The tangled reality of hairballs

While they are generally a nasty bit of business, excessive hairballs may indicate an underlying problem like anxiety or inflammatory bowel disease. Getty Images While they are generally a nasty bit of business, excessive hairballs may indicate an underlying problem like anxiety or inflammatory bowel disease. Getty Images

I’ve always been a sound sleeper. Garbage trucks? Thunderstorms? Please. But the low, glugging sound of my cat depositing a hairball three rooms away can wrest me from the deepest slumber in an instant. It’s as if that noise is wired directly to the sleep center of my brain.

Most cat owners are somewhat familiar with these grudging bouts of nocturnal carpet-cleaning. Sometimes you just find a few wisps of hair wet with bile. Other times, you recover a big furry slug, technically known as a trichobezoar (hideous regardless of what you call it). But is it true that hairballs are just a normal part of being a cat? But how much is too much? The answer is, so to speak, fuzzy.

Hairballs may be common, but that doesn’t mean they are normal. While hair is ingested as part of regular grooming, it is meant to pass straight through like everything else. If too much hair accumulates in the stomach at once, it may come back up as a hairball. But in a healthy cat, these instances should be infrequent. Serial offenders likely have a broader underlying problem.

It stands to reason that cats who consume more hair are more likely to produce hairballs, so the first thing we look for is evidence of excessive grooming. Cats may ingest too much hair while tending to fleas, allergies, or other skin conditions. And others may overgroom as a response to psychological stress or anxiety.

If a cat isn’t swallowing too much fur, the next worry is that the gastrointestinal system is doing a poor job of handling it. Inflammatory bowel disease is a common underlying problem in cats, and frequently comes with liver or pancreatic disease in tow, requiring varying degrees of medical and dietary intervention.

Confusing things further is that unrelated conditions can be misinterpreted as hairballs. People frequently describe “coughing” and “hacking” when they suspect their cat might have a hairball, but these verbs can be ambiguous and misleading. Hairballs are vomited, not coughed. A coughing cat is more likely to have a respiratory condition like asthma than a hairball problem. In these cases, video of an episode can be invaluable in making sure that diagnostic efforts get started on the right track.

None of this is to say that every cat who pukes up a hairball, or even several, needs a massive medical investigation. Hairballs may be abnormal, but so long as they are infrequent, they may represent minor, transient upsets. We all have our bad days. But if a pattern starts to emerge, or if those hairballs are seen alongside other symptoms like weight loss, it may be time to consider underlying causes before they get out of hand.

The management of hairballs is not one-size-fits-all. Commercial hairball diets and supplements are intended to grease up hairballs and allow them to pass normally, but their efficacy is dubious. Brushing your cat regularly may help by reducing the amount of hair ingested during grooming, especially in long-haired cats. But when it comes down to it, the best way to manage hairballs is to discover and address the root cause.

Dr. Mike Fietz is a small animal veterinarian at Georgetown Veterinary Hospital. He received his veterinary degree from Cornell University in 2003 and has lived in Charlottesville since.