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¡Ay Caramba! Life with a stray cat

A cat found from a cowshed in Kouvola ended up in the care of HESY, when facilities of the local operator did not have enough space for the whole cat family. The active teenager grew up to be a thick-coated lady, who found a loving home for the rest of her life and got her own human and cat friends. As Caramba the cat has grown older, she has experienced a lot of housecat life: joy, sorrow, and even illness.

Caramba, nicknamed Cara, was found in a cowshed in Kouvola with her mother and two siblings back in November 2009. The kittens were getting old enough for adoption, and the facilities of the Kouvola region  animal welfare association (Kouvolan Seudun Eläinsuojeluyhdistys) were only able to house the siblings and the mother, so therefore Cara traveled into the capital city region, into the care of Helsinki Humane Society (HESY).


Beginning brawls

At HESY, the nurses had to handle Cara with leather gloves at first, because she was quite irritated – and no wonder, when she was separated from her family and brought to an unfamiliar place! Cara was seven months old when she moved to our place. Cara had been at HESY for four months, and during that time she had already gotten used to being handled by people, but was still shy and fearful. In my eyes she was such a lovely little furball.

Feline friends

Cara moved into a new home, where two cats already lived, 10-year-old Alma and 12-year-old Nelli. Poor little Cara spent her first night in a litter box for cats, and at first was really scared of the new cat friends. Gradually the trio got to know each other and became best friends.

Senior cats Alma and Nelli taught Cara to hunt houseflies on the balcony. It was fun to watch the trio’s coexistence. In the evenings the trio entertained themselves and us people by running all over the place in the apartment.

Life changes

When Cara was three years old, Alma passed away due to kidney failure. The loss of a furry friend is a tough spot for people, but also for Cara and Nelli. At first the cats were depressed and clearly missed Alma, who never came back to them again.

Cara and Nelli were left together, but after one year since Alma’s death, a new feline friend named Vili moved into the home. Vili was a bit over one year old when he arrived into the life of Cara & Nelli. In the beginning there was brawl and hissing between them, because you don’t simply march into the home and take Alma’s spot. However, as time passed, the trio began to get along quite nicely.

Once again we had three cats hunting down houseflies on the balcony, watching birds through the balcony windows, and running their evening rally. Nelli was like a mother for the younger cats Cara and Vili, and licked them clean in the evenings.

Kissapuu cat tree when cat gets sick

From trio to duo

Cara was seven years old when Nelli died at 19 years old. Her osteoarthritis got so bad that Nelli left into cat heaven to be with Alma. It was a very tough spot for Cara and Vili. Even today when a cat is heard meowing in the staircase, they go to the door to wait and see if Nelli is coming home.

Now it has been five years since Nelli passed away. Cara and Vili are best friends who play together. Both of them are already seniors, Vili is 9 years old and Cara is 12.

Senior life

As every senior cat should, Cara and Vili go to a health checkup yearly. On the last checkup Vili was quite healthy, but two sore teeth had to be removed from him, which is a quite common operation for senior cats.

Cara’s bloodwork indicated that she is suffering from hypothyroidism, and she was prescribed a medication for it. The medicine used to be only available in pill form, but luckily nowadays it is also available in liquid form. Liquid medication is significantly easier to give to Cara.

Cara will firstly receive the medication twice a day, and the effectiveness of the medication is observed on a check up appointment. After the check up appointment the medication may possibly be cut down in half, so that Cara would only receive it once a day. After the medication is in balance, next up is daily dental care, which consists of calculus removal and dental X-ray, which shows the condition of the teeth better, down to the roots.

Kissapuu cat tree cat hyoerthyroidism


Every pet owner must prepare for the pet eventually getting sick.

Some pets already get sick in their youth, but usually senior age at the latest brings forth different kinds of hardship. Illnesses can be symptomless at first, and therefore pet owners do not necessarily even consider that their pet could be sick. Most disorders are however revealed at the latest when the pet is brought to the vet for inspection. Because of this, regular checkups at the vet are important.

Especially more serious illnesses sometimes surprise the pet owner, who may wonder why their pet is sick, and what the treatment options are. At this point it is recommended to have a discussion with the vet about the pet’s lifespan and quality of life. Many illnesses can be controlled with medication, keeping the quality of life good. A healthy diet can also slow down the progress of illnesses, and even bring years of more lifespan. Surgery is also one treatment option.


Daily life with a sick pet can be difficult. If the illness is treated with medicine, medication may turn out to be difficult. Giving pills to a cat is classical example! Fortunately nowadays a lot of medicine is also available in liquid form.

It is also important to remember that medication must be given to pets at the same time every day, and sometimes even twice a day. You must adapt your own schedule to fit the care of the sick pet. You may not skip on medication.

The pet’s well-being must be observed. It must be ensured that the animal eats, drinks, defecates and urinates, which means that basic needs have be in order. For example if a cat stops eating even for just one day, it’s liver begins to get damaged. Drinking is also important in order to keep the pet’s body from dehydrating. It is also recommended to observe the pet’s bowel movement, and it to document both runny and hard excrement, in addition to constipation. The pet’s weight and the condition of fur should also be observed.


Hyperthyroidism is a common disease for senior cats. The underlying cause for hyperthyroidism is still mostly unknown.

A cat’s thyroid produces thyroxine, which regulates the cat’s metabolism. Hyperthyroidism leads into a hormonal inbalance, which causes the cat’s bodily functions to accelerate. If not taken care of, cases of hyperthyroidism may lead to a cat’s cardiomyopathy, which in turn leads to heart failure.


Weight loss

Increased thirstI

Increased appetite

Bad condition of skin and fur


Diarrhea and/or vomiting



Special diet

Daily medication

Radioactive iodine treatment



Text & photos by Heidi Dahlman


The story was originally published in Helsinki Humane Society (HESY) membership maganize 1/2022


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Author: Veterinarian Mimma Aromaa

I work as a veterinarian at Kaarinan Eläinlääkäriasema Oy (Kaarina, Finland). In particular, I am interested in the internal diseases of cats and dogs, ie. vomiting, diarrhoea, and weight loss - sluggish and tired patients are a daily challenge for me. I specialize in extensive abdominal ultrasound examinations. My two Burmese cats are my daily guide to the interesting soul landscape of cats.




Vomiting is one of the most common symptoms in cats. A common symptom means that vomiting is a symptom of the entire body, and therefore there may be a number of different causes in the background. Sometimes it can be difficult for the owner to distinguish between coughing and vomiting. Indeed, coughing suggestive of respiratory disease can be misinterpreted as, for example, vomiting or trying to clear the throat from hair. Vomiting is defined as a reflex series in which the pumping motion of the abdominal muscles and diaphragm causes the contents of the stomach to be emptied by pressure. During coughing, on the other hand, the cat often stretches its neck long and "pushes" air or mucus out of the airways without pumping movement from the stomach or emptying the stomach contents into the mouth. It is also normal for cats to empty their stomach by vomiting due to undigested material such as feathers and bones of prey animals. In this case, the cat may aid in the vomiting reflex by eating grass, for example. But how do you know when vomiting is worrying?

Cats groom their fur

All cat owners are familiar with the fact that cats groom their fur daily by licking and plucking it. In this case, it is normal that small amounts of hair end up in the stomach and intestines. In a balanced situation, the hair passes through with the stool, and only rarely does a cat have to vomit and empty the stomach of hairballs or suffer from constipation due to hair. The balance may be shaken if abnormal amounts of hair start to move into the intestine or because of a problem with the digestive tract and the hair does not pass through the intestine normally. Especially in long-haired cats, the amount of hair entering the intestine at the time of hair loss can increase significantly. Also certain hair types may result in continuously increasing amounts of hair entering the intestine. Skin problems or excessive grooming due to pain or behavioral disorders, may also increase the amount of hair entering the gut. It is therefore always important to consider whether there is a predisposing cause for hair vomiting that could be addressed and treated, rather than just treating the hairball vomiting symptomatically. However, if persistent episodes of excessive hair loss, vomiting, or constipation have not been shown to have a clear predisposing cause, or if the cause cannot be remedied, measures preventing the hair from accumulating in the cat's stomach and intestines should be taken. Increased drinking can promote normal hair passage through the digestive tract; for example, the cat may be offered tuna or honey flavored water, or the number of water bowls can be increased by placing them around the apartment if the cat likes to drink in unusual places. To improve bowel function, a high fibre diet is recommended. Choose high fibre food or introduce fibre supplements. Cat malt, paraffin oil or lactulose can be used for short periods or as a treatment when needed, as in continuous use they may interfere with normal gut function and food absorption. Regular grooming and finishing by wiping with eg. a damp cloth is recommended to remove small loose hairs from the fur, otherwise they may end up in the cat’s mouth.

Typical causes for symptoms

Nausea, loss of appetite and vomiting can be caused by a variety of reasons that may not involve hairballs at all. Food allergy, inappropriate food or contaminated food can trigger symptoms. Many medicines, unsuitable plants or intake of other substances known to be toxic or harmful can also cause symptoms. The digestive tract may also have an internal parasitic infection, chronic inflammation, foreign objects or a tumor. Foreign objects, such as pieces of a plastic bag or soft parts from a toy, are likely to cause only temporary vomiting, but eating a cord or eating an ear plug can cause intestinal obstruction, which can have very serious consequences. Also many visceral diseases such as diabetes, hyperthyroidism, kidney, liver, biliary or pancreatic problems commonly lead to nausea, fasting and vomiting.  Only on rare occasions do dental diseases cause vomiting or loss of appetite in cats, even though a food dropping, drooling cat that has abandoned kibbles and switched to wet food alone, may seem to have something wrong in the mouth. In such cases the behaviour is commonly due to nausea, and the fact that wet food does not cause uncomfort and nausea in the same extent as dry food.

Cat's age, lifestyle and history

The age, lifestyle and history of your cat will help determine what causes may be more likely than others. For example internal infections, inappropriate food, foreign objects, and consumption of inappropriate matters are likely causes of symptoms in young cats. A young cat from a large cattery may have symptoms due to a parasitic infection, or may carry asymptomatic giardia, which may infect older cats in the family. An outdoor cat, and especially a predatory cat, is also more susceptible to internal infections or intoxication. An indoor cat that has lived alone or in the same herd for a long time without newcomers is highly unlikely to have an internal parasitic infection. In older cats, symptoms caused by endocrine disorders and tumors are much more common.

Duration and severity of symptoms

Symptoms can be acute, ie. lasting less than a week, or chronic with symptoms for weeks, months, or even years. The severity of the symptoms can range from a mild to a very serious collapse in the general condition, where the cat does not eat, is dehydrated, in pain and even feverish. Acute and rapidly transient symptoms of vomiting in an alert and pain free cat does not require immediate examination or treatment, but if eating does not return to normal within a few days, the vomiting is abrupt and the cat cannot hold his food, is in pain or very weak, it is good to seek medical advice immediately.  Most commonly, chronic wavy symptoms such as gradually creeping vomiting, on / off loss of appetite, and weight loss occur in chronic endocrine disorder, where examination and treatment is not acute. However, even in these cases, it is a good idea to consult a veterinarian in a timely manner, which often makes it much easier to treat the underlying cause or get it under control. Acute syndromes causing acute symptoms, on the other hand, are often severe and require immediate medical attention and treatment.

Examination and treament

Reviewing the cat's history with the owner, reviewing the severity and duration of the symptoms, and a thorough veterinary examination are the most important steps for choosing the correct follow-up exam. Unnecessary tests are also avoided.  In acute cases with mild symptoms, dietary changes or symptomatic treatment may be recommended without an examination, as the underlying cause for symptoms is likely to be self-healing. Acute severe and chronic symptoms often require blood tests. Occasionally, urine and/or fecal samples are also advisable. For example, X-rays can assess the size and shape of organs and the possibility of a foreign object. Often a well-performed ultrasound examination is more informative for a vomiting cat than an X-ray. This enables an examination of the structure and shape of the internal organs, indicates the possibility of a tumor or degeneration in tissues, and show the thickness, structure and contents of the mucous membrane of the stomach and intestines, as well as possible obstructions and inflammation in the pancreas and bile ducts, bladder contents, or whether there may be free fluid in the abdomen or reactive lymph nodes. The aim is to combine the various exam results to find the cause of the symptoms and then discuss treatment options and prognosis with the owner.


The article was originally published in Finnish Siberian Cats Association, issue 1/2019.


Andrea Harvey & Séverine Tasker. BSAVA Manual of Feline Practice A Foundation Manual. BSAVA 2014.

Jacquie Rand. Problem-based Feline Medicine. 1.p. Saunders, Toronto 2006.

Susan E. Little. August’s Consultations in Feline Internal Medicine vol 7. Elsevier 2016.

Etienne Côté. Clinical Veterinary Advisor Dogs and Cats. 3 ed. Elsevier, Missouri 2015


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