It’s 2 a.m. and you hear your cat throw up. No big deal, right? How about throwing up 10 times? What if they are screaming in the litter box? What if they are limping. It can be hard to tell when an emergency is a real emergency and when it can wait until the next morning.

While it’s always better to call your veterinarian when you are in question, I will discuss some situations that are absolute emergencies and some that may not be. For instance, if your pet has just been hit by a car they should be brought in to the veterinarian as soon as possible. If you are seeing things that look like they belong inside on the outside, call us right away. If your dog has had diarrhea for 10 days but now you are sick of it, please wait until the morning (or better yet, don’t wait 10 days to begin with!)

Cats hide pain and illness better than dogs, so many times they get to where they need to be seen as an emergency before you even knew something was wrong. However, any time your cat stops eating, drinking, or using the litter box normally they should be seen the next business day. Unfortunately these are signs that something has usually been going on for a while, so waiting many days after you begin to see changes can decrease the chance of an easy fix and will often increase the cost of treatment.

If your cat stops going to the bathroom, this is something that should be addressed. Constipation is a fairly common problem that is much easier and cheaper to resolve if you bring your cat in sooner rather than later. Constipation is an issue that can wait for the next business day, but if your cat does not defecate for more than a day you should schedule an appointment.

If your cat (especially male cats) are unable to urinate, this is an emergency situation. Straining to urinate with little to no pee coming out, vocalizing (screaming or howling) while in the litter box straining, and pain in their abdominal area on gentle pressure are indicators of a urinary blockage. This requires immediate attention — if the bladder gets too full it can rupture, which is usually fatal. Additionally, urinary blockages can cause heart and kidney failure if not dealt with immediately.

If your cat loses the ability to move their hind end, this is an emergency. Cats with heart disease (which can often go undiagnosed) are prone to developing clots. These clots become lodged in the aorta near the rear legs (an aortic thromboembolism). Signs of this include howling, inability to move the hind legs and tail, urinating or defecating on themselves, and rear paws which are cold to the touch. Less often this can happen to front limbs. This is difficult to treat, but is very painful, and medication to ease this pain and the subsequent stress should be given immediately regardless of the long-term plan.

Severe respiratory distress is an emergency. Cats can develop fluid in their lungs from asthma and also throw blood clots to their lungs. Minor heavy breathing is something which should be seen soon; it becomes an emergency when your cat is laying down, wheezing, and breathing with their mouth open. Fluid in the chest cavity can be drained to increase comfort immediately, and cats that are breathing abnormally and unable to stand are essentially drowning. This is something that is dangerous and very stressful, so should be resolved as soon as possible.

If you are noticing changes in breathing on and off, it could be a sign of a lesser problem like early asthma. These cats should be seen, but are not as urgent as one who is collapsed and gasping.

Additionally, many times heart problems can present as coughing. Since we are all used to our cats leaving hairball presents, clients often think this is the reason behind the cough. However, coughs that persist without any hairballs showing up could be a sign of an underlying problem. Older cats that have never had hairballs before are much more likely to have a heart or lung issue rather than sudden old-age hairballs.

Any time a cat eats something toxic (lilies, antifreeze, any human medication, any medication not meant for them, etc.) they should be seen immediately. This applies to dogs as well! If we can induce vomiting immediately it greatly decreases the time the body has to absorb the toxins. Vomiting is not indicated in all toxin exposure. So check with your veterinarian.

This is not an extensive list, but are some of the things that make me want to see your cat, even at 2 a.m. There are many situations where we see animals for an emergency and find out that the pet has not been right for many days. If you address a problem as soon as you find it, it will be easier to treat.

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