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Dr. Dan M.
Dr. Dan M., Veterinarian
Category: Cat
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Experience:  Small Animal Veterinary Surgeon
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I have a 9 year old cat, Chloe, who for the past few days has

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I have a 9 year old cat, Chloe, who for the past few days has been retching/gagging at the exact same time every morning, between 4 - 6am. She never produces more than bile or saliva. Afterwards, she acts completely normal- all day she eats, drinks, uses the litterbox, plays with toys, runs over for her treats, cuddles, etc. This has only ever happened first thing in the morning, after she wakes up from a deep sleep of typically 4 - 5 hours.

The first three mornings, when this happened, she had also just eaten- very, very quickly. When I go downstairs with her at this time, she gets very excited and gobbles food down (on an empty stomach). Then she went to sleep beside me, and within the hour, woke up and started retching.

We took her to the vet two days ago, who examined her and said it was likely because of the fast eating, that it was probably something involving stomach acid and to give her smaller portions and 1/2 tablet of Pepcid at night. She said Chloe had no masses in her stomach, didn't seem to be in any pain, her mouth/gums looked good, she had no fever, etc.

This morning, however, Chloe had been sleeping for four hours or so, didn't gobble down any food (we've since been taking it away at night), and still woke up and vomited just a bit of saliva. It was at the exact same time. She did eat a little at 11pm, but not fast, and not too much.

I'm very confused, since if this was because of the overeating/lying down right after eating, why would it happen now? She's only been on the Pepcid two nights, and both nights we had trouble getting her to take it- we crushed the pill and hid it in cream cheese but I'm not sure she got much of it (she figured it out quickly). We're getting pill pockets for tonight. Still, it's very strange. She's completely happy and normal all day long- you would never know anything was wrong except for that window of time in the very early morning.

Should we continue to give her the Pepcid (more successfully from now on) and see how she is for a couple of days? She gets very stressed at the vet, and I hate to take her a second time if it's nothing.

Any idea what could be causing this?

I am sorry Chloe has this sickness and I a secure she will be OK.

There are many things that cause vomiting and these can be gastrointestinal in origin or non gastrointestinal (other organ disease, hormonal problems or metabolic disease).

The priority is that Chloe is bright and alert and eating and drinking normally which she is and this is great news.

Gastrointestinal causes include parasites, dietary indiscretion, gastritis (inflammation of the stomach) pancreatitis, liver disease and inflammation of the intestines as well as physical obstructions (foreign bodies).

The regular occurrence of this vomiting may indicate and gastritis as it may be exacerbated when rising from sleep. I would be comfortable with you carrying on with the Pepcid for a few days and seeing if things settle. But you must get her checked if it is becoming more frequent or she is becoming quiet and reclusive or is not eating or drinking. This would require further investigation such as blood tests and possible x rays, but I suspect she will settle.

Also make sure she is Up to date with her routine worming.

Good luck

Dr Dan Makin
Dr. Dan M. and 3 other Cat Specialists are ready to help you
Hi Megan,

I'm just following up on our conversation about Chloe. How is everything going?

Dr. Dan M.
Customer: replied 3 years ago.

Hi, thanks for following up-

Chloe seems to be doing a little better. This definitely only happens as soon as she's woken up from a longer sleep (4 - 6 hours uninterrupted). As soon as she wakes from a longer sleep, she retches/gags saliva or bile, and then she is 100% normal the other 99% of the day. Eats, drinks, uses the litterbox, everything.

She went 36 hours without doing it (the longest so far). She didn't do it Sunday morning, but did it Sunday afternoon (we were out all afternoon, and she always sleeps when we're gone). Then she didn't do it Monday morning OR Monday afternoon. But she did it 4:30 this morning (Tuesday). It's less now, too- she gags one or two times, rather than four to six times during the first few days.

Also, when she did it Sunday afternoon, there was some hair mixed with bile, so I think maybe a hairball might have woken her? We found it right under the bed where she was sleeping.

So the constant here is that it's ALWAYS right after she's slept for a longer period of time. Upon waking, she does it, and then is totally fine all day. So it makes sense that, like you said, it could be exacerbated when rising from sleep. Do you have any idea WHY this might be happening? Why it bothers her ONLY after a longer sleep, and then all day, she's completely normal?

We thought we would let her take the Pepcid for at least a full week and see how she does. She's only taken the Pepcid three times so far. (Four will be tonight.) Our vet also mentioned that, if it didn't work, aside from doing blood tests just in case, it could have to do with her food (she's on a C/D prescription diet for bladder health). Do you think that's possible?

Thanks for your help,


PS: We have a cardboard scratcher that Chloe loves to lay on. A lot of times, she'll eat the little pieces of cardboard paper she pulls up. We took it away from her today. Could that bother her stomach?

Hi Megan,

Glad to hear things are stable if not better with Chloe.

It is a strange pattern and certainly hair balls will cause varying degrees of wretch from non-productive hacking to full blown vomiting.

Cardboard shouldn't cause this kind of problem unless she reacts badly to it (causing vomiting) or it could cause a more obstructive problem which would cause vomiting on a more persistent basis with or without an absence of faeces, so I wouldn't worry too much.

Certainly, if there is a sudden deterioration or other clinical signs develop bloods would be a good port of call as organ disease (particularly kidneys) can cause varying grades of vomiting.

Food can cause hypersensitivities or intolerances which can manifest as vomiting. This would be much more likely if the diet was new and coincided with the vomiting. Hills c/d shouldn't specifically cause vomiting.

The reasoning for the timing of the vomiting/wretch is bizarre and could ever be from a reduced consciousness (when awake the conscious control of vomiting and wretching maybe stronger than when asleep or first roused), when awake there are many distractions that occupy animals so often mild vomiting can be masked.

Again, it maybe positional in that laying on her side for a prolonged time increases stomach acidity/reflux into the oesophagus causing acting wretch which dependant on the stomach contents at that time will or will not be productive.

No problem seeing how things go, but definitely if there is no respite or things worsen then head back to your vets.

Take care