Running out of options

Hi. I seem to be out of options concerning my 14 year old male cat. This may be a long story, but i want you to have all the information to give advice.

About 3 monts ago he had a blockage in his bladder. The vet removed it and he has been urinating fine since then. However, he stopped eating after that event and now is wasting away before my eyes. He has lost more than half his body weight since August, dropping from about 15 or 16 pounds to 7. He literally looks like a skeleton with skin stretched over the bone. For a while he would try to eat but when he picked up the food in his mouth he would just drop it. My vet said he "probably" has thyroid disease. I disagree because his decline was instant. I never noticed over activity or excessive eating as always mentioned with the disease.

Now he sleeps all the time and when I try pet him he starts drooling profusely and shaking his head. I understand this could be from nausea. I wake up every morning expecting to find that he has passed on, but he raises his head as if to answer my question then goes back to sleep.

We started him on methimazole 5 mg twice a day and had to force feed with a syringe for about two weeks at the first part of august. He started coming around and began eating on his own. However it seemed to be difficult for him as he would chew up the bite of food and leave half of it on the floor.

Now he has stopped eating entirely again. Probably for about 5 days. He is drinking water. The doctor has checked for mouth problems but can't find any.

I'm very reluctant to put him down because I think he has been misdiagnosed. I have been to two veterinarians and they came up with the same conclusion. (I told the second vet what the first vet had said). But both of them acted like they weren't really sure and were just guessing.

I'm sure his organs are shutting down since he has been so long without. Does anyone have suggestions or thoughts on what I should do?

He does need to be force fed again to avoid liver problems.  Was he checked for hyperthyroidism?  I had a vet guess at pancreatitis went to another vet who did the blood test and he didn't have pancreatitis.  I would say for right now you need to start force feeding and look for another vet to take a look at him.  I went through 2 vets and an emergency vet before I found one that did all the diagnostics and figured out what was going on with him.  Do you have any feline only vets in your area?  That does not mean that they will be good but I think the odds are better.

You will need to start force feeding him now though.  Even if there is liver involvement the treatment for it is to eat enough so he quits trying to use his fat stores.

Don't give up.  I was at the same point with my cat.  He was skin and bones, slept constantly, and wouldn't eat.  I too was expecting to find him dead at any time.  I decided to try one more vet.  I took him to a cats only clinic on the other side of town.  He was very sick by that point, he had fatty liver disease, but he survived.  That was almost 3 years ago.  He is still here and doing fine.  He does take medication every day but he is doing well.

Thanks so much for your reply. That was what I was thinking but I guess I just needed confirmation that I was right. It's just that the act of force feeding makes him so miserable that I don't know if it is time to put him down. If it doesn't work, I've just put him through misery in his last days. I know it is a decision I need to make now. It's just so hard when they become part of your family.

The decision about putting a beloved pet down is a very personal one.  It's not something that I would do until I was sure there were no other good options.  I know force feeding isn't pleasant and my cat absolutely hated it.  He was also very difficult to syringe feed.  It's not something that I would do if I were sure there were no good options but I would need to be sure of that.

I decided I had to keep trying. Started force feeding again and gave him fluids that I got from the vet. Wish us luck.

You said you got the same diagnosis from both  Vets.  What WAS the diagnosis?  If it was for hyperthyroidism, they don't need to guess at that, all they need to do is take a blood test.  Same with diabetes and kidney disease. 

Is he turning yellow around his ears and gums?  I worry that he might already have developed HL with that rapid weight loss back in August.

Have you tried getting him to eat canned food, maybe even thinned down a little with water. It sounds like he does have issues with his mouth, even if the doctors cannot see them.  It may be painful for him to eat, and that may also be why he fights you when syringe feeding him.  Can you at least get one of the two Vet's you have seen (or another if you are getting a 3rd opinion) to write you a prescription for Hills A/D, which a nutrient rich food that works really well for syringe feeding, and is also very palatable for most cats. 

What you are describing sound like what happened to my old guy, and it was kidney disease.  Does your guy drink excessively?  My guy went from about 13 lbs to half his weight, looked like a skeleton with fur, and ate just minimally. 

that you can get him back on the right track.

BTW, my older female now has kidney disease, and she is starting to lose weight.  She was a kibble eater for 12 years, but about 1 1/2 years ago we took away all kibble and switched to a combination of canned and raw.  Now I'm letting her eat anything she wants,since she's losing weight.  Her big thing right now is Fancy Feast classics.  She's eating more lately than she has in months.  Maybe you could try some of those   .  I put hers in my Magic Bullet with a little bit of water, her probiotics and digestive enzymes, and some cooked eggwhites for a little more protein and blend them all together to make a nice soupy conconction that she can just lap up.  Then at meal times I actually heat it up (on defrost cycle in the microwave) until it's just warm.  She will usuallly eat at least 1.5 oz each meal, and I try to give her 4 meals per day (she's just a petite little thing though, her "fighting weight" is just under 7 lbs)

You have been given some good answers here. However you still have not said if your cat has had a blood test. My thoughts are that your cat needs a total senior blood panel. Only then does a vet need to make a diagnosis. I have a 14 year old cat who has thyroid disease and so I know it can be challenging to deal with. I agree that your cat needs to eat, even to be force fed until something else can be done. Find another vet, make an appointment for a senior blood panel if the vet thinks the cat can endure it. Also there are some other options, like an appetite stimulant by mouth and also a probiotic sprinkled over the food sometimes prompts the cat to eat. Your cat needs a vet who is trying to help him.:nod:

Yes. The first vet did blood test and X-rays. That is where I got the original information about the thyroid issue. However, this doctor said he had lost too much weight so quickly it probably had affected other organs OR he had cancer. She just said the best thing to do was put him down. I suspect at his age she simply didnt see it worth doing more. So you see my quest for a second opinion.... When I went to the second vet (the next day) I took the information from the first one hoping not to have to pay for all the test again. This doctor agreed with the thyroid theory but I could tell she was not sure. She kept him for 2 nights feeding and hydrating him. She was the one who gave me instruction on force feeding and medication. After two weeks he started improving and doing his best to eat. He started jumping up with us on the couch and snuggling with us. I continued giving him the thyroid meds. He improved for about 2or 3weeks then started declining again by not eating and staying hidden under the table only to come out to get a sip of water a time or two a day.

I agree I need yet another opinion, but I already have spent about $1,100. The first visit with all the test was $350 which I assume will be about the cost of another set of test. Just not sure how long the money will hold out. I will spend what I can, but don't want to do it just to keep him living a life of misery. I am so torn, I don't know what to do. I did go ahead and start feeding him again today. I will see if he shows any signs of improvement over the next few days and make a decision. Thanks for your advice!

Ms GreenJeans. The two vets agreed that something in his blood was elevated (can't remember the term), but I don't think it was excessive. But that is pretty much all they had to work with because everything else looked okay considering he had lost so much weight, so they said it was a thyroid issue. I had already thought it was a mouth problem by the way he was shaking his head and drooling. But both vets looked in his mouth and didn't see a problem. As far as seeing the yellow in his ears and gums, I haven't seen it. However he vomited a little this morning and the phlegm that came up was very yellow opposed to being clear as it has been with his previous bouts of vomiting.

Did his problems start immediately after his surgery or was it a few weeks or days? My friends cat had a bad reaction to anasthesia and shook and had balance problems after that.

HI Kgreer68

Did you tried Homeopathy yet? If not, please search for a homeopath in your area but dont forget to ask him if he can treat a feline or not.

I just can't understand this.  Either his blood values were out of whack or they weren't .  Do you have a copy of them?  You must, since you had them to give to the 2nd Vet (or did you leave them with them?)  For thyroid, you need to know if the T4 was out of normal range. 

If you have a copy, you need to look at anything that is out or the normal range, which will be indicated on the report by either an "H" or "L" in the margins.  Here is a chart to help you decipher what everything means:  http://www.petplace.com/cats/unders...omplete-blood-count-cbc-for-cats-2/page2.aspx.

Right now it makes total sense that he is hiding and lethargic since he isn't getting good nutrition and naturally would have no energy without it.  Hopefully now that you have started assist feeding him, he will begin to feel better, although you still need to try to find the problem or he will probably just continue this cycle. 

If you'd like to post his bloodwork (anything that is out of the normal ranges), maybe we can at least give you our collective thoughts on it.

PetCrazy76:  I believe his problem started after his bladder surgery.  It was all so gradual that it took a while to realize he was even sick.  The first thing we noticed was when we would give him bites from our dinner . . . he begged like a dog for food and we always obliged him ;-)  He would pick up the piece of food, but put it back down like he didn't like it.  Which was not normal.  Kitty would eat ANYTHING.  I didn't notice he wasn't eating from his bowl until he started loosing weight.  My husband and I are at work most of the day, so I assumed he was eating when we were gone or at night.  

When I noticed he was loosing weight, I started taking notice that he was not as active and sleeping a lot more than normal.  I'm guess on the dates, but it was probably 2-3 weeks after the surgery.

That is when I took him back to the vet who did the surgery.  She did the blood work and xrays.  I could tell when she came back with the results that she was clueless.  That is when she told me the T4 (as Mrs. Green Jeans mentioned) was a "little" elevated, so it much be his thyroid.  "If not, it must be cancer," she said.  Cancer of what????  She had no idea.  That is when I picked him,up,  got his records and got the heck out of there  (after paying another $350 bill for her to tell me this bogus information  (the surgery was also $350)).  So I have come to the conclusion this vet is obviously in it for the $$$$.  I went straight to the vet in the next town.  So to answer Mrs. Green Jeans question, no I don't have a copy of the records because I didn't even have time to look at them (I figured I wouldn't understand the levels anyway), but now that I'm here and you guys can make heads or tails of them, I will get copies and post it.  

You have to understand, I live in a small town with only one vet.  The next town also only has one or two.  I told her of my plight and she didn't even act as if she heard me when I told her I thought the other vet didn't know what she was doing.  I have a feeling she gets a lot of people come from the Walkertown vet and doesn't want to badmouth her.  However, this vet did keep him a couple of days and start him on the force fed diet, gave us  fluids to give to him and thyroid meds, getting him back on the right track . . . for a while.  More than the first vet did.  All along, I'm telling both vets I think it has something to do with his mouth or throat.

So, my theory is first of all he doesn't need the thyroid meds at all.  They told me this medication can make them nauseous.  So if he truly does have a problem with his mouth and is nauseous, of course he is not eating.  

I have one more vet a little farther out, that I've heard good things about.  I'm going to try to get an appt. there today and insist they take a better look at his mouth and throat.  I'm thinking maybe the first vet damaged something when they put him to sleep for the surgery.  (don't they run something down their throat when they put them to sleep?)  I swear the first vet has something to do with this, but I just can prove it.

I am so glad I posted here.  I was so close to having him put down and after talking to you guys it all just fell into perspective.  He may be old, but I still feel like he has a lot of life left in him.  If we can just get past all this . . . .

I'll keep you posted on my progress today.

Thanks again!

I don't know if there is a mouth problem or not but the behavior of picking up food and then letting it drop out of his mouth can be a sign of nausea.  My cat has IBD and it took me six years of vet hopping to start the right treatment.  He would do that when he was having what I later found out was an IBD flare.  When I would give him a meal he would also act excited and go to the bowl.  I thought he was going to eat and then he would walk away.  I think the survival instinct causes them to try to eat but then the nausea stops them.

I can't add anything to the good advice you have already gotten here, but just wanted to let you know I said a prayer for your little guy, & that a correct diagnosis is found quickly, so correct treatment can begin.

Sending healing vibes to you both!

Took Kitty to a third vet. They did all the test over and sure enough his thyroid was fine. Which means I no longer have to give him the meds that make him nauseous. However, they did find a problem with his intestines and liver. The prognoses was still not good. The vet gave him a series of shots and said to continue to force feed him. He is terrified of me now because he associates me with someone shoving something down his throat and it totally breaks my heart. But yesterday he was cuddling with my 11year old daughter which makes it all worth while.

We are still hanging on....by a thread, but still here. Please send prayers for my sweet Kitty. We will need all the help we can get! Again, thanks for all the advise and comments!

Did they specify a problem?  He may have developed IBD and fatty liver disease.  My cat has IBD which is controlled with a small dose of a steroid.  Many cat's IBD can be controlled with a diet change.   Fatty liver, though serious, is an acute condition that a cat can survive.  The main part of the treatment is getting enough calories so he quits trying to use fat stores.

Yes, the problems with his liver is not surprising at all.  That is the HL I referred to in my earlier post.  That's Hepatic Lipidosis (also known as fatty liver disease) and why I asked if he was getting yellow anywhere. It's very dangerous, but cats CAN survive it if force fed (sometimes they end up with feeding tubes inserted, just because it's so much easier for both the cat and the human .  One of my cats had this years ago, and we had to force feed him for FOUR months, but via a feeding tube.  He didn't mind it at all...used to purr while getting his meals .  Most cats don't take that long to get over it, but this was probably 18 years ago, and maybe we were just overly cautious or something, I honestly can't remember why he was on it so long.

So what did they say was the issue with his intestines?  Did I miss something about him having diarrhea or vomiting?  What about his mouth?  Did they find anything, or is it still just that he may be nauseated (from possible HL?)

Have you seen this video put together by one of our member on how to syringe feed a cat?  It's very good, and might be of assistance:  http://www.thecatsite.com/t/227858/syringe-feeding-lucky-video-if-your-cat-is-not-eating