Can you reliably induce vomiting in cats?

New case series suggests “yes”—with Dexmedetomidine

If you’ve ever tried to induce vomiting in cats, you already know: it’s a challenge. Unlike their canine counterparts—who tend to respond predictably to injectable and ophthalmic emetic agents—cats are notoriously stubborn when it comes to decontamination efforts. But new research presented in a recent IndeVets Journal Club meeting might provide another option as we approach treating feline toxin ingestion.

The topic? A novel method using orally administered dexmedetomidine. The results? This study delivered promising results–enough to rethink our protocols. The results also sparked a dynamic conversation among IndeVets about safety, success rates, and real-life applications.

This post distills the insights from the Journal Club discussion and the findings of the 2024 Journal of Feline Medicine and Surgery article by Maxwell, Odunayo, and Wissel into practical takeaways for your next tough feline toxicity case.

The challenge: feline emesis is rarely straightforward

Traditional emetic protocols for cats rely on injectable alpha-2 agonists like xylazine or dexmedetomidine. But even with these agents, success rates vary widely—sometimes dipping as low as 0%. Hydrogen peroxide, once considered, is now off the table due to its risks (necroulcerative gastritis).

Meanwhile, cat-specific options remain limited—and the need is real. Cats frequently ingest harmful substances like lilies, onions, acetaminophen, and even common household medications.That’s why this new study drew so much attention from the IndeVets community.

The study: a new route, a familiar drug

The case series evaluated six cats who were administered 20 µg/kg dexmedetomidine orally, aimed at inducing emesis after suspected toxin ingestion. Of the six cats:

• Five vomited successfully
• All six experienced moderate to profound sedation
• No adverse effects were observe
• The emesis episodes occurred within 12–20 minutes (when recorded)

Toxins ingested included lilies, onions, acetaminophen, and aspirin. In some cases, the offending substances were visibly recovered in the vomitus. Importantly, four of the five cats who vomited did not go on to show any clinical signs of toxicity.

IndeVets Journal club takeaways: the power of practical insight

During our September Journal Club session, IndeVets broke down the clinical implications of this novel administration route—and shared real-world reflections on using dexmedetomidine in emergency cases.

Here are the key takeaways from the conversation:

Oral administration is a game-changer

One of the most resonant points from the group was the practical ease of oral administration.

“You can give it while the cat’s mouth is open, with minimal restraint—it’s low-stress, especially in fractious patients.”

Unlike intramuscular injections, which can escalate fear and restraint needs, the oral route allows for a gentler approach, particularly valuable in ER settings or with difficult cats.

An 83% success rate? That’s worth noting

In this small case series, 5 out of 6 cats vomited, putting success at 83%.

That’s significantly higher than many previously published rates for injectable agents in cats.

“It’s not just about the numbers. It’s about what’s available and works predictably—and this seems to tick both boxes.”

Sedation isn’t a bug—it’s a feature

All cats in the study became sedated, but no complications were observed. And in practice, this sedation may even be helpful.

“I could see this helping with catheter placement or further diagnostics, especially if you’re already planning fluid therapy.”

Still, clinicians were mindful of patient selection, especially avoiding alpha-2 agonists in cats with cardiovascular compromise or hypotension. The opinion that all previous criteria for alpha-2 agonist use should still be considered when utilizing the oral route for the induction of emesis in cats.

Know the risks: sedation and aspiration

While sedation can be beneficial, the team discussed the theoretical risk of aspiration pneumonia, especially in cats already neurologically compromised or showing clinical signs.

“In dogs, aspiration post-emesis is rare, but this kind of sedation in cats makes me cautious. Definitely a case-by-case decision.”

Clinical takeaways for practicing veterinarians

Whether you’re in emergency medicine or GP with urgent walk-ins, here’s how to integrate this new information into your clinical decision-making:

When to consider oral Dexmedetomidine:

• Suspected ingestion of highly toxic or rapidly absorbed substances
• Cases where injectable administration is not feasible due to stress or behavior
• When hospitalization or sedation for follow-up care is already indicated

When to use caution:

• Cats with cardiac disease, hypotension, or comorbidities
• Patients already exhibiting neurological signs or at high risk for aspiration
• Cases where the ingestion timeline exceeds the 1–3 hour post-ingestion window
• Cases where vomit induction is contraindicated (e.g. caustic substances that can cause esophageal damage)

Suggested workflow:

• Confirm timing and substance of ingestion
• Administer oral dexmedetomidine (20 µg/kg over the back of the tongue; the recommended dosing to induce emesis is arbitrary and further studies are indicated to determine the ideal dose to achieve emesis)
• Monitor for vomiting (12–20 min expected onset)
• If needed, administer atipamezole IM to reverse sedation (~1-hour post-dosing)
• Proceed with decontamination, diagnostics, or hospitalization as needed

The IndeVets Advantage: shared wisdom = better medicine

One of the most powerful elements of being an IndeVet is never having to face cases like these alone. Our private Clinical Collective channel and monthly Journal Clubs are just two examples of the opportunities our vets have to run questions by colleagues in real time—whether you’re questioning a toxin dose, considering emesis, or just looking for a second opinion.

Opportunities like these help keep our doctors ahead of evolving protocols, and encourage curiosity, collaboration, and the continual sharpening of clinical skills.

Final thought: emesis is just one tool, use it wisely

While this study opens up a promising new route for inducing emesis in cats, the IndeVets community agreed: it’s not a silver bullet. It’s another tool, and tools are best used by hands that are informed, supported, and collaborative.

If you’re ready to practice medicine with more support, more curiosity, and more time to think deeply about your cases, maybe it’s time to join the team that values that kind of care.

Want to explore all the ways IndeVets supports better clinical decisions and a better quality of life as a veterinarian? Join our next IndeVets webinar or connect with us to find out how we’re transforming veterinary careers—one vet (and one case) at a time.

References:

• Maxwell KM, Odunayo A, Wissel C. Use of orally administered dexmedetomidine to induce emesis in cats. J Feline Med Surg. 2024;1-5. [DOI: 10.1177/1098612X241248980]
• IndeVets Journal Club Meeting Transcript, September 2025