Sweet Purrs, Sour Stomach — Spot the Signs Early
This condition may not always show itself in dramatic ways, but if left untreated, it can cause lasting damage. The sooner you recognize the signs, and the gentler you are in your response, the better your cat's chances of bouncing back to their curious, cuddly self.
Reviewed by Dr. Elizabeth Hardoon
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STORY AT-A-GLANCE
- Acid reflux in cats, also called gastroesophageal reflux disease (GERD), happens when stomach acid flows backward into the esophagus, causing irritation, inflammation, and discomfort that can silently damage delicate tissues
- Because cats instinctively hide pain, early signs like drooling, gulping, regurgitation, or appetite loss often go unnoticed until the condition worsens into ulcers or chronic swallowing issues
- Common triggers include esophageal injury from medications, anesthesia-related reflux, foreign objects, diet changes, food allergies or sensitivities, or congenital issues like hiatal hernias that disrupt normal digestion and stomach acid flow
- Natural management focuses on a low-carbohydrate, hypoallergenic diet, smaller frequent meals, probiotics, digestive enzymes, and soothing herbs like slippery elm, marshmallow root or papaya leaf to protect the esophagus
- Prevention means consistency; maintain a steady feeding routine, limit stress, avoid dry food and table scraps, monitor symptoms closely, and partner with your veterinarian for early, gentle intervention
If your cat has been acting a little off lately, turning up their nose at meals, swallowing a lot, or drooling more than usual, you might chalk it up to fussiness or a hairball. But sometimes, those subtle signs are your cat’s quiet cry for help. Beneath that soft purr could be something burning — acid reflux.
While we often hear about acid reflux in people (or even dogs), cats can suffer from it too — they’re just experts at hiding the discomfort. Knowing what to watch for and how to respond can make a world of difference in keeping your cat’s tummy and overall health in balance.
What Exactly Is Acid Reflux in Cats?
Acid reflux, also known as gastroesophageal reflux disease (GERD), happens when stomach acid or partially digested food flows backward from the stomach into the esophagus, the tube that connects your cat’s mouth to their stomach.
Normally, a small muscular valve (called the esophageal sphincter) closes after your cat swallows, keeping stomach acid where it belongs. But when that valve weakens, relaxes too soon, or if there’s inflammation or injury, stomach contents can creep back up.
That backward flow irritates and inflames the delicate lining of the esophagus, leading to pain, inflammation, and tissue damage over time.1,2 You can think of it like a tiny fire inside your cat’s chest, one they can’t tell you about, but that quietly causes them distress with every swallow.
Why Cats Hide the Signs of GERD
Cats are masters of disguise when it comes to illness. In the wild, showing pain or weakness made them vulnerable to predators, so domestic cats still carry that instinct to hide discomfort.
That means acid reflux can simmer unnoticed for weeks or months. According to Animal Wellness Magazine, many cat parents miss the early clues because their cat simply seems "a little off" rather than sick.3
But beneath the surface, that irritation can grow into something more serious, such as ulcers, strictures (narrowing of the esophagus), and chronic swallowing problems.
Subtle Signs You Might Overlook
The symptoms of feline acid reflux can vary from cat to cat, and they often look like minor quirks or typical cat behavior. But taken together, they paint a picture worth paying attention to. Here are the most common signs:4,5
- Regurgitation, meaning food or liquid coming back up shortly after eating, often without much effort
- Vomiting (especially after meals)
- Drooling or salivation
- Pawing at the mouth or neck (A sign your cat is feeling discomfort when swallowing)
- Repeated swallowing or gulping
- Loss of appetite
- Unexplained or gradual weight loss
- Change in meow (sounding hoarse or strained due to throat irritation)
- Chronic coughing or nasal discharge
- Change in eating habits
Some cats also lick their lips or the air repeatedly, which can be a subtle clue of nausea. Others might seem anxious after eating, pacing or stretching their necks as if trying to ease the discomfort.
If you notice these signs happening more than occasionally — say, a few times a week — it’s worth checking in with your veterinarian.
What Causes Acid Reflux in Cats?
Several factors can set the stage for reflux, and sometimes more than one is involved. Below are a few common causes:6,7
- Esophageal injury or irritation — The most common trigger is esophagitis, inflammation of the esophagus. This can result from vomiting, chemical burns (like licking cleaning agents), or trauma caused by pills getting stuck.
For instance, doxycycline, a commonly prescribed antibiotic, can cause painful narrowing if swallowed without enough water. Always follow your vet’s directions to give any medication with water or request liquid medications instead of pills. - Anesthesia or surgery — Cats undergoing surgery often have a breathing tube placed for anesthesia. If a cat vomits before or during this process, the acid can travel up and burn the esophagus. That’s why it’s crucial to withhold food and water after midnight before any anesthetic procedure.
- Foreign objects — Cats are curious. String, thread, or small toys can get lodged in their esophagus and cause inflammation or obstruction, triggering reflux. Even large hairballs can cause a temporary blockage that leads to irritation.
- Anatomical issues — Certain cats may be born with, or develop, structural problems such as:
- Hiatal hernias (when part of the stomach pushes through the diaphragm)
- Vascular ring anomalies (abnormal blood vessels pressing on the esophagus)
- Megaesophagus (an enlarged esophagus that can’t push food down properly)
- Diet and feeding habits — Feeding your cat table scraps, a dry food diet, or offering high-fat foods can make acid reflux more likely. Some cats may have undiagnosed food allergies or sensitivities that can cause gut inflammation which can lead to GERD.
Other cats may have an imbalanced microbiome which can also cause these symptoms. Work with your holistic vet to make sure your cat is on an appropriate diet and probiotic to help prevent and alleviate any symptoms.
How Veterinarians Diagnose Acid Reflux
Because cats are so good at masking discomfort, vets rely on a combination of observation, testing, and imaging to diagnose GERD. Your vet will start by asking about symptoms and your cat’s eating habits, followed by:8,9
- Physical exam — Checking for signs of dehydration, discomfort, or throat sensitivity.
- X-rays or contrast studies — These can reveal narrowing, blockages, or structural problems.
- Ultrasound — To look for inflammation or thickening of the stomach or intestinal lining that may be the underlying cause of vomiting and gastrointestinal symptoms.
- Blood work and urinalysis — These rule out other causes of vomiting or appetite loss.
- Endoscopy — A small camera is passed down the throat (under anesthesia) to inspect the esophagus for inflammation, ulcers, or strictures. This is usually done at a specialist’s office.
- Swallow studies (fluoroscopy) — Real-time imaging to watch how food moves down the esophagus. This is usually done at a specialist’s office.
Bringing a video of your cat’s symptoms can also help your vet see exactly what’s happening, especially since regurgitation and vomiting can look similar but mean different things.
Natural Treatment Options for Acid Reflux
When your cat is dealing with acid reflux, the goal is to calm the irritation, support healing, and prevent recurrence. But although there are conventional medications for acid reflux, they don’t get to the root of the problem, and some may lead to serious side effects.
Instead of leaning on medications alone, you can use natural strategies, comfort measures, and lifestyle adjustments that work together with veterinary oversight. Below are natural, integrative tools and approaches to help manage feline acid reflux.10
- Switch to a low-carbohydrate, hypoallergenic diet — Cats are "obligate carnivores" and thrive on protein, not carbs. Diets heavy in carbohydrates or common proteins (like chicken or fish) may worsen reflux. Switching to a novel protein (rabbit or venison) might reduce irritation if your cat is sensitive.
- Limit dry food — Dry kibble is harder to digest and may encourage acid production. Wet food or raw diet is naturally easier to digest.
- Feed smaller, more frequent meals — Instead of two large meals, feed several small ones. A light snack before bed may help prevent acid from accumulating in an empty stomach overnight.
- Avoid dietary triggers — Fatty foods, spicy seasonings, or human scraps may spark reflux. Also consider whether your cat has a food sensitivity and is reacting to certain proteins or additives. You may want to do a "food trial" with your pet — limiting your cat’s diet to more novel proteins to see if this decreases sensitivity.
- Manage weight — Overweight cats are more prone to reflux because excess abdominal fat can push the stomach upward. Bringing your cat to a healthy weight by changing their diet and increasing exercise through play will reduce that pressure and hence the reflux.
- Look into microbiome testing for your cat — An unbalanced microbiome can lead to issues with digestion and increased reflux. A healthy microbiome will optimize the "healthy gut bacteria" your pet has and boost digestion.
There are also supplements and ingredients that can calm and protect the digestive lining. Use them cautiously and under veterinary supervision:
- Digestive enzymes — These help your cat digest fats and proteins, reducing stress on the stomach and keeping food moving forward instead of backing up.
- Probiotics — Introducing beneficial gut bacteria can restore balance and help reduce irritation and inflammation.
- Natural antacids/soothers — Papaya leaf, slippery elm and marshmallow root help coat and soothe the mucosa (the inner lining of the digestive tract). These "natural antacids" aim to relieve burning and protect the tissues. Marshmallow root in particular is often used as a demulcent (a soothing substance) in herbal medicine and slippery elm can be made into a gel that coats the digestive tract and helps with inflammation.
These natural approaches can support recovery and reduce your cat’s reliance on harsher medications. However, they are not guaranteed to be enough alone, especially in severe cases. If your cat’s symptoms worsen, or if you see signs of esophageal damage (like difficulty swallowing, weight loss and frequent regurgitation), consult with your vet for a more well-rounded healing protocol.
Recovery, Prevention, and Long-Term Management
Healing from reflux takes patience. Most cats improve within weeks when their diet, stress, and gut health are balanced. The goal isn’t just to stop symptoms but to build resilience so flare-ups are rare. To prevent recurrence:
- Stick to a consistent feeding routine.
- Avoid sudden diet changes.
- Keep toys, strings, and chemicals out of reach.
- Give pills properly (always with water or food).
- Stay alert for small behavior shifts that might hint at discomfort.
As a cat parent, you know your feline’s habits better than anyone. That’s your best tool for catching acid reflux early. Maybe they start eating slower, drooling just a bit, or skipping their favorite meal — those subtle changes speak volumes.
Trust your instincts. If something feels off, it probably is. Getting your cat checked sooner rather than later can prevent serious esophageal injury and spare them unnecessary suffering. After all, every purr deserves to be a sweet one — not soured by an aching stomach.
