Help!!! Spencer won't eat :(

I need advice I don't want to repeat all I wrote in previous threads, but to make a long story short my cat Spencer came back on Sunday evening from a stay at the vet hospital for a urinary blockage.

He's been home 4 full days, and I am worried about his food intake. He is not eating much.

He came home with the Royal Canin Urinary SO canned food. I have also tried giving him Friskie Pate, and some Fancy Feast canned food, and yesterday I finally gave in and went and bought some urinary SO dry kibble. No matter what I give him, he eats 3-4 bites and leaves the bowl, or just plain refuses to eat. He looked really interested when I shook the bag of kibble last night and he ran to his bowl, but again, a few bites and that was it.

He is currently on the following meds:

Clavamox twice a day

(He had another antibiotic to take of which I forget the name - a big blue pill with apparently a disgusting taste? but anyway he took his last dose yesterday)

Diazepam twice a day

Bethanecol 3 times a day

I am getting frustrated with the vet. The vet that dealt with his blockage is a big vet hospital, not my regular one. Whenever I call there I can never speak to a real vet but only to a vet assistant (the one who took care of Spencer when he was satying there). She's a nice girl but always sounds as if she's reading me a prepared wriiten template answer. I was just on the phone with her trying to find a reason why my baby is not eating, and basically she told me that NONE of the meds I named above has appetite loss as a side effect. I google all these meds AND searched on this site and found several entries telling me the exact opposite. Who's messing with me here?? And when I asked her if this type of problem happens often, i.e. cats not eating after a blockage & being put on meds, she sounded baffled and said she could not give a me an answer on this. She suggested I try another type of urinary food but if he is not eating Friskies or Fancy Feats (I KNOW my boy) he will not eat prescription food any better.

I am worried and frustrated and don't know what to do. Besides the not eating part Spencer has been doing great. He's alert, affectionate, pees good size clumps several times a day and  has a small stool maybe once a day. He is drinking good and does eat a little but like I said far from enough for his size (20 lbs).

My questions to you much more experienced cat parents (this is my first blockage and/or medical emergency with my cats),

- Are his meds causing nausea and the loss of appetite?

- Should I take a chance and stop the meds and see if he eats again? (He only has one more day of Diazepam & Bethanecol)

The vet assistant's suggestions were that I come and buy a different food, or bring him in for observation - but I am afraid this will only stress him out more.

I have limited experience with drugs (for UTI and stomach upset) and only experience with one cat, Ritz.  But I would say that meds can defintiely cause nausea and loss of appetite (one can go hand in hand with the other).  And as you said, you know your cat the best, so would know if your cat has reacted to drugs this way before.  Fortunately/unfortunately, nothing much affects Ritz' appetite.

I would not discontinue the antibiotic.  And since you only have one more day of the Diazepam and Bethanecol, I'd continue with those drugs.  And see if his appetite picks up.  Meanwhile, would an appetite enhancement like Forti Flora be possible?

And I'd call your regular vet too for advice.

Thanks. I called the emergency and not the regular vet because my regular vet was closed for Christmas, which is when the blockage happened, so I brought Spencer to the emergency and as such I thought they would be better able to follow up, because they have his file, etc. I spent a lot of time in their waiting room and did notice that when people call with questions, they are transferred to the vet assistants and not to a vet itself - which makes sense, it's a hospital and the vets are busy.

I did ask about an appetite enhancer but she suggested that I try first with a different kind of food, then if this doesn't work bring the cat in and then they will assess and then maybe prescribe the enhancer, but that it was like a "last resort" type of thing. But at this point I am really doubting whatever this girl told me.

I did feed him with my finger by rubbing canned food on the roof of his mouth and he swallows it ok. He has not been vomitting. I may try more of that or even with a syringe. I really hope this is just a side effect of the medication and that it will resolve itself.

Perhaps your cat is not eating because of the interaction of the medications, as you suggested, or from the stress of his hospital stay and then being forced to take medications. I think as long as he's alert, playing as normal and eating something there's no need to panic. Don't stop the Clavamox, because with antibiotics you usually need to finish the course for them to be effective. The other medications only have a day left, so obviously don't stop them either.

If you'd like to boost his appetite you could try warming up wet food for him to enhance the smell or syringe feeding him a bit to remind him it feels good to eat. His stomach may have shrunk from not eating so much, causing him to feel full faster, so you could try leaving out a tasty liquid like low sodium chicken broth or clam juice to get him to drink and expand his stomach a bit. You could also try supplementing with a Vitamin B-Complex which works extremely well to boost appetite. I always use it during cat colds and serious illnesses and almost never have to resort to syringe feeding. Again though, I wouldn't worry too much yet; if your cat was starving he would not be alert and playful. Watch for signs of sluggishness.

Thanks. I did try warming up the food and it did not make any difference.

A positive point is that his poop this morning was much bigger than the previous days. But then also this morning he would not eat anything, no tuna water, no food and I even tried treats which he didnt't take.

I guess I am mostly wondering if this is something that has happened to someone else before? And what did you do to fix it.

Clavamox caused one of my cats to lose her appetite. Do you know why the each of the meds was prescribed? The diazepam has me curious in this case. I would try to get an answer from the Vet as what recovery time frame is expected. In the meantime, get him to eat even if you have to syringe-feed him. Don't let his loss of appetite go as they can quickly go downhill.

Plenty of information on syringe feeding here and on the web. If you need suggestions, let us know.

I know that the diazepam was prescribed to relax his urethra. The Bethanecol of course to help his bladder contract; after a few days at the vet he wasn't blocked anymore but but was kind of dripping urine, instead of having a good stream; they gave me Bethanecol before he came home and he stopped dripping right away.

I am a loss less sure of why the antibiotics were prescribed. I was in such a panic and anxious, even when I picked him up that I didn't ask. I know they told me the obstruction was caused by a mucus plug, which came out easily and then they found crystals in his urine. His potassium and creatine levels were also all out of wack; before he left the vet they did tell me they tested his levels again and they were back to normal.

I did check him for jaundice this morning and he wasn't yellow. First sign of this and it will be straight back to the vet, in the meantime I will continue to assist-feed him...

Spencers Mom said:

...He is currently on the following meds:

Clavamox twice a day

Diazepam twice a day

Bethanecol 3 times a day

I...Whenever I call there I can never speak to a real vet but only to a vet assistant...she told me that NONE of the meds I named above has appetite loss as a side effect....when I asked her if this type of problem happens often...she sounded baffled and said she could not give a me an answer on this...

I am worried and frustrated and don't know what to do....Spencer...does eat a little but like I said far from enough for his size (20 lbs).
- Are his meds causing nausea and the loss of appetite?
- Should I take a chance and stop the meds and see if he eats again? (He only has one more day of Diazepam & Bethanecol)

Click to expand...

OMG.............this ASSistant knows NOTHING!!!!!!!!!!

ALL three of these drugs have anorexia as a potential side effect.

With Clavamox, when gastro-intestional issues arise, the usual advice is to first give some food, then the meds, so that they're not irritating an empty stomach...and, of course, the best advice to give in the first palce is: feed first, then medicate!

There is potential concern with the diazepam, however. From Plumb's Veterinary Drug Handbook 7th edition:

Contraindications

Use of diazepam in cats is controversial, primarily because of case reports of serious hepatotoxicity [liver toxicity]...

Adverse Effects

There have been reports of cats developing hepatic [liver] failure after receiving oral diazepam (not dose dependent) for several days. Clinical signs (anorexia, lethargy, increased ALT/AST, hyperbilirubinemia [*] ) have been reported to occur 5-11 days after beginning oral therapy. Cats that receive diazepam should have baseline liver tests [**]. These should be repeated and the drug discontinued if emesis [vomiting], lethargy, inappetence or ataxia develops.

[ ] are mine

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*hyperbilirubinemia: http://www.foothillsvet.com/index.p...:hyperbilirubinemia&catid=41:feline&Itemid=55

** my reading of "baseline" is a test done prior to starting the drug...so that later test results can be compared to what was "normal" prior to introducing the drug

If Spencer were mine, and, if I just discovered this, I would first of all stop the diazepam. Then I would be taking him to whichever of the two Veterinarians I felt was the more competent - and I would do this without delay. If that meant going to the large hospital, I would expect and insist that it be without charge to me. I'd have the bloodwork re the liver tests/values done. I'd demand a meeting with that Veterinarian and the clinic manager to review what has occurred - including the patently false and misleading information - potentially life-threatening - provided by Ms No-Nothing.

Now, on top of all this, the fact that he hasn't been eating the usual quantity of food - and, that he is a large cat - would give me cause for even more concern. We know that cats, most especially large cats, can develop Hepatic Lipidosis ("fatty liver disease") if they go without a portion of their required caloric intake for a period time. This, in itself, can be life threatening...add in the potential for liver failure from the diazepam, and there's real danger.

I guess the bottom line on where you take him really is really an issue of trust...whom do you most trust? The cost angle can be reckoned later, he needs competent evaluation immediately.

(On the "fatty liver" issue...if a cat is in this state, there's an important point to consider, the danger of "refeeding syndrome" which occurs if too much food is reintroduced too quickly. That's discussed here, at the page bottom http://www.marvistavet.com/html/body_hepatic_lipidosis.html I wouldn't leave it to chance, I'd bring it up with whichever Vet treats him.)

I don't want this to panic you - only to inform. Hopefully it is helpful.

My cat is going through liver failure and hasn't been eating. Today was a break-though day, though. I was syringe feeding him and accidentally dropped food on his fur. All of a sudden he did a 180 and went from struggling to eat to lapping the food up. Oddest thing, but can't hurt to try with your cat. I hope Spencer is back to eating normally soon.

Hun, call your regular vet. Bring them up-to-date on what happened.

For a large kitty, hepadic lipisosis (fatty liver) is a VERY real concern, and FOOD is the only solution. You may have to start syringe feeding him. I don't know if a/d (the prescription food designed to be used for assist feeding) is appropriate for a kitty that just blocked with struvite crystals - but your regular vet will know. They will COMPLETELY understand you went to an emergency vet because they were not open. But now that they ARE, you want him back in their care. :heart2:

I am so sorry the other foods didn't help.

They'll also need his records from the emergency vet. The main question here is - did his urine culture show he had an infection as well as a blockage? Why is he being given the clavamox? That can really do a number on appetite. At this point, they may want to consider discontinuing it, trying a different antibiotic, or other options as mentioned - maybe an anti-nausea medication like reglan or cerenia, and/or an appetite stimulant.

But not eating after a blockage - other than not liking the prescription food - isn't a normal reaction. There's something else going on here: most likely a side-effect of the drugs or the combo, and something needs to be done, and quickly. I do NOT mean to scare you, but not eating for four days for a big kitty is its own can of worms.

myrockymeister said:

My cat is going through liver failure and hasn't been eating. Today was a break-though day, though. I was syringe feeding him and accidentally dropped food on his fur. All of a sudden he did a 180 and went from struggling to eat to lapping the food up. Oddest thing, but can't hurt to try with your cat. I hope Spencer is back to eating normally soon.

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Sometimes all you have to do is to just get them started with some syringe food and they 'remember' how to eat. I was afraid that my girl was getting to like being fed like a baby as she would reach and lean towards the syringe as I fed her. 

myrockymeister, I hope your cat gets well soon. I feel your pain, thrust me.

To clarify, he hasn't stopped eating completely. But he used to have a big appetite, so this is a big change for him.

Nope I am very dissapointed with that vet assistant, it seems like she is coached to give general, non-commital answers to anything. And yes, she did tell me these meds do NOT have appetite loss as a side effect. I also asked her if this was something she saw often in other cats recovering from a blockage - she looked to be in her thirties so she must have worked there a couple of years??? she as I said she was completely baffled by my question. I would definitely take my cat back to the regular vet for follow-up. 

I know you guy don't mean to freak me out but I am freaking out right now, I just called my (very helpful and retired) nighbour and they are going to go check on him now. I think I'll leave work anyway I just can't concentrate.

Thank you all for your support.

I'm not trying to freak you out. If a cat does not get adequate calories, problems will develop. Four days would freak me out too. Big, older cats are more prone than youngsters. I don't know how much he is eating but would guess should have AT LEAST a 5.5 oz can of food per day. If he is just licking gravy or taking a few bites, you have to get more food into him. Pet stores and places like Walgreens have syringes for feeding. Pick up some Hill's a/d or Gerber 2nd food Chicken Baby Food. They are high in calories which is essential.

Thanks for the advice

My neighbour just went over and Spencer apparently is doing great. I'm going home soon and I'll see what comes next.

And after this crisis, I'd call the big vet hospital, ask to speak with the office manager/vet/legal affairs department, and tell them their vet assistant is dispensing medical advice without a license.

Vibes for Spencer. 

I'm so glad your neighbor was able to check on him - how wonderful you've got a retired vet!

How's he doing? Did you get a chance to talk to YOUR vet about any of this? :cross:

Spencer update!
I don't want to jinx anything, but Spencer is doing much better today. I took the decision yesterday not to give him his meds - none of them. So the last time Spencer had clavamox, diazepam and bethanechol was yesterday morning. I also phoned my regular vet after getting home yesterday afternoon, and we agreed I would come in around 7pm with Spencer.
So, a little after I came home last night Spencer got up and what a change! He ate a lot more than he had in the past few days, lots more energy, he was chasing toys etc. later the vet said he looked good and advised not to put him on appetite enhancer for now, to which I very much agree, I'm fed up with all these meds and their side effects.

This morning Spencer was by my bed at 6:30 am asking for his breakfast as he used to do before getting blocked my only disappointement right now is that I had to resort to mixing dry kibble to his canned food, but I am hoping he will transition to all canned food by himself in the next few days. I don't want to push it on him at the moment.
Spencer peed 3 or 4 tablespoon full this morning, which the vet had told me is normal.

I'm really glad I listened to my instinct and took him off the meds, especially the diazepam, and I really have to thank everyone on this site who replied with advice!!! Without you guys I would still be listening to that weirdo vet's assistant who fed me such gems as "diazepam has no side effects".

I don't think Spencer is out of the woods yet but he's getting there. We have an appointment for a urine analysis as well to see if he really needs to continue with the antibiotics, if so I will definitely ask for another choice than clavamox - I don't think it agrees with him.

Awesome news!

I certainly don't have to tell you that any food, at this point, is better than no food. Keep your paws crossed.

I know, that's why I'm not too upset about the kibble. I'll try to transition him in the next few days!

Aw, that's great!