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Hairballs are never normal. Ah hem, I’ll repeat…Hairballs are never normal!

When we look at feral cat populations, the incidence of vomiting up a hairball is very uncommon. Yes, it does happen but it is a rare occurrence. Because of these studies, we can confidently say that vomiting up a hairball is not a normal feline physiological process. In other words, hairballs are not normal.


Before we begin, we have to address the incorrect phrase I hear weekly which is “My cat coughs up hairballs.” The act of coughing involves the lower respiratory tract (i.e. trachea and lungs). We cough to get rid of irritants in the respiratory tract. Your cat vomits hairballs to remove them from the gastrointestinal (GI) tract. The terms “hairball” and “vomiting” are the same. There is no difference between your cat vomiting versus getting rid of a hairball. When we say “coughing up a hairball,” we are referring to two different body systems. Your cat cannot cough (i.e. respiratory tract) up a hairball that is in the stomach or intestines. It can be difficult to distinguish between a cough and vomiting. To make matters more confusing, your cat may be coughing to such an extent that they vomit a little.

Now that we know that vomiting and hairballs are the same and cats cannot cough up a hairball, the next step is to determine why your cat is vomiting up hairballs since we now know that it is not normal. A cat’s GI tract is designed to “handle” or allow hair to pass through. Too often, the assumption is made that hairballs are “normal” for cats. In reality, vomiting hairballs is a clinical sign that something is wrong with the GI tract. The assumption that a vomiting cat is normal is wrong. It’s a clue something is not quite normal with your cat. We do expect long-haired cats to vomit a hairball more often than short-haired cats. However, vomiting a hairball in long-haired cats is still not normal.

Hairball diets and treatments are generally ineffective

There is a huge market for hairball “treatments,” and I generally do not recommend any of them. The treatments are essentially petroleum jelly concoctions that allow “things to slide through” the GI tract with the idea that your cat has a “grease deficiency.” Imagine if you went to the doctor for vomiting and they advised you to eat petroleum jelly 2-3 times a day. When you put it in that context, it sounds a bit ridiculous. However, this practice has been widely accepted within the cat community. The “hairball” treats and diets are trying to “bulk up” the stool with the addition of fiber to allow more hair to pass. There will inevitably be a few reading this that will argue these treatments or diets help their cat with hairballs. Great! In my experience, when I push a client to determine if they think these products really reduced the frequency of hairballs, the answer is almost always no.

There are generally two thoughts as to why cats vomit hairballs: (1) ingesting an abnormal amount of hair (i.e. more than their normal grooming behavior) or (2) some GI disease. If a cat feels pain or inflammation, they tend to overgroom and ingest more hair. The most common causes we see include fleas, urinary issues (i.e. over grooming the belly), or arthritis (elbows, hips, knees, lumbosacral region). When cats groom, it feels good (think serotonin release) which is why they tend to overgroom in times of pain/discomfort or stress. When a shorthair cat has frequent hairballs, we immediately suspect something is wrong with their GI tract.

Unfortunately, there is no quick fix for a cat that has hairballs. If your cat has hairballs, it requires a visit to your veterinarian. A comprehensive examination with a detailed history should help pinpoint the diagnostic and treatment path one should undertake to determine the root cause for your cat’s hairballs. After all, hairballs are not normal!