Stomach and Intestinal Ulcers in Cats

The condition is often called gastroduodenal disease and the ulcers that are symptomatic of this condition are called gastroduodenal ulcers. While there are numerous possible causes, these sores are most commonly caused by a bacterial infection within the gastric system of the cat and can result in abdominal discomfort, vomiting, and bleeding within the digestive tract and consequently in the feces. Pain is often worst when the stomach is empty or after consumption of fatty or spicy foods. Both the ulcers and the underlying cause will need to be treated under the supervision of a veterinarian.

Stomach and intestinal ulcers, also referred to as gastric ulcers, are open sores that develop on the mucous membranes that line the stomach and small intestines. These sores are then exposed to the stomach acid, which can be painful.

Some cats suffering with stomach and intestinal ulcers will not present with any visible symptoms, which makes it nearly impossible for a pet owner to realize that the cat is experiencing nearly constant discomfort. Many cats with this condition, however, will experience the following symptoms:

• Chronic vomiting, sometimes with blood in the vomit
• Very dark red or black stool, which indicates blood in the digestive tract
• Pale gums, which results from anemia, or low levels of red blood cells
• Loss of appetite 
• Weight loss
• Lethargy
• Borborygmus, which is internal gas noise, often called gurgles
• Abdominal discomfort
• Diarrhea, often bloody

There are several possible causes of gastric ulcers in cats but the most common are the following:

• Bacterial infection of the digestive tract, usually by one of the many variations of bacteria called heliobacter, which studies have shown is exceedingly common in the gastrointestinal system of cats.
• Sustained use of non-steroidal anti-inflammatory drugs
• Stress caused by surgery, injury, or shock
• Various intestinal parasites
• Underlying diseases such as renal, or kidney, failure, hypovolemia, which is low blood plasma, inflammatory bowel disease, or cancer

If you have observed any of the symptoms listed above, it is important that you contact your veterinarian immediately as stomach and intestinal ulcers can be very painful for your cat and can sometimes result in life-threatening internal bleeding. In order to make a diagnosis of gastric ulcers your vet will likely employ the following diagnostic tools:

• Ask you questions about the symptoms you have observed and how long it has been since these symptoms began.
• Ask you about your cat’s diet.
• Take a fecal sample to test for blood.
• Test blood for anemia.
• You may be required to return after a period during which your cat has not ingested water or food for a prescribed length of time
• Perform abdominal ultrasound to locate possible ulcers.
• Perform abdominal x-ray to locate possible ulcers
• Perform  endoscopy to locate possible ulcers. An endoscopy consists of using a flexible tube called an endoscope that has a small video camera on the end. It can be inserted through the mouth to examine the stomach or through the rectum to examine the intestines. Your cat will be under anesthesia during this procedure.
• Biopsy of gastric or intestinal tissue or of any tumors found in the stomach or intestines.

While stomach and intestinal ulcers are not exceedingly common in cats, it is not uncommon that those cats that are diagnosed with the condition are not diagnosed until they are in critical condition as a result of prolonged gastrointestinal hemorrhage, or bleeding. It is imperative that treatment begin immediately upon the diagnosis of gastric ulcers. Treatment of these ulcers requires treatment of the ulcers themselves and, even more important, the treatment of the underlying cause of the ulcers. Possible treatments include the following:

• Intravenous liquids for hydration
• Antibiotics to fight bacterial infection
• Antacid medications
• Bland diet
• Cessation of nonsteroidal anti-inflammatory drugs
• Rest and isolation for animal recovering from traumatic experience or surgery
• Anti-parasitic medications if necessary

Depending upon how critical your cat’s condition was at the time of diagnosis, your cat may need to stay at the veterinary hospital overnight or for several days for hydration, observation, and treatment. Your cat’s prognosis is dependent upon the underlying cause of the ulcers. The prognosis is usually not very good for cats that have developed ulcers due to cancer or kidney failure. However, cats that have developed ulcers because of bacterial infections, gastrointestinal parasites, or nonsteroidal anti-inflammatory drugs usually have a positive prognosis after six to eight weeks of treatment. Your veterinarian may perform periodic endoscopies to measure your cat’s progress.