Cats are masters at hiding illness, which means the first sign you notice can already be a late sign. One hour your cat’s napping on the couch; the next, she’s breathing with her mouth open or straining in the litter box. That shift can go from concerning to critical fast. Knowing which symptoms demand an immediate call to the on-call vet can literally save a life—especially with male urinary blockages, toxin exposure (like lilies), or breathing trouble. You’ll learn the red flags that aren’t negotiable, how to quickly check vitals at home, what to do while you wait for a call back, and when it’s okay to monitor for a few hours. I’ve worked with worried owners at 2 a.m. enough times to know the difference between “watch closely” and “grab your keys.” Once you see the patterns, it’s much less scary. And you’ll act faster, with more confidence, when it matters.
Quick Answer
Call an on-call vet immediately for trouble breathing, pale/blue gums, seizures, trauma, suspected toxin exposure (especially lilies), repeated vomiting, inability to urinate, sudden severe pain or collapse, eye injuries, or sudden back-leg weakness/paralysis. Also call if temperature is above 104°F or below 99°F, your cat hasn’t eaten or drunk for 24 hours (sooner for kittens), or you’re seeing rapid deterioration. If you’re unsure, call—early triage beats waiting and risking a crisis.
Why This Matters
Cats can deteriorate quickly. A male cat with a urinary blockage can go from uncomfortable to life-threatening within 24–48 hours as potassium builds up and stops the heart. Lily ingestion can trigger kidney failure in as little as 24–72 hours; one leaf or a small amount of pollen is enough. Breathing problems spiral fast because stress increases oxygen demand. Waiting until morning can be the difference between routine treatment and intensive care.
Real life looks like this: a cat “constipated” in the litter box is actually blocked and yowling by midnight; the kitten that “just skipped dinner” is hypoglycemic and wobbly by 3 a.m.; the cat that bumped a window and “seems fine” is hiding an internal bleed and collapses later. On-call vets triage dozens of similar cases and can steer you on the phone—sometimes straight to the clinic, sometimes with safe, immediate first aid to buy time. Knowing the red flags removes the guesswork, lowers panic, and gets your cat the right help at the right moment.
Step-by-Step Guide
Step 1: Do a 60-second check of breathing, gums, and temperature
Count breaths while your cat is resting: one rise-and-fall is one breath. Normal is roughly 16–30 breaths per minute; consistently over 40 at rest is a red flag. Look at gum color by gently lifting the lip: healthy gums are bubblegum pink and moist. Pale, white, blue, or yellow gums need immediate attention. If your cat tolerates it, take a rectal temperature with a digital thermometer and a little lubricant—normal is 99.5–102.5°F. Above 104°F or below 99°F is urgent. You might find which symptoms mean you should call an on-call vet for cats kit helpful.
- Capillary refill time: press a gum until it blanches; color should return in 1–2 seconds.
- Open-mouth breathing, belly heaving, or noisy wheeze is never normal in cats.
Step 2: Identify non-negotiable red flags that mean “call now”
These signs merit an immediate call to the on-call vet, day or night:
- Breathing trouble: open-mouth breathing, rate >40 at rest, blue/pale gums.
- Urination issues: straining without urine, frequent trips/yowling, a tense belly—especially male cats.
- Repeated vomiting (more than twice in an hour), vomit with blood or string/foreign material, or severe diarrhea with lethargy.
- Seizures (first-time, lasting >3–5 minutes, or multiple in a day), collapse, or inability to stand.
- Trauma: falls, hit-by-car, bite wounds, or any heavy impact—even if the cat seems “okay.”
- Suspected toxins: lilies, rodenticides, human meds (acetaminophen, ibuprofen), essential oils, string/yarn.
- Sudden back-leg weakness or cold hind paws with pain (possible saddle thrombus).
- Eye emergencies: sudden blindness, bleeding, bulging eye, penetrating injury.
- Fever >104°F or temp <99°F; extreme pain (crying, hiding, not moving).
Step 3: Call the on-call vet with the right info ready
Be concise and specific. Share your cat’s age, sex, weight, indoor/outdoor status, medical conditions, medications, exact time signs began, and what you’ve observed (breathing rate, gum color, temperature). If a toxin is involved, have the product name and estimated amount. Note any recent falls or exposure to lilies or strings. You might find which symptoms mean you should call an on-call vet for cats tool helpful.
- Ask if you should come immediately or monitor, and what to do while you wait.
- Do not give over-the-counter meds or induce vomiting unless explicitly instructed; this is rarely recommended in cats and can be dangerous.
Step 4: Provide safe first aid while waiting or en route
Keep your cat calm and contained. For breathing distress, reduce stress, keep the cat in sternal (chest down) position, and avoid heat. For bleeding, apply firm, direct pressure with clean gauze for at least 5–10 minutes. For heatstroke, apply cool (not ice-cold) water to paws/ears and use a fan; for hypothermia, wrap in a warm towel and use your body heat.
- Seizures: darken the room, keep hands away from the mouth, cushion the head, and time the event.
- Toxins: remove plant material from the mouth; gently wipe the gums/tongue with a damp cloth. Bring plant or packaging.
- String: never pull from the mouth or rear—immobilize and let the vet remove it safely.
- Eye injuries: prevent rubbing; use an e-collar if you have one and keep the eye closed and protected.
Step 5: Transport smart and safely
Use a sturdy carrier lined with a towel; for painful cats, slide them onto a board or towel to minimize movement. Keep the carrier level and secure in the car. Call ahead so the team can prepare oxygen, IV access, or a triage cart. Bring medications, toxin packaging, and a written timeline. Keep the car warm or cool as needed and drive smoothly—no sudden stops or loud music. You might find which symptoms mean you should call an on-call vet for cats equipment helpful.
Expert Insights
The most common mistake I see is waiting because a cat looked “okay” after a scare. Cats mask pain and illness beautifully. Purring is not a guarantee of comfort—many cats purr when stressed or in pain. Another big one: assuming a cat that’s straining in the litter box is just constipated. In male cats, this is often a urinary blockage, and 24–48 hours can be the difference between a straightforward unblocking and cardiac arrest from sky-high potassium.
Vomiting “hairballs” more than once every few weeks isn’t normal. Two or more vomits in an hour, vomit with blood or string, or a cat that vomits and then becomes lethargic—pick up the phone. Open-mouth breathing is never normal for cats at rest. Sudden back-leg weakness with cold paws and a painful cry is an emergency until proven otherwise.
Pro tips from the trenches: know your cat’s resting respiratory rate when healthy (count during sleep; 16–30 is typical). Keep a kit with a digital thermometer, water-based lubricant, gauze, towels, a soft e-collar, and corn syrup (for known diabetic cats that become wobbly and are still conscious). Save your vet’s and poison-control numbers in your phone. If you’re on the fence, call—on-call teams triage all night and would rather talk early than race the clock later.
Quick Checklist
- Count resting breaths; call if consistently over 40 per minute.
- Check gum color; call for pale, white, blue, or yellow gums.
- Take a rectal temperature; call if <99°F or >104°F.
- Call immediately for straining to urinate, especially in male cats.
- Secure toxin details (name, amount, time) if ingestion is suspected.
- Do not induce vomiting or give human meds unless a vet instructs you.
- Stabilize calmly: dark room, minimal handling, quiet transport in a carrier.
- Bring meds, packaging, and a written timeline to the clinic.
Recommended Tools
Recommended Tools for which symptoms mean you should call an on-call vet for cats
Frequently Asked Questions
What are normal vital signs for a healthy adult cat?
Typical resting respiratory rate is 16–30 breaths per minute; over 40 at rest is concerning. Heart rate at rest usually ranges from 140–220 beats per minute, trending higher when stressed. Rectal temperature should be 99.5–102.5°F. Know your cat’s baseline when healthy so changes jump out at you.
My cat vomited twice tonight—should I call now or wait?
If your cat vomited more than twice in an hour, can’t keep water down, seems weak, or you see blood or foreign material (like string), call the on-call vet. A single isolated vomit in a bright, interactive cat can often be monitored, but repeated vomiting or lethargy can spiral into dehydration or indicate a blockage.
How do I tell constipation from a urinary blockage?
Constipated cats may strain and pass small, dry stools, often without vocalizing. Blocked male cats strain and repeatedly visit the box, cry or yowl, lick the genital area, and may leak tiny drops or nothing at all; the belly can feel tense and painful. A urinary blockage is life-threatening and needs immediate veterinary care.
Is lily exposure really that dangerous for cats?
Yes. True lilies (like Easter, Asiatic, daylilies) can cause acute kidney failure; even a small amount of pollen or a single leaf is enough. If you saw your cat near lilies or suspect chewing, call immediately. Early decontamination and fluids dramatically improve outcomes.
Can I induce vomiting at home if my cat ate something toxic?
Not without veterinary guidance. Common at-home methods used in dogs (like hydrogen peroxide) can be harmful to cats. Call the on-call vet; they’ll advise whether hospital-induced vomiting is appropriate and safe based on the substance and timing.
My cat is breathing fast while sleeping—how worried should I be?
Count for a full minute. A resting rate over 40, belly heaving, open-mouth breathing, or lips/gums that look pale or blue means call immediately. If the rate is 30–40 but your cat is otherwise bright with pink gums, recheck in 15–30 minutes and reduce stress; still call if rates stay high.
When is diarrhea an emergency for cats?
Call urgently if diarrhea is accompanied by lethargy, blood, vomiting, black tarry stool, abdominal pain, or dehydration (sunken eyes, tacky gums). Kittens and seniors dehydrate fast; diarrhea lasting more than 12 hours in kittens or 24 hours in adults warrants a call, sooner if they seem unwell.
What if I can’t afford an emergency visit right now?
Still call. The team can triage, offer the most critical next steps, and sometimes provide lower-cost stabilization options or point to local assistance. Share budget constraints upfront—vets would rather prioritize essential care than see a condition worsen overnight.
Conclusion
You don’t need to be a veterinarian to recognize when minutes matter. Trouble breathing, inability to urinate, suspected toxins, seizures, major pain, repeat vomiting, abnormal gums, and extreme temperatures are all cues to call right away. Check a few basics—breathing rate, gums, temperature—then contact the on-call vet with clear details. Save numbers in your phone, keep a simple first-aid kit, and trust your gut. Acting early is the most powerful thing you can do for your cat when something feels off.
Related: For comprehensive information about Ask A Veterinarian , visit our main guide.