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During a physical exam, the veterinarian will examine the cat to look for signs of ill health that could cause vomiting, and also feel the abdomen for masses or blockages. The following steps discuss the various aspects of a physical exam. Your vet will lift your cat's lip to look at the color of the gums. These should be pink, much like our own gums. Pallor (very pale pink or even white) gums indicate anemia, and a yellow stain suggests jaundice. These give the clinician clues as to where to look to identify the problem. A useful way to assess if the cat's circulation is coping, or if the cat is in a state of shock because of fluid loss, is the capillary refill time. This is the amount of time it takes for the gum to become pink again after the blood is pressed out of it. A normal capillary refill time is under 2two seconds, and usually, the refill is too brisk to count. A refill of more than two seconds is delayed. To measure the capillary refill time lift the lip and press a fingertip firmly to the gum, such that the gum goes pale or white. Release the finger and watch closely to see how many seconds it takes for the gum to become pink again. Lift the scruff away from the shoulders and then let it go. The skin should return to its normal position instantaneously. Dehydration decreases the skin's elasticity which means that it returns slowly when released. Severe dehydration results in "tenting" which is when the skin remains in a peak, rather than sliding back down. In the case of a vomiting cat, this may indicate that the cat is losing more fluid than she is taking in. This finding indicates a cat in need of urgent replacement fluid, such as being put on an intravenous drip. Intravenous fluids are given via a catheter which is placed in the vein in the cat's front leg. A giving set and bag of saline are attached to the catheter and the fluids drip directly into the bloodstream. Typically it takes 24 to 48 hours to slowly correct an underlying fluid deficit, during which time the cat will need to be hospitalized. Although this sounds like a strange thing to do when investigating vomiting, there is an underlying connection. Conditions such as hyperthyroidism (an overactive thyroid gland) can cause vomiting and is also associated with a racing heart. A resting heart rate of 180 beats per minute is abnormal, and the vet will feel the cat's throat area to see if an obviously enlarged thyroid is palpable. A cat's temperature should be below 39 degrees Celsius (102.2 degrees Fahrenheit), and if it is above this, it is an indication of fever. A vomiting cat with a fever may be suffering from an infection. To do an abdominal palpation, the veterinarian uses his fingertips to gently feel the cat's abdomen. He or she is checking that the gut, kidneys, bladder, spleen, and liver feel like they are a normal size and shape, and are not painful. Organ enlargement can indicate infection, inflammation, cancer, or a blockage to outflow from that organ. He or she will also feel for any abnormal formations. If your cat is not unduly ill, not running a fever, is well hydrated and keeping most of her food down, the vet may suggest getting her up to date with preventative treatments such as worming. A heavy worm burden can cause a physical obstruction in the bowel, or irritate the stomach lining and cause vomiting. The treatment for hairballs includes a gentle liquid paraffin based laxative that you put on your cat's paw. One such typical product is Lax-a-paste, of which you put about an inch onto the cat's paw twice a day for two to three days. The idea is that this seeps in through your cat's paw and gently lubricates any hairballs that are rattling around in your cat's stomach and causing inflammation, and helps them to either be passed out in the feces or vomited up.
Schedule a physical exam for your cat. Know that your vet will check your cat's mucous membranes. Look at the capillary refill time. Check hydration status. Know that your cat's heart rate will be checked. Understand that the cat's temperature will be tested. Understand what an abdominal palpation is. Update your cat's worming medications if the physical exam does not help you determine what is wrong with your cat. Treat your cat for hairballs.