Gastritis in Cats

What is Gastritis in Cats?

Gastritis is defined as inflammation of the stomach lining. Gastritis in cats can be either acute (short and immediate or less than one week in duration) or chronic (lasting longer than one to two weeks).

Acute gastritis is typically a presumptive diagnosis, and the underlying cause often goes undiagnosed because symptoms resolve with either minimal treatment, or no treatment. Chronic gastritis signs can vary in frequency and type and are characterized by inflammatory cells determined through a biopsy by a veterinarian. 

Gastritis can develop in any breed, age, or sex of cat. Younger cats are more likely to ingest inappropriate items or different foods, so they are more prone to developing acute gastritis.

Acute gastritis often is self-limiting or responds to mild therapy. Chronic gastritis can be very serious or even fatal in some cases. 

Symptoms of Gastritis in Cats

Symptoms of gastritis in cats may include:

• Vomiting (with or without blood)

• Decreased/absent appetite

• Abdominal pain

• Lethargy

• Dehydration

• Melena (dark tarry stool)

• Diarrhea and/or weight loss

Causes of Gastritis in Cats

Gastritis can be a primary or secondary condition. This means it can occur on its own or be secondary to other systemic diseases, such as liver disease, kidney disease, diabetes mellitus, or neurologic disease.

The most common cause of acute gastritis in cats is dietary indiscretion (ingesting food or other items that are novel and cause inflammation of the stomach lining). Acute gastritis can also be caused by:

• Medication reactions

• Toxin ingestion, including plants, spoiled or toxic foods, antifreeze, and cleaning agents

• Infections (bacterial, viral, or parasitic)

• Overeating

• Stress

• Ingestion of foreign objects

Chronic gastritis can be caused by:

• Pancreatitis (inflammation of the pancreas)

• Chronic foreign objects in the stomach causing partial blockage of outflow

• Tumors of the gastrointestinal tract (benign or cancerous)

• Inflammatory bowel disease (IBD)

• Stomach ulcers

• Other systemic illnesses (such as liver disease, kidney disease, diabetes mellitus, or neurologic disease)

How Veterinarians Diagnose Gastritis in Cats

A thorough history—including any known dietary indiscretion, toxin ingestion, other illnesses, or stressful situations—and physical examination should be performed by your veterinarian when gastritis is suspected. Diagnostic testing becomes more aggressive as clinical signs become more prominent and based on the findings of other less-invasive tests.

Diagnostic tests your veterinarian may perform include:

• Bloodwork: A complete blood count (CBC) and chemistry profile with electrolytes helps to assess hydration status and any underlying systemic disease.

• Urinalysis: Testing of your cat’s urine helps to assess kidney function and bladder health.

• Fecal testing: Your cat’s feces will be analyzed to diagnose any intestinal parasites that may be causing gastritis.

• Abdominal radiographs: Radiographs help to find any masses, fluid in the abdomen, foreign objects, and/or blockage of the gastrointestinal tract.

• Contrast radiographs: These are used when an abdominal ultrasound is not an option. A contrast agent is introduced into the gastrointestinal tract and monitored via a series of X-rays to see how it is emptied from the body. This test can illuminate masses, blockages, and/or motility issues in the gastrointestinal tract.

• Abdominal ultrasound: Ultrasound can help assess all the organs of the abdomen for any possible disease. This modality is more specific when trying to assess intestinal wall layering and thickness—and for possible obstructions.

• Biopsy of the gastrointestinal tract: A biopsy is the only definitive way to diagnose the cause of underlying inflammation. Your vet may recommend an upper gastrointestinal endoscopic partial thickness biopsy or a full thickness surgical biopsy. Surgery or endoscopy can often be used to help remove foreign objects from the gastrointestinal tract—if these are the cause of gastritis.

Treatment of Gastritis in Cats

Treatment of gastritis depends on the specific cause and the severity of clinical signs. Many cases of acute gastritis are self-limiting, meaning they can be resolved without therapy.

Nonmedical therapy for gastritis includes withholding any food for 8 to 12 hours after the last vomiting episode to allow the stomach to settle. Typically, small amounts of water are offered over the first 12 to 24 hours, followed by about 8 to 12 hours of no food and small amounts of a bland diet (which is easy to digest and low in fat) several times throughout the day.

It is recommended to gradually increase the amount of food over one to two days, then slowly transition back to the original diet over a period of three to five days to avoid further belly upset.

If vomiting restarts, or if your cat continues to vomit during nonmedical therapy, you’ll need to schedule a veterinary visit. If your cat cannot keep water down and continues to vomit only when drinking, contact your veterinarian immediately.

Medical therapy for gastritis in cats includes:

• Anti-vomiting medications, such as Cerenia, Ondansetron, or Dolesetron

• Pro-motility agents (unless a foreign-object blockage is suspected), such as Metoclopramide

• Acid-reducers, such as Pantoprazole, Famotidine, or Ranitidine

• Fluid therapy (either subcutaneous for mild dehydration or intravenous for moderate-to- severe dehydration)

Cases of chronic gastritis caused by chronic inflammation (IBD or cancers) may benefit from chronic steroid usage, chemotherapeutic agents, and/or immunosuppressive medications.

Your veterinarian will help formulate a plan with you based on your cat’s diagnosis and your long-term goals.

Recovery and Management of Gastritis in Cats

Most cats with acute gastritis will improve on their own with no medical intervention. Other cases of more severe acute gastritis will require medical therapy, with a good prognosis dependent on the underlying cause. Certain blockages or toxins can be fatal if untreated. For example, antifreeze ingestion is deadly if not diagnosed and treated within a few hours of ingestion. 

The prognosis for chronic gastritis also depends on the underlying cause. Often, changes to a novel protein diet (a new protein never before introduced to the pet) or hydrolyzed protein diet and probiotic therapy is recommended for the duration of the cat’s life.

Stress should be kept to a minimum in the household. Sources of stress as well as holistic or medical therapies can be determined by your veterinarian. Frequent vet visits (every one to three months) are recommended for cats on immunosuppressive medications, including steroids and chemotherapy. Blood testing and a routine schedule of abdominal imaging may be required.

Acute gastritis can recur if your cat continues to ingest anything inappropriate, so it is important to eliminate those items—such as strings, toxins, and plants—and avoid abrupt diet changes. Unfortunately, even in the face of treatment, flare-ups are common in cats with chronic gastritis.