Difficulties pinpointing the issue with my senior kitty (weight loss etc.)

My kitty Rexy is now a senior cat at 15 years old. She came from a no-kill rescue. An entire group of cats was rescued from a crack house that was shut down, and there was all sorts of inbreeding so they were never a healthy group of cats. In fact, all of her relative cats have died many years ago. She is probably one of the last surviving ones.

The history is that Rexy is asthmatic (been on flovent for ~ 3 years now) and has a mid-grade heart murmur that has been very stable over the years. She's had a few serious lung infections related to her asthma that have been resolved with antibiotics etc. I have a wonderful vet team that I work with (a great vet at a clinic and an at-home vet). So Rexy is under careful vet care. I am also very meticulous in taking care of my cats.

I have a baby scale at home so I have a meticulous record of her weight since about 2008 or so. Gradually over the years, there has been weight loss. Nothing alarming or sudden, but very consistent. In particular, when her lungs cause her troubles, she loses weight and she never seems to gain it back. She has lost about 1 pound between fall 2010 to fall 2012, and then in the past year and a bit, she has gradually lost another 1 pound. I do bloodwork on all of my senior cats annually. Her bloodwork was last done 5 months ago and came back just fine. Her coat in the past year has become quite greasy and not very good (it always had this tendency). I will redo bloodwork in the next week I think (she has lost about 6 ounces of weight since last bloodwork done 5 months ago). Two vets looked at her at different points this summer, and nothing alarming seemed to be going on.

As of today, unless something has changed in her bloodwork, her blood and body functions (poop and peeing etc.) are all normal. No vomiting. No anemia. A weak appetite overall which is the obvious reason for weight loss. She can still jump and has strength. Up until now, I attributed the weight loss to aging badly and weaker organs (asthma in particular). I've just started her on a probiotic in case the repeated antibiotics have caused tummy issues.  

But she seems to be doing worse in the past while (the past few months), and as much as I hate to write it, I wonder if there could be cancer and am just confused what else is going on. There is no organ to target for further examination, her lymphnodes are fine. Rexy gets very very stressed/frightened (trembles a lot and vomits/dry heaves in car) at the vet clinic so the last thing I want to do is untargetted aimless testing and really upset her.

What do I do? I am meticulous in vet care and have had her looked at several times this summer. She seemed to stabilize a bit after her bloodwork/vet visits this summer, but she's once again she has lost a few more ounces over the fall. Something is not right, I can just tell looking at her. Sometimes, this happens before a lung infection breaks out, so we could try an antibiotic. I will take her to the vet for a recheck and redo bloodwork (hopefully they can fit me in tomorrow) but unless something shows up in her vet exam, I just do not know what else to do. 

Thoughts? What does one do in such situations?

I would have the vet re run the bloodwork.  A cat ages 7 years for each one of our 1 years so it has been 3  years since she had bloodwork technically, a lot can change.  I have bloodwork ran twice a year on my older girl.   I am dealing with a similar situation with my own elderly cat, we have ran bloodwork which was all pretty much normal, although she did test positive for pancreatitis, we think it is chronic based on other lab tests and her symptoms, recently diagnosed with mega colon and now we may be facing the dreaded cancer in her intestines.  She is on medications right now as well as an appetite stimulant.  Some times just being old can cause a decreased appetite.  But a lot of times there is a medical reason for it. 

I do think bloodwork is the best place to start as I had mentioned, so I am in complete agreement with you. Are you going to do any scanning/further testing, or just wait for something more obvious to stare you in the face? I just feel like I am letting her down not to do fancy testing, but I have no clue where we would even be looking.

I was wondering about an appetite stimulant. Do you happen to know if they are contraindicated with a low to mid grade (but stable for many years) heart murmur. It is not going to help her if she is not eating enough. Is your kitty on the appetite stimulant long-term?

I just found out yesterday about the cancer.  We are deciding whether or not to do an endoscopy guided biopsy or do an exploratory surgery biopsy, or just treat symptomatically.  As of right now, if my kitty doesn't get the appetite stimulant she doesn't eat, so right now yes she is going to be on it long term.  I do not know if it is contraindicated with heart issues, but do know that people who have cats with heart issues have used this particular one (Cyproheptadine).

Did you see the cancer on an ultrasound then? I guess because of the pancreatitis type issues, you knew where to begin looking for the ultrasound?

My kitty is really having one of her worst days today. I feel badly as I hover around her too much when likely she wants to snooze and be left alone. Whatever this is, I hope that she has a better day tomorrow and does not stay like this. A very worrying way to spend Christmas otherwise. I really hope that they can fit her in at my vet clinic tomorrow, even just to draw blood if not an appointment.

I know countless of people on here have been through this kind of worry with their senior cats, but my heart is kind of breaking with worry tonight.  

Does the bloodwork include thyroid levels?  If not it needs to.  Agree about getting it done again.

Hi Scarlett

What a hard time for you and for Rexy.  And what a good mom you are.

I think the big question your asking (not us specifically for answers, but of the universe and your vet) is, is what's happening to Rexy part of a specific disease process that may or possibly may not benefit from treatment (hopefully yes), or is what's happening the result of a downturn in overall health that is not necessarily attributable to one cause, but might benefit from supportive care (food supplements, appetite stimulants, vitamins, etc)?

The only way to safely arrive at the latter and rule out the former (being that it is very hard to prove a negative) is to run a sufficient quantity and quality of diagnostic work such that you and your vet can say (if this turned out to be the case) "there is really nothing else to test for, I think she is in a decline and let's see what quality of life we can give to her or let's see if we can get her past this and into better health."

So there are 4 primary possibilities overall:

1- A diagnosable illness that will benefit from treatment.

2- A diagnosable illness that may only benefit from supportive care for a period of time.

3- A non-diagnosable "decline" that will benefit from supportive care for a period of time.

4- A non-diagnosable "idiopathic acute crisis" (ie, a sudden decline of unknown origin) that may respond to treatment and may resolve itself over time with supportive care.

You're a good mom, that's obvious, and whatever the issue may be, Rexy needs you and depends on you.  Work with your wonderful Vets.  You have enough time and you have the resources to work through this, but working through this is the job in front of you.  There may be no quick fix, and there is the possibility that in the end Rexy will need you to be strong for her, like the wonderful mom that I know you are.

I'm sending you every possible good thought.  Rexy is in wonderful hands.

Stephen

I feel your pain. I had an inbred cat as well. She was expected to live to 12, but made it to 15.

She had an endless slew of health problems, some of which were never clearly identified. She did shed weight in her old age, despite continuing to eat well. This sometimes just happens in old cats, but it may be more dramatic in a cat with poor genetics -- their organs just might not be as efficient.

I would ask your vet if they think it would be beneficial to get more specific blood tests to look at a few things:

1. Liver function. This is sometimes responsible for weight loss, and general blood work doesn't tell the whole story when it comes to the liver.

2. Tests that look for signs of cancer, possibly including more specific blood cell counts/bone marrow function. While this doesn't tell you what's wrong, it can tell you if there is something chronic causing blood cell decline.

3. Anything else more specific they think might be a good idea.

Those are my two ideas off the top of my head. You may also want to look into imaging, possibly informed by whatever the results of the more specific tests are. Of course, there is the consideration of putting an old cat under. Personally, I only did imaging when I knew what we were looking for. My kitty was pretty frail in her last year, and I didn't want to take unnecessary risks.

Of course, it could just be old age. As you've said, these cats weren't very healthy to start with, and Rexy has only lived this long because of your amazing care. So no matter what the issue turns out to be, or if you cannot find a fixable issue, you should be proud of yourself.

I hope you and Rexy get some good news and figure this out!

Well, the ongoing weight loss aside, Rexy got very ill overnight. My worry yesterday was the prelude before something took hold. Took her in to vet first thing. Started her on 2 types of antibiotics and subq fluids. Bloodwork done - increased white blood cells. This is playing out like her previous lung infections so we think that this is what this is. Even if it were a URI, we have to be careful it does not travel to lungs, so antibiotics would still be a main course of action.

So playing nurse and worrying like crazy.

Poor Rexy.  Hope she gets feeling better soon.

Thank you. Shaping up to be a worrying Christmas Eve/Day. My vet already forwarded a bunch of stuff to my chosen emergency vet clinic, so all they would need is on file in case I end up there when regular clinic closes for Dec. 25/26. What bad timing.

Scarlett 001 said:

 
Thank you. Shaping up to be a worrying Christmas Eve/Day. My vet already forwarded a bunch of stuff to my chosen emergency vet clinic, so all they would need is on file in case I end up there when regular clinic closes for Dec. 25/26. What bad timing.

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I am so sorry you are dealing with this.  I think my DeeJay is going to need a christmas eve enema tomorrow :-(  She hasn't gone for a couple of days now even with the miralax.  Why do they always chose to get sick around the holidays?  My dad is a retired vet and without fail whenever he is out of town something happens to one of my pets lol.  I think they know.  I hope that Rexy will be okay through christmas.

So sorry to hear... my Angel is having problems too... its horrible this happening at any time but xmas just feels worse. Sending positive thoughts your way. X

A bit of good news. Rexy looks a bit perkier today, even holding her tail a bit higher. Her antibiotic combination for her lungs must  have kicked in. She even jumped onto the bathroom counter for her morning drink of water which is her morning ritual - nice to see her in a bit of "routine". Good news is that I think that the lung infection will sort out and she should be fine over xmas. I could still have a longer-term issue perhaps, but for now she will probably recover from this major crisis.

So glad to hear she is on the mend, what a great Christmas present to you :-)

The best present. I just got home and she sort of trotted to the door.

She is not doing well again today. Looks very uncomfortable and not moving around. No fever. I have her on subq fluids and am doing enough syringe feeding to avoid other secondary issues.

Sort of hoping the antibiotics are just upsetting her stomach or we just need more time to help sort out the infection (she had increased white blood cells on Monday - she has been on the antibiotics just 48 hours).

Still I am disappointed as she had been doing better yesterday so not sure what is going on.

So sorry to hear she isn't doing as well today.  Fingers crossed she will feel better soon.

Thank you for checking in on this thread. This is not the merriest xmas for me. Rexy really likes to be nursed/coddled when she is sick. So I've been holding her and comforting her all morning. And now she has turned to her kind brother Duncan, sleeping in a laundry basket next to him. He is a kind soul, and his kind of nursing may comfort her, thus allowing her wee body to find the reserves to fight.

Getting so confused. I don't know what to do to help Rexy. At this stage, I am waiting to see if the antibiotics work in the next day or so, and now I really just have to let her rest. If not, then I guess in a day or two she has to see a vet again and press further as she cannot continue in this stage indefinitely. I am getting frightened.

I wonder how long before I should see the antibiotics help her if they are going to help her. It has been just over 48 hours - maybe about 54 hours. I suppose that this is not necessarily quite enough time. Still, I just wish there was some positive sign today. What a miserable xmas.