Do cats get reflux? What the hacking and gagging actually means

You're sitting on the couch when you hear it. That rhythmic, wet, thumping sound from across the room. Your cat is hunched over, neck extended, looking like they're trying to exorcise a demon. Most of us just sigh and grab the paper towels, assuming it’s another hairball. But sometimes, nothing comes up. Or, if it does, it’s just a bit of clear slime or some undigested kibble that looks exactly like it did in the bowl. This brings up a question many owners ignore until it becomes a problem: do cats get reflux?

Yes. They absolutely do.

In the veterinary world, we call it gastroesophageal reflux disease, or GERD. It’s remarkably similar to the heartburn you get after a spicy taco, but for a cat, it's a lot more stealthy. They can't tell you their chest burns. They can't ask for a Tums. Instead, they just slowly stop eating, or they start acting "weird" after meals. Because cats are masters at hiding discomfort, reflux often simmers for months before a vet even sees the animal.

Why your cat's throat is on fire

So, why does this happen? Basically, it’s a mechanical failure. There is a circular muscle called the lower esophageal sphincter (LES). Its only job is to act like a one-way trapdoor. Food goes down, the door shuts, and the stomach acid stays where it belongs. When that muscle relaxes at the wrong time or becomes weak, stomach acid—and sometimes even bile from the small intestine—creeps back up into the esophagus.

The lining of the stomach is built like a bunker; it can handle acid. The esophagus? Not so much. It’s delicate tissue. When acid sits there, it causes inflammation, known as esophagitis.

✨ Don't miss: J. Iverson Riddle Developmental Center: What Really Happens Behind the Gates

Chronic vomiting is the most common culprit. If your cat barfs once a week, that constant flow of acid is scarring the "trapdoor." But it’s not just about puking. Sometimes, it’s about what happened during a routine surgery. If your cat was under anesthesia for a dental cleaning or a neuter, the LES relaxes completely. If they weren't fasted properly, or if they were positioned at a certain angle, gastric juices could have pooled in their throat for an hour. That single event can cause enough damage to trigger long-term reflux in cats.

The signs you’re probably missing

It isn't always a dramatic gagging fit. Honestly, the signs are often subtle enough that people mistake them for "just being a picky eater."

Look for the "lip smack." If your cat finishes a meal and then starts licking their lips excessively or swallowing hard over and over, they aren't just cleaning up. They are trying to wash down the acid creeping up their throat. Some cats will approach the food bowl, look interested, take one bite, and then back away. It’s not that they aren't hungry; it’s that they’ve associated eating with the pain that follows.

Then there’s the "painless" regurgitation. This is different from vomiting. Vomiting is active—the cat’s whole body heaves, there’s a lot of noise, and it’s a big production. Regurgitation is passive. They just lean their head forward and oop, there’s a pile of undigested food on your rug. No warning. No heaving. That is a classic sign of an esophageal issue.

Weight loss follows. Obviously. If it hurts to eat, they eat less. You might also notice bad breath that smells more "acidic" than "fishy." In severe cases, they might even develop a cough. This happens when tiny droplets of acid are inhaled into the windpipe, causing micro-irritation in the lungs.

The Hiatal Hernia and other culprits

Sometimes it’s not just a weak muscle. Some cats, particularly Persians and other brachycephalic (flat-faced) breeds, can be born with a hiatal hernia. This is a structural defect where a piece of the stomach actually slides through the diaphragm and into the chest cavity. It wreaks havoc on the pressure systems that keep acid down.

Dr. Audrey Cook, a specialist at Texas A&M University, has noted in various veterinary forums that feline esophagitis is likely underdiagnosed because we don't scope cats nearly as much as we should. To truly "see" the damage, a vet has to put a camera down there. Most owners opt for trial treatment instead, which is fair, but it means we're often guessing at the severity.

Diet plays a massive role too. High-fat foods are notorious for relaxing the LES. If you're sneaking your cat bits of buttery chicken or fatty scraps, you might be the one causing the "fire" in their chest.

Managing the burn: It’s not just about meds

If you suspect do cats get reflux is the answer to your pet's recent behavior, don't just reach for your own medicine cabinet. Never give a cat human antacids without a specific dose from a vet, as some contain xylitol or other ingredients that are toxic to felines.

1. The "Gravity" Trick: Feed your cat on an elevated surface. Use a platform or a stack of books to raise the bowl to chest height. This lets gravity help keep the food and acid down where it belongs. It sounds simple, but for many cats, this is a game-changer.

2. Smaller, Frequent Meals: Instead of two big meals that distend the stomach and put pressure on the LES, try four or five tiny snacks throughout the day. A full stomach is a reflux-prone stomach.

3. Low-Fat Diets: Transitioning to a high-protein, low-fat wet food can help. Wet food is generally better than kibble here because it passes through the esophagus more smoothly and helps with hydration, which buffers stomach acid.

4. Medical Intervention: Your vet might prescribe gastroprotectants like Sucralfate, which acts like a "liquid bandage" for the throat, or prokinetic drugs like Metoclopramide that help the stomach empty faster. If the acid moves into the intestines quickly, it has less time to back up.

What happens if you ignore it?

Left untreated, the esophagus can develop strictures. These are narrow bands of scar tissue that physically shrink the diameter of the throat. Eventually, the cat might reach a point where they can't even swallow solid food. At that stage, you're looking at "ballooning" procedures to manually stretch the throat back open, which is expensive and stressful for everyone involved.

It's also worth mentioning "silent reflux." This is where there’s no gagging or spitting up at all. The acid just sits in the lower esophagus, causing a constant, dull ache. These cats often become lethargic or grumpy. You might think they're just "getting old" or "losing their personality," but really, they're just in pain.

Taking Action

If your cat is displaying these weird eating habits, your first move is a vet visit to rule out kidney disease or dental issues, which can mimic these symptoms. Mention the lip smacking. Mention the "passive" gagging.

Start tracking when the episodes happen. Is it always 20 minutes after eating? Is it only at night? Having this data helps a vet differentiate between a stomach bug and true GERD. Switch to an elevated bowl immediately; there is zero downside to it and a massive potential upside.

Monitor their breathing. If that "reflux" turns into a wheeze, it's an emergency, as aspiration pneumonia is a real risk. Be proactive. Reflux is manageable, but only if you catch it before the scarring starts. Your cat can't tell you their chest is on fire, so you have to watch the way they eat to find the truth.