Cat hairballs: how often is normal and when to worry

Cat hairballs are one of the most common things owners find on the floor, and most of the time they’re a nuisance rather than a danger. But a hairball is not always “just a hairball”. Frequent ones can point to a problem worth treating, and a hairball that gets stuck can be serious. Not sure how fast to act? Our should I go to the vet check can help.

What are cat hairballs?

The medical name is trichobezoar, a clump of hair in the stomach or gut. Cornell Feline Health Center explains that the tiny backward-facing barbs on a cat’s tongue carry loose fur down the throat as it grooms. Hair is made of keratin, which cats can’t digest.

Most swallowed hair passes through the gut and comes out in the poop. Some stays in the stomach and slowly builds into a damp wad. Cats usually bring it up.

Despite the name, a vomited hairball is rarely round. Cornell describes it as slim and tube-shaped, like a cigar or sausage, because it’s squeezed through the narrow food pipe on the way out. It’s usually about an inch long, the color of your cat’s coat, and darkened by food and stomach fluids.

Which cats get hairballs most?

• Longhaired cats. Cornell says breeds such as Persians and Maine Coons are at greater risk. A 2013 review in the Journal of Feline Medicine and Surgery found frequent hairballs were about twice as common in longhaired cats as in shorthaired cats, based on polls at one cat clinic.
• Adult cats. Kittens and young cats get fewer hairballs than older, more experienced groomers, according to Cornell.
• Shedding season. Cornell says hairballs are more common at the times of year when cats shed their coats.
• Cats that over-groom. VCA Animal Hospitals notes that cats with allergies, skin disease, stress or pain lick more and are more prone to hairballs.
• Cats with gut problems. VCA says hairballs are more common in cats with underlying gastrointestinal disease that slows the movement of hair through the gut.

How often is it normal for a cat to have a hairball?

Experts don’t fully agree, so here’s what the main sources say.

Cornell Feline Health Center says it’s not uncommon for a cat to bring up a hairball once every week or two, and calls that nothing to worry about in an otherwise healthy cat.

The 2013 review by Martha Cannon takes a stricter view. It says that in most shorthaired cats, frequent hairballs are a sign of an underlying chronic problem that makes the cat swallow more fur or slows its gut. It lists itchy skin, fleas and food intolerance as common contributing causes that shouldn’t be overlooked. In the clinic’s poll, around 10% of otherwise healthy shorthaired cats vomited hairballs.

Merck Veterinary Manual advises seeing your vet if your cat has frequent hairballs or vomits repeatedly, because something more serious could be to blame.

A practical middle ground: an occasional hairball in a longhaired cat that’s eating, playing and pooping normally is common. If your cat’s hairballs are frequent, getting more frequent, or your cat is shorthaired and seems to have them regularly, tell your vet. Treating fleas, itchy skin or a gut problem often cuts down hairballs too.

Is it a hairball, a cough or vomiting?

Owners often mix these up, and the difference matters.

International Cat Care warns that coughing can look like a cat trying to be sick, and is often mistaken for hairballs. A coughing cat may gag or retch afterwards, with its neck stretched and body low to the ground. Cornell adds that frequent hacking may have nothing to do with hair and may instead be asthma, which can need emergency care.

If your cat keeps “trying to bring up a hairball” and nothing comes out, take a video on your phone to show your vet. Our guides to cat coughing and cat vomiting explain what each one can mean.

When are hairballs a sign of a problem?

Most hairballs come up without trouble. Cornell warns that a wad of hair can become a serious threat if it grows too large to leave the stomach, or passes into the small intestine and lodges there. That’s uncommon, but it can be fatal without surgery.

VCA notes that when a hairball is causing a blockage, you may not see any hair in the vomit at all. Signs can be vomiting, belly pain and not passing stool. The 2013 review adds that hairballs left in the gut for a long time can harden, which makes them harder to pass or vomit up.

To find a blockage, your vet will examine your cat and usually take x-rays. Ultrasound, a contrast study or blood tests may follow. VCA says a stuck hairball usually has to be removed by surgery, or occasionally with an endoscope, and most cats do well if it’s done promptly. Some hairballs can be moved through with hospital care instead.

Hairballs aren’t the only thing cats bring up. Our guide to a cat throwing up white foam covers another common one.

What hairball remedies actually help?

Brushing is the best-supported step. Cornell recommends brushing and combing your cat daily. International Cat Care says longhaired cats need grooming at least daily, and that grooming during shedding season removes most of the loose hair before your cat swallows it. Keep sessions short and stop while your cat is still relaxed.

Clipping can help longhaired cats. Cornell suggests a haircut from a vet or a reputable groomer if your cat won’t allow brushing. The 2013 review says a short “lion clip” may help in severe cases.

Hairball diets. VCA says these usually contain extra fiber, meant to move hair through the gut before it clumps. The 2013 review found no published studies proving how well they work. Some also use a bigger kibble, which the review notes has been linked to hairballs leaving the stomach more easily. Ask your vet whether one suits your cat, and switch foods gradually. Our food transition calculator can help you plan it.

Hairball gels and lubricants. These usually contain a mild laxative, such as a petroleum-based product or mineral oil, to help hair slide through. Cornell strongly advises never giving your cat a laxative without your vet’s approval and supervision. Your vet can tell you whether one is right for your cat and how to use it.

Small, frequent meals. The 2013 review notes that cats empty their stomachs faster after small meals, so feeding smaller meals more often may help, though this hasn’t been proven in studies.

Treat the reason for extra grooming. If fleas, allergies, pain or stress are making your cat lick more, fixing that cuts the amount of hair swallowed. Cornell notes that over-grooming can be a sign of a food allergy skin problem. See our guide to a cat scratching a lot.

Keep string off the floor. Cornell advises keeping thread, twist ties, paper clips and similar items out of reach, because they can become part of a dangerous hairball.

If your cat’s hairballs keep coming back despite brushing, book a vet visit. Frequent hairballs are worth a proper look, not just a new remedy.

Written by the CatsMed Team from the sources above. This guide isn’t reviewed by a veterinarian and isn’t a substitute for one. See how we research.