image of Hairballs
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Hairballs typically present as a tubular wad of tightly or loosely packed ingested hair. The extreme is a true trichobezoar, a hard concretion consisting of hair, which is lodged in the stomach and is too large to vomit or pass through the pylorus and intenstines. This chapter considers causes, empirical tratment pending results of investigations, diagnosis and treatment of underlying causes.

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5.14.1 A typical hairball. (Courtesy of Susan Little.)
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5.14.2 A large trichobezoar removed, at laparotomy, from the stomach of a middle-aged cat that was presented with a suspected gastric mass. The trichobezoar, which almost filled the stomach, has been cut open to show its contents. The cat had been grooming excessively and had gastrointestinal ileus of unknown origin. (Courtesy of The Feline Centre, Langford Veterinary Services, University of Bristol.)
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5.14.4 A diagnostic approach to the causes of hairballs.
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5.14.5 This cat was presented for inappetence and regurgitation with concurrent weight loss. On conscious plain radiography, aerophagia and a dilated oesophagus were suspected; so a follow-up image was taken immediately after oral administration of 5 ml of liquid barium. In this lateral view, the column of barium stops at the 4–5th rib, with a conical shape outlining the proximal portion of the hairball lodged in the oesophagus at this point. An orthogonal VD view is required for further localization. (Courtesy of John Graham.)
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5.14.6 This cat was presented for a progressive decrease in appetite. The large falciform fat pad ventral to the liver occupies half the ventrodorsal dimension of the patient, indicating severe obesity. The obliquely longitudinal structure in the mid-cranial abdomen (the stomach) is filled with a radiodense object, representing some type of soft tissue foreign body. At laparotomy this was revealed to be a trichobezoar. (Courtesy of John Graham.)
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