Symptoms, testing and diagnosis
Lucy, a 13 year old calico kitty came to see me because she was vomiting and losing weight. The prior vet had done blood work but didn’t find anything conclusive and the owners wanted a second opinion. After I saw and examined Lucy, I took x-rays which showed a foreign object in her stomach with the same appearance as food. To make sure it wasn’t food, I had them withhold food from her for 12 hours and then repeated the x-ray, when her stomach should be empty. The follow up x-ray still showed the same object in her stomach. I was worried that at 13, I was going to find a tumor, but when I took her to surgery to retrieve the object, I found that it was a giant hairball! I was so relieved but just to be prudent, I took a little piece of the stomach tissue for the pathologist to look at. I figured the pathologist would say that it was just reactive tissue from the hairball having been stuck in there, but to my surprise it came back as cancer and specifically, lymphoma.
Doctor Katz rethinks underlying cause and effect
I have thought a lot about this case because I was at first so happy to find a hairball but then to get the diagnosis of lymphoma was such a disappointment. I had been to a lecture a few years back during which the internal medicine specialist said that cats should not vomit hairballs. He said that they should be able to pass them and if a cat vomits hairballs, it’s a sign of underlying disease. At the time, I took this with a grain of salt, because I had known many cats to vomit hairballs that were not losing weight or seemed to have significant disease.
But after Lucy, I began to revisit that idea. I feel now that the hairball was indeed a symptom of a much bigger problem in her digestive tract. When a cat swallows hair in great quantities, the body forms a slimy covering to allow the hairball to slide through the intestinal tract and be expelled with stool. The fact that Lucy’s body could not process the hairball properly, I now felt, was because there was something wrong with her digestive system. The cancer cells took the place of her normal cells and couldn’t provide the same function as normal cells would.
Healthy cats should not vomit hairballs
I’m not saying that every cat with a hairball has cancer, but I do believe that if a cat has recurring hairball issues that cause him to expel hairballs as vomit, then it is worth looking into whether that cat actually has a primary digestive issue. It should be noted that cancer cells aren’t the only cells that can replace normal digestive cells. Inflammatory cells too can take the place of normal cells and prevent the body from working properly. This can result in vomiting in general, not just hairballs.
Though given an unfortunate diagnosis, at this point Lucy is remaining stable on medication and we hope she has much more quality time with her loving family.