Cat Vomiting Blood (Hematemesis)

Last Updated on January 11, 2021 by Julia Wilson

At a glance


Hematemesis is the medical term for blood in the vomit which is an alarming sight for cat owners. It can be bright red (upper digestive tract) or have the appearance of coffee grounds (lower digestive tract).


  • Blood clotting disorders (rat poison ingestion, low blood platelets, hemophilia)
  • Gastrointestinal ulcers, trauma (ingested sharp objects), inflammation (IBD) and infection
  • Swallowed blood (mouth, nose, esophagus, lungs)
  • Tumours of the stomach or esophagus
  • Heartworm or hookworm infection


Baseline tests diagnostic imaging, blood coagulation tests, fecal analysis.


Find and manage the cause of bleeding as well as supportive care.


Vomiting is caused by the forceful ejection of the stomach contents and is a common symptom in cats. More often than not, it contains digested food, but you may also notice vomit which contains bile (a green substance) or blood.

Blood in the vomit (also known as hematemesis) has several causes the colour of the blood can provide a clue to the cause.


Bright red blood in the vomit indicates the vomit has come from the upper digestive tract (mouth, nose, and esophagus).

Dark red with the appearance of coffee grounds means the vomit has come from the lower digestive tract and it has been partially digested.

Blood clotting disorders:

  • Rat poison ingestion
  • Low blood platelets
  • Hemophilia

Ulcers and erosions:

  • Ulcers of the esophagus or stomach (ingestion of corrosives or heavy metals, steroids, NSAIDs)
  • Mast cell tumours


  • Foreign body such as a bone which can cause laceration of the intestines or stomach.


  • Gastroenteritis (viral, bacterial or protozoal infection)
  • Inflammatory bowel disease

Swallowed blood:

  • From the mouth, nose, esophagus or coughed up and swallowed from the lungs.


  • Tumours of the esophagus or stomach.



Vomiting, with blood, is the prominent symptom, however additional symptoms may occur which can help your veterinarian to narrow down a probable cause, which includes:

  • Loss of appetite
  • Weight loss
  • Black, tarry stools
  • Bleeding from other parts of the body, such as the nose, or mouth
  • Coughing
  • Lethargy
  • Pale gums (due to anemia)
  • Difficulty breathing


The veterinarian will perform a medical examination of your cat and obtain a medical history from you, including accompanying symptoms you may have noticed and exposure to medications or toxins.

Diagnostic workup:

  • Complete blood count, urinalysis, and biochemical profile to check the overall health of your cat, look for signs of infection, inflammation, liver function, and platelets.
  • Endoscopy – A narrow tube with a light and a camera on the end (endoscope) are inserted into the cat’s digestive tract to look for the presence of tumours, ulcers, and foreign objects.
  • Biopsy of the intestinal tract to look for the presence of inflammatory cells in the intestinal wall.
  • Prothrombin time – A test to measure how long it takes the blood to clot.
  • Fecal studies – A sample of stool is evaluated under a microscope for the presence of worm eggs.
  • Ultrasound or x-rayTo evaluate for foreign objects, growths and look at the internal organs.


Most cases of vomiting blood will require hospitalisation to address the cause of vomiting blood and providing supportive care which may include intravenous fluids, nutritional support, and anti-vomiting medications.

  • Medicines to reduce stomach acid such as cimetidine, ranitidine or famotidine which prevent further damage and also allows your cat’s GI tract or stomach to heal. Sucralfate is a medication which forms a gel-like consistency in the acidic stomach, covering the ulcers and preventing further damage to the already eroded tissue.
  • Worming medications to treat hookworm.
  • There are no drugs registered for use in cats for heartworm and treatment is aimed at managing symptoms.
  • Dietary changes and immunosuppressive drugs for cats with inflammatory bowel disease.
  • Antibiotics for bacterial infections and supportive care which may include fluids and switching your cat to a bland diet to rest the GI tract.
  • Surgery to treat tumours or remove foreign bodies.
  • Gastric decontamination (induce vomiting, pumping of the stomach) and administration of activated charcoal to prevent further absorption of ingested toxins.
  • Blood transfusion for severely anemic cats or those suffering from low blood platelets.
  • Determining the cause of liver failure and treating accordingly, this may include dietary changes or surgery.

Julia Wilson is a cat expert with over 20 years of experience writing about a wide range of cat topics, with a special interest in cat health, welfare and preventative care. Julia lives in Sydney with her family, four cats and two dogs. She enjoys photography, gardening and running in her spare time. Full author bio Contact Julia