Immediate Action Required: Your cat is exhibiting a triad of symptoms—shivering, vomiting green fluid, and vocalizing in distress—that signal a potentially life-threatening medical crisis. You must contact an emergency veterinary clinic immediately. Do not wait. This article explains the possible causes to emphasize the urgency and guides you on what to expect, but it is not a substitute for professional veterinary care.
Interpreting the Symptoms
- Vomiting Green Fluid: This is typically bile. Bile is a digestive fluid produced by the liver, stored in the gallbladder, and released into the intestines. Vomiting bile often indicates that the stomach is empty but nausea persists, or that there is an obstruction downstream preventing normal forward flow of intestinal contents.
- Shivering (Tremors): This can be due to severe pain, fever, nausea, or systemic toxicity. It is the body’s stress response to a significant internal problem.
- Crying/Vocalizing: This is a clear sign of acute pain, severe discomfort, or profound distress. Cats are stoic; when they cry out, the pain is intense.
Potential Causes (Etiology)
The combination points to severe abdominal or systemic issues:
- Gastrointestinal Obstruction: The most common concern. Ingestion of foreign objects (strings, hair ties, toys, rubber bands) can block the intestines. This causes bile vomiting (as nothing can pass), agonizing pain (crying, shivering), and can lead to tissue death and sepsis. This is a surgical emergency.
- Pancreatitis: Inflammation of the pancreas is extremely painful and causes severe nausea and vomiting (often bilious). Cats may hunch, cry, and tremble. It can be triggered by dietary indiscretion or occur idiopathically.
- Severe Inflammatory Bowel Disease (IBD) or Lymphoma: Chronic conditions can flare acutely, causing intense inflammation, pain, and vomiting.
- Poisoning/Toxicity: Ingestion of toxins (plants, chemicals, human medications) can cause acute GI upset, neurological signs (tremors), and pain.
- Cholangiohepatitis (Liver Inflammation): Liver disease can cause nausea, bile vomiting, and systemic signs like fever and lethargy.
- Infectious Diseases: Such as severe enteritis or systemic infections leading to sepsis.
Diagnosis
The emergency vet will perform a rapid, systematic workup:
- Physical Examination: The vet will palpate the abdomen carefully for signs of pain, foreign bodies, or thickened intestines, check for dehydration, and assess overall condition.
- Diagnostic Imaging:
- X-rays (Radiographs): Essential to look for foreign body obstructions, gas patterns suggestive of blockage, or other abdominal abnormalities.
- Ultrasound: Provides a detailed view of the GI tract, pancreas, liver, and lymph nodes. It can identify inflammation, blockages, and foreign objects not visible on X-ray.
- Bloodwork:
- Complete Blood Count (CBC): Checks for infection, inflammation, or anemia.
- Serum Chemistry & Pancreatic Lipase (fPLI): Evaluates organ function (liver, kidneys) and specifically tests for pancreatitis.
- Urinalysis: To assess kidney function and hydration status.
Treatment
Treatment is supportive and targeted at the underlying cause, always requiring hospitalization:
- Immediate Stabilization:
- Fluid Therapy: IV fluids to correct dehydration and maintain blood pressure.
- Anti-Emetics: Medications to stop vomiting (e.g., maropitant, ondansetron).
- Pain Management: Critical. Opioid or other strong analgesics to relieve suffering.
- Gastroprotectants: Medications to soothe the stomach lining.
- Definitive Treatment:
- For Obstruction: Emergency surgery to remove the foreign object.
- For Pancreatitis/IBD/Hepatitis: Hospitalization for IV fluids, pain control, anti-nausea meds, and often a course of anti-inflammatory or immunosuppressive drugs. Nutritional support is vital.
- For Toxicity: Administering specific antidotes if available, decontamination, and supportive care.
- Nutritional Support: Once vomiting is controlled, a bland, easily digestible diet or assisted feeding may be necessary.
Prevention
- Kitten-Proof Your Home: Keep all small, ingestible objects (thread, yarn, toys with small parts, hair ties) out of reach.
- Dietary Caution: Avoid sudden diet changes. Do not give fatty table scraps which can trigger pancreatitis.
- Toxin Security: Keep all human medications, toxic houseplants (lilies are especially deadly), cleaning products, and chemicals secured.
- Regular Veterinary Care: Annual exams can help manage chronic conditions like IBD before they become acute crises.
Home Care & The Critical Warning on “Home Remedies”
There are no safe or effective home remedies for this acute presentation. Your actions before the vet visit are crucial:
- What You MUST Do:
- WITHHOLD ALL FOOD AND WATER. Offering anything can trigger more vomiting and worsen the situation, especially if surgery is needed.
- Do not administer any human medications (e.g., Pepto-Bismol, aspirin, Tylenol—Tylenol is fatal to cats).
- Keep your cat confined in a safe, quiet, comfortable carrier with soft bedding. Limit stress and handling.
- If possible, collect a sample of the vomit in a plastic bag to show the vet. Note the frequency.
- Call the emergency clinic, describe the symptoms, and go immediately.
- What NOT to Do:
- Do not try to induce vomiting.
- Do not ignore the symptoms hoping they will pass.
- Do not attempt to diagnose or treat yourself.
Prognosis: The outcome depends entirely on the underlying cause and, most importantly, how quickly veterinary care is initiated. An intestinal obstruction, for example, can be fatal within 24-48 hours without surgery. With prompt, aggressive treatment, many cats can make a full recovery.
Your cat is in acute pain and danger. Your swift decision to seek emergency veterinary care is the single most important factor for their survival. Please, go now.
