Artie - IBD or Lymphoma

Hi everyone,

I do not want to hijack this thread and will start a new one if you would like me to...

I am starting the IBD roller coaster. I am so confused, scared, and wiped out. The more I read, the worse I feel..

Artie is an 11 yr old neutered orange male whom I adopted 3 yrs ago. He was sick from the first day...sneezing, bad appetite, etc. He has had episodes of vomiting forever. His vet and I thought it was because he had fur balls, and then bad teeth, and then just being fussy. He is also a skittish cat. He had 4 homes in 3 months, not his fault--just circumstances...he was also found to have a grade 4 physiological heart murmur...He has had 2 cleaning in 3 years. 

I am trying to be short with his story.

He has been increasingly fussy and vomiting over the past couple months. I tried the novel protein route, in addition to pilling him twice a day with 1/4 pepcid. 

I had the pepcid on hand when he was into his not eating phases; thought was took much acid so vomiting and not eating much. Artie started to run away from me when he saw I was coming with the pill gun..We switched to compounded pepcid about 2.5 months ago. Not really working.

Artie has been losing weight all year. The most dramatic loss was the past 2 weeks. From 11.3 lbs down to 10.7. He is a big cat. Very skinny now. I had gotten his weight up to 11.8 lbs. His average for a while was 11.4........

Time for an internal medicine consult which we had yesterday. Artie had an ultrasound which showed moderate thickening of the pylorus part of stomach. IMVEt recommend biopsy. I agreed to it--to be done next week, we hope. We are in the process of the insurance company pre-approving it...

The IM VET prescribed Reglan in the mean time. 

What I am really stressing about is the possible lymphoma...I am thinking that he has had IBD for a long time. The longer an irritant is there, the faster it is to turn cancerous...

I am really scared.. Yes, I read too much.. and I know a little from human medicine.. worked in medical field for over 30 years...

Artie is only 11 yrs old. He is my therapy cat...he is so sweet....I do not want to lose him...we have been thru so much together...he was always by my side..watching and cuddling...

Am I just being too pessimistic... I mean when I look at him, and see how skinny he is, my heart breaks.. I leave food out for him..he wants to eat, but he refuses what I am giving him..fancy feast, novel protein....

Right now he is exhausted from yesterday. He did eat good yesterday when we got home. He is not eating well today...

Sorry if I am sounding so down...I am now doubting his regular Vet for not sending him for a consult sooner. I am kicking myself for not being forceful enough..I am doubting myself and his care...I really like his regular Vet. We even chatted yesterday about his IM appointment..but I am still questioning...I guess I am saying i am just scared...I do not want to lose this little/big guy...I want to see him eat...I do not want him to lose more weight...

sorry---but thank you for at least reading this.....

Cindy

Hi artiemom! Welcome to the forum.

First of all I know exactly what you are feeling and how scared you are. I have been there. If you read the beginning of my threat you will see how much pain and fear I had.

I am not gonna lie to you. You don't know what it is and only with trial and error and time you will find out.
Second you need to work with your vet who you trust, on a plan, like prednisolone. Mimi is taking 1/day and on episodes I increase it accordingly (after suggestion from my vet of course).
My vet recommended the hills prescription but it made it worse so I tried what the wonderfull people here in the forum said, mainly novel protein from e.g. natures variety and freeze dried raw which it worked wonderfully for Mimi. I bought probiotics and went to a holistic vet which she gave me enzymes for her diarrhea. I either sprinkle it on her food or put it in capsules and then to pill pockets. Or any treat , I make a tiny meatball, she never knew she was eating it hehe.

Also you need to avoid carrageenan and read this website ibdkitties.net

Mimi did an ultrasound and it was unclear, the intestines where thickened. So I opted out for biopsy because I was scared. Vet was unsure so I risked.. Only you know what is best for Artie.

I have some tips for him.

1.if he vomits, try novel protein and buy slippery elm bark, either out it into capsules or sprinkle (better) it soothes the tummy and esophagus, also buy enzymes and probiotic. The vet will give you Pepcid or celenia (I don't remember the name of this medicine it's for nausea)
2. For diarrhea buy s. Bouldarii and capsule it , the forum has tons of good info about it.

If he doesn't like raw food I use freeze dried as Stella and Chewys. Vet will say the usual oh raw is bad blah blah, well I say if the cat pukes and doesn't get well I give it a try and look at that it worked fantastic. Mimi gained weight in a few months she is 4 kilos but that her normal (she is a tiny cat)
3. Have emergency food in case he doesn't eat like friskies, yes, the unhealthy kind. Also baby food gerber only chicken.

You wont loose him! He will be fine, but I have to tell you this. If you don't trust your vet or have a weird feeling change vets. Try internist, try another. The most import net thing is to trust your vet and your feelings. My vet sent me to a internist and he wanted biopsy etc, I got a weird feeling about it because he was too excited for a biopsy and my brother in law noticed it too. So I talked to my vet and we had a long talk about it. I opted out for prednisolone but know that isn't masks the symptoms from lymphoma so even if you desire to do the biopsy it may not show much.

In general it is your call and I hope Artie will feel better! Browse this forum it has such nice members and wonderfull advices. Good luck artiemom!

Sorry for typos, iPad is changing my words lol

Hi. I feel for you! I second Arinlars comments.But I have to say I am perplexed about why your vet did not Rx perdnisolone..I have Obi on Natures Variety rabbit,pepcid,pred a probiotic/digestive enzymes and egg yolk lecithin for hairballs. Obi does well on this with a recent need for Cerenia,
4 days. Every IBD cat is different. IBD does not sslways mean lymphoma. Keep us posted.

Artiesmom, I remember your previous threads asking about food options for Artie: I'm sorry to hear he's not eating well.

What you write reminds me a lot of our situation with our previous cat. She, too, had been sick for a long time but her vets (an entire practice!) missed her IBD symptoms until her last months, though I'd figured it out long before they did. I still kick myself for not pressing harder or realizing things earlier; like you, I had no idea, for example, that hairballs weren't normal. I learned a lot from Brooksie's illness -- including how to feed our new cats -- but feel terrible that she had so many health problems. Brooksie was much older than Artie -- she was at least 17, probably older -- and I'm sure she was considerably frailer, too, with a shockingly bad arrhythmia, minor but measurable kidney disease, and minor but measurable thyroid disease. She was never fully diagnosed because she was so frail so I'm glad you have the option with Artie! We are pretty certain, though, that her IBD progressed to lymphoma. Brooksie was our therapy cat, too: we called her "Prozac on Paws"! She was just a wonderful cat.

Our experience was different from yours and @arinlars's -- they're all different -- but there are a few things that I want to repeat:

-Definitely go to another vet if you don't trust the one you have. We take our new cats to a cat specialist and it's so much better than the old clinic because the new vet really knows about cat illness and nutrition.

-Have that emergency food ready! Ours was Fancy Feast, which was high phosphorus for a cat with kidney disease, but she had to eat.

-Try the raw food if you think that might help: commercial raw, like the Stella & Chewy's that arinlars mentioned, can be surprisingly convenient for you and appealing to a cat. Brooksie's vet was very anti-raw and said not to feed her "that RadCat" but guess what? RadCat was one of the foods she enjoyed up to the end and I'm sure it's one of the reasons her symptoms eased a little in her last months. Stella & Chewy's, by the way, can make a great topper to get cats to eat canned food.

-The ibdkitties site is wonderful. The page about taking care of yourself is very good, too. I remember how obsessed I got with trying to get Brooksie to eat; she'd gotten very skinny, too, which made the whole experience very stressful so it was great to read about what other people go through.

Good luck. And a virtual hug to you, too. I know how hard this is to go through.

Also if he doesn't eat the food I use toppers like catmando the dried fish flakes she goes nuts about it!

Good luck :grphug2:

sending    to you and artie.

i'm also one who has 'been there', with diagnosing and learning to effectively treat my cats IBD. my snick and (her brother, litter mate) mickey were diagnosed with IBD when they were 9 years old.

my experience with my two cats IBD was different from others, as it's a very individual disease kind of thing. our vet at the time suggested adding fiber in the form of plain/unflavored metamucil to their wet food to treat the IBD. at that time, the vet and i agreed that as long as we were successful in treating the IBD symptoms there would be no need for further testing. around about one month into adding the metamucil to their wet food, the diarrhea stopped. there have been flare ups since then (some quite severe), but they've been farther and farther apart as time has marched on. our mickey crossed the rainbow bridge in 2013, totally unrelated to his IBD. snick, while she has occasionally had IBD flare ups, has other medical issues which are more pressing/severe. in my case, my cats IBD has been able to be managed relatively well.

i found it helpful when my cats were in the process of being diagnosed and then while learning to treat it to try to focus on what was going on in the short term, and not let my mind get further ahead into the future. i just took one day at a time, and concentrated on how my two were doing that day.

arinlars said:

Also if he doesn't eat the food I use toppers like catmando the dried fish flakes she goes nuts about it!

Good luck :grphug2:

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Toppers can be great, and I also pureed some foods, with extra water, in a miniprocessor. There were several that Brooksie would only eat that way. There were also some shredded foods that I fed her from a fork. That cat always loved service!

Did you know that even if he does currently have lymphoma, it is highly treatable?  

Artiemom. I really hope the biopsy has a good outcome. You have nothing to blame yourself for - you're a wonderful mom to Artie. It really sounds as though his health problems were established long before he found you. You've been working on damage control from the moment you got him. Preston can make a massive difference to IBD patients (though I fully understand that it's not an option until after the biopsy). There are treatments out the for lymphoma too. A diagnosis could make such a difference to Artie - diagnosis means appropriate treatment, and that's huge. Cats aren't stupid - Cali was awful to medicate all his life, but after his chf kicked in badly he was suddenly much more accepting. He still didn't like it, but he knew it made him feel better. The best way to drug a meds resistant cat is to wait for them to be deeply asleep and then go in. 90% of the time you can get the drugs in before the cat starts to resist.

You've both been in my thoughts since o heard this news in your other thread. There are many here who've been down this road before (as you can already see). Diagnosis is not the end - its the beginning. Keep trying Artie on different foods. You will find something he enjoys in the end.

We're all here to support you. Hang in there, and stay strong.

Artiemom said:

 
sorry---but thank you for at least reading this.....

Cindy

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As soon as the biopsy is done your cat needs to start prednisolone therapy to get the IBD into remission. If he is positive for lymphoma, there are treatments including pred and Leukeran which can get him into remission.  But the weight loss is a serious problem and needs to be reversed as soon as possible.  If its IBD, pred alone can do that and it can work quickly.  If you're doing a full thickness surgical biopsy that's major surgery, and its optional.  I say "optional" because the treatments for IBD and lymphoma are basically the same.  One starts with Pred.  If there is weight gain then you can presume its IBD.  If there isn't weight gain you can presume its lymphoma, then you add in Leukeran.  80% of cats are supposed to tolerate Leukeran.

If you obtain a biopsy and a diagnosis of lymphoma and then the leukeran stops working, you have the option of stronger chemo drugs that an oncologist can't offer you without the positive diagnosis.  So some future options may be lost to you without the biopsy, however its not a given that you will want to use those options if and when you got to that point.

StephenQ said:

As soon as the biopsy is done your cat needs to start prednisolone therapy to get the IBD into remission. If he is positive for lymphoma, there are treatments including pred and Leukeran which can get him into remission.  But the weight loss is a serious problem and needs to be reversed as soon as possible.  If its IBD, pred alone can do that and it can work quickly.  If you're doing a full thickness surgical biopsy that's major surgery, and its optional.  I say "optional" because the treatments for IBD and lymphoma are basically the same.  One starts with Pred.  If there is weight gain then you can presume its IBD.  If there isn't weight gain you can presume its lymphoma, then you add in Leukeran.  80% of cats are supposed to tolerate Leukeran.

If you obtain a biopsy and a diagnosis of lymphoma and then the leukeran stops working, you have the option of stronger chemo drugs that an oncologist can't offer you without the positive diagnosis.  So some future options may be lost to you without the biopsy, however its not a given that you will want to use those options if and when you got to that point.

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NB - in my last post Preston should read predicted (predictive text working against me..grr..

Thank you all so much for your help, advice and support. I was really feeling down last night. Yes, I have read IBDkitties. I have also joined their FB page. A wonderful group of people, as are the ones here. 

I think just seeing Artie not eating and so wiped out really got to me last night. I have a tendency to be pessimistic. 

I got him to eat last night. I pulled out some of the prescription dry GI food; he ate a bit. I also tried the Fancy Feast Classic Beef with Cheese. I have a stockpile of extra food here. He is refusing the novel protein. I tried buffalo last night. 

He was getting out of the 'funk' late last night. He even fought me with his Reglan. I do not know enough to ask the IMVet to prescribe cerenia. I did not question the Reglan. It seemed ok with me because it was supposed to help the motility of food~~~~made sense to me at the time. If it helped to move the food along, I thought it would make sense..

ARtie is vomiting at least once a week. He is also suffering from constipation. I try to handle the constipation and he goes to the other extreme, diarrhea....then constipation, causing not eating and the vomiting and the the cycle begins with the diarrhea.....

I have always liked his regular Vet. Explains everything to me, does not rush during exams, returns phone calls, every gentle, young and up to date with things. I feel I can talk to her. 

The IMVet seems pretty much the same, although I only met her once. It will take me a couple more times to get a better feeling....

I am also giving Artie the compounded liquid Pepcid. 

I do try to sneak up on him when he is sleeping.....for meds....

He is more like himself today. Alert, cuddled with me all night. He ate 1/4 can of Fancy feast while I was at church. We also played a bit, he wanted to be brushed, and even jumped into the clean laundry basket...He is trying to get some rest now...it is his nap time. He seems a bit restless. It may be because of the Reglan..I will have to wait a couple days to see. 

Yes, I agree,  his Vet and I have been doing damage control since I got him~~3 yrs...... We first thought, stress of a new home, first time in an apartment building, had to check out his heart murmur since it was never mentioned before, being left alone during the day, bad teeth, just skittish in nature, being fussy with food, 2 episodes of iFLUTD,  gastritis, then teeth again....It was a process of elimination until he started the weight loss. The weight loss put him over the edge. Despite all the previous issues, his weight remained pretty stable. He was eating 3 small cans of food a day..... His Vet did not hesitate to recommend and strongly recommend an IM Consult. She came out and told me how she felt. She prepared me for IBD. The IMVEt really did not tell me anything that his regular Vet did not....

All the other stuff and testing was so expensive for me. And his being a skittish cat, caused me to try not to take him to the Vet very often. Although they all know me in the office, by name and Artie.....

Thanks again. I have to coax him to eat, then I have to go get him so of his "special food"...for the days when he does not eat...or has sedation. It is Solid Gold tuna or fish..He loves that. I do not give him much because he has early kidney disease...

((hugs)) to all of you...

Glad Artie is having a better day.

Regarding the constipation, personally if possible I would remove the dry food entirely from his diet. You can encourage more water intake with flavoring water with things he tends to go for, whether tuna water added, chicken baby food, cat milk, chicken broth, boullion cubes, moving water, and adding extra new bowls around the house.

Any canned he likes I would give him. Fancy feast is fine.

Temptation treats in the turquoise pouch (tuna) are pretty irresistible and will help add calories too.

Krissy's ultrasound last Oct I believe, showed diffusely thickened walls, inflammed pancreas, lymph nodes and intestines. 

I opted not to have a biopsy done, not to give prednisone, but to treat with only dietary changes, and it has worked. It took months to get her settled down, and any time I tried to feed her anything else, it would cause a flare up, pepcid for a couple days and she went back to being fine.

As others have said, IBD is very individual. What works for one might not for another. But there are several options available, whether it be novel diet, prednisone, cerenia, pepcid, or going the leukeran route, something will work for Artie, it's finding it.

His vomiting once a week only but losing weight.

Despite how individual IBD is, there is one thing that they ALL seem to have in common, as IBD is a reaction triggered by a specific protein given long term that the body decides to become allergic to it, responding by inflammation, vomiting, etc.

The very first and most prominent advice in treating IBD is change the diet. Change it to a food/protein with as few ingredients as possible, a single protein he was not eating prior, so the allergic reacting stops, and his system is able to settle down. Whether this works alone or he also needs additional meds to assist is dependent on case by case.

I just know that, if I remember right from your first thread, your vet had never advised you of this, which is surprising actually.

SO many of us here have experience with IBD, it's quite common it seems. But honestly, I highly advise not feeding a wide variety of foods/proteins, and hoping others here will chime in about this as well. Maybe if several of us here support this as a critical need, you will investigate it further and understand how necessary it is.

Artiemom -

I know exactly what you are going through.  My cat, Bo, developed IBD later in his life.  He was also diabetic and developed epilepsy.  The epilepsy meds caused constipation...and the Laxatone the vet gave him for the constipation caused diarrhea. 

My cat had long hair and would often vomit.  The vet gave me Cerenia for that....that seemed to really help him.  When my cat first started having seizures, he quit eating.  The vet gave him an appetite stimulant that really helped him start eating again....I can't remember the name of what that was. 

My cat began losing weight as well....at his heaviest he was 18 pounds.  As his health deteriorated, he dropped some weight...I think the last year of his life, he was between 9-10 pounds.  When he first started to drop the weight, I went out and bought a few different flavors of as many brands as I could find.  My cat loved Fancy Feast....but he quit eating that for a couple of months...then he eventually came back around to that.  I even tried canned tuna...my cat seemed to like that. 

Something else that seemed to perk my cat up was subcutaneous fluids.  For several months, I was taking my cat to the vet 2-3 times per week for fluids.  This can be done at home.  I tried a couple of times to do this at home but wasn't successful.  So, I let the vet administer the fluids.  The vet also suggested a Vitamin B12 injection.  Honestly, that didn't seem to help my cat...so after 2 or 3 B12 injections, I asked my vet to discontinue those. 

You might want to talk with your vet or do some research on Cisapride.  My cat was taking that....it helps food move through the system.  My cat wasn't very good about taking pills....and, luckily, Cisapride was able to be compounded into liquid form. 

As for the vet situation, it can't hurt to get a second opinion.  I ended up switching vets in the middle of treatment for my cat.  At that time, I really liked my regular vet.  The entire office staff knew me and my cat and were very nice and willing to squeeze us in if we needed to be seen.  Their prices were above average...but since they knew Bo and were familiar with his needs, I stayed there.  Bo began having seizures so I called to see if they could look at Bo...and they told me he was booked solid and couldn't see Bo for 2 weeks.  Anyway, I ended up taking Bo to a vet that is only a couple miles from where I live...and they are absolutely wonderful.  Plus, their prices are a LOT more reasonable.  At my original vet, a regular office visit was around $65....just to "walk in the door."  My new vet is around $35 or so.  So, as I stated earlier, it couldn't hurt to get a second opinion. 

I wish you and Artie the very best of luck! 

Glad to hear Artie's had a better day.

catwoman707 said:

 
Glad Artie is having a better day.
<snip!>
Despite how individual IBD is, there is one thing that they ALL seem to have in common, as IBD is a reaction triggered by a specific protein given long term that the body decides to become allergic to it, responding by inflammation, vomiting, etc.

The very first and most prominent advice in treating IBD is change the diet. Change it to a food/protein with as few ingredients as possible, a single protein he was not eating prior, so the allergic reacting stops, and his system is able to settle down. Whether this works alone or he also needs additional meds to assist is dependent on case by case.

I just know that, if I remember right from your first thread, your vet had never advised you of this, which is surprising actually.

SO many of us here have experience with IBD, it's quite common it seems. But honestly, I highly advise not feeding a wide variety of foods/proteins, and hoping others here will chime in about this as well. Maybe if several of us here support this as a critical need, you will investigate it further and understand how necessary it is.

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I'm also glad Artie's having a better day! May they continue!

I'm so glad catwoman707 mentioned the diet: I couldn't agree more about the role of food/ingredients in IBD and the role of diet in treatment. I seem to recall, from previous threads, that Artie wasn't taking kindly to novel proteins but perhaps with the Pepcid (and perhaps other medications next week) added in he'll be more amenable to some new foods. With our IBD cat, sometimes it took a few attempts -- along with pureeing and/or toppers -- to get her to like (or at least eat!) new foods. Cats can be so fickle!

Unfortunately, based on our experience two years ago, I'm not surprised that Artie's vet didn't recommend more dietary changes: Brooskie's last vet had no real suggestions other than feeding boiled chicken and rice (ha! not with that cat!), "anything in a can," and "none of that RadCat." She couldn't believe it when Brooksie's kidney numbers improved and IBD symptoms lessened after I'd put her on a grain-free, fish-free diet, low-phosphorous diet. My mother's a retired dietitian so I'm used to hearing her stories of doctors reacting that way about diet and human patients, too!

@Artiemom: I don't remember from your other thread: Do you have any sense at all of what ingredient might be causing Artie's IBD? I know it can be difficult to pinpoint.

indymovieman said:

 
Something else that seemed to perk my cat up was subcutaneous fluids.  For several months, I was taking my cat to the vet 2-3 times per week for fluids.  This can be done at home.  I tried a couple of times to do this at home but wasn't successful.  So, I let the vet administer the fluids.  The vet also suggested a Vitamin B12 injection.  Honestly, that didn't seem to help my cat...so after 2 or 3 B12 injections, I asked my vet to discontinue those.

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Fluids really can work wonders! Our cat got them too, and "perk up" is just the right way to describe the effect. We did them at home but it was definitely a two-person job, even with a very sick cat.

I also remembered that my vet recommended B12 shots which I did (really easy) and it helped her a lot. For constipation or diarrhea is also nice canned pumpkin to his food but the one without the sugars or anything just pumpkin.

Hi,

yes, his Vet did suggest the novel protein. It took me a while to find out which one he would eat. When I did, and then ordered it, Artie got tired of it and turned his nose up at what he had been eating. I tried sticking to just one, then he got tired of it. The Vet was hoping with the novel protein diet change along with the Pepcid (0.5 cc twice a day) would get things under control. He was eating a bit of rabbit, he was enjoying the pork and the lamb, but then turned his nose up at all. That was when I decided to stock up on Pork and Lamb. To use one and have the other on hand when he gets fussy. I was planning on using the rabbit as a 'just in case" protein.

Before we tried the novel diet, I watched how he reacted to his regular food. To see if there was a correlation with a certain protein. He was eating Fancy Feast Classics Pate only. No fish at all. I noticed he was vomiting as soon as he ate Chicken or Turkey. So I got rid of those. 

I even tried putting Forti-Flora as a topper and a mix-in. He loved it as first, but then grew tired of it. When I mentioned that to the IM Vet, she said that Forti-Flora contains chicken so I was probably defeating my own purpose, unintentionally.

Since he so vehemently turned his nose up at all novel proteins, I went back to Fancy Feast. I was only giving him Classic Beef Pate or Chopped Grill. He has since lost weight on those...and he is fussy with those also.

I just returned from Petco where I got one can of  Natures Variety limited ingredient turkey and one of chicken. I want to see if it is really poultry which is the problem or something that is in the Fancy Feast which can be bothering his system.

He just gobbled down 1/3 of a can of the turkey....no belching, no vomiting.. it has been over an hour now....

I do not think I can do raw...I do not have the stomach to do so..ARtie is also free fed. I rent and my freezer is very small. I have a lot of food for me in there. 

But mostly, I do not think I will be physically able to do the raw...

I know it sounds tempting, but.....and the price is very expensive. There are not any pet stores locally which carry it. I would have to travel a bit to get it....

My Vet was seriously hoping the dietary changes would help; along with pepcid....

I tried giving canned pumpkin in the past to him. He hates it!!

I tried slippery elm bark mixed in with his food, last year. He smelt it and refused to eat....

Artie also gets really nervous. it comes out in iFLUTD. We have to be careful he does not block again from stress...My Vet calls him a 'high maintenance cat"...

Yes, I have noticed when they give him some sub-Q fluids, he perks right up. The Vet does that automatically when he has issues..

The IM Vet did draw blood for B-12 and folic acid... she said those are depleted with malabsorption....

Artie is sleeping on my bed now... I am tired....

thanks again...

I'm glad Artie is fine!

Raw food is difficult but I give Mimi dehydrated freeze dried food , it's not frozen and you just mix it with water it's from Stella and chewy or sometimes I get primal. You can leave it all day and it's fine. It costs like $21 and it lasts 2 weeks maybe. Ibd kitties are sadly high cost I spen a lot to the vets and food but once the cat is stabilized the maintenance is pretty easy. Bottom line avoid carrageenan and grain. Also you can order food online!

And once you know how to stop the flare ups it's easy after that. Mimi had diarrhea last week but we stop it with s. Boulardii. Next day she was fine again.

Hang in there Artie has a wonderfull mom and a good plan.

I'm not convinced about the safety of leaving even freeze dried raw out all day. I use freeze dried raw myself, though, and it is very easy to use. My greyhound (who is almost as difficult to feed as Artie) goes nuts for it. It might be worth a go, even if you just keep it as a standby emergency food for when he won't eat anything else.