Can a bulimic cat be cured?
March 23, 2021 12:48 PM   Subscribe

Our cat is the poster child of the phrase “scarf and barf.” The vet thinks she can be cured. I think we could spend thousands of dollars and still find ourselves living with a puking cat. Cat-people of Metafilter, have you cured your cat’s bulimia?

Two years ago we adopted an adult cat from a rescue that got her from an out-of-state shelter. When she first came home with us, she puked multiple times per day. We figured out that she was eating too quickly and immediately puking, so we got an automatic feeder and broke up her food into 8 separate feedings (some wet, some dry). We tweaked the food type and the quantities, and eventually she settled into a rhythm of puking once in the morning about 3-5 times per week. We tried a puzzle feeder, but that made her frantic and even quicker to puke. We’ve seen a couple vets who think she needs a prescription food, more labs, and a $600 abdominal ultrasound to diagnose her. Her labs always come back 100% normal, much to the surprise of the vets.

She’s currently on a hunger strike after puking up said prescription food this morning. She’s lost 1.5 pounds in the last two years. I am tired of cleaning up cat puke. I am also in the midst of pandemic working from home and kid distance learning hell. What do we do? Do some cats puke forever? Was her brain warped by food insecurity as a stray? Am I am asshole for not wanting to go down a potentially pointless and expensive medical diagnostic journey for this cat? Have you fixed your puking cat?

Cat tax
posted by Maarika to Pets & Animals (33 answers total) 7 users marked this as a favorite
Have you tried any kind of anti-anxiety meds?
posted by amtho at 12:54 PM on March 23, 2021 [6 favorites]

Temptations cat treats, the catnip kind, have chilled everybody out around here anxiety-wise.

In people, eating disorders are anxiety-related. I'd suspect the same applies to cats. You might try things like the feliway or kitty cbd drops just to see if it helps. (Dog CBD does wonders for fireworks-anxiety, I've discovered.)
posted by stormyteal at 12:57 PM on March 23, 2021

She is beautiful!

I had a cat who would eat too fast then puke and the solution we used was to spread her kibbles out on a big cafeteria tray so she would have to eat each kibble one at a time rather than grabbing a mouthful of kibbles and inhaling them. That slowed her down just enough so that she'd hold it in.
posted by nathanfhtagn at 1:00 PM on March 23, 2021 [4 favorites]

We successfully got one puker to mostly stop by being helicopter owners while he was eating.

Melvin was the sort of cat who, upon seeing food placed before him, decided that he had NEVER, NOT EVEN ONCE, EVER BEEN FED BEFORE, and therefore would set upon this delicious and probably only meal he will ever have ever with the fervor of a desperately starving creature. (He was, of course, spoiled and overweight and not starving, even a little bit.)

He would tend to scarf his food without stopping to actually chew it or take breaths, so we would just gently nudge his fuzzy dumb head out of the bowl so he would actually chew and breathe, and we got it such that he only puked maybe once every other week or so, if we let our guards down. But he never got that "NEVER BEEN FED BEFORE" attitude out of his head, so we had to do this every time he ate. This may not work for you since it takes some effort and hovering, but it (mostly) worked for us.
posted by bedhead at 1:01 PM on March 23, 2021 [3 favorites]

i came in to suggest an automated feeder but see you have already tried that. i have had many snarf and barfers and it is traumatic for everyone involved. my cats have just barfed... the automatic feeder curbed it by about 90%.

what does the vet think the ultrasound will do/show? are you absolutely against trying a few more foods (maybe novel proteins?)? maybe your vet or fancy stores have samples you can try, or you can get them from the mfg.
posted by misanthropicsarah at 1:02 PM on March 23, 2021

Your poor kitty and you! We also have a puker, although not one as prolific as yours. In addition to smaller feedings, which you are already doing, our vet recommended famotidine (Pepcid.) We give her a quarter-pill of a regular-strength tablet daily. Ask your vet first, of course. We also switched to Hill's sensitive stomach wet food, which helped a lot. And we brush her daily to keep hairballs at bay - even if the main culprit is food, it's good not to have any extra puking incentive. Good luck!
posted by prewar lemonade at 1:04 PM on March 23, 2021 [1 favorite]

We did the quarter pill of Pepcid with my first cat for years and it really did help. We also had to cut all wheat out of her diet.

My Instagram ads are trying to convince me we need elevated cat bowls to prevent barfing. Maybe make a platform of books and stuff under the auto feeder and see if that helps?
posted by advicepig at 1:06 PM on March 23, 2021 [3 favorites]

My experience with a recreational puker was that it never went entirely away but got way better when I figured out which foods she didn't tolerate (anything beef-related, as it turned out) and the cleanup got much nicer when I made foods without any dyes in them a priority. (Turns out those dyes work just fine on carpet even when gently-used!)
posted by restless_nomad at 1:06 PM on March 23, 2021 [2 favorites]

My beastie’s automatic feeder drops her kibble onto a ceramic puzzle plate thing with raised fins and bumps, and a lot ricochets off onto the underlying tray. It has been 100% successful at defusing the scarf-n-barf. She gets mad at the puzzle plate - but having to use her paws to move the kibble to wear her face can reach it is just slow enough to work. She still tries to Hoover up the bits on the tray but it is spread out enough that she has to breathe and move her feet before getting it all into her face. She is still finished eating in minutes, so it’s not as aggravating as a puzzle ball thing. She actually chews now. Miracle.
posted by janell at 1:11 PM on March 23, 2021 [5 favorites]

Our cat inhales her food and throws up if she jumps around too much after eating - however, incidences of throwing up were reduced sharply after we started giving her 1/4 tsp PEG laxative every day. It seems to have improved her digestion in general. After we started this, we realized that she had basically always been sort of constipated. (She's even a bit more active now.) If you're seeing rather dry and small results in the litterbox, constipation might be a factor in the vomiting. (We had been feeding her both wet and dry food on a rather elaborate schedule, she drank lots of water and we'd even been giving her just a little bit of PEG most days - it wasn't until we increased to 1/4 tsp that things changed. Per the vet, this is actually a low dose and not of concern.)
posted by Frowner at 1:19 PM on March 23, 2021 [5 favorites]

If anxiety is part of the issue, there is calming music on youtube that works on cats and dogs. Works great on a lot of cats and dogs. Free.
posted by aniola at 1:23 PM on March 23, 2021

Also pheromone collars work great for anxiety. $10-20/month.
posted by aniola at 1:24 PM on March 23, 2021 [1 favorite]

Oh! Also, if anxiety is part of the issue: pets pick up on the emotions of their humans. Some of this may be situational to some extent.
posted by aniola at 1:28 PM on March 23, 2021

I do have one cat who, if she can inhale her food, will, and then regurgitate it (and then her sister will eat that). It sounds like you've got a more extreme case. We give her a combination of wet and dry food, and I really mash the wet food into her bowl so she can't gobble it up. I'm guessing you're already way past such measures, but I mention it FWIW.

Feliway has done nothing for our cats, AFAICT.
posted by adamrice at 1:30 PM on March 23, 2021

So one of my cats will eat too fast and throw it back up, and both of these poor orphan street cats definitely had food insecurity issues when we got them and would steal anything we happened to be eating (pizza slices, entire hamburgers in the wrapper—the whole thing was really cute but not good for anyone). We got this puzzle feeder and made dry food available in it all day and night—having the food available all the time, but requiring some hunting work to get it, has helped a lot to slow down the cat who throws up more, reduce both cats' begging behavior, and entirely eliminate the stealing behavior.

We initially transitioned to always-available ad libitum dry food (I asked MetaFilter for suggestions a year ago, and Farmina has been awesome!) by filling up a bowl with it and letting the cats gorge on it at first, until they realized that it wasn't going away and they didn't have to eat it all at once. It had the short-term risk of vomiting, but with the long-term gain of helping reduce their food insecurity. Then once they were used to the dry food and we realized they were really into hunting, we switched to the puzzle feeder, with a smaller amount each day. Both of them took a little time to figure it out and did seem a little frustrated, but after a while they got it. Now we have a puzzle feeder box specifically for treats as well, which reinforces the hunting behavior. I'm working on training them to use a bell to ask for food or treats, and they do it sometimes with prompting but not as often on their own yet. We'll get there!

Re: wet food, we use Darwin's Natural Pet Products' Natural Selections. There's a small inconvenience factor there, because it's frozen and you have to keep up a routine of putting a new packet in to defrost every day, and you end up with between 4 and 20 pounds of cat food in your freezer at any given time. But now I just put a new one in the refrigerator to defrost when I pull out the defrosted one from the day before each morning. Two cats get half the packet in the morning and half at night. The second half of the food lives in a ziplock bag in the refrigerator between the two meals. Half the packet is actually probably a little too much for them, and they finish it all some days and don't finish it other days—but what's awesome is, they're food-secure enough now that they don't just scarf it all down every time!

I've tried three canned wet foods, because it's nice to have a backup plan in case of disaster, as well as when I forget to defrost new food, and I wanted to find something that had more organic ingredients. One cat does great with every wet food I've tried, but the cat that throws up more (just seems to have a sensitive stomach in general) has only been able to tolerate one of the three (your basic Fancy Feast chicken paté; she hates seafood). I'm not sure what ingredients she's sensitive to yet, because there doesn't seem to be a lot in common across the two she threw up, but you might just try a few different wet foods and see what she tolerates. I gave away the food that didn't end up working out.

If you can get the puzzle bowl thing to work with dry food, I highly recommend it. But in your case, it sounds like getting the right foods that work for your cat and making them available as much of the day as possible in specific portions may be the key to reducing your cat's food anxiety and bingeing behavior.
posted by limeonaire at 1:48 PM on March 23, 2021

Before spending money on more tests (I'm also not sure what the vet is looking for with those? Maybe ask what specific thing they're testing for?) I'd look into treating it as an anxiety problem. Even if she's not an anxious cat in general eating might still be bringing up bad memories from her time on the streets. And it's not just food insecurity, cats feel vulnerable when they're eating because they can't watch for predators and other aggressive cats. You could experiment with sitting next to her and petting her while she eats — some cats are 'social eaters' and like to have someone they trust watching their back. If that helps her slow down then it's a big indicator that the problem is anxiety.

There is a wide range of things that can help with cat anxiety. You can start with easy stuff like catnip and Feliway/pheromones, then move to CBD and then a kitty-sized prozac Rx from the vet. People with anxious cats who try Prozac usually say it helps a lot and side effects are rare. A month of Prozac will probably be cheaper than those tests, too.
posted by 100kb at 1:52 PM on March 23, 2021 [2 favorites]

My scrappy Tonkinese was a scarf and barfer as well.

The one thing that helped her a lot was this ring shaped food, meant for Siamese cats. She also enjoyed the taste, so it was no problem in getting her to eat it. Siamese Dry cat Food.
posted by spinifex23 at 2:22 PM on March 23, 2021

Response by poster: Thanks, everyone. The last vet said daily steroids for inflammatory bowel disease might be the end result, but I like the anti-anxiety angle. She is definitely an anxious cat, though I had previously assumed she was more dog than cat based on how she waits for us by the window whenever we leave the house. She can identify my husband’s car and waits by the door the instant she sees it approach!

We’ve tried the elevated cat bowls and fed her grain-free Farmina dry food and single-protein wet food from the hippie local pet food deli until this recent attempt at Royal Canin RX food. Any suggestions on where to order cat CBD during a pandemic?
posted by Maarika at 2:47 PM on March 23, 2021

We also have a puker. We feed her wet food, spread out on a big dinner plate like you are frosting a cake. Sometimes we throw in a few pieces of dry kibble for speed bumps. It has stopped 99% of her puking. She just has to eat slower and not too much. Also, too many treats will make her puke too, as I was reminded just yesterday.
posted by Ochre,Hugh at 2:48 PM on March 23, 2021

Response by poster: Also, Feliway has never worked on her.
posted by Maarika at 2:55 PM on March 23, 2021

Have you tried anti-nausea meds like Cerenia to see if it reduces the frequency of the vomiting? Its frequently given along with the steroids for IBD, so it might not hurt to try it on it's own to see it helps before fully committing to that route.
posted by cgg at 2:57 PM on March 23, 2021

This is my second rec of the day for Milk Barn Farm, this time their CBD tincture for dogs and cats. I swear I get no kickbacks, I just trust them because the proprietors are internet people from way back and we've crossed paths every so often, so I know they are real, and their care for their plants and animals seems sincere. It's the same tincture as for people, but without the mint and using a nuttier coconut oil.

I have never tried this with a cat, but we sometimes use a snuffle mat for a dog who just needs a lot of enrichment, but also sometimes I just pick a room we're not going to walk through for a little while and scatter some handfuls of kibble across the floor.
posted by Lyn Never at 3:23 PM on March 23, 2021 [1 favorite]

Best answer: If reducing quantities of food per feeding (and spreading it out throughout the day) hasn't helped, I would strongly suspect something like feline IBD. I had a cat with this, diagnosed when she was 8 years old (via ultrasound), and a daily dose of steroid meds turned out to be nothing short of miraculously effective for her. She went on to live another 8, almost 9 years (with the only side effect of the steroids being that she was slightly more prone to UTIs).

I currently have an ex-feral scarf-and-barfer, but in her case, reducing quantities works like a charm. She still wolfs down her meals, but as long as they're not more than roughly half a small can of wet food in one sitting, it stays put.

In your cat's case, I might be inclined to ask the vet to do a steroid trial even without the ultrasound. If the puking stops, that's a bit of diagnostic data as well as a cat who feels better.

Oh, one more thing: my vet recommends withdrawing all food for 6-8 hours after a scarf-and-barf episode, in order to give the stomach irritation a chance to level off. This method works very well for my current puke-prone girl, and thankfully we don't have to use it very often these days.
posted by aecorwin at 4:39 PM on March 23, 2021 [1 favorite]

We had a cat that was taking medication that made him absurdly, ferociously scarf and consequently barf.

After some trial and error we had the best luck with smearing wet food around the divots of a muffin tin. Silicone muffin pans were easy to wash in the dishwasher.

For dry food we tried a DIY enrichment toy. Burned holes in a plastic water bottle and filled it with dry kibbles. The cat has to push the plastic bottle around to get kibbles out of the holes slowly (by making fewer or smaller holes you can make this easier or harder for the cat to get all the crunches out). Sounds like the puzzle feeder was not a great solution, so this may be too similar.
posted by forkisbetter at 5:50 PM on March 23, 2021

I have a cat that would do this, and curbed it by switching her to an all wet-food diet and carefully learning what the best portion control for her was. It took months of trial and error and adjustment for her though. Too much, she'd barf then eat it. Too little, she'd be hungry. Then I slowly re-introduced kibble, which I would never give her within a couple hours of her recent wet food feeding. Eventually, she graduated to being able to free-feed on dry food for most of the day (with the carefully calibrated wet food portions, of course.) This would probably not have happened if I wasn't working from home and been able to constantly keep track of her eating habits and how seriously she's begging.

She's also a feral rescue. tl;dr: it just took an enormous amount of time paying attention to how she communicates and what her dietary needs are, and some judicious trial-and-error.
posted by mrgoat at 7:03 PM on March 23, 2021

A friend of mine has reduced the scarf'n'barf by using a raised feeding bowl. Lifting it a few centimetres just seems to slow her cat down enough.

Good luck!
posted by eloeth-starr at 3:20 AM on March 24, 2021

For one cat: the dental kibble that the other cat in the household needed had the added benefit of forcing the food-insecure cat to slow down and chew more, and consequently not barf up as much. For another cat, smaller portion sizes decreased frequency of puking slightly, but what seems to have actually fixed the problem was raising the food bowl (simple version: set smaller food bowl on top of an upside down larger food bowl). For the first cat, the vet also recommended petting while eating to help calm and slow the cat down, which had partial results. Now that cat very strongly associates food with love and attention. The second cat does not tolerate being pet while eating. So none of these are guaranteed fixes, and it sounds like your cat is or was puking with even greater frequency, so may have something more serious going on. But those are a couple free and easy things with no negative side effects to try at home before the next vet appointment.
posted by eviemath at 5:51 AM on March 24, 2021 [1 favorite]

could experiment with sitting next to her and petting her while she eats — some cats are 'social eaters' and like to have someone they trust watching their back.

My snarfing cat actually comes to get me to pet her while she eats dry food. It does help. To deal with the underweight thing, I feed her broth-based foods, such as the Rachel Ray packets. They seem to go down easier. She likes to eat these alone in a room so brother cat doesn't eat it first. No response to Feliway. Relaxing and learning to trust that her environment is secure helps most of all. So many barfing cats. I thought it was just mine!
posted by Armed Only With Hubris at 8:09 AM on March 24, 2021 [1 favorite]

Not to be the ultimate Debbie Downer on the thread but, I had a cat with intermittent irritable bowel and puke issues; her labs were always normal, the vets occasionally suggested more invasive testing and we always declined. After a couple years, and when she began to lose significant weight/stop eating reliably, we finally did the ultrasound, only to find that she was basically MADE of cancer. She lived about 5 days after her ultrasound.

So that is what your vet would be looking for, frankly, in the ultrasound--though they may not want to panic you by telling you as much. Ours never mentioned the word "cancer," they were just "looking for abnormalities."

Caveats: We don't know for a fact that 100% of the kitty's problems were cancer-related; we don't know how long she was actively sick. But if all of your interventions have been fruitless at this point, you may need to consider that your cat could have a serious health problem.
posted by We put our faith in Blast Hardcheese at 9:29 AM on March 24, 2021

Any suggestions on where to order cat CBD during a pandemic?

If you are by any chance in California, we have used and found effective VET CBD. If marijuana is legal in your state CBD products are best acquired through a dispensary as there is usually some degree of testing and reporting. Bloom Farms (who I have bought products from and trust) has some helpful recs on their site that you may be able to find where you live. Here's the Pet-Ness site with specific cat products.
posted by oneirodynia at 11:12 AM on March 24, 2021

I should add: CBD is very effective for calming our very anxious cat. His brother, who is cheerful and gregarious, does not seem to be affected at all that we can tell- even when he's snuck in and gotten his brother's dose when I was inattentive (I put in in their food or on a snack).
posted by oneirodynia at 11:15 AM on March 24, 2021

I've been thinking about this. I had a pukey foster cat for a while, and I'm sure she was stressed, but I wasn't as experienced then as now.

If I had to do it over again, I would probably do a couple of months of "Japanese tea ceremony" style feedings, where I played soothing music or sounds that she liked, set up a very safe, calm, comfortable, soft place for both of us where she could be extra secure (maybe a windowless enclosed area like a closet with the doors closed), pet her and get her into a relaxed state, then feed her maybe a couple of kibbles at a time (at first) kind of treat-style. I'd make sure she spent the first few days of this never being hungry so there would be as little urgency as possible to the feeding. I'd sit with her the whole time she ate, so she'd feel protected and loved -- maybe petting her while she ate.

I'd definitely try a pheromone -- there is at least one pheromone product that is different from Feliway, that might work better for your kitty -- after making sure it didn't disagree with her.

Anyway, I'd probably get the whole "tea ceremony" thing wrong at first, but I'd adjust it until I found a way to get her feeling as secure as possible. Then I'd gradually relax about the rate at which I was feeding her, the amount I was touching her, etc., until she was scarcely aware of me. Then I'd introduce something else into the area that could gradually be a substitute me (maybe a large pillow, or a phone playing the sounds of me talking soothingly, or both). This is because, if this works, your presence will probably be a huge part of why, and you eventually need to be able to do other things while she eats -- and you need to be able to leave the house, too, eventually.

Anyway, that's an experiment you can try if you're interested. If you do, I hope you let me know how it works out!

Incidentally - my pukey cat was also a nag-for-food cat, and I successfully trained her out of that with another experiment: setting a cell phone to play a specific song at feeding time, and demonstrating that I heard the song and was cued by that to feed her. Once that was established, she'd sit and watch the cell phone for a while before every feeding time, waiting for it to go off. It was adorable.
posted by amtho at 5:44 PM on March 24, 2021

Response by poster: Posting for closure: turns out that oral steroids were the magical cure. We skipped the expensive tests and went straight for the drugs, and one tablet per day has stopped all the puking. I still think she’s an anxious cat, but addressing the inflammation has allowed her to eat more food and keep it down (she still scarfs it down as quickly as ever). Amazing!
posted by Maarika at 5:30 AM on May 20, 2021

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