Cats and String

𝐓𝐇𝐄 𝐃𝐀𝐍𝐆𝐄𝐑 𝐎𝐅 𝐒𝐓𝐑𝐈𝐍𝐆: 𝐖𝐇𝐄𝐍 𝐂𝐀𝐓 𝐓𝐎𝐘𝐒 𝐁𝐄𝐂𝐎𝐌𝐄 𝐋𝐈𝐅𝐄-𝐓𝐇𝐑𝐄𝐀𝐓𝐄𝐍𝐈𝐍𝐆!

Did you know that something as seemingly harmless as a piece of string, thread, yarn, or ribbon can become a life-threatening emergency for your cat?

As a veterinarian, one foreign-body danger I want cat owners to understand is the 𝐥𝐢𝐧𝐞𝐚𝐫 𝐟𝐨𝐫𝐞𝐢𝐠𝐧 𝐛𝐨𝐝𝐲. These objects can cause devastating intestinal damage, sometimes requiring emergency surgery to save a cat’s life.

𝐖𝐇𝐀𝐓 𝐈𝐒 𝐀 𝐋𝐈𝐍𝐄𝐀𝐑 𝐅𝐎𝐑𝐄𝐈𝐆𝐍 𝐁𝐎𝐃𝐘?

A linear foreign body is a long, thin object that a cat swallows. Common examples include:

• String and yarn

• Thread, sewing thread, and dental floss

• Ribbon and curling ribbon

• Tinsel

• Elastic cords and string-like toy attachments

• Pieces of feather toys or other toys that have come apart

Cats are natural hunters, and dangling, moving objects can trigger their prey drive. Unfortunately, the same toys that entertain our cats can become dangerous when chewed apart and swallowed.

𝐓𝐇𝐄 𝐓𝐎𝐍𝐆𝐔𝐄 𝐂𝐎𝐍𝐍𝐄𝐂𝐓𝐈𝐎𝐍

One particularly concerning scenario occurs when a piece of string becomes caught under the tongue. Cats have tiny, backward-facing structures on their tongues that help them groom, and string can become trapped around these structures or anchored beneath the tongue.

A cat may swallow more of the string while one end remains stuck. The string can then extend down the esophagus and into the stomach and intestines.

𝐍𝐄𝐕𝐄𝐑 𝐏𝐔𝐋𝐋 𝐒𝐓𝐑𝐈𝐍𝐆 𝐅𝐑𝐎𝐌 𝐘𝐎𝐔𝐑 𝐂𝐀𝐓’𝐒 𝐌𝐎𝐔𝐓𝐇 𝐎𝐑 𝐀𝐍𝐔𝐒!

If the string is anchored internally, pulling can cause severe injury to the digestive tract. If you see string protruding from either end, do not pull it. Seek veterinary attention immediately.

𝐇𝐎𝐖 𝐃𝐎𝐄𝐒 𝐒𝐓𝐑𝐈𝐍𝐆 𝐃𝐀𝐌𝐀𝐆𝐄 𝐓𝐇𝐄 𝐈𝐍𝐓𝐄𝐒𝐓𝐈𝐍𝐄𝐒?

This is where the real danger begins.

The normal movement of the intestines, called 𝐩𝐞𝐫𝐢𝐬𝐭𝐚𝐥𝐬𝐢𝐬, pushes food and intestinal contents forward through the digestive tract.

When a long piece of string is swallowed and becomes anchored, the intestines continue contracting and moving along it. The string can cause the intestines to bunch up or accordion together, a process called intestinal plication.

As the intestinal walls gather along the string, it can cut into delicate tissue, compromise blood supply, and cause severe inflammation. In serious cases, the string can cut completely through the intestinal wall, resulting in 𝐢𝐧𝐭𝐞𝐬𝐭𝐢𝐧𝐚𝐥 𝐩𝐞𝐫𝐟𝐨𝐫𝐚𝐭𝐢𝐨𝐧, leakage of intestinal contents into the abdomen, septic peritonitis, and potentially death.

This is not simply a matter of a cat needing to pass something in its stool. A linear foreign body can cause extensive damage along multiple sections of the gastrointestinal tract.

𝐖𝐇𝐀𝐓 𝐒𝐈𝐆𝐍𝐒 𝐒𝐇𝐎𝐔𝐋𝐃 𝐘𝐎𝐔 𝐖𝐀𝐓𝐂𝐇 𝐅𝐎𝐑?

Signs may include:

• Vomiting or repeated retching

• Refusing food or eating less than usual

• Lethargy or hiding

• Abdominal pain or a hunched posture

• Drooling or pawing at the mouth

• Dehydration

• Changes in bowel movements

• A visible string beneath the tongue or protruding from the mouth or anus

Do not wait for every symptom to appear. Cats can initially show subtle signs, and intestinal injury can progress quickly. A cat may still pass stool even with a partial obstruction.

𝐇𝐎𝐖 𝐃𝐎 𝐖𝐄 𝐃𝐈𝐀𝐆𝐍𝐎𝐒𝐄 𝐀 𝐋𝐈𝐍𝐄𝐀𝐑 𝐅𝐎𝐑𝐄𝐈𝐆𝐍 𝐁𝐎𝐃𝐘?

Diagnosing a linear foreign body can be challenging because 𝐬𝐭𝐫𝐢𝐧𝐠 𝐢𝐬 𝐮𝐬𝐮𝐚𝐥𝐥𝐲 𝐧𝐨𝐭 𝐝𝐢𝐫𝐞𝐜𝐭𝐥𝐲 𝐯𝐢𝐬𝐢𝐛𝐥𝐞 𝐨𝐧 𝐗-𝐫𝐚𝐲𝐬. Instead, we look for changes in the intestines that suggest a foreign body is present.

𝐀𝐛𝐝𝐨𝐦𝐢𝐧𝐚𝐥 𝐗-𝐫𝐚𝐲𝐬 (𝐑𝐚𝐝𝐢𝐨𝐠𝐫𝐚𝐩𝐡𝐬)

Radiographs are often an important first step in evaluating a cat with vomiting, abdominal pain, or suspected foreign-body ingestion. Although the string itself may not show up, X-rays can reveal:

• Abnormal bunching or plication of the intestinal loops

• Small, abnormally shaped gas pockets within the intestines

• Intestinal dilation associated with an obstruction

• Other changes that raise suspicion for a linear foreign body

𝐍𝐨𝐫𝐦𝐚𝐥 𝐨𝐫 𝐢𝐧𝐜𝐨𝐧𝐜𝐥𝐮𝐬𝐢𝐯𝐞 𝐗-𝐫𝐚𝐲𝐬 𝐝𝐨 𝐧𝐨𝐭 𝐫𝐮𝐥𝐞 𝐨𝐮𝐭 𝐚 𝐥𝐢𝐧𝐞𝐚𝐫 𝐟𝐨𝐫𝐞𝐢𝐠𝐧 𝐛𝐨𝐝𝐲.

𝐀𝐛𝐝𝐨𝐦𝐢𝐧𝐚𝐥 𝐔𝐥𝐭𝐫𝐚𝐬𝐨𝐮𝐧𝐝

Ultrasound is especially valuable when a linear foreign body is suspected. It allows us to evaluate the intestines in real time and look for:

• Intestinal plication: the intestines appear bunched or folded along the length of the string

• An echogenic linear structure within the intestinal contents, when visible

• Changes in intestinal wall thickness and normal layering

• Abnormal intestinal movement and signs of obstruction

• Free abdominal fluid or other findings that may raise concern for intestinal injury or perforation

Ultrasound can provide important information about the location and severity of the problem and help guide decisions about surgery. However, it is operator-dependent, and no single imaging study can exclude every foreign body or early intestinal complication.

𝐖𝐡𝐲 𝐝𝐨𝐞𝐬 𝐭𝐡𝐢𝐬 𝐦𝐚𝐭𝐭𝐞𝐫?

Sometimes, the history and physical examination strongly suggest a foreign body even when the initial X-rays are not definitive. Additional imaging, repeat evaluation, or surgical exploration may be necessary when clinical suspicion remains high.

𝐄𝐚𝐫𝐥𝐲 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬 𝐜𝐚𝐧 𝐦𝐚𝐤𝐞 𝐚 𝐜𝐫𝐢𝐭𝐢𝐜𝐚𝐥 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐜𝐞. The sooner we identify a linear foreign body, the better our opportunity to prevent severe intestinal damage, perforation, and life-threatening abdominal infection.

𝐇𝐎𝐖 𝐈𝐒 𝐈𝐓 𝐓𝐑𝐄𝐀𝐓𝐄𝐃?

If a linear foreign body is suspected, prompt veterinary examination is essential. Your veterinarian will examine beneath the tongue when possible, evaluate the abdomen, and may recommend bloodwork and diagnostic imaging.

Treatment depends on where the string is located and how much damage has occurred. Some cases may be suitable for endoscopic removal, while others require abdominal surgery to remove the foreign material. If sections of intestine have been severely damaged or perforated, surgical removal of those sections may be necessary.

Unfortunately, waiting at home to see whether the string passes can turn a treatable problem into a much more serious emergency.

𝐇𝐎𝐖 𝐂𝐀𝐍 𝐘𝐎𝐔 𝐏𝐑𝐄𝐕𝐄𝐍𝐓 𝐓𝐇𝐈𝐒?

Choose cat toys that are durable and appropriate for your cat’s size and play style.

Put away sewing supplies, dental floss, yarn, ribbon, and thread where curious paws cannot reach them.

Inspect feather toys and wand toys regularly for loose strings or damaged attachments.

Supervise play with wand toys, and put them away when playtime is over.

Avoid leaving string-like toys unattended, especially with cats that chew or swallow nonfood objects.

If you suspect your cat has swallowed string, contact your veterinarian immediately—even if your cat seems completely normal.

Never attempt to make your cat vomit or pull swallowed string out yourself. These actions can cause additional injury.

𝐓𝐇𝐄 𝐁𝐎𝐓𝐓𝐎𝐌 𝐋𝐈𝐍𝐄

String may look harmless, but inside a cat’s digestive tract, it can become a surgical emergency. The combination of intestinal movement, an anchored string, and delicate intestinal tissue can lead to devastating complications.

A little prevention, prompt recognition, and timely veterinary care can save your cat a tremendous amount of pain—and may even save their life.

— 𝐃𝐫. 𝐂𝐚𝐬𝐬𝐢𝐞 𝐒𝐡𝐞𝐞𝐡𝐚𝐧, 𝐃𝐕𝐌, 𝐂𝐕𝐀, 𝐂𝐕𝐌𝐌𝐏 Floral City Animal Hospital, Inverness, Fl