Why can't my cat eat? (Also: can you get my cat to eat?)
October 17, 2014 8:19 AM   Subscribe

My cat is having trouble eating. We've taken her to the vet, and everything seems fine. But she's losing weight, and we're getting very anxious and frustrated and scared and confused. Any idea what's going on?

My cat, Adi, is 8 years old. We got her when she was 6 months old. In the entire time that we've had her, she's been a vaccuum. She would scarf down ANYTHING. Her food would disappear IMMEDIATELY -- there just weren't leftovers, ever. We even invested in some of those "active eating" cat toy things, in order to get her to slow down. She's also a little fat bowling ball. She's been on a diet for about two years now, because she's such a voracious little eater.

But not for the last week and a half.

Here's what happens now: you put the food in front of her, and she shows interest. She tries to pick up the kibbles with her tongue, but then... they fall out. It's like she just can't keep them inside her mouth. The vast majority of what she tries to eat ends up on the floor, and then she turns to you and starts meowing for food, while there's still food left in the bowl. Seriously: what the hell?

She's on dry cat food. When this started up, we tried giving her wet cat food -- she did the same thing, but along with a serious attitude of contempt. (For some reason, she hates wet cat food.) We've tried softening her food with water and then milk -- no dice. We've tried crushing the food up into tinier pieces -- no dice. This morning, we even gave her the leftover can from tuna (her OMG FAVORITEST THING EVAR) and she went crazy for it, but ended up leaving some bits of tuna in the can. (Which, given her past behavior, is seriously unusual.)

(By the way: I recognize it's not the greatest thing in the world to give your cat milk, or tuna, or to change their diet suddenly. We're reaching to more desperate measures, in an attempt to get food into her tummy.)

Again, she is in fact interested in the food. She wants the food. It really seems like something is just going wrong, mechanically. But we have no idea what to do.

Additional factors: she's been struggling with hairballs for the last few months. When we most recently saw the vet, she gave us this goopy stuff for the hairballs -- we smear the goop on Adi's paw, and she licks it off just fine (although, of course, she hates it). Also, we moved cross country a few months ago, and maybe there's some sort of environmental factor? We have no clue.

We have taken her to the vet. The blood tests came back perfectly fine. The vet says her teeth look absolutely beautiful (they were cleaned just back in July), and can't see anything wrong with her mouth. Vet also says there's no indication of intestinal blockage or anything. Had no explanation for the eating problems.

Any idea? Any suggestions? Should we go back to the vet -- and, if so, to say what?
posted by meese to Pets & Animals (31 answers total) 2 users marked this as a favorite
You've done all the right things. You have to go back to the vet, or to another vet, saying just what you have said here. It's serious when a cat does not eat. There is a risk of fatty liver disease.

I'm sorry your cat is ill.
posted by artistic verisimilitude at 8:23 AM on October 17, 2014 [6 favorites]

One of my parents' cats developed exactly this problem, which turned out to be neurological and incurable, but manageable: she's permanently on steroids. She had to be tube-fed for several months while they worked out the dosages, and some foods remain more difficult for her to eat than others.
posted by thomas j wise at 8:25 AM on October 17, 2014

While you are working this out, you should be feeding her yourself -- this has suggestions for how to syringe-feed a cat that are more or less what I have done to (successfully) feed cats who refused to eat. It's messy but not terribly difficult.
posted by jeather at 8:49 AM on October 17, 2014 [3 favorites]

A couple of suggestions:

1) Yes, take her in again, maybe to another vet. We had a cat who lost an alarming amount of weight and was clearly both interested in food, but then immediately stopping after she started to eat. But whenever we took her to the vet, her mouth looked fine. Finally on the fourth or fifth vet visit, suddenly her mouth was inflamed - it turned out that she had stomatitis, which wax and wane in severity, and we'd never managed to take her in during a visible flare-up before. It doesn't sound exactly the same as what's going on here, but it could be some sort of intermittent condition that you aren't catching at the right time for the vet to diagnose it. Maybe a different vet would ask different questions and figure it out.

2) Meanwhile, perhaps baby food (with no onion or garlic), or the 'cat milk' meal replacement stuff they sell at pet stores for kittens or elderly cats? Our cat could eat those when she couldn't eat either dry or wet food. Depending on the mechanics of your cat's problem it might or might not help - but if it did, at least you'd have a way to get some nutrition into her while you work on a longer-term diagnosis and solution.
posted by Stacey at 8:56 AM on October 17, 2014 [1 favorite]

Does she ever have hair balls? Super bad hair balls can compact and make it difficult for cats to eat.
posted by Hermione Granger at 8:59 AM on October 17, 2014

I would guess teeth/gum problems, which are very very common in cats and your vet may not have known how to look for properly. We have a cat with this problem and are about to take her in again to have her few remaining teeth pulled; fortunately cats can function perfectly well without teeth.
posted by languagehat at 8:59 AM on October 17, 2014 [1 favorite]

Contemporary thinking in feline medicine attribute hairballs to intestinal inflammatory disease, and not a grease deficiency treated with laxatives.

Cats should be able to easily pass the small amount of hair they ingest when grooming themselves. But the inflammatory disease can cause a decrease in gastrointestinal motility. Treatment of decreased motility should focus on gastrointestinal inflammation.

Combined with the increase in vomiting, inappetence and weight loss may be due to an ongoing inflammatory GI disease. Has she showed signs of nausea (lip licking, drooling) when presented with food? Has she had any diarrhea?

Bloodwork values are often normal with GI inflammation, but a GI panel assessing pancreatic function, cobalamine, and folate may help pinpoint the problem.

Abdominal palpation may or may not reveal thickened bowel loops. Intestinal wall thickening may also be apparent on abdominal ultrasound, but the gold standard for diagnosis is full-thickness biopsies of the upper GI, obtained surgically while under general anesthesia.

She can be treated symptomatically (including gastroprotectants (antacids), anti-nausea medications, pro-motility medications, supplementation with B12, trial with oral steroids) in the meantime. Many IBD cats respond well to a grain-free diet (fish and grains are thought to be most irritating to the GI).

In pursuing this, I would suggest referring to an internal medicine specialist (DACVIM) or a feline-centric practice, both of which may be more familiar with the most current diagnostic and treatment approaches for this issue. Good luck!
posted by Seppaku at 9:00 AM on October 17, 2014

Response by poster: Does she ever have hair balls?
Yep, and they've been pretty bad lately. She has been vomiting a lot (although, it's been better since the vet gave us the goop.)

Has she showed signs of nausea (lip licking, drooling) when presented with food? Has she had any diarrhea?
I haven't seen any lip licking or drooling. The only indication I see of nausea would be disinterest in her food -- she shows interest in the general idea of eating food, just not the specific food right in front of her. She hasn't had any diarrhea.

Thanks so much for the answers so far. I definitely would appreciate more suggestions, advice, or possible explanations. I get the message: she needs to go back to the vet. But, the more I understand the potential underlying causes and the like, the better I'll feel like I know how to advocate for her while there and take care of her before we can get her there.
posted by meese at 9:15 AM on October 17, 2014

I don't have any possible diagnosis, but when my cat couldn't eat regular food, she would eat Greek yogurt. I got her full fat Fage brand. It's a temporary measure but may help till you get a diagnosis.
Alternately, a have the vet insert a stomach tube. They're not as bad as they sound and it will keep your cat alive till you figure out what's wrong.

Best of luck to you and your kitty. Crossings my fingers for a quick diagnosis.
posted by MexicanYenta at 9:15 AM on October 17, 2014

IANYV, but I am a vet student. I would bring Adi to see a vet again. Ask your vet for a referral to a specialist. It sounds like your current vet did a physical exam and found nothing abnormal in Adi's mouth. She's also interested in food and wants to eat. I think something else is going on here that is physically preventing her from getting the food from the bowl into her stomach. There are lots of different possibilities for what that could be (neurologic issue, foreign body in the oral cavity, neoplasia or benign growth preventing prehension of food, etc), but it's impossible to say without bringing her in to the vet again.
posted by gumtree at 9:33 AM on October 17, 2014 [2 favorites]

I don't know what could be causing her to not eat, but when my old cat was going downhill and wouldn't eat, the vet gave me some high calorie goop stuff that they could lick off of their paws. It came in a toothpaste-like tube. It sounds like if she can lick the goop for the hairballs, you could get some of the high calorie goop for until you figure out the eating thing.
posted by Weeping_angel at 9:36 AM on October 17, 2014 [1 favorite]

While I have no suggestions as to the cause (besides agreeing on the second vet opinion thing), when my cat was very sick and wouldn't eat, we would dropper-feed him wet food. He would also lick up liquid things so we got him some lactose-free milk at the pet store, and some packets of really stinky wet food with gravy. He'd lick the gravy but not eat the solid stuff, but that at least got some nutrients into him.

The grossest option: meat baby food. Seriously. When my cat was at his sickest and wouldn't even drink milk or stinky gravy, he would eat pureed ham out of a dropper.
posted by bedhead at 9:36 AM on October 17, 2014

I second meat baby food. My folks have fed that to many a sick cat. Sorry to hear kitty is not feeling well.
posted by ATX Peanut at 9:59 AM on October 17, 2014

Ask your vet for a referral to a specialist.

I came here to suggest this. You might want to ask for a veterinary gastroenterologist or do a google search to see if there is one near you.

I am very sorry your kitty is sick, this sounds so stressful.
posted by Librarypt at 10:27 AM on October 17, 2014 [1 favorite]

High calorie cat goop is available without a vets perception in petco around Il.
posted by AlexiaSky at 10:34 AM on October 17, 2014

We had something very similar happen with our cat once. She'd just stopped eating normally, and the night before we were going to take her to the vet, she darted out the door, disappeared for almost a week, then came back rail thin and jaundiced. So we took her to the vet, where she got a feeding tube and some medications for her liver, and after about a month of treatment, she bounced back fully.

We never did figure out what the original cause was, but the way the vet explained it to us, cats are very prone to anorexia, such that even a minor fleeting health problem can cause them to stop eating, which causes them to get sicker, which causes further appetite loss, and it just spirals like that. She said it was one of the most common problems she'd see cats for.

If you can get her eating without a tube, all the better (and, obviously, less expensive)--and you may want to try others ideas for that, including syringe feeding--but regardless of the underlying cause of her not feeling well, the most important thing is to get food into her somehow.

I hope things get better for both of you soon.
posted by ernielundquist at 10:49 AM on October 17, 2014

You've got to get her back to the vet ASAP, and get some food down her in the meantime, even if it's by oral syringe. Fatty liver disease is no joke, and it can be triggered with very little weight loss.
posted by zug at 10:52 AM on October 17, 2014 [1 favorite]

Have you had her tested for heartworm? When my cat started showing symptoms the vet said there could be a heartworm risk (which leads to internal inflammation causing gagging while eating). Turned out my cat just had a bad tapeworm infection but maybe get it checked out anyway. My cats are all indoor-only but until I put them on Revolution they still kept getting worms.
posted by Anonymous at 11:40 AM on October 17, 2014

Definitely time to go back to a vet. When they said there was no sign of intestinal blockage, was it by physical exam alone, or did they do X-rays and/or do an ultrasound?

My cat, Wolf, had some mystery digestive problem that we never figured out. He also got skinny despite much beg-meowing for food. Once he got on prednisone, his appetite came back - unfortunately, we could never get him weaned off of the steroid, every time I tried tapering off, he'd start getting sick again. But it helped for a long time.

My other cat, Loki, developed pancreatitis, which made him vomit and interfered with his ability to eat. Did they test for that? My vet said it used to be a hard thing to diagnose, but that in recent years they'd developed a new blood test that gives a very clear result. But I don't think it's part of the regular bloodwork, they'd need to run that specific test.
posted by oh yeah! at 12:07 PM on October 17, 2014 [1 favorite]

My cat had been going through something like this. After the second vet visit, she was prescribed a hunger stimulant. It took a few hours to start working, but it jump started her appetite again. It's a not a solution, though, just a stopgap measure to prevent fatty liver disease.
posted by hooray at 12:09 PM on October 17, 2014

I've had my mind blown by the effectiveness of acupuncture for getting my cats to eat. Mind blown because I'm skeptical by nature but I assume that cats are not responding to a needle placebo. It has now worked on two cats, one with a liver cancer issue and one who had stopped eating for unknown causes. Cat gets a bunch of needles, cat comes home and chows down. Works repeated if the appetite wanes again. Might work for you if you have someone in your area who does it.
posted by quarterframer at 12:12 PM on October 17, 2014 [2 favorites]

A thing I have done too many times for sick ferrets that need to eat and don't much want to:

Take half a cup of her regular kibble. Put that in a blender and hit puree until it's ground into a fine meal. Put the ground kibble in a small pan with one cup of water, and simmer over low heat, stirring fairly often. (This will stink.) When it gets to the point that it forms a skin if you go a couple of minutes without stirring, it's done. Give it another stir, turn off the heat, and let it cool. Eventually it will congeal to a consistency like Jell-O pudding, but you can offer it while it's still thin once it's cool enough.

Ferrets that won't eat otherwise often will eat this. No clue why they find it so much more appealing, but they usually seem to unless they are seriously ill. Not sure if a cat will find it more appealing, but if you do have to syringe feed, it's easy to draw up into the syringe, and it's a familiar food in a somewhat more digestible form so you don't have to worry so much about the effects of a sudden change in diet on top of everything else. And if they do like it, you can make larger batches and freeze it in ice cube trays for later.
posted by dilettante at 2:20 PM on October 17, 2014

Sounds like it is time for an ultrasound. Seriously. Because this is a lot like what I just went through with my cat Pumpkin. He started vomiting, then vomiting and being unable to stop and not wanting to eat over just a few weeks. The bloodwork and xrays were fine. Vet said nothing seems really wrong but if you insist we'll do an ultrasound. I insisted because I knew what was happening was wrong. (I had just lost my other cat the previous month to IBD and unknown tumor growth.)

The ultrasound, done by a radiologist not the regular vet, showed inflamed intestines and lymph nodes. Luckily, he got a good needle biopsy of a lymph node. Because it was cancer. Large cell lymphoma in fairly early stage.

We are very lucky and have a vet oncologist in town. Pumpkin started chemo a week after the ultrasound. That was 5 weeks ago, and he is now nearly in clinical remission. The cancer vet expects full remission at or after the next chemo treatment in two weeks. He is now hungry and not vomiting and way more energetic. His long term odds are better because he was still otherwise healthy when we started, but we are lucky that he responded well to the chemo.

Observing big changes is very important, because they don't just happen for no reason. You know your cat way better than any vet. Don't stop asking until you are satisfied that you have the answer. Something is causing anorexia and vomiting. She is probably nauseated. Don't wait until your cat is any worse. Hepatic lipidosis is dangerous and can happen very fast. It could be a parasite, though indoor only cats are at low risk. Pancreatitis is incredibly painful, and your cat might not show how bad she feels for a long time. IBD is a very real problem, and needs medication. Worse, it could be cancer. The treatments are not all that different for these illnesses (steroid + something else), but it is best to know which one it is before you start, if possible. In any case, if your vet wants to give prednisone, go find another vet because this one isn't good at treating cats. Cats should get prednisolone because not all cats can convert prednisone into prednisolone internally.

At the very least and very very soon, some ondansetron (Zofran) to relieve the nausea might help your cat feel well enough to eat and buy you more time to get a diagnosis. Metoclopramide (Reglan) might also work, but not as well. Even Pepcid could help, as famotidine works a bit differently in cats than in people due to the differences in neurotransmitter receptors. Mirtazipine is used for appetite stimulation, but shouldn't be used without something else to treat nausea, because who wants to be starving and nauseated at the same time? Cerenia should be used only for acute vomiting in cats, because it can cause even worse rebound anorexia if given for more than a few days.

I know I sound like an alarmist. I hope your cat is just having a bit of tummy trouble and nothing is really wrong. But it is hard to find good information about how seriously to take this. So many people have had their vet tell them that the cat is ok, up until it is an emergency, usually because owners can be reluctant to push or to spend the money for diagnostics. Almost anything diagnostic, aside from surgery, is less expensive than trips to the emergency vet.
posted by monopas at 2:29 PM on October 17, 2014 [6 favorites]

Nthing the recommendations for an ultrasound and also testing for pancreatitis. Also consider asking for an appetite stimulant, but be aware that something like Mirtazapine, although it might work to get your cat to eat, can also cause agitation -- which is why it is sometimes called "meowzapine."
posted by merejane at 4:15 PM on October 17, 2014

Second opinion. And if necessary a third opinion. And a fourth. I had three vets (including one phone consult with Cornell) that my 16-year-old cat wasn't eating because a, or b, or c, over a six-month period. And I *knew* it was hurting him. The boy had been a damned eating machine his whole life. He LIVED for the bowl.

Then a first-year vet student examined him and said, "he has a growth in his head, and it's pushing down into his mouth." It was too late and he was too old for surgery and chemo. RIP, Bumper Garcia. Your cat is much younger and I am not saying he has a tumor. Just that you should keep pushing... not eating is very serious.

Beams and please keep me posted.
posted by cyndigo at 6:50 PM on October 17, 2014

My cat stopped eating when the company making his food changed the formula after him eating the same food for 7 years. I had to find a different urinary diet for him, but it did the trick and got him eating again. Previously, when he was two and had his urinary episode, he wouldn't eat the brand of food the vet gave us for him and I had to find something different then too.

Try this...but still see a vet again.
posted by 101cats at 10:11 PM on October 17, 2014

I will nth everyone saying back to the vet. But, assuming you aren't rushing off right now this minute, you could also try something really simple: raise her food off the floor. When my kitty had problems eating, I did heaps of reading to try all kinds of things to get her to eat. One of the most effective was just raising her food bowl off the floor. Not much, just on top of a phone book (because who uses those anymore?) It did actually help, she seemed better able to access the food.

My cat had other reasons for her problem with eating and yours may too, but this is still probably worth a shot. And involves very little effort.
posted by Athanassiel at 11:18 PM on October 17, 2014

Oh, and also, on a flat plate instead of a bowl. Obviously this works better with dry than soupy food.
posted by Athanassiel at 11:20 PM on October 17, 2014

If she continues to have problems eating, here's a last-resort option: Feeding Tubes For Cats.

If she otherwise has a good quality of life, you should seriously consider it. A feeding tube port doesn't seem to bother cats that much and helps you ensure that they get enough nutrition and liquids every day.
posted by Jacqueline at 3:34 AM on October 18, 2014

When my cat was getting ready to die from unexplained weight loss a very very thorough dental exam revealed a resorptive lesion on a tooth which was causing her inability to eat.
Best of luck to your kitty!
posted by SLC Mom at 9:34 AM on October 18, 2014

Response by poster: Update:

Poor kitty got worse over the weekend -- she started acting lethargic, which terrified us. But, we did manage to find a wet cat food that she's willing to eat: it smells absolutely foul and it costs a fortune, but she can get it in her mouth and (it seems) keep it down.

We took her back to the vet today. Xrays looked perfectly fine. (And she was tested for pancreas stuff last time we were there -- also fine.) Vet still doesn't know the cause, but says it is most likely something to do with the intestines. They've prescribed prednisone for a few days.

And, of course, here are the requisite kitty pictures. She is a good cat, and she is a pretty cat.
posted by meese at 9:44 AM on October 20, 2014 [2 favorites]

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