HELP! My senior kitty is driving my crazy.

I am writing here in hopes someone can offer advice to help with my senior cat. A little background: I have two cats. My oldest is Riley - he's a beautiful, all white boy and 11 years old. Lance is 10, and a sweet, fat, black and white. Both are domestic shorthairs and rescues - Riley I picked up when he was 4 months old, starving and flea ridden at a campground. Lance is from a litter of 7 I rescued from the back of an old air conditioning unit behind a bar along with their mother before they even had their eyes open (the kittens were about 7 days old). His mother died when they were only 4 weeks of a cardiac myopathy - so all 7 were nursed with an eye dropper and KMR. 

I adore these cats - they've been with me for over a decade, and I'd do anything for them. In the spring of 2012, Riley had a major urinary tract infection and blocked. I rushed him to an emergency vet. Unfortunately, when inserting the catheter they accidentally ruptured his urethra - a complication they'd said could happen, but they didn't expect it to. I was left with the choice of putting Riley down or an expensive PU surgery (for those unfamiliar with this surgery, it's effectively a sex change operation for male cats). I opted for surgery. A long 2 1/2 week stay at the emergency vet clinic and $5000 later, Riley was back home with me, and it seemed he was going to be just fine. He had lost A LOT of weight from his ordeal, but he was happy. In fact,  he's so sweet that when I picked him up, I waited a long time in the lobby - and when I finally asked about whether they were bringing him, I was told that he'd become a staff favorite - so much that one of the vet techs wanted to keep him - and the staff were all in the back saying goodbye to him. 

A little more about Riley: he has had major stomach issues his entire life. He vomits almost daily. I've run thousands of dollars of tests on him over the years, which have all turned up nothing. The only thing that seems to help is prednisone, which he takes daily - and we up the dosage whenever he has a vomiting flair-up. 

Since Riley recovered from his PU surgery, he has been inconsolably RAVENOUS. I know all cats ask for food a lot, but this is abnormal and desperate. Nothing seems to help. He put weight back on, but he still acts as if he's starving 24/7. I can feed him, and as soon as he's done (and he wolfs down his food like he hasn't eaten in months), he starts yowling again. I cannot leave food out for Riley, because his feline 'brother' is very fat, and Lance cannot have access to food all the time for his health (trying to get Lance to lose weight is another uphill battle). 

We (my partner, my cats, and my dog) moved from the U.S. to the Netherlands about a month ago (new job!). Unfortunately, that meant moving from a two-story row house to an apartment. The apartment is big - but we're all on one level now, which means that Riley thinks since were all within relative proximity to the cupboard with the cat food, every time someone moves, we should be feeding him. Right before we left the States, I had another blood panel done on Riley to rule out (again) any thyroid issues, diabetes, or cancer. Again, nothing. He seems perfectly healthy. 

Both he and Lance are on prescription urinary tract food too, so I can't change his diet and see if that helps.

I am just at a loss for what to do. He's obviously uncomfortable -feeling like he's starving all the time - and yowling at the top of his lungs all day, every day. It's getting to the point of being unbearable. I am wondering if anyone on here has had a similar issue, and might be able to offer some advice. Are there drugs or herbal supplements that might help calm him down a bit that I could get or suggest to my new vet? 

Can you tell us what your vet has said and done to date on the appetite issue?

stephenq said:

 
Can you tell us what your vet has said and done to date on the appetite issue?

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Nothing. After his blood work came back clear on the thyroid panel, she said that maybe upping his prednisone dose would help (if he was having some inflammation or irritation that was causing him to feel hungry, then that would help). It hasn't. 

It seems that your vet isn't taking this seriously.  Here are two good articles on Polyphagia (cat appears to be ravenous all the time)

http://www.petmd.com/cat/conditions/digestive/c_ct_polyphagia#.UsBK3fbD7kw

http://www.cat-world.com.au/increased-appetite-polyphagia-in-cats

Other causes not mentioned as clearly in these articles and that I found in http://www.catchannel.com/experts/arnold_plotnick/whats-behind-my-cats-ravenous-appetite.aspx:

Maldigestion would be another possible cause for your cat’s ravenous appetite. There is an uncommon condition in cats called Exocrine Pancreatic Insufficiency (EPI) in which the pancreas does not produce enough enzymes necessary to properly digest food. Cats eat, but the undigested nutrients do not get absorbed by the body, and the cat eats excessively because she feels as if she is starving. Affected cats often have diarrhea and weight loss.

Diagnosis is easily achieved by running a blood test called a Trypsin-Like Immunoreactivity (TLI) test. Although you mention that your cat is healthy, I think it would be a good idea to run these tests just to rule out any serious medical cause for your cat’s overactive appetite.

There are many possible causes as the 2 articles state and your vet should be trying to figure this out.  Maybe you need a vet who's more interested in your cat's health...?

Stephen

Just guessing, but did the vet say anything about hormonal changes due to his PU surgery? Also, prednisone can affect every organ in the body, so maybe there's something going on with it that got activated because of the surgery?

As a side note, prednisolone and not prednisone is usually prescribed to cats as it is better tolerated by cats. There is, however, a prednisolone shortage, so think a little bit before asking the vet to change.

Prednisone in and of itself can cause a ravenous appetite.  Do you free feed, feed canned?  How often are you feeding him?  I have a kitty on prednisolone right now and her appetite is increasing, I feed her 4-5 smaller meals per day and that seems to stave off her appetite some.

What are they eating? You mentioned a urinary Rx diet, but which one? There are ways around some Rx diets, and usually for the better.

You mentioned almost daily vomiting; is there any constipation or diarrhea? I'm wondering about IBD/IBS, a food intolerance/allergy, or both.

It is not the cats fault, usually this is caused by the hunger signal telling the cat he needs to eat. My cat is less than 7 lbs now and he typically eats 4 - 6 cans of food a day which are 85 grams each and this is more than double what is recommended. Even though he eats huge amounts of food he doesn't put on weight and he is little more than skin and bones. What you need to do is try to figure out what the problem is and if there is anything that can be done to help it. My guy is an IBD cat and blood tests then ultrasound showed where the issue is but there is little that can be done other than control it. I basically feed him a fork full at a time to let the food digest a little bit and then make the cat wait between feedings. It is not easy and he makes a lot of noise but if I just feed him what he wants it would end up on the floor in no time. This means I am up at all times of the night making sure he has food because with some IBD cats they have issues with stomach acid so if they don't have food it can do further damage to their insides.

I agree that your kitty's body may be feeling malnourished. I have some ferals who were constantly hungry but are responding well to boiled chicken with a little "Real Salt", baking soda and apple cider vinegar added to the cooking water.  I blender the broth & skins to make a gravy, add some L-lysine, Co-Q 10 & sometimes I add red raspberry leaf, marshmallow root & slippery elm if they are having digestive issues such as diarrhea.

What were you feeding them before you started feeding them the urinary tract prescription food?  Was it kibble with corn in it?  I'm just wondering if corn is what is causing your guy to throw up (his entire life)  .  I'm thinking it's probably the Pred that is making him feel so hungry (or at least that's ONE reason). 

How many times did he have a UTI?  Just that once when he blocked, or did he get them often?  I've never had a cat with a serious UTI, let alone P/U surgery, but I'm really wondering if that prescription food is really necessary since the P/U surgery was needed because of an issue with the catheter, NOT because of consistent blocking.  Have you spoken with any of the Vets there in the Netherlands about that?  If there were any way to get them off that food and onto something with more protein and no grains I would think he would feel a lot more full.  AND, if there were no grains, he might not throw up, which would mean he wouldn't need the Pred (maybe). 

Another thought...are they still eating kibble, even though now it's the prescription food?  Reason I ask is that one of mine is on a perpetual diet and so always seems to be hungry, and our Vet suggested adding a little pumpkin into his food because it might make him feel a little more full.  Problem with that is, he eats raw, so it's hard to blend pureed pumpkin into chunks of raw meat

That Guy said:

 
It is not the cats fault, usually this is caused by the hunger signal telling the cat he needs to eat. . . What you need to do is try to figure out what the problem is and if there is anything that can be done to help it. 

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Yes, I know it's not his fault. That's why I am on here asking for help, since we've been to several vets since his PU surgery and this incessant hunger thing started, and nothing has come of it to make him feel better - in fact, he seems worse. 

In any event, thank you, everyone, for your thoughtful answers and advice. 

I was feeding Riley Natural Balance, L.I.D (limited ingredient diet), both wet and dry before he had urinary tract problems. He started with the vomiting when he was just shy of two years old. He hadn't had problems with his bladder before he blocked though.  Even with the limited ingredient diet, he would still vomit - though in combination with the prednisone, it seemed to help a lot. I had switched him to the L.I.D. food about a year before he had bladder problems. Prior to that, he ate Blue Buffalo adult cat food. The vet - after his surgery, said due to the severity of his problem and that he could potentially have scar tissue, that he would need to be on the prescription Urinary tract food for the rest of his life.  He's currently on Royal Canin Urinary S/O dry food. 

He doesn't have any diarrhea or constipation . . . his bowels and stool are totally normal and firm. They always have been. He just vomits. A lot.    

Raintyger, I'll ask my new vet here in Holland about switching him to prednisolone. I didn't even know there was a different and similar drug that might work better. Thanks! 

Catsknowme, I appreciate the recipe. Maybe Lance will like that too I'll ask the vet first though before I give them anything but their prescription food - just in case. Sounds great and healthy though. 

Stephenq, thank you for the fantastic info and links. I also had never heard of EPI. I know   my vet didn't test for that, but sounds like it may be it - I'll definitely get him into my vet and get that test run!!

In general dry food has grains and carbs that can cause problems. My kitty would vomit hairballs every once in a while. Then I switched to wet and hairballs went down from once every couple of weeks at the height of hairball season to 2 or 3 times a year.

Make sure you ask the vet about the availability of prednisolone. Some people have switched to entocort due to unavailability of prednisolone.

Years ago, my cat Sammy was always and i mean always hungry. Turned out she had a thyroid issue. Could that be the cause?