet parents that will say, I read about steroids online and I'm really scared to use them. And it really does such a disservice for the number of cats that actually really benefit from steroids. And so, a lot of cats do really well. And there's the caveat of that. It needs to be a certain dose. There are.

two different types of steroids that you can use. And a lot of veterinarians just don't have time to have the conversation about the pros and cons of each type of steroid for inflammatory bowel disease in cats in the exam room. And so people, lot of people are really surprised to hear that they actually had options in the type of steroid and that there are pros and cons and that there are things that we can do to mitigate side effects.

JoJo Smith (08:01.486)
Huh.

Dr. Angie (08:09.79)
and that most cats, given the right dose, don't have a lot of long-term side effects and if anything...

JoJo Smith (08:16.746)
including diabetes, that's the one we hear a lot.

Dr. Angie (08:19.934)
Yeah. And I'm so glad that people are worried about diabetes because once again, it's that conversation in the exam room that just doesn't happen between most veterinarians and cat lovers because there's just not enough time. And so, when steroids cause diabetes in cats, which is rare, but it does happen. So if you start your cats on steroids, you need to know this.

when it happens, if we catch it quickly enough, we can reverse it. And so the key is using the smallest dose of steroid possible to treat the disease and then catching the diabetes if it happens early on. And that's something I can help you do in a consultation because for every cat it's gonna be different and make sure you're talking to your veterinarian.

about how you might detect the diabetes and how quickly you can test. it's something that shouldn't stop you from using steroids, but it's something to be educated about.

JoJo Smith (09:32.888)
And that is the gift of a consultation. I've seen it time and time again of just the dedicated space to piece out all of the options, know, talk through the fears, go through the data because there's, it's treatable. The IBD is, it can be managed. Your cat doesn't have to be miserable. There are diet options too. I know that you talk a lot about diet, especially for our IBD kitties.

Dr. Angie (09:55.05)
Mm-hmm.

Dr. Angie (10:02.77)
Absolutely. Usually I start with diet. so for my patients that I'm seeing that are vomiting once a month, or sometimes even once a week, a lot of these kitties can be helped with diet. And so that's something else, that we can work through in a consultation of what are you feeding now and what might you feed to help your cat stop vomiting, basically to reduce the inflammation in your cat's

GI tract. I also put out a course. that's okay.

JoJo Smith (10:33.314)
And there are options, I didn't mean to interrupt you. But there are options, I think it's important for people to know that there are options outside of prescription diets as well.

Dr. Angie (10:43.147)
There are options outside of prescription diets and there are some prescription diets that work really well for cats with IBD, but every cat is so different that I wish I could say, Hey, here are the three diets I use for IBD. I'd give them to you right now. And then it just doesn't work like that. Every cat is so individual. And one thing that we use a lot are novel proteins. And so I could say, we should try.

venison diet but if you said hey Angie I've been feeding my cat venison their whole life and now we have IBD then that probably wouldn't be the best recommendation and so that's why it's so important to get more personalized care.

JoJo Smith (11:28.686)
I love that, like the care plan. So when I interrupted you, you were gonna share that you have more information available.

Dr. Angie (11:34.348)
Yes. Yes. So I put out a course on both of our websites. So boulderholisticvet.com and natural cat vet, no, natural cat.

JoJo Smith (11:44.622)
I'll help you. You can also find it. It is kind of hard to say that at naturalcatvet.com.

Dr. Angie (11:47.488)
Natural cat vet doctor.

JoJo Smith (11:53.71)
www.hashelcavet.com

Dr. Angie (11:57.291)
For a minute, was like, could not remember the name of our own website. natural cat vet.com. I put out a course on each one of them. They have the same course content, where I walk you through what happens if your cat's vomiting, what you should do with their diet, walk you through all the diagnostic that you need to do, including the ultrasound, maybe the endoscopy.

JoJo Smith (12:04.28)
fair.

Dr. Angie (12:23.998)
I walk you through your treatment options, how to check for diabetes. And then we talk about the slew of, you know, natural and integrative treatments for inflammatory bowel disease. And there are a lot of them. And so usually by the time we get to steroids, your cat's probably lost weight or is very ill. And there are a lot of things before steroids. And so most veterinarians aren't saying, well, your cat vomits sometimes, let's just put them on steroids.

Usually there's something to prompt us to recommend that.

JoJo Smith (12:57.134)
Well, let's maybe close this out by asking if I have a cat and it's a vomiting cat, at what point do I need to seek care? And does it help if I have a journal of how many times they're vomiting, what they're vomiting, what their stool looks like? What helps you when I come to the exam room?

Dr. Angie (13:17.056)
Yeah, I want to know how frequently your cat's vomiting. And for me, I want to know, it weekly? Is it monthly? Or can you not remember the last time your cat vomited? Cause some people will be like, Oh, maybe cat vomits twice a year. And I don't care about that. We're not going to do anything about that. But if your cat's vomiting pretty regularly, I want to know about it. Um, that's about all I probably need to know. I want to know what your cat's eating and then.

if you know what their poop looks like and you can get online and there are poop scores. And so as we're scooping our cat's litter box, we're thinking about our urine clumps, but we're also thinking about how the poop looks like the texture of the poop, the shape of the poop. Is it a log or is it little tiny pellets?

JoJo Smith (14:09.08)
Photos are fantastic too. I mean, our phones are full of poop photos. This is a thing. I've told you it's a party trick for me when people are like, well, let's see your photos. I'm like, you don't want to see my photos. But they're helpful.

Dr. Angie (14:13.972)
They really are. Yes.

Dr. Angie (14:21.024)
Yeah, totally. They are helpful and we want to see them. So your veterinarian's like, my gosh, they are never walking out of an exam room and thinking that client gave me poop photos. No, they, we want to know. Yes, we absolutely want to know.

JoJo Smith (14:35.31)
We're celebrating that.

JoJo Smith (14:42.132)
That's, that was a lot of information packed in a very short time, I feel like. Yeah.

Dr. Angie (14:47.349)
Very short time. We did it. So if your cat's vomiting, we'd love to hear from you. What are you feeding your cat? So I'm not sure what platform you're watching this on, but leave us a comment or feel free to reach out to us, boulderholisticvet.com or naturalcatvet.com and you can check out our course. I did it. Okay. See you later. Bye.

JoJo Smith (15:06.584)
You did it.

Next time.

To download Dr. Angie's course on Vomiting and Diarrhea in Cats, please go to www.boulderholisticvet.com and use the code TruthTails during checkout to download for free.