My cats have always had occasional hairballs, but one cat seems to have more than most — two or three a week. How can I prevent them, and should I worry?

Unfortunately, cats that vomit hairballs two or three times per week may be suffering from something much more serious than the common excuse of "just hairballs." Sometimes chronic vomiting may be due to a dietary hypersensitivity. But it could be something much more serious.  

A recent study published in the Journal of the American Veterinary Medical Association found that of 100 cats with chronic vomiting studied, only one had normal gastrointestinal tissue biopsy results. The fact is that cats with chronic vomiting, even of hairballs,  may be dealing with underlying inflammatory bowel disease or even cancer of the small intestine.  

You should see your veterinarian if your cat has a problem with chronic vomiting of hairballs. We are discovering that this is not a stomach disease, but a small intestine disease. An abdominal ultrasound is recommended to evaluate the small intestine and if abnormalities are found, biopsies should be performed via abdominal surgery. A biopsy diagnosis of inflammatory bowel disease (IBD) is the most common and overall carries a good prognosis. IBD is usually not curable, but proper treatment can help control chronic vomiting and weight loss. Symptoms may be controlled with immunosuppressant medications,  prescription diets, probiotics, and vitamin B12 injections. These must be discussed and managed only under the expert and knowledgeable guidance of your veterinarian.

This week's expert is Dr. Meghan W. Johnston of Hunt Valley Animal Hospital. Send your questions to sun.unleashed@gmail.com.