Cat not eating. Mystery to me and the vets

My cat, Marcel, recently stopped eating and drinking. Recently had x-rays done which did not show any problems, latest blood work showed slightly high liver enzymes but everything else looked great, kidneys, white/red blood cells, thyroid, etc. This all started about 2 months ago with completely different symptoms (difficulty breathing, congested). Now he seems totally himself (12 yrs old), no other problems besides 1) not eating anything (and trust me, Ive been researching this for a while and I have tried everything, warming food, baby food, wet, dry, treats, Hill's prescription, tuna, human food, etc), and 2) he gags (kind of thrashes his head/tongue around) when he smells human food or wet cat food. He just got home yesterday after 3 days at the vet with an NG tube (nose) which went well and there was no vomiting/diarrhea (never has since this started). Im giving him Denamarin (liver supplement). A few days before the NG Tube he was no longer drinking any water (had been taking him in for subcutaneous fluids 1-2x's a week), since home I have at least seen him drinking a some amount of water, just turns his head to any kind of food.

He hasn't been diagnosed with Heptic Lidosis (vet said he isn't too concerned since the only symptoms are the not eating and "slightly" high liver enzyme count).

Anyone have any idea the cost of a more permanent tube feeding (neck/stomach). I live in WI. Have read online anywhere from 800-2,000...Anyone have this done?

Anyone with similar experience that can share their thoughts?

Has the vet tried an appetite stimulant?  Did anything change or happen when he stopped eating?  Any other symptoms? Vomiting? Stool ok? Drinking water? energy level?

Even if Marcel hasn't officially been diagnosed with Hepatic Lipidosis, it should definitely be a concern and something that needs to be avoided at all costs, which I guess is why the NG tube was put in in the first place. HL can really creep up.

@Denice has a cat that had a feeding tube. I'm sure the cost varies widely throughout the U.S. Did you ask your vet how much they would charge for a more permanent feeding tube?

While the liver enzymes could be elevated from not eating, there are other conditions that can cause elevated liver enzymes, such as cholangiohepatitis (inflammation of the liver and biliary system), liver cancer, toxins, etc. This article lists common liver diseases: http://www.icatcare.org/advice/cat-health/liver-disease-cats

Pancreatitis seems to be popping up more frequently lately and can affect the liver since they are in such close proximity. I might also think about other conditions that might not get picked up by blood work, like a heart condition.

I'm just throwing some things out there. I'm sorry you're having such a rough time with your boy. It's so frustrating not knowing what the heck is going on. 

The vet tried an appetite stimulant 2x's, before the NG Tube (a different Dr. at the same vet) thought that the head/tongue thrashing/gagging was nausea so he treated him for that and also gave an appetite stimulant...no change. Then the tube was done, after 3 days at the vet with no change they ran the blood work again and gave the appetite stimulant again. No change the next day and since they really cant figure out the cause to all this, sent him home.

Nothing else has really changed, moved over a year ago, started a new job but work as much as the job I had before. I thought it may be stress related so I did look into that but nothing matches up with that either.

Only time he vomited was when they (a different vet closer to home) misdiagnosed him with hyperthyroidism. This was over a month ago (when he was still eating and drinking just not very much), ran blood work and the only thing it showed was "slightly" high calcium levels. This was actually the last time he ate because I was able to get him to take the hyperthyroid pill (crushed then mixed in wet cat food) for the first week but then this is when he eventually stopped eating. He wasn't getting his medication, went back a week early to test blood again and get the trans-dermal for of the medication. He was vomiting, maybe 1x a day, a quarter sized amount of white foam but no food, has never since this started had diarrhea or any changes in stool/urination (not as frequent but that's because he wasn't really eating or drinking). The second round of blood work (and after not taking the thyroid med for about a week, only in his system for a week) was fine, liver, kidneys, thyroid, calcium, etc.

Been back and forth to the vet 1-2x's a week ever since this started. Sticking to original vet who has their x-rays and blood work, records from other vet (and x-rays, blood work). He was never a picky eater before, but since I was desperate for him to eat something, I tried everything, one day he would like something (but not much) next day would be something different (still not much), some days he wouldn't eat at all, the 2 days prior taking him in for the NG Tube he ate maybe 15 cat treats total. Pretty much not drinking water at all (why Ive been doing the fluids every couple of days).

As of now, hes good, really good, wouldn't even think anything is wrong. Last night he drank the most water Ive seen in weeks but today only a few sips here and there.

GoHolistic said:

 
Even if Marcel hasn't officially been diagnosed with Hepatic Lipidosis, it should definitely be a concern and something that needs to be avoided at all costs, which I guess is why the NG tube was put in in the first place. HL can really creep up.

@Denice has a cat that had a feeding tube. I'm sure the cost varies widely throughout the U.S. Did you ask your vet how much they would charge for a more permanent feeding tube?

While the liver enzymes could be elevated from not eating, there are other conditions that can cause elevated liver enzymes, such as cholangiohepatitis (inflammation of the liver and biliary system), liver cancer, toxins, etc. This article lists common liver diseases: http://www.icatcare.org/advice/cat-health/liver-disease-cats

Pancreatitis seems to be popping up more frequently lately and can affect the liver since they are in such close proximity. I might also think about other conditions that might not get picked up by blood work, like a heart condition.

I'm just throwing some things out there. I'm sorry you're having such a rough time with your boy. It's so frustrating not knowing what the heck is going on. 

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I do realize this, why Ive been taking him in to the vet often, doing fluids, and eventually the tube feeding. The blood work done about 2 weeks prior to the tube feeding all came back great, even the liver. It wasn't until the ran the blood work again, just yesterday and after having the NG Tube (feeding) for the last 3 days that this time it showed his liver enzymes were slightly higher than normal. Vet said he would be concerned (well he's still concerned but...) if other things were going on or his behavior was different and suggested to just give it about a week and then consider doing an ultrasound/biopsy. The NG Tube cost about $325 and Ive spent in the last 2 months close to about 1200 now total. I'm actually all for the more permanent tube feeding but everything extra Ive had Ive already been giving to the vet, so money has become a problem. I cant give up on him, yes I know hes getting older, but the fact that everything else checks out great, he acts like himself...I cant just let him starve to death. So I'm doing everything I can. Vet didn't want to quote me until check up next week.

As far as his heart, years ago (5+) we found out he has a slightly enlarged heart but again, nothing to be too concerned about. When all this started 2 months ago ( congested, difficulty breathing) x-rays showed he had fluid in his lungs and they drained a half cup! of fluid out (no blood) and this helped. 2 sets of x-rays since then show no more fluid and those first symptoms haven't reappeared.

If money wasn't a problem I would do whatever I could (as long as he is comfortable) to try to figure this out. Sounds like options are 1) permanent tube 2) ultrasound 3) biopsy...all which are super expensive. Ive read about people doing an ultrasound and/or biopsy and STILL not knowing what the underlying cause it...that scares me. Although I would love to know, I'm trying to do what will benefit him the most first (nutrition/feeding tube).

Thanks for your concern!

Is the cat currently on meds for the nausea/stomach acid? You may not be seeing extreme nausea, but even a little nausea will put a cat off food.

cocheezie said:

 
Is the cat currently on meds for the nausea/stomach acid? You may not be seeing extreme nausea, but even a little nausea will put a cat off food.

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Not currently. About two weeks ago or so we saw a different Dr at the same vet (its a walk-in vet, not always guaranteed the same Dr) he thought (after seeing a video I took of the head/tongue thrashing) that it was nausea. That was the first time he was given an appetite stimulant but on another occasion was given a shot for (possible) nausea and was given another one this time too. Was given Famotidine (cat Pepcid AC) to give at home (also got a shot of this at the vet) and gave a few times for a few days but didn't make a difference. That was actually when he was still eating but just a very tiny amount. After that is when he pretty much stopped eating/drinking altogether.

I do have some of the Famotidine left, was thinking about still giving it to him to see...don't think it would hurt to still try it, even if its not nausea. But right now he is only taking the Liver supplement (Denamarin) 1x a day (as prescribed)

UPDATE: Since I started this thread today, he did eat about 4 cat treats (unfortunately only about 2 calories each). Somewhat of an improvement (better than nothing) but still nowhere near what he should be getting in daily calories.

Also...he was always a bigger cat (was a rescue, got him when he was about 2), last vet visit (before all this started) he was about 21lbs. When I first took him to the vet 2 months ago he was down to 18 (was still eating like normal at that time), as he slowly lost interest in food he slowly lost weight (of course) but it has been gradual, he is at 15lbs now so a total of 6 over the last 2 months, 3lbs in about the last month alone, which I heard is still bad/too much for a cat in 1 month. I haven't let it go more than 2.5 days without him getting at least fluids. Obviously couldn't keep doing that and he needed more nutrition than just a handful of cat treats a day (only because that's all he would eat) which is why I resorted to the temporary feeding tube. So right now, the little bit of water and now little little bit of food is kind of where he was at about 2-3 weeks ago. Ive read some amazing stories about the Denamarin, hoping my/our story can turn into one of those!

I just went thru something very similar.  My suggestions...

1) Do not feed the cat treats.  Cats will avoid real food and hold out for treats.   Only use treats if you must as an enticement to try new food.

2) The head thrashing/gagging is stomach acid reflux which is very painful.   Cats will associate the pain with eating/drinking and avoid food/water.    Give the cat 1/4 pepcid every day.   REGULAR pepcid is 10mg - do not use maximum strength which is 20mg.    You must put the pepcid in a Greenies pill pocket - the taste is horribly bitter.   Keep this up as long as the cat is eating normally.   If you stop pepcid cold turkey the acid rebounds stronger temporarily.

3) If the cat vomits heavily - you must get electrolytes into him quickly.   Syringe in unflavored pedialyte.   A cup is good.   Of course you can bring him to the vet or learn to give sub-q fluids on your own.   If your cat vomits ask the vet for cerenia.   Its great for nausea.

4) 3 natural remedies that I totally recommend are:

a) homemade chicken broth - dont get canned crap from the store.... it has to have the whole chicken boiled for 3 hours minimum.   If you can hack up the bones to get the marrow out thats best.

b) Slippery Elm Bark - it works.   Whole Foods has the powder.  I just go to GNC and get the capsules and open them.   You mix the SEB with water to make a slurry - most cats like the taste.    This stuff not only heals the gut but also is survival food so it will help if your cat is eating little else.

c) Probiotics - alot of the medicine has the effect of killing off much needed gut flora (flagyl, antibiotics, etc)   - you have to add this back in.   There are many decent ones available.

Does the cat gag/vomit reflex as he lowers his head to the water bowl....  this is acid reflux.   buy one of those raised dishes to help.

My vet advise...  they often recommend tests and dont explain to you why.  For example, they will tell you they want to do an ultrasound to check for tumors.    Well then what?   Are you prepared to put the cat on chemo?     All I`m saying is have the vet give you the entire picture beforehand and unless its an emergency always go conservative.....  

Last but not least....  try feeding your cat raw food if not doing so already.    If you can get Radcat - start with that - most cats like the taste.    Herer is where you would sprinkle treats on till they `get` it.

Good luck and God bless.

First of all I just wanted to say thanks to those who have responded...advice/thoughts mean a lot.

In response to "zoneout":

1) I'm only feeding him treats because that is all he will eat. I have 3 different dry foods, have tried (and still am) pretty much every brand, flavor, type of wet food. I would love it if he ate his normal food again. The treats are just the last resort/option and even then he doesn't always eat them. All he ate yesterday were those 4 treats (and I kept trying throughout the day).

2) I gave him his dose of the Famotidine (cat pepcid) before I went to bed. The pills are 20mg but the vet cut them into 4's ...so 5mg every 12 hrs is what he is supposed to take. I do agree with you, there does have to be some sort of nausea/reflux. A couple weeks ago when he was still eating (barely, but eating) he would do the head/tongue thing. Thought it was a problem with his mouth or teeth, had that all checked out, and couldn't find anything. But since then (since he's not really eating anymore) he does it at the smell of food (just taking food out of the oven or opening a can of wet cat food) which makes me think it is more of a gagging type thing, although he still seems interested in the food.

3) He only vomited once in the last few weeks and that was shortly after I brought him home after the NG Tube. The only other time he vomited was when he was taking the Tapazole 5mg (for hyperthyroid) but since last 2 sets of blood work, vet decided it was a false positive (misdiagnosed) and was told to stop giving it to him... this was roughly a month ago. He has been drinking water fine actually, happy about that, Id even say its close to normal intake. I also did try elevating his food/water dish when the not eating started, also tried out different spots around my apartment...didn't make a difference.

4) I looked up the "Radcat" brand and there is only 1 (one!) store in the Milwaukee area that sells it...but its worth a try so will pick some up today. Ive tried the Greenies Pill Pockets in the past (long time ago) and he wouldn't eat it. Ive been having to pry open his mouth to pill him, which he hates (and I do too) but there is no other way...since not eating. Can try again though, pet supply store I normally go to lets you return products if they don't use/like them.

Vet options: Yeah, Ive read about people (ironically while looking up reviews for the Denamarin (liver supplement) how they had an ultrasound and/or a biopsy done and still no cause or were actually treating their cats with the Denamarin after the results.

His fluid (water) intake seems pretty normal, but I'm worried about nutrition (food). Ive read they sometimes start eating again on their own after a few days off the tube feeding, only been about 2.5 days and he did eat at least something yesterday so I'm hopeful but obviously know he cant go much longer without any food. Will pick up some more food "options" from the only place that sells the Radcat brand (a "natural" pet store) and maybe see what they suggest as well, otherwise going to put in a call to the vet tomorrow morning. I do have the sub-c fluid supplies here but not sure that is enough (since getting his water but not food). Vet acted like he wanted to wait til Monday (would be 6 days since his release from the NG Tube) but if he's still not eating I cant wait THAT long.

Otherwise hes doing great, as I mentioned yesterday, anyone who didn't know would think hes a normal healthy cat.

Trying to stay positive!

Thanks for all the feedback so far! 

While you're out shopping see if they carry Stella & Chewy's Absolutely Rabbit freeze-dried patties. A lot of cats seem to like those. They are technically for dogs, but do contain taurine and would be fine for intermittent/supplemental feeding. Each patty is 70 calories and can be broken up into pieces and fed dry or can be rehydrated with water and made into wet food.

Marcel said:

As far as his heart, years ago (5+) we found out he has a slightly enlarged heart but again, nothing to be too concerned about. When all this started 2 months ago ( congested, difficulty breathing) x-rays showed he had fluid in his lungs and they drained a half cup! of fluid out (no blood) and this helped. 2 sets of x-rays since then show no more fluid and those first symptoms haven't reappeared.

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Did the vet say why Marcel had so much fluid in his lungs? That's seems like a pretty big deal. 

GoHolistic said:

 
While you're out shopping see if they carry Stella & Chewy's Absolutely Rabbit freeze-dried patties. A lot of cats seem to like those. They are technically for dogs, but do contain taurine and would be fine for intermittent/supplemental feeding. Each patty is 70 calories and can be broken up into pieces and fed dry or can be rehydrated with water and made into wet food.

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Also, as an FYI, if you think Marcel might like rabbit, Stella & Chewy's also has very new raw frozen "dinner morsels" for cats -- I haven't tried them yet but am going to order some through a local store. They have chicken, duck/goose, and rabbit. Our cats love Stella & Chewy's freeze-dried chicken and duck/goose cat food though didn't take to it immediately so, based on my experience with it, I'm not sure I'd recommend it for Marcel's situation.

When our previous cat was very, very sick and barely eating, Rad Cat chicken was one of the few things she'd eat. I feed Rad Cat to the cats we have now, too, and they also loved it from the beginning. Their favorite is turkey.

I hope you're able to find something to entice Marcel to eat.

Hmmm...  cat famatodine is 1/4 of 10mg twice a day  (2.5mg).    1/4 of the max strength pill 20mg is 5mg which you might get away with only once a day.   But 5mg 2x a day is 10mg makes it a human dose.    

I would SERIOUSLY double check the vets directions. 

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Radcat comes in 8oz and 16oz frozen tubs.    The chicken and turkey are good - my cat prefers the turkey.       You can run it under warm faucett water to speed up the thawing.

Other than that  - cats can be enticed with stinky tuna.   

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The big question is does the cat have an appetite - like they want to eat (maybe go to the bowl but just pick and stop)  Wait a few minutes ....  go to the bowl....  pick and stop .    OR  does the cat have no appetite at all - in which case they wont even go to the food dish for any type of food.

Oh yeah...  last thought.   Cats will not eat if they cannot smell their food.   So if they have some kind of nasal infection or something blocking the sense of smell it will stop them from eating.

Godspeed to Marcel

Marcel said:

 
As far as his heart, years ago (5+) we found out he has a slightly enlarged heart but again, nothing to be too concerned about. When all this started 2 months ago ( congested, difficulty breathing) x-rays showed he had fluid in his lungs and they drained a half cup! of fluid out (no blood) and this helped. 2 sets of x-rays since then show no more fluid and those first symptoms haven't reappeared.

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Has there been any further discussion about heart disease?  Fluid in the lungs is a very big deal.

Wow thanks for all the response. I hope other people are able to find this thread useful too!

Just returned from picking up some of the chicken Rad Cat (now I'm wishing I would have picked up the Turkey instead). Store owner also suggested Fussie Cat (brand) tuna and chicken (wet food) as well as the Stella & Chewy's (got 2 packs) herring and tuna/duck duck goose, and some raw (frozen) goats milk.

Tried the goats milk first. Seemed very interested but when I put some in a dish he started doing the head/tongue thrashing again, almost like he is wanting to paw at his tongue then walked away. A little later I made up some of the duck duck goose (Stella & Chewy's)...did not seem interested at all (followed the directions on the pouch). The head/tongue thing (even pawing at his tongue) has been going on, showed the 2 different vets the video, only thing they can think of is nausea that is causing him to do that, no obstructions, through mouth/teeth exam, mouth x-ray...all good. He did eat a few cat treats earlier (about 4 again) and of course today  different brand flavor (seems to change everyday) but still not enough. Currently he seems to be relaxing comfortably (sleeping) on the enclosed back porch.

Some more background info:

As for the fluid in his lungs, they could have tested it but at the time (the congestion/breathing difficulty) seemed to resolve itself almost immediately, prescribed him Predinsolone 2.5mg 2x's a day. This is when everything else was fine, if anything wasn't drinking as much water but assuming it was because of the fluid build up. The vet wanted an extra $125 to test the fluid and I decided against it (which of course I wish I would have done now to see if that would have told us anything). It was just in one of the lungs (I believe the left?) and vet said it looked like milky water, no blood. About a week later is when I took him in to the other vet for sub-c fluids (because he seemed lethargic and I know wasn't drinking much water at all and was still eating but that's when the decrease started). They ran blood work, showed slightly high calcium levels, diagnosed him with hyperthyroidism. As soon as he got home from the vet he started pigging out on his normal food, this lasted about a week, also when I was giving him the Tapazole 5mg 2x's a day with the wet food juice. He then stopped eating wet food all together (not even the juice) and therefore was not getting the thyroid med but part of me thought that's what may be causing it? Took him back in, ran blood work again (this is about 2 weeks later, first week with the med, 2nd week not taking the med. Blood work for everything all came back normal. Was given the trans-dermal form of the Tapazole and told to do that 1x a day (so half of dose as before w/pill basically). Also had x-rays done there that showed no fluid build up anywhere, all organs appeared to look good (besides the slightly enlarged heart) and functioning well. Got him home, did well for about 2 days, then went back to barely eating. Took him to original vet, checked his mouth, gave sub-c fluids, a shot for nausea and a shot for pain. Did well for 2 days, then right back to not drinking water, barely eating. At this point I was trying everything, every brand (well almost I guess), every type, every flavor, tips & tricks I read online...nothing. Numerous more vet visits, x-rays done again that showed everything look good and healthy, always more of the sub-c fluids (eventually gave me some so I could do at home if need be), eventually given the Famotidine (a whole pill would = 20mg, vet already broke them up into 4 pieces per pill and directions state 1/4 pill every 12 hrs). Did that for a few days (to his disliking) didn't seem to be helping and that's when it was time to do the NG Tube because nothing seemed to be working. After the NG Tube they ran blood work again, felt the diagnosis from the other vet of the hyperthyroidism was wrong (false positive) and liver enzymes were slightly elevated but vet really seemed to think that the Deramarin would do the trick and didn't seem too concerned, everything else checked out great. I was concerned and asked how long before I bring him in again if things stay the same and he said early next week (this was on Tue 06/24) so basically a week?! I will be calling first thing tomorrow (Fri) a.m. to see what I should do. He did see a specialist for the enlarged heart, this was because he used to do this coughing/dry heaving thing occasionally, had some money saved at the time so went and had it checked out. He was given a steroid for this and it eventually stopped on its own, Id maybe catch him doing it once every 3 months and hasn't in probably the last 6 months. He would never vomit, just a dry heave, and within seconds be back to his normal self like it didn't phase him at all. There was talk of possible heart disease or congestive heart failure when all this started (with the fluid in his lung) but after blood work and x-rays it has never been mentioned again. ~ Hope this added info helps?

He does seem to want food, not like he is starving but definitely interested. When I prepare food for myself he is always there (then, unfortunately starts to do the gagging type thing) so acts like he wants to eat what I'm eating but then gets a whiff of it and walks away. The only successful thing has been  with cat treats, which drives me nuts, but I guess anything is better than nothing.

I will be trying the Rad Cat a little later (still thawing and giving him a little break). But so far no to the goats milk and no to the Stella and Chewy but will keep offering.

Thanks again for all the suggestions!

Have you tried a raised feeder? Will he eat out of your hand? Maybe it's something about bending his neck to eat?

Yes, tried raising the food dishes, didn't make a difference. Some days he only eats out of my hand, some days only if I throw the food and he goes to catch it, sometimes out of a bowl, sometimes I have to put an individual piece down at a time...varies every day.

Marcel said:

 
I will be trying the Rad Cat a little later (still thawing and giving him a little break). But so far no to the goats milk and no to the Stella and Chewy but will keep offering.

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I hope Marcel goes for the Rad Cat! And definitely keep offering Stella & Chewy's -- that (ed: repeated offering) was what worked with our cats. I also think they like it best when it's really soaked well, not right after it's been mixed. (I also use more water than the pouch says to use.)

How does he react to syringe feeding?

Marcel said:

The head/tongue thing (even pawing at his tongue) has been going on, showed the 2 different vets the video, only thing they can think of is nausea that is causing him to do that, no obstructions, through mouth/teeth exam, mouth x-ray...all good. He did eat a few cat treats earlier (about 4 again) and of course today  different brand flavor (seems to change everyday) but still not enough. Currently he seems to be relaxing comfortably (sleeping) on the enclosed back porch.

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I really can't picture this gagging/thrashing thing that you describe. When you say they examined his mouth, was Marcel under anesthesia?

Were they checking his temperature during every vet visit? Has he ever had a fever during all this? Can you also confirm whether the fluid was in the lungs (pulmonary edema) OR outside of or surrounding the lungs (pleural effusion)?

Something is going on with Marcel. It's not that he's fine and just not eating or drinking, which is kind of how it came across in the first post. He has a history here with some things that sound pretty serious. The fact that he went from 21 lbs. to 15 lbs. in two months is not good.   

ETA: Also, did they rule out heartworm?

I would REALLY discourage treats.   The cat doesnt know it is a `treat`.   He thinks its food that tastes good and will hold out until you give in.   In fact you should hide the bag far, far away as chances are he is smelling it and will avoid real food until he gets it.   Basically think of it as a kid that avoids veggies when he knows he can have ice cream.

You should give the pepcid WITHOUT food since food will counteract the effectiveness.  Once they are split, the tablet loses the coating which hides the bitter taste - they are VERY bitter.   If you can, give your cat a shot of water from a syringe to wash it down.    If the bitter pepcid pill is sticking in his throat maybe this is causing the thrashing you are seeing - since it is stuck under his tongue or something.

Otherwise, only way for a vet to do a thorough mouth/teeth/throat exam is under sedation.  

If your cat is not vomiting and does not have diarreah then you are ahead of the game.

The fact that the cat seems to have an appetite but is having some aversion to eating is good in a way.    A cat with no appetite is a much worse matter.

Dont get discouraged if he doesnt dive into the radcat right away.   you may have to put a tiny amount of treats to get him to nibble.

If nothing is working you have to get food into him.   I would suggest beechnut baby food turkey or beef thru a syringe.  (gerbers uses cornstarch so avoid if possible)