Anything long and thin is more dangerous than almost anything else a cat can swallow. One end snags, usually under the tongue, and the intestine bunches up along the rest like fabric on a thread. If you can see string at the mouth or the other end, do not pull it. Come in. We are open around the clock.
Why a piece of ribbon beats almost anything else for danger
A swallowed coin or a swallowed bottle cap is a problem because it blocks. A swallowed ribbon is a problem because it cuts.
Here is the mechanism, and it is worth understanding because it explains every piece of advice below. One end of the string catches on something and stops moving. In cats that anchor point is very often the base of the tongue, which is why we always look under the tongue. It can also lodge at the exit from the stomach. The rest of the string carries on into the intestine, and the intestine does what it always does and tries to move it along. Because the string cannot advance, the intestine walks itself up the string instead, gathering into tight folds like a curtain on a rod.
Now the string is under tension through an accordion of bowel, and with every contraction it saws against the inside edge of each fold. Given time it cuts through, and when it does, intestinal contents enter the abdomen. That is the difference between an uncomfortable night and a life-threatening emergency, and the thing that decides which one you get is how early we see it.
What cats actually swallow
Tinsel. Reflective, moves in a draft, and sits at exactly cat-eye height on a tree. If you have a cat, the simplest decision in this whole article is to not have tinsel in the house.
Curling ribbon and gift ribbon. Shiny, springy and left on the floor during wrapping and unwrapping. Both ends of that process are the risk.
Thread, especially with a needle still attached. The needle gives the string a perfect anchor, and it does its own damage. A sewing basket left open is one of the few hazards here that can hurt a cat in seconds.
Dental floss. Strong, thin, flavored, and usually in an open bathroom trash can.
Hair elastics and rubber bands. Cats bat them, then swallow them. They are short, which makes them more of a blockage than a sawing problem, but they are also easy to miss on an X-ray.
Yarn and twine. Including the twine off a roast, which is soaked in fat and therefore extremely attractive.
Cord from toys. Wand toys with a string, and anything with a dangling cord, are fine supervised and are a hazard left out overnight.
Wrapping paper and tissue. The least dangerous item on this list. Small amounts of paper usually pass. A large volume can obstruct, and the tape and ribbon that come with it are the actual concern.
What it looks like
Early signs are vague, which is the hard part. A cat who has swallowed a ribbon an hour ago may look completely normal.
- Repeated vomiting, often bringing up nothing but foam or fluid
- Refusing food, including food they would never normally refuse
- Hiding, or sitting hunched in a way that is not how they usually sit
- Resenting being picked up, or tensing when the belly is touched
- Drooling, or repeated swallowing and gagging, which can mean the anchor is under the tongue
- Straining with nothing passing, or very little
- Lethargy that deepens over a day rather than lifting
- String visible at the mouth or at the rear end
Two of those deserve emphasis. A cat who is drooling and gulping, with no vomiting at all, can have a string anchored under the tongue and a problem already developing further down. And a cat who seems to settle between bouts has not necessarily improved. Signs with this are often intermittent, and a quiet hour tells you nothing about what the string is doing.
The single most important instruction
If you can see string, do not pull it.
This is the one thing that turns a manageable case into a surgical emergency, and the urge to pull is almost irresistible. By the time you can see an end, the other end is anchored and the bowel is gathered along the length between them. Pulling drags that against the cut edge of every fold and can tear right through.
The same applies to string at the rear end. Do not pull it, and do not cut it short and hope. Bring your cat in with it as it is.
What to do
- Come in. We are open 24 hours a day, seven days a week, every day of the year, so there is never a reason to wait until morning with this one.
- Phone ahead before you leave if you can, so we know what is coming, or have someone call on the way.
- Do not pull on anything you can see, at either end.
- Do not try to make your cat vomit. With something long and anchored, bringing it back up can do the same damage as pulling, and a distressed cat can breathe material into the lungs.
- Look under the tongue only if your cat is relaxed enough to allow it, and stop if they are not. Do not fight them for a look, and do not try to free anything you find there. If a needle may be attached, do not look in the mouth at all, and come straight in. A cat with a string under the tongue is sore and may bite, so never force the mouth open.
- Bring the rest of the item if you have it, and an idea of the length that is missing. Knowing we are looking for eighteen inches rather than two changes the plan.
- No food or water once you have decided to come in, because a cat who may need anesthesia does better on an empty stomach.
- Bring the whole roll or spool if the item is something like floss or thread, so we can see what we are dealing with.
Come in through our emergency care. Our diagnostics team images the abdomen, and this is one of the situations where the picture can be subtle rather than obvious, because string does not show up the way metal does. What we look for is the pattern of bunched intestine rather than the object itself, and ultrasound, which we have in-house, is often what shows it, because it picks up the bunched loops and lets us check the bowel wall itself. Where it has to come out, our surgical services team does that, and that team also watches the recovery, which for a bowel that has been under tension is usually days rather than hours.
How involved the surgery is depends almost entirely on timing. A string caught early can sometimes be retrieved through one small opening. A string that has been in place for days may need the bowel opened in several places, and a section removed where it has cut through. That is the whole argument for coming in on the first day rather than the third.
Keeping it from happening
- No tinsel, at all, in a house with cats. There is no safe way to hang it at a height a cat cannot reach.
- Clear the floor during and after wrapping. Ribbon scraps, tape and paper go straight into a closed trash can, not a pile for later.
- Keep a lidded trash can in the bathroom and the kitchen. Floss, meat twine and elastics all arrive this way.
- Close the sewing basket, and never leave a threaded needle anywhere a cat can reach, including pinned into fabric.
- Put wand toys away after play. Any toy with a string is a supervised toy.
- Do not use string, ribbon or yarn as a toy. It teaches a cat that long thin things are for chasing and chewing, which is precisely the habit you do not want.
- Secure the tree. Anchor it, skip the edible decorations, and keep the lower third plain.
- Check behind the furniture. Ribbon and elastics collect under sofas and behind the stove, and that is where a bored cat finds them weeks later.
Our guide to toxic plants every cat owner in Ingleside should know covers the other category of thing cats swallow that behaves very differently, where the danger is chemical rather than mechanical.
Questions we are asked
I can see an inch of ribbon at my cat’s rear end. Can I just ease it out?
No, and this is the most important answer on the page. If you can see one end, the other end is anchored somewhere above it, and the intestine is gathered along the length in between. Pulling drags the ribbon against tissue it has already been cutting into, and it can tear through. Leave it exactly as it is and come in. We would far rather see it in place.
My cat swallowed some string yesterday and seems completely fine.
Come in today anyway. “Fine” is the normal first chapter of this, and the window where the fix is simplest is while your cat still looks well. We can often tell a great deal from an examination, a look under the tongue and imaging, and if everything is reassuring you have lost an hour. If it is not, you have gained a day, and a day is the difference between one small incision and several.
How long is too long to swallow?
There is no safe length, and a short piece is not automatically a minor problem. What makes something dangerous here is the combination of being long enough to span from an anchor point into the intestine and being strong enough not to break. A short, strong piece of floss can still obstruct, and a longer piece can set up the whole bunching problem; a longer piece of soft tissue paper usually will not. Because that judgment depends on the material as much as the length, call us rather than measuring.
Is this a cat problem or do dogs do it too?
Dogs do it, and when they do it is just as serious, but it happens less often and the pattern differs. Dogs tend to swallow larger, bulkier objects and are more likely to present as a straightforward blockage. Cats get the classic version of this because the barbs on a cat’s tongue point backward, so once something long starts heading back it is very hard for a cat to spit it out. That anatomy is why the base of the tongue is such a common anchor point.
What about wrapping paper? My dog ate a lot of it.
Usually less serious than the ribbon that came with it. Paper breaks down and small amounts pass without incident. What changes the answer is volume relative to the size of your dog, and whether tape, ribbon or a bow went down with it. Repeated vomiting, no appetite, straining with nothing passing or a tender belly over the next day or two means come in.
Why can you not just see the string on an X-ray?
Because string and fabric are close to the same density as the tissue around them, so they do not stand out the way metal or bone does. What we are looking for instead is the shape the intestine makes when it is bunched along something, plus gas patterns that do not look right, and an ultrasound is often the thing that settles it. That is a less obvious picture, which is part of why the history matters so much. Telling us a spool of thread is missing changes what we are looking for.
My cat plays with hair ties constantly and has never had a problem.
That is genuinely how most of these cases start, and it is worth changing while it is still a habit rather than an emergency. Hair elastics are among the most commonly swallowed cat items, they are easy to overlook on imaging, and the cat who has batted a hundred of them around is the cat who eventually swallows one. Swap them for a toy with no small loose parts and keep the elastics in a drawer.
Speak to the team at Ocean Avenue Veterinary Hospital
If your cat or dog has swallowed ribbon, tinsel, string, thread or floss, or you can see any of it at either end, come in now and do not pull on it. We are open 24 hours a day, every day of the year, including holidays. Phone ahead before you leave if you can.
Published by the team at Ocean Avenue Veterinary Hospital.
This article is educational in nature and is not a replacement for hands-on assessment of your own pet by a veterinarian.
Ocean Avenue Veterinary Hospital
1001 Ocean Ave, San Francisco, CA 94112
Phone: (415) 586-5327
Hours: Open 24 hours a day, 7 days a week, 365 days a year