MEMO and the Vomiting Cat – A Case Study

Posted on August 23, 2026August 23, 2026 by felinepurrspective_u3q4o6

Miso, a 5 year old NM cat, was diagnosed with chronic pancreatitis when he was 3 years old. Pancreatitis presented as episodes of violent vomiting every 1-2 months. In addition to giving anti-emetics, managing these episodes involved fluid therapy and antibiotics, and the occasional ER visit.

In cats, the common bile duct and the main pancreatic duct join together into a single shared channel before opening into the small intestine. When a cat vomits, the gut contents from the proximal intestine move into the stomach, exposing the pancreas to bacteria and concurrent inflammation on the way (Reference 1).

The overall strategy is to keep Miso from vomiting. We decided to try a schedule of frequent meals combined with environmental enrichment (MEMO) (Reference 2).

MEMO stands for Multimodal Environmental Modification, a therapeutic framework pioneered by Dr. Tony Buffington of Ohio State University to aid in the treatment of cats suffering from Lower Urinary Tract Syndrome and from “Pandora syndrome”.

MEMO and the vomiting cat – the feeding schedule

Miso is fed both canned and dry food in multiple small meals as recommended for vomiting cats (see Managing the Vomiting Cat – Dietary Strategies). About half his calories come from canned food; the remainder from dry food. He is monitored closely for signs of an impending episode of pancreatitis (, i.e. nausea and vomiting).

Feeding Schedule
Time	Food
6:00 am	10 kibbles of dry food
6:30 am	50% of morning ration of canned food.
7:30 am	50% of morning ration of canned food.
12:00 pm	10 kibbles of dry food
6:00 pm	50 % evening ration of canned food
7:00 pm	50 % evening ration of canned food
9-10 pm	20 kibbles of dry food

MEMO and the vomiting cat – Environmental Modifications

We try to fulfill the physical, nutritional, social and behavioral aspects of MEMO while managing Miso’s pancreatitis.

Physical: In additional to having access to scratching posts and places to rest and hide, Miso takes a morning walk on a leash. The leash is mainly used to keep him from eating grass, which causes him to vomit.

Nutritional: We feed Miso and his roommates their canned meals at individual feeding stations (hard plastic cat carriers) located in the corners of the dining room. The cats are out of sight of each other while being fed. This gives each cat an opportunity to eat their dinner without interference from the other cats.

Social: The cats enjoy daily positive interactions with people in the process of being fed.

Behavioral: The evening meal is fed in two portions: half is fed at the cats’ feeding stations while the human dinner is prepared. The second half of is fed later when we sit down for dinner. The canned food is spread on textured silicone “lick mats”, keeping the cats off the counter and dining table while the humans are having dinner.

The nighttime snack of dry kibbles is fed using food puzzles (foraging behavior) or tossing the kibbles for the cats to chase and “hunt down”.

This routine may seem complicated but actually works quite well. Canned meals sandwich the morning routine of breakfast and getting ready to go out for the morning. Canned meals sandwich the evening routine of preparing then serving dinner. The bedtime routine tells everyone to prepare for a good night’s sleep.

Memo and the vomiting cat

Feeding small frequent meals helps manage Miso’s chronic pancreatitis. It is more work compared to ad lib feeding of dry food but it is worth the reduction in the severity and frequency of Miso’s vomiting episodes. After implementing this regimen, a bout of pancreatitis occurs every 2-3 months and only requires only a few days of oral medication with minimal vomiting, no ER visit and often no fluid therapy.

The silver lining: The cats seem to enjoy eating more often and it is can be fun to watch them work the food puzzles or to toss them kibbles. The four cats even seem to get along better together!

references

Batchelor DJ, Devauchelle P, Elliott J, et al. “Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review”. Journal of Feline Medicine and Surgery. 2013;15(4):237-265. doi:10.1177/1098612X12473466
Herron ME, Buffington CA. “Environmental enrichment for indoor cats”. Compend Contin Educ Vet. 2010 Dec;32(12):E4. PMID: 21882164; PMCID: PMC3922041.

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Environmental Tactics to Manage The Vomiting Cat

Posted on August 9, 2026August 9, 2026 by felinepurrspective_u3q4o6

It is a common misconception that it is normal for cats to vomit. The last post investigated dietary and feeding strategies that can help reduce vomiting and make cats more comfortable.

Sometimes, there is an emotional component to gastrointestinal distress. Many of us are familiar with the “butterflies in the stomach” preceding a stressful event. Emotional stress can upset your stomach, and an irritated gut can send distress signals back to your brain (Reference 1). Like people, cats experience anxiety which can affect their GI tract. Here are some tips to help a vomiting cat manage anxiety.

Environmental Tactics to Manage The Vomiting Cat

Pandora syndrome refers to cats suffering from multiple medical ailments that do not resolve with appropriate medical treatment. Instead, the symptoms are chronic, waxing and waning in response to environmental stressors (see Reference 2).

MEMO addresses the environmental needs of cats, dividing these into five categories (Reference 3).

physical resources – elevated perches, multiple scratching posts, hiding places
nutritional – multiple, separate food and water stations out of sight of other pets
elimination – multiple, separate litter boxes in quiet areas
social – consistent routines and predictable interactions with humans and other pets
behavioral – opportunities for predatory play and foraging for food

Adam Rudinsky, a small animal internal medicine specialist at Ohio State University, recommends implementing MEMO in addition to medical treatment to help cats with chronic vomiting (Reference 3).

Environmental tactics to manage the vomiting cat – Did you get the memo?

Physical Resources

Having quiet places to retreat to can help a cat manage fear, anxiety and stress. Multiple, separate feeding stations, litter boxes and resting places in secluded areas allows a cat to avoid harassment by other pets while eating, eliminating and snoozing. A little “alone time” sometimes works wonders.

Nutritional and Social

Feeding smaller meals more frequently (see “Managing the Vomiting Cat“) means we will be meal feeding our cat, not leaving out a big bowl of kibble for them to graze on. Meal feeding respects the physiology of the cat, who has evolved to eat small prey and has a relatively small stomach. Wild cats typically eat alone and spend most of their waking hours hunting and foraging for food (see “Why Meal Feed your Cat”).

Meal feeding brings social elements into feeding the cat:

Predictable human-cat interactions as the human gives the cat food
Establishment of routines involving feeding
In homes with more than one cat, each cat must feed at their own feeding station. These stations should be separated to keep cats from “stealing” each other’s food and prevent timid cats from gorging, eating their food too quickly and vomiting (see “Why Separate Cats when Feeding“).

Nutritional, Social and Behavioral

Although canned foods provide a more rapid transit through the stomach, dry food can still be part of the vomiting cat’s diet. A fun game to play with your cat is to toss them a meal of dry food. This gives a cat the opportunity to listen for, chase and pounce on their food.

Feeding our cats smaller meals more frequently gives us opportunities to allow the cats to engage in foraging behaviors with food puzzles or timed feeders placed around the house. Food puzzles can accommodate both canned and dry foods (see “Cats at Work: Using Food Puzzles“).

MEMO and the Cat with Hairballs

Cats that live indoors have a lot more time on their paws than their outdoor counterparts. Indoor cats tend to spend more time grooming and ingesting fur. MEMO can help reduce stress and boredom that gives rise to excessive grooming in house cats and the accompanying hairballs.

Vomiting is commonly reported by feline caregivers. Per AI generated searches, it is considered normal for cats to vomit once or twice a month. Such vomiting is not “harmless” and steps should be taken to find the medical cause. Even if there is a clear medical cause, treatment can include dietary and environmental tactics to manage the vomiting cat, giving them a better quality of life.

references

“The Gut-Brain Connection”, July 18,2023. Harvard Health Publishing. https://www.health.harvard.edu/diseases-and-conditions/the-gut-brain-connection. Viewed 8/8/2026.
Meyer, Phyllis. “Treating Pandora Syndrome in Cats: The environment”, January 14, 2024. https://www.felinepurrspective.com/treating-pandora-syndrome-in-cats-the-environment/
Herron ME, Buffington CA. “Environmental enrichment for indoor cats”. Compend Contin Educ Vet. 2010 Dec;32(12):E4. PMID: 21882164; PMCID: PMC3922041.
Rudinsky, Adam. “Approach to the Vomiting Cat: Causes, Treatment, and Management”. Webinar. https://catvets.com/events/approach-to-the-vomiting-cat-causes-treatment-and-management/

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Managing The Vomiting Cat – Dietary Strategies

Posted on July 19, 2026July 19, 2026 by felinepurrspective_u3q4o6

Vomiting is a common finding when taking a feline medical history. Cat owners seem to accept that all cats vomit and are often not concerned if a cat is vomiting several times a month or weekly. If you do a Google search,“how often do cats vomit” , the AI overview will state something like “It is considered normal for cats to vomit occasionally, typically once or twice a month, often due to hairballs or eating too quickly.”

Managing the vomiting cat

Per Dr. Adam Rudinsky at Ohio State University, there is “no such thing as harmless vomiting”. There are a number of possible medical causes, ranging from gastritis and food reactions to cancer and kidney disease (Reference 1). But what about the cat who is diagnostically healthy? And is there more (apart from medications and supplements) we can do to manage those cats that vomit regularly due to a chronic condition such as Inflammatory Bowel disease?

Coughing or vomiting?

When a cat vomits, the abdominal muscles and diaphragm contract at the same time. The diaphragm moves forward while the abdominal muscles compress the stomach, forcing the contents up and through the esophagus (Reference 2).

The diaphragm and abdominal muscles are also active when a cat coughs but there is no retching and production of stomach contents when a cat coughs. Sometimes violent coughing can result in vomiting.

Both vomiting and coughing use the same muscles, hence the confusion that “hairballs are coughed up”. The cat must vomit to expel a hairball – you will see the stomach heaving back and forth in intense, rhythmic contractions that you don’t see in coughing. Many cats will vocalize, lick lips, and drool prior to vomiting.

Dietary tools in Managing the Vomiting Cat

The tools available to the caregiver of a cat prone to vomiting are dietary and behavioral. Let’s first look at how we may modify the cat’s diet.

The vomiting cat’s diet must meet their nutritional needs and also be (Reference 4):

Palatable
Reduce excess stomach and intestinal secretions
Keep food moving through the digestive tract

The diet should be easily digested and contain enough protein to maintain lean body mass. There are veterinary diets that are formulated to be palatable and easily digested.

What form of food?

The form of food (e.g., liquid, canned or dry) affects how quickly the stomach empties. Liquid diets are the fastest to leave the stomach, followed by canned foods and finally dry kibble. One study aimed at determining the optimal time to fast a cat before anesthesia found that some dry kibble could be found in the stomach after an 8 hour fast whereas canned food was gone in less than 4 hours (Reference 3).

Vomiting is associated with fluid loss. Cats with mild fluid deficits can be managed with oral water intake or fluids under the skin. If the cat will eat it, canned food can provide moisture and faster transit through the stomach. If your cat is a confirmed dry food eater, adding some warm water to their dry food can offset some of the fluid loss and improve palatability (Reference 4).

Vomiting may trigger food aversion in some cats. You may want to use a diet made with different ingredients than the regular diet during an episode of vomiting.

Small meals frequently

Consider feeding smaller meals more frequently ( 3-6 meals daily). Smaller meals result in less stomach distention, reduce gastric acid secretion, and transit the stomach faster (Reference 4).

Hairballs

Cats prone to hairballs can benefit from the addition of fiber to their diet to help clearance of swallowed hair. Commercial hairball diets blend insoluble fibers such as cellulose and soluble fibers, typically beet pulp.

Managing the vomiting cat includes several dietary strategies:

Adding more canned food in their diet
Feeding smaller meals more frequently
Feeding a diet with fiber added if hairballs are a problem

The type of diet, form of food, or number of meals is often not the full picture. The asocial cat becomes a social eater living in the human home. Next up, behavioral concerns with managing the vomiting cat.

references

Rudinsky, Adam. “YouTube Live: Chronic Vomiting Cats: What Can We Do?”. October 4, 2022. https://www.youtube.com/watch?v=CkZsUYhswGk. Viewed 7/18/26.
Batchelor DJ, Devauchelle P, Elliott J, et al. “Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review”. Journal of Feline Medicine and Surgery. 2013;15(4):237-265. doi:10.1177/1098612X12473466
Castro, JLC et al. “Determining the Optimal Time of Gastric Emptying in Cats Using Dry or Wet Food”. Acta Scientiae Veterinariae, 2016. 44: 1365. Pub. 1365I. 24June2016
Purina Institute, Centre Square. “Feline Chronic Enteropathy”. https://www.purinainstitute.com/centresquare/therapeutic-nutrition/feline-chronic-enteropathy, viewed 7/14/26.

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