Hairball Management

Ever heard of feline trichobezoars? Do not worry. Though it sounds like an alien invasion, it is just the scientific name for hairballs in cats. Cats are meticulous groomers, using their rough tongues to remove loose fur and debris from their coats. However, this constant self-cleaning can lead to a common feline woe: hairballs.

The tiny, backward-facing hooks on a cat's tongue (papillae/barbs) effectively grab loose hair, but some may be swallowed inadvertently as the cat grooms. The ingested hair accumulates in the stomach, forming a hairball often too large to pass through the digestive tract.¹ As the cat continues grooming, the hairball grows, and the cat's body instinctively tries to expel it. This can lead to coughing and gagging and can ultimately lead to vomiting up the hairball. Alternatively, hair is made from an insoluble protein, keratin, that is indigestible, the hairball may pass through the intestinal tract undigested.^2,3 Passage into the small intestine may cause partial or complete intestinal obstruction, leading to vomiting and abdominal discomfort, or it may pass through and exit with the feces.

Hairballs may be a natural occurrence, but they can be managed with nutrition playing an important role in improving skin and coat quality, thereby reducing the amount of hair ingested and looking at ways to move hair through the digestive system. Let’s look at how:

Improve Skin and Coat Quality

Dietary Protein:

• Promote healthy skin and coat: Cats are obligate carnivores, meaning their bodies are designed to obtain most of their nutrients from animal protein. An adequate intake of protein ensures that cats have the building blocks they need for healthy fur growth and repair. A deficiency in protein can lead to brittle fur, hair loss, and a dull coat.⁴ Brittle hair that breaks while a cat grooms and falls out, leading to increased hair being ingested and can lead to the formation of hairballs.
• Supporting skin cell renewal: Skin is a living tissue that constantly undergoes renewal. Protein provides the essential amino acids needed to produce new skin cells. Without sufficient protein, the skin can become dry, flaky, or irritated.⁵ This dry, flaky, irritated skin coat leads to increased grooming by a cat and causes more hair loss that can lead to increased hairballs.
• Boosting the immune system: Protein plays a crucial role in supporting a cat's immune system, which helps fight off infections and allergies that can manifest in skin problems.⁶ In the case of most skin conditions, they lead to increased grooming that can increase hair ingestion and the risk of hairball formation.

Omega-3 and Omega-6 Fatty Acids:

• Essential for a shiny coat: Omega-3 and omega-6 fatty acids help keep a cat's skin hydrated and supple. This translates to a shiny, healthy-looking coat. Deficiencies in these fatty acids can lead to a dull, dry coat. This dry coat can lead to pruritis or itching, causing overgrooming that can result in hairballs.⁷
• Maintaining the skin barrier: Fatty acids are essential components of the skin's natural moisture barrier. This barrier protects against environmental irritants, allergens, and pathogens that can cause dryness, inflammation, and discomfort for a cat.

• Nourishing hair follicles: Both omega-3 and omega-6 fatty acids are vital for nourishing hair follicles. These follicles are responsible for hair growth and overall coat health.
• Calming the itch: Omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are long-chain omega-3 polyunsaturated fatty acids (omega-3) that are abundant in fish, shellfish, and some algae, possess anti-inflammatory properties. This can help manage skin conditions like allergies and flea dermatitis, which often manifest as itching and irritation.
• The ideal ratio matters: While both omega-3 and omega-6 fatty acids are important, there's an ideal balance for optimal health and anti-inflammatory effects. A typical recommendation from AAFCO is an omega-6 to omega-3 ratio below 30:1 but for skin and coat health it is better to be below 10:1.⁹

Move Hair Through

Dietary Fiber:

• Promote elimination: Adding fiber to a cat's diet can help move hair through the digestive tract more efficiently, preventing hairball formation. Soluble fiber forms a gel-like consistency in the digestive tract. This gel helps trap the loose fur as it moves through the intestines, promoting its elimination in the feces rather than accumulating and forming a hairball. It can be found in ingredients like oat bran and pumpkin. Insoluble fiber acts like a bulking agent in a cat's digestive system. It absorbs water and helps form stools with a softer consistency, easing the passage of hair through the intestines. This smoother passage reduces the likelihood of hair accumulating and forming hairballs. It is commonly found in cellulose and miscanthus grass,

Hydration:

• Hydration is key: Just like for humans, proper hydration is essential for healthy digestion in cats. Water acts as a lubricant, softening stool and making it easier for hair to pass through the intestines. Dehydration can lead to constipation, which prevents the elimination of hairballs and allows hair to accumulate.
• Bulkier stools: Adequate water intake helps form bulkier stools, which can effectively "trap" loose fur as it moves through the digestive tract. This bulkier waste helps eliminate hair more efficiently, reducing the risk of hairball formation.
• Keeping things moving: Proper hydration encourages regular bowel movements in cats. This minimizes the time hair spends lingering in the intestines, where it can clump together and form a hairball.

Supplementation:

• Lubricate the hair: Nutrition plays an integral role in hairball management. Sometimes, especially with long-haired cats, hairballs may still be an issue even with a properly designed hairball diet. In those cases, the next step is to look at additional hairball care products. These products provide lubrication and elimination. They come in gels, pastes, or treats that can help lubricate the digestive tract and aid in the passage of hairballs. These products are typically administered orally and come in various flavors that most cats find palatable.

Some Additional Tips:

• Regular brushing and grooming: Regular grooming and brushing help remove loose fur before a cat ingests it while grooming. This can significantly reduce the amount of hair in their digestive system. This is also a great time to bond with a cat.
• Monitor hairball frequency: Occasional hairballs once or twice a month are usually okay. If a cat seems to be coughing up hairballs excessively, consult a veterinarian. They can rule out any underlying medical conditions and advise on appropriate dietary or hairball management strategies.

Hairballs are a natural consequence of a cat's grooming habits, but excessive hairball formation can sometimes indicate underlying health issues like allergies that can lead to increased shedding and contribute to poor skin and coat health. Poor nutrition is another cause of increased hairballs. If a cat's diet is not sufficient, their skin and coat health may decline, leading to excessive shedding and, in turn, more hairballs. Consulting a veterinarian if a cat seems to be experiencing hairballs more frequently than usual is always recommended. By incorporating a fiber-rich diet, promoting healthy skin and coats, and ensuring proper hydration, a cat can naturally manage hairballs and reduce their frequency.

References

1. Barnette, C. Trichobezoars (hairballs) in cats. VCA. Retrieved on July 28, 2024. https://vcahospitals.com/know-your-pet/trichobezoars-in-cats
2. Grazziotin, A, Pimentel, FA, De Jong, EV, Brandelli, A. 2006. Nutritional improvement of feather protein by treatment with microbial keratinase. Anim. Feed Sci. Technol. 126(1-2):135-144. Doi:10.1016/j.anifeedsci.2005.06.002
3. Marshall, RC, Orwin, DF, Gillespie, JM. 1991. Structure and biochemistry of mammalian hard keratin. Electron Micro. Rev. 4(1):47-83. Doi:10.1016/0892-0354(91)90016-6
4. Trüeb, RM, 2020. Nutritional disorders of the hair and their management. Nutrition for healthy hair: Guide to understanding and proper practice. Nutr. Healthy Hair. pp. 111-223. Doi:10.1007/978-3-030-59920-1_5
5. Saseendran, A, Sherin, GK., Banakar, PS, Rajkumar, G, Jayaprakash, G, Sheethal, C. 2016) Skin disease in companion animals: A nutritional impact. Indian J. Nat. Sci. (IJONS). 6(36):1-11. https://tnsroindia.org.in/JOURNAL/issue36/ISSUE%2036%20FULL%20TEXT.pdf
6. Saker, KE. 2006. Nutrition and immune function. Vet. Clin. Sm. Anim. Pract. 36(6): 1199-1224. Doi:10.1016/j.cvsm.2006.09.001
7. Norsworthy, GD. (Ed.). 2018. The Feline Patient. John Wiley & Sons. 16:33-34. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=e3c40e87768f2ebe0496544cfa040048c1d7906c
8. Park, HJ, Park, JS, Hayek, MG, Reinhart, GA, Chew, BP. 2011. Dietary fish oil and flaxseed oil suppress inflammation and immunity in cats. Vet. Immunol. Immunopathol. 141(3-4):301- Doi:10.1016/j.vetimm.2011.02.024
9. Burron, S, Richards, T, Krebs, G, Trevizan, L, Rankovic, A, Hartwig, S, Pearson, W, Ma, DWL, Shoveller, AK. 2024. The balance of n-6 and n-3 fatty acids in canine, feline and equine nutrition: exploring sources and the significance of alpha-linolenic acid. J. Anim. Sci. 102:skae143. Doi:10.1093/jas/skae143

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About the Author

Dr. Katy Miller works as the Director of Veterinary Services at BSM Partners. She earned her veterinary degree at Ross University and completed her clinical year at Louisiana State University. She previously served for 11 years as the Director of Dog and Cat Health and Nutrition for Mud Bay where she earned multiple certifications and specialized in pet food nutriton, prior to which she practiced general and emergency medicine for seven years. She is also a competitive three-day eventer, licensed falconer, and claims only two (Golden and Mini Doxie) of their nine dogs.