An x-ray of a foreign body in the abdomen
©David Godfrey

Any cat can get something stuck in its gastrointestinal tract, but younger cats are perhaps more at risk. Intestinal foreign bodies in cats are often something the cat has been playing with. Common foreign bodies in cats are wool, string, fishing line, cotton thread, tinsel or ribbons, hairbands and rubber bands. Although wool or string might seem harmless these so called ‘linear foreign bodies can cause severe problems if swallowed. The thread may pass easily through the stomach and into the intestine. Here it becomes stuck to the wall of the intestine and causes the intestine to bunch up in a knot which means that other food cannot pass through. Moreover, the thread rubbing on the intestinal wall can make a hole allowing gut contents to escape into the abdomen causing peritonitis. In some cases, the object may be looped around the base of the tongue at one end and runs through the esophagus and through the stomach into the intestine. It is unable to pass on because it is fixed in the mouth.

Sometimes small objects such as buttons, coins, fruit stones and headphone ear plugs are swallowed, and these may be able to pass all the way through the intestines and be passed from the other end without causing any obvious problems.

Unlike dogs, cats rarely swallow sharp objects like a stick but occasionally they accidentally swallow a needle if they have been playing with a thread from a sewing basket which has a needle attached or scavenging cats may eat cooked bones which splinter when eaten. Sharp objects may penetrate through the intestine wall allowing gut contents to leak out. This can rapidly result in life-threatening peritonitis. Alternatively, the sharp object may pass through the gut wall and may enter another abdominal organ and cause significant damage.

A linear foreign body may be present for weeks before signs start to show. Your cat initially may have vomiting or diarrhea, sometimes with fresh blood in feces or black feces passed. If this is left untreated your cat will become more unwell, commonly with abdominal pain (growling when picked up or hiding), decreased appetite and depression. Sometimes a small piece of the object can be seen hanging from their bottom, but this cannot be passed if the other end is fixed, eg around the tongue. Cats with a linear foreign body caught around the tongue may paw at their face or mouths.

Foreign bodies in the stomach often do not cause many problems and occasionally a cat will vomit and bring up a foreign body that the owner did not know was there. The stomach is relatively large when distended so anything that has managed to be swallowed has plenty of room to move about in the stomach. The exit from the stomach into the intestine is a much smaller hole and this only opens periodically when liquidized food is expelled from the stomach some time after eating.  A foreign body can therefore remain in the stomach for a long period of time without causing many signs. Sometimes the object will wedge into the outflow from the stomach for a time and prevent food leaving. Your cat may then vomit back food hours after eating and this may occur on and off for a while if the object moves into the outflow and blocks it and then moves away again.

If the object is small enough to pass out of the stomach into the intestine it may become jammed further along the intestinal tract. This is a much more serious condition and requires urgent veterinary attention. Cats with an intestinal obstruction will generally be unwell and may have abdominal pain with signs of vomiting and diarrhea.

Some objects, eg old pennies and batteries or lead can be very toxic if swallowed and they sit in the stomach or intestines for long periods of time, and these can make your pet very sick without any obvious signs of gastrointestinal disease.

Your veterinarian may suspect that your cat has an obstruction from what you describe of the history. If they examine your cat and feel its tummy, they may detect pain or tenseness and sometimes they can feel the foreign body lodged in the intestine. Your veterinarian will check your cat’s mouth if they suspect a linear foreign body in case this is caught around the tongue.

In order to confirm what is there and where it is stuck your veterinarian will want to take an X-ray or ultrasound of your cat. If your cat has been vomiting or had diarrhea for even a few days, they may be dehydrated or have other abnormalities in their blood. Blood samples may be taken to see if there are any effects of dehydration and intravenous fluids may be given.

Once the foreign object has been identified it is likely it will need to be removed at surgery. It is important not to try and pull it out even if can be seen either in the mouth or at the anus as this risks serious damage to the gastrointestinal tract.

In a few cases a foreign body stuck in the stomach can be grabbed using a scope passed into the stomach through the mouth and removed through the esophagus. In most cases your veterinarian will need to open the abdomen during surgery to remove the object through the wall of the intestine or stomach.

Being able to visualize the gastrointestinal tract properly means that your veterinarian can check there is no damage or signs of a hole in the gut. If the foreign body has been present for some time there may be damage to the wall of the stomach or gut and, in severe cases, part of the intestine may need to be removed during the surgery.

Following removal of the object your pet will be quite sore for several days and will need nursing care at home or in a veterinary hospital. They will be monitored closely until they are eating and drinking normally and able to pass feces.

If there was a lot of damage to the intestine, your pet had peritonitis before surgery or was dehydrated, they may have to stay in hospital for several days until your veterinarian is happy, they are well enough to go home. It is likely that they will also need a variety of medication to make them more comfortable and to reduce the risk of long-term damage.

Unfortunately, septic peritonitis caused by a hole in the stomach or intestines can be fatal despite appropriate treatment by your veterinarian and linear foreign bodies represent a higher risk for this complication than non-linear objects. There is also a risk of septic peritonitis following surgical treatment for intestinal foreign body due to poor healing and leakage through the surgical wound(s) in the intestinal wall. Your veterinarian will advise close monitoring for signs of this complication of intestinal surgery, and you should contact them if you are at all concerned during your pet’s recovery.

It is important to make sure your pet does not have access to anything they could swallow that might harm them. Never let your cat play with a ball or toy that is small enough for it to swallow.

However, accidents do happen and despite everyone’s best efforts some cats are ‘repeat offenders’ – having to have multiple surgeries for removal of things they shouldn’t have eaten. Eating non-food items and the need for repeated foreign body retrieval can be a sign of an underlying anxiety condition. Referral to a veterinarian specially training in treating animal behavior disorders, can help you identify and address the underlying causes for the behavior.

Foreign bodies in the gastrointestinal tract can be very serious and potentially fatal. If you are worried that your cat may have swallowed anything it shouldn’t, or you are worried that it is unwell always ask advice from your veterinarian. Early intervention can mean a successful outcome and may save your cat’s life.