My cat is not eating. I know this is bad :( Help please

May 20, 2020 6:50 AM

Over the last several weeks we noticed one of our two cats, George, eating less. He's typically been overweight, weighing around 17 lbs. for the majority of his 8 years. When we weighed him a little over a week ago he was around 12 lbs. I put out some wet food (he is normally on dry food) which he ate. I also brought out treats, which he also ate. However, that night he didn't have a second meal of wet food, or any of his dry food.

I took him to the vet the next morning, who did a variety of blood tests. His thyroid is ok, and according to the vet there wasn't really anything alarming in general. The only standout was elevated liver enzyme levels, specifically his ALT. He sent George home with some different dry food than we normally feed him.

Since then he has continued to lose around 2oz. a day. He also spends much of his day in only 2 or 3 places. I called the vet again yesterday to let him know the new food wasn't doing much. He sent me home with an intradermal appetite stimulant. I've now applied that to his ear twice. I'm going to pick up some more wet food today in hopes that he takes to that.

Otherwise, I'm not really sure what I'm supposed to do. Should I call another vet and get a second opinion? Just as a note, we have a second cat, George's brother, who is fine. We also had our first baby at the end of January, so there has been significant change in the environment. George has always been an anxious cat, but for the first month or two with the baby home George was still clingy to us, as he's always been. Is it possible he's become more anxious, frustrated, etc. leading to this behavior? Ultimately, I just want to get him eating again. Thanks for any help you can offer!

posted by indyjones to Pets & Animals (16 answers total)

How old is he? Did they check his teeth? When our cat James stopped eating like that it was a sign of kidney disease which took his life a few months later. You might try gently heating either canned food or some baby food. I've had luck spoon or dropper feeding a sick cat when it was a temporary issue but if he's really sick that's less likely to work and he's lost a lot of his bodyweight at this point. Good luck but be prepared to lose him - I'm sorry!
posted by leslies at 6:59 AM on May 20, 2020 [3 favorites]

We have a very picky eater and have been through several rounds of vet visits to address. Baby food (specifically turkey, ham, or chicken) have made a huge difference. We can put meds in there or blend baby food with cat food and convince the cat to eat it. He loves it without meds but that he will eat it when laced with meds is an indicator of the mighty power of the stuff. Highly recommend.

There are many many many reasons a cat may not want to eat. We supplement potassium (because our cat had low potassium) and miralax (because our cat is prone to constipation which leads to not eating and not pooping) AND CBD oil (because our cat is old and creaky). With the supplement regiment we've mostly been back on track eating. Since adding CBD oil we have noticed an appetite spike.
posted by countrymod at 7:05 AM on May 20, 2020 [3 favorites]

Get meaty human baby food while you're out, and plenty of wet food options, especially ones marketed as treats (Fancy Feast has some foil packs, I think). You want stuff that'll seem stinky and gross to you, because the more he doesn't eat, the higher the barrier to him feeling like eating becomes. Appetite stimulants can certainly help, so keep up on those. The goal today and for the next several days is just to get calories into him. If there's anything he normally particularly likes to steal from you, let him. Don't worry about whether you'd want him eating whatever it is long-term, because cats can indeed starve themselves into liver failure through sheer stubbornness.
posted by teremala at 7:09 AM on May 20, 2020 [3 favorites]

Did you check blood sugar and see if he might be diabetic? Though I'd expect increased appetite with that, it could explain weight loss.

Seconding checking his teeth. If his teeth hurt then that might explain his reluctance to eat.

If you suspect anxiety, you might try Gabapentin or something to relax him a bit. The first few days he'd be pretty stoned, but that can 1) help deal with pain he might have and 2) will chill him out a bit. (We've used it for one of my older cats who has arthritis, but also to calm down a younger cat who was really hostile to our older boy cat when first introduced.)
posted by jzb at 7:29 AM on May 20, 2020

We went through a bout of no-eating with our cat recently and the approach was to get a few cans of a bunch of different canned Fancy Feast flavors and keep trying small amounts (like a teaspoon worth at a time, sometimes presented on a spoon) until we found ones he would eat. Sometimes fish flavors were best, ultimately settled on the Turkey in Gravy. When he was feeling worst, we had luck with Hartz Delectables lickable treats in foil pouches. (They won't work for a long term diet but they're good for "here's a small amount of highly palatable very wet food" - he would lick up some of the gravy even when he wouldn't eat the solids.)
posted by LobsterMitten at 7:32 AM on May 20, 2020

Another data point. When my cat stopped eating, the vet's consensus was either some sort of cancer or a GI based auto-immune decease (this is what was leaning toward). She got onto prednisolone (thanks to Greenies Pill pockets this was easy to administer) and was much better. She gained her weight and appetite back and was fine for years on a relatively low dosage of prednisolone and occasional B12 shots. The only thing I'd mention is, if that's the direction you go, make sure you're very careful with any sort of infections and treat them aggressively as her immune system will be suppressed.
posted by pyro979 at 8:09 AM on May 20, 2020 [1 favorite]

Make sure his teeth are thoroughly checked. We were considering euthanasia for a middle aged cat when a substitute vet discovered two teeth with resorption lesions. They were pulled and she became a new cat and purred along nicely for several more years.
posted by SLC Mom at 8:24 AM on May 20, 2020 [7 favorites]

It could be stress, and it could be cancer which generally takes more testing, but did they run an SDMA? Some vets run an SDMA routinely as part of their chem panel or in addition to one (I'm sure your vet ran a chem panel, which in humans would be a metabolic panel, mainly checking organ function); other vets very commonly don't even know what an SDMA is.

An SDMA will predict kidney disease at 40% loss of function, giving time to address the illness. A common chem panel, which measures waste that the kidneys would normally filter out (BUN and creatinine), normally does not detect kidney disease until your cat is near complete kidney failure and has less than a week to live (and there's rarely much to do except euth when the suffering becomes terrible).
posted by Shane at 8:34 AM on May 20, 2020

The other advice here is great, so here's what I'll add:

If vet #1 isn't figuring it out, go to vet #2. Cats not eating is serious.

Get him a feliway collar to help with anxiety, if you don't already have one on him.

Good luck.
posted by bile and syntax at 8:55 AM on May 20, 2020 [3 favorites]

One more anecdata tale in support of a thorough dental exam -- I had a cat of unknown provenance who had been with me for more than 15 years. When she started losing weight, didn't want her normal diet OR her treats, and her activity levels dropped, I assumed her advanced years were just catching up and my time with her was soon to end.

We went for a routine exam and saw a new vet at the practice, who did a complete dental exam. Poor dear had at least four bad teeth. We opted to have them removed, despite her age -- and it was like rolling the clock back! She was with me for almost 10 years longer.
posted by peakcomm at 10:01 AM on May 20, 2020 [6 favorites]

I know getting to the vet during a pandemic isn't necessarily trivial, but I would look into having them check carefully for any lumps or thickening of the intestines.

I don't mean to cause any needless upset, but I found out the hard way that cancer does not necessarily show up on blood tests. My (at the time) 9 year old cat, Shadow, developed a gigantic inoperable sarcoma with no symptoms other than "he seems a little off" and weight loss. He died less than 2 months after diagnosis. The tumor grew *inward* from his rib cage and neither us nor the vet noticed anything amiss until it started making one of his shoulders seem subtly asymmetrical. I really, really hope your kitty doesn't have anything like this, and statistically speaking, the tumor Shadow had is very rare, but if I could have one wish right now to change something in the past, it would have been pushing for more testing immediately after the blood test and physical exam came back normal.
posted by aecorwin at 1:53 PM on May 20, 2020

This was the same scenario we had with one our cats (who ultimately passed away pretty soon thereafter).

Our other cat - his brother - started getting very yowly recently for food and also started to lose weight so we took him in and it seemed like he was on the same path. But, then, I started pureeing his wet food in the blender and topping it off with beef or seafood stock and he has been much better.
posted by tafetta, darling! at 2:51 PM on May 20, 2020

The only standout was elevated liver enzyme levels, specifically his ALT.

Did the vet not consider hepatic lipidosis? Because this stands out to me. Irrespective of why he stopped eating, once a very overweight cat stops eating and starts losing weight quickly they're at risk of developing hepatic lipidosis and once that's in full swing all bets are off. The cat will feel worse and worse and they still won't eat even if the original reason for not eating is fixed. I was able to save my cat but it was extremely expensive and involved feeding tubes and multiple overnight stays at a vet hospital and she even lost a limb because she contracted an antibiotic-resistant infection at said hospital. Do not mess around with this. Please, please call your vet and ask if this is a possibility.
posted by Anonymous at 3:27 PM on May 20, 2020

I'm so sorry. It's so frightening when they stop eating. You've got to get calories into that cat before hepatic lipodosis kills him.

These tactics worked when my cat stopped eating:

1) High calorie cat food gel like https://www.chewy.com/tomlyn-nutri-cal-high-calorie-dietary/dp/57187

It's lickable and doesn't need chewing. Try to get him to lick it off your finger multiple times a day. If that doesn't do it, put it on a paw so he'll lick it up.

2) Thin out canned food or mix up powdered kitten milk: https://www.chewy.com/petag-kmr-kitten-milk-replacer-powder/dp/125389

Squirt it into his mouth with a mouth-safe completely plastic syringe, like this one: https://www.chewy.com/lixit-small-animal-oral-syringe/dp/131598

This is the only option if he's just not interested in eating. It will take forever. You have to be careful not to squirt it into their airways. Everyone involved will hate everything. It works, though. I pulled my cat through a month of refusing to eat anything. IME about 1-2 mL is as much as a cat can stand at one go. I gave about 15-20 minutes between squirts so he didn't stay in panic mode.

3) If he's at least mildly interested in food again, soft, smell cat treats instead of the hard, crunchy cat treats. Also, extra fancy and smelly food like lamb, salmon or duck. I never got mine to try anything with pea protein, though.

Did the vet do an x-ray for intestinal thickening? That was the only way my cat's IBD was diagnosed. Prednisolone worked.

Definitely also get a thorough tooth exam.

Do you know exactly what the vet tested for? Vets don't always think of everything.
posted by Ahniya at 6:25 PM on May 20, 2020 [2 favorites]

Another scary and difficult possibility is peritonitus, from which our Rupert recovered but only after a lot of expensive intervention, hospital stays at the distant emergency facility, feeding tubes, novel protein diet, etc. Diagnosis is also tricky. Peritonitus is very painful, and to this day some six years later Rupert won't touch certain foods that had been his favorites because we tried to tempt him with them before seeking professional help. Bad associations, I guess.

I will add that if George's vet suggests a feeding tube, don't reject it out of hand. They do well and it's simple to manage: just a tube going into a neck incision that deposits food and water right on the sphincter separating his esophagus from his stomach. You screw syringes into the end of the tube and use them to give water, meds and a meat slurry. It was so much easier to feed Rupert his meds and ensure that he got enough water and nutrition. For the first few days, it was every two or three hours but the schedule got better quickly. Rupert must have felt better after the treatment because he never fought it and eventually started waiting patiently near the station we set up when the scheduled hour drew near.

I hope George is ok.
posted by carmicha at 8:24 PM on May 20, 2020 [1 favorite]

Make his food stinkier, either by applying tuna juice or warming it up a little in the microwave. Cats' sense of smell degrades as they age.
posted by Jacqueline at 12:23 PM on May 21, 2020