Help me help my cat
June 23, 2023 6:13 PM   Subscribe

This is going to be long but tldr, about two weeks ago my cat stopped eating and drinking. Trying to think outside of what the vet is saying.

Cat tax. You Are Not My Vet what else should I be considering?

Dayton (15ish y/o neutered medium hair tuxedo) stopped eating and drinking, which I confirmed late because he was otherwise 'normal' and we had switched foods and at first I thought he was just being stubborn. Old food (now current food) Iams Chicken.

When I finally noticed I pulled out all the stops. Favorite wet food, favorite snacks, can of tuna, etc. No result.

Vet visit #1, they gave him subcutaneous fluids and a cerenia injection. Blood work determined Hyperthyroidism. He had lost almost 3 lbs. He started eating after we got home, but never back to how much he used to eat. After a few days he stopped eating again. Never saw him drink.

Vet visit #2 (a week later), they gave him subcutaneous fluids, a cerenia injection, and had to sedate him for imaging. Imaging came back clean (they mentioned gas and that his lungs look like he may have asthma which could be attributed to the fact that I smoked in our previous apartment). He had lost another .2 lbs.

At this point he's eating MAYBE a whole can of fancy feast chicken gravy lovers a day. Sometimes a little more if I give him the Mirataz transdermal ointment on his ear. Sometimes nothing. Occasionally he will also graze on his dry food. It's ups and downs every day.

What could the vet and I be missing? Am I just not waiting long enough for the Felimazole to take affect?

If he starts gaining weight again I really want to get the radioactive iodine therapy, because both of us are unhappy about the constant pilling this is requiring. I'm hesitant to commit to that until then though, am I wrong? He was at 7.1ish lbs on his last vet visit. Down from 10 before this all started.

History of seizures. He isn't on medication but has been in the past. Last seizure was probably 2 years ago.

Kindness is appreciated because this is difficult for both of us.
posted by one4themoment to Pets & Animals (23 answers total) 3 users marked this as a favorite
 
Response by poster: Possibly relevant, I gave him Advantage II treatment for 9+ lb cats shortly before this occurred. He may have been below 9 lbs at that point. And I couldn't get the regular Feliway that I usually get in the diffuser so I got the Feliway Optimum (since unplugged).
posted by one4themoment at 6:19 PM on June 23, 2023


The hallmark of hyperthyroidism is an insatiable appetite in the face of weight loss. This means there is something going on in addition to the hyperthyroidism, and that treating the hyperT4 will not improve the appetite.

You need to keep looking. At the minimum, re-run a full blood panel including urinalysis (cbc/chem/t4/ua) and compare it with baseline. Often, an underlying kidney issue can get unmasked when hyperT4 is treated. This also helps dial in the methimazole dose. Note that there's often a special code for the re-check panel within 30 days at a lower cost.

At his age, IBD and intestinal tumors are on the list of possibilities. That can be ruled in or out with an abdominal ultrasound. Everybody's finances are different, but in general, if you would do the tests when he gets sicker, then it's better to do it now. Keep working the problem.
posted by dum spiro spero at 6:24 PM on June 23, 2023 [2 favorites]


Gerber chicken baby food for now. Sorry I can’t offer any specific medical advice.
posted by Hypatia at 6:33 PM on June 23, 2023


Also, ask them to show you how to give subcutaneous fluids at home. It'll help kitty stay hydrated, and feel better all around.
posted by dum spiro spero at 6:35 PM on June 23, 2023 [4 favorites]


Gently, 15 years old is an old cat. Sometimes the answer is just in old age things stop working. You can search for exact names and exactly what may be causing it in this moment, but it won't fix that as animals age things just stop working at some point.

I know you love your cat and you want to do the best. Sometimes there are things that are easily identifiable and fixable. It may be worth having a discussion on keeping your cat comfortable instead of more tests. This is entirely up to you in guidance with your vet.


Take gentle care
posted by AlexiaSky at 6:35 PM on June 23, 2023 [36 favorites]


Sometimes when our cat has been in a barfy/not eating round (probably IBD) it takes several go-rounds with Cerenia [typically an injection at the vet's and then they gave us a few 1/4 pills to give him]; we also have him on a daily steroid pill and regular B-12 shots. They did a special set of bloodwork that found the B-12 issue; cats can become deficient due to GI problems because they end up not being able to absorb B-12 from their food. I don't know if any of this will be relevant for your handsome guy but figured I would mention it just in case.
posted by LobsterMitten at 6:45 PM on June 23, 2023 [1 favorite]


Is it possible for the vet to give you cerenia to keep on hand and to show you how to administer sub-q fluids at home? With my cat and my dog, I find they can get into this cycle where they aren't feeling well, so they eat less, which then makes them feel worse, they get dehydrated, they get nauseous, their appetite goes downhill even more.

If nothing else, sub-q fluids are relatively safe, and if you can do it at home, should be hopefully low stress for your kitty, and if nothing else, are good palliative care.
posted by litera scripta manet at 6:47 PM on June 23, 2023


I’m going through this right now, with a slightly younger cat (12) who has a history of IBD. He has had multiple recent ultrasounds showing inflammation of his gallbladder, liver, and common bile duct. We were doing antibiotics to see if it would help his blood work results but after a week of treatment they were worse and he had stopped eating entirely again. We’re on day two of mirataz and at home fluids and this coming Tuesday have an appointment with an internist specialist at the big vet hospital downtown. Hopefully he will manage to eat enough to sustain himself until then and the internist will be able to determine the best course of action. One thing it could be is cancer, which shows up with very similar symptoms to IBD but then has a fast progression. Luckily that specific kind of cancer does have treatment options in cats. It could also be a blockage of his bile duct, which would involve surgery, or it could be a persistent antibiotic-resistant infection. I’m sure there are other things it could be that the internist will look for. Anyway my point is, my greatest sympathies! This fucking sucks!

Also, try to find a specialist. An internist is the one who deals with organs in the abdomen; I’m not sure what kind you should be looking for - considering the seizures maybe a neurologist? Ask your vet for referrals and call around, chances are there will be a wait for an appointment but since your cat is eating something every day that’s better than mine and you should be able to make it.

It is true that fifteen is an age where many cats start to decline rapidly. I can tell you after doing two days of fluids at home that it is totally doable and great to feel like I’m actively helping my cat feel more comfortable when he is in distress, so please ask for a demonstration and a bag to keep at home. An ultrasound can be an excellent diagnostic tool if you haven’t done it yet, I love that they are non-invasive but give so much information. The place we go to, you pay one price and they do as many ultrasounds as needed to get a full picture - in our case that involved two a few hours apart one day and then bringing him back the next morning for a third one. Pricey, but worth it and thorough. If your cat is still up and about and enjoying life and being with you, and is tolerant of medical treatments, it sounds like at the very least you will want to engage in palliative care, which would involve diagnostics to figure out what his pain situation is and treatment for that.

I wish you the best of luck and am sharing with you all the stubbornness I’ve had to hold in my heart as I watch my cat refuse his food time and time again these past weeks. Much love to your fluffy guy from mine. I’m gonna go shove a cerenia down his throat.
posted by Mizu at 6:58 PM on June 23, 2023 [1 favorite]


Cats can go downhill pretty quickly. I’m sorry that you’re having to deal with all of this. I hope you get some clear answers soon and your kitty gets better.

I’ve had a cat who needed to be syringe fed to get him going again after he stopped eating for reasons no one could figure out. It wasn’t pleasant, but it got food into him.
posted by Maeve at 7:13 PM on June 23, 2023 [1 favorite]


A hug to both you and Dayton.

When my cat Zach lost his appetite - which was a HUGE change, because he had the appetite of a Clydesdale Horse - we ultimately found that it was colon cancer; the vet found it simply through a physical, manual exam (I think she did something as simple as stick a finger in his butt and felt it there). As gently as she could, she told me that yes, while there was a way to treat it, it was a pretty invasive thing, and Zach was 18 and the treatment itself would probably run the risk of killing him right there. So we opted for pallative care instead. (Zach was a tough little putz, and that was the ONLY TIME EVER he was sick.)

But something the vet thought it might be was an escalation of the renal disease we already knew he had; that can be treatable. In fact I'd been already treating him for it for several months at the time of that last illness, and it worked so well that at the time he died, he had regained normal kidney function.
posted by EmpressCallipygos at 7:20 PM on June 23, 2023 [3 favorites]


I'm a brainstormer, so here's what I thought of:


- Do what you can to find out if he's in pain: headache, arthritis, stomach pain. He may not be, but ... that's what stops _me_ eating. If he has had seizures, is there a chance he has a headache or something (note: I don't actually know that headaches are a thing in cats).

- If he engages in "head pressing" (pushing his head against a wall for an extended time) - that's something to ask the vet about _immediately_.

- If he is OK with going to the vet, maybe get a second opinion? You could also try a telehealth vet.


--------------------


Easy things to do at home that might help him:

- Cat fountain; keep it clean

- Learn to assess his hydration (skin fold test) and give fluids at home

- Make sure you're giving him the right kind of fluids. There are at least two: saline and lactated Ringer's

- Some cats will eat a lot more if you pet / stroke them a lot, although that may just be cats who are stressed or depressed. Still, why not? Brushing can help too. It just feels good! And when you feel good, you're more likely to eat.

- If he's not barfing, ask the vet about syringe feeding. If you do this, be careful and watch >1 video on doing it.

- Play with him if he's into it. Seriously. Why not? Moving helps, unless you're too sick and that just makes you feel worse. Don't overexert him, obviously.

- Try different foods. My cat would eat freshly cooked crab when he would eat nothing else. Boiled chicken can be good too.

--> All of this is predicated on the idea that you've had his blood work and urine analyzed and there's no reason to restrict his diet or movement.
posted by amtho at 8:14 PM on June 23, 2023 [1 favorite]


Get a different opinion from a different vet.
posted by kschang at 10:58 PM on June 23, 2023 [1 favorite]


As no-one has mentioned it yet, make sure the vet has checked his teeth as dental issues are a common reason for cats not eating.

Seconding that breathing problems might be a factor as cat's feeding habits are heavily influenced by smell.

But, I also sadly and gently agree that you may just need to prepare yourself for palliative care. if so, he's lucky to have a human who loves him so much.

Good luck and hugs to both of you.
posted by underclocked at 4:58 AM on June 24, 2023 [1 favorite]


We went through this with our cat a couple years ago (though in her case it was kidney failure). I'm sorry you're going through it, it's really hard. A few thoughts:

Doing subcutaneous fluids yourself at home might seem scary but it's eminently doable. We had to learn how to do it over Zoom because our kitty started declining at the height of the pandemic, and it went fine. It became just part of our routine for the last two years of her life.

I noticed that the Mirataz worked well at first, but then declined in effectiveness quickly. It took me a little while to realize that this was because it was building up on our kitty's ears and forming a thin crust that prevented the new doses from actually penetrating. Once I started breaking up the crust before each new application it worked much better.

Meat-flavored Gerber baby food would get our kitty to eat when nothing else would, and had the advantage of having a large water content as well.

Also, be prepared for anything. This might just be a new normal, or your cat might decline quickly, or they might recover fully. Whichever way it goes, at 15 you probably don't have too many years with them left. You've given them a wonderful, loving home for many years, and your goal should be to make their remaining time as comfortable as possible.
posted by firechicago at 5:04 AM on June 24, 2023


The hallmark of hyperthyroidism is an insatiable appetite in the face of weight loss.
While this is typically the case, it isn't always the case. My cat was losing weight, and our vet diagnosed hyperthyroidism. She was treated with radiation, recovered, and live a few more years.

I'm sorry you and your cat are going thru this.
posted by elmay at 5:46 AM on June 24, 2023


You don't mention it though I'm tired this morning and may have misread - did the doctor do a urinalysis and check his kidney values? When my elderly cat started having kidney issues, this is what she did because she felt terrible and blamed every food for it. I honestly went to the store and bought a whole bunch of different brands and flavours of food because she'd eat one one day and then refuse the next, so I always wanted to keep something palatable on hand for her.

Like others, when my cat had hyperthyroidism (which I eventually had treated with radioactive iodine treatment, which was worth every penny) she ate lots and lots and lost weight, so that diagnosis is surprising to me as well.

Good luck. This is so hard because they are such jerks about hiding what is actually up with them and we just want to help them! Hope you find a solution and can get your kitty back on the road to usual again.
posted by urbanlenny at 7:58 AM on June 24, 2023 [1 favorite]


You could offer kitten milk replacer in addition to his regular food and water. That's what we did to help keep weight on our cat while she waited for radiation treatment. It's very high calorie and high nutrients, basically kitty Ensure.
posted by Jacqueline at 8:34 AM on June 24, 2023 [1 favorite]


I'm so sorry you are going through this. I have gone through similar with my little guys so here are all the things we do when their behaviors change.

How are you giving him his pills? If the process of giving him the meds is stressing him out then maybe he wont want to eat? Have you tried pill pockets?

Have they looked at his teeth? Have you given him a thorough body check for any lumps, bumps, skin issues? Try a specialist vet if possible.

If you haven't tried - canned tuna or mackerel or sardines. Any canned fish or chicken (in water). Real chicken. There are lots of freeze dried food options for animals. You can crush them and sprinkle it over wet food or you can add water to soften it. I recently started using freeze dried chicken hearts for my pickiest cat. I cut it up and sprinkle it over wet food.

We have a lot of different cat "crack" options. Crack 1 is Fortiflora probiotic powder. It comes in little packets and we sprinkle it over his food. Crack 2 is tuna flakes. Super fishy super thin flakes you can sprinkle over their food. Other cracks are powdered freeze dried chicken, beef, duck. They sell small packets. I have also crushed up whiskas crunchy snacks. Freeze dried minnows. Something we recently added to the rotation is squeezy tubes. We put this over food but i also use a recipe to give one cat his meds. I crush the pill completely, add some of the chopped up chicken hearts, mix it all together. Then add a squeezy tube, mix that up, then if necessary, add a little more chicken heart.

I hope this helps. Sorry for not including all links.
posted by mokeydraws at 8:43 AM on June 24, 2023


Adding onto mokeydraws' answer above - the tuna flakes can be found in the Asian foods section of most supermarkets; these are also known as bonito flakes, and are one of the main ingredients in Japanese dashi soup stock. Adding that to give you the good news that it's something you could therefore pick up and try right away (and if it doesn't work, it can be saved for you to try making dashi).
posted by EmpressCallipygos at 8:58 AM on June 24, 2023


I'm so sorry that you're going through this as well. It's so hard.

When this happened for our boy, there were a few factors going on. First, his teeth were a big issue, something we started having to have cleaned every 6-12 months with attendant removals.

Second, we started him on a once daily steroid, which after about two days seemed to just turn the lights back on. The vet thought that he may have had some kind of brain tumor, which was causing symptoms like confusion (including getting lost by walking into the corner of a room and not being able to back up). It would have taken 8 hours in the car and several thousand dollars to diagnose, without giving us any additional treatment options so we chose to continue the treatment that was working. The vet explained that if that was what was happening, the steroid may be having some kind of effect of shrinking the tumor and reducing the pressure.

Third, we spent about four months doing daily subcutaneous fluids. Once he started recovering and eating/drinking on his own, we were able to stop.

It was a hard time, but we had about another three good years because of the care we were able to give him.
posted by past unusual at 1:50 PM on June 24, 2023 [1 favorite]


His pupils look uneven, has the vet mentioned that?

This video called knowing when to say goodbye to a pet was extremely helpful for me when I had to decide when it was time to euthanize my two beloved cats.

He’s a beautiful cat and looks very loved.
posted by nouvelle-personne at 12:39 PM on June 25, 2023


His pupils look uneven, has the vet mentioned that?

I hadn't checked the photo but this is a good observation - the summer before my cat was diagnosed with kidney disease she had uneven pupils. That is, strangely, a symptom of hypertension in cats and that can be an indication of kidney disease in cats. Might just be the angle of the photo, but just in case I wanted to mention that!
posted by urbanlenny at 7:27 PM on June 25, 2023


Response by poster: Just want to update everyone. He went back to the vet this morning (of course yesterday and last night he ate more than he has since this all started, just to prove me wrong). Fecal sample was clean. Bloodwork will be back tomorrow to see if the thyroid meds are working. They gave me a refill of the cerenia (sp?) they did not do fluids or the cerenia (sp?) shot as before because he was 'grumpy'. (He's very much over the vet visits).

He has eaten and drank since he's been home, not a lot but enough that I'm not going to worry myself all night.

I did go out and buy the Kitten Milk Replacer, he totally turned his nose at it. The baby food worked once, he ate about two tablespoons.

He pooped after the vet and it stuck in his fur so I got it all cut out and trimmed up, so hopefully at least the next few days that won't repeat.

Re his eyes, the left eye doesn't dilate at all and hasn't for about 2 years. I had attributed it to brain damage related to the seizures. The vet hasn't mentioned it as a factor. The right eye usually does dilate but will on occasion mimic the left eye. He can still see out of the left eye, and is sensitive to bright lights. Still loves to sunbath.

I really appreciate everyone being kind and want to thank you all for that. He only lost .1 lbs since his visit a week ago, which I was happy with because I thought he had lost much more than that.

Our new pilling procedure is that after he gets pilled he gets to explore something he's usually not able to. Tonight it was the cabinet above the fridge. He was excited about 'new thing' and it makes it easier to see if he actually swallowed or if he faked me out.
posted by one4themoment at 5:31 PM on June 28, 2023 [1 favorite]


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