Underweight cat, very small appetite, / behavioural or medical issue, Suggestions?

I've been reading on this place for months, I tried everything so maybe someone can address my issue, please. Thank you in advance, I am So Sorry it is so long!
My cat Gilbert, is a 4 yr old Himalayan boy (neutered/ inside cat/outside with leash, rarely) who does not eat much. His appetite is so unstable!! (?) He's always been a rather tiny boy but last 2 years have been extremely puzzling. He is always very playful, day/night.  He is only 2,6 kg!!! Skin & bones.

- Before : grew up with Royal Canin dry with occasional wet cans. It changed to dry urinary SO after a urinary problem, the vet 1 recommended us. He's been eating half the amount described for him, 1 cup in 2-3 days. He did NOT like other brands especially. He was set on this amount since a kitten.

*- First Appointment Vet 1, to find out why he is not eating / why is he so skinny. The vet DID blood tests and said nothing is wrong and gave us Gastrointestinal cans, with the goal of 1 can per DAY. Gilbert was eating half per day, and the amount only got smaller. He got bored of it. (is, what I assume)  But, he will always eat dry in the night, same tiny amount.  He gained a bit of weight thanks to the cans, and the vet was content.

- At the last appointment I told them he WON'T eat the cans anymore, and they said, "WELL, DRY IS OK TOO, you know." They also neutered him since there is "no problem" with him. They said he will get fat. I believed it. (stupid!)

- Few months pass, he did not gain any weight. I decided to give him Merrick chicken divan shredded pieces (+gravy) because we (Gil) are pate haters. He loved them!

*- First appointment Vet 2. Gilbert was 2,8 kg. Did blood tests again and told me he has worms from our doggie. We treated both. (Pills, revolution on the skin) (my doggie has an ideal health) . Gilbert started eating 1 or 2 cans of merrick per DAY.

*- Second appointment Vet 2 and it is 2,6 kg now.   I tell the Vet 2 that he eats MORE (150+ calories per day is MUCH more than what he was eating as dry.)  and the vet says  "that is so little. They have to eat about 200 ~ 250 per day. " There. Is. No. way he will eat more cans.

I tried :

- putting warm water for the pate, didn't last;

- I have to play with him to eat a tiny bit more

- feeding him scheduled times, lost weight, returned to free feeding

- changing his eating place, didn't want

- the bowl does not touch his whiskers, and it's glass

- he will not touch raw meat

- tried rotating every can he has but has times when he WON'T eat any of them

*- 2nd appointment vet 2, he gave us other pills + more revolution for our dog and Gilbert. I do not believe this will change him.

*- tried other brands and basically his eating amount is small, besides merrick cans who are currently ALSO being tossed aside because I don't even know.  

I do know other leash/outside/healthy 3.5kg+ cats that DO NOT undergo such worm treatment and are healthy! These cats eat 130+ calories per day and are healthy!

Why isn't Gilbert a healthy weight? Could it be stress? In what case? Nothing has changed in our house. What other tests should we try besides the blood tests where everyone seems to stop at? I tried, I believed in vets and who knows, maybe they are right but there is NO change and I am worried as I feel his bones with detail at every touch. I tried 2 times but I am a poor student. I don't have $1000 for this anymore. I am mentally tortured by this. Never reached 3 kg in those months, he looks like a living mummy.

I am considering a vet 3, but I get the feeling they will say the same things.

Any ideas, please? :'( Thank you very much if you read this far, you are a hero. 

I think this is medical rather than behavioral.  I know how it is to do the vet hopping thing with a chronically ill kitty and paying money with no results.  I did it for 6 years with my kitty before finally finding a vet that got things right, his to were digestive issues.  Since you are using kg I am assuming you aren't in the U.S.  I finally took my kitty to a certified feline specialist and he had IBD with atypical symptoms which started when he was only 18 months old which is also unusual.

Normal  blood work will come back normal with a lot of digestive issues.  An ultrasound can be useful but also expensive, the results are also dependent on the abilities of the person reading the ultrasound.  I don't know if you have any type of cats only vets or feline specialists but if you do I would take your kitty there.

A kitty with access to food that is past the skinny lanky kitten stage should not be very thin like your kitty is.  Even parasites, unless it is a very heavy load, would cause extreme thinness.. 

@Denice

Thank you very much for the information.

I know I have to seek another place, a better place. I have a list, but the most desired place is really far away and I don't have a car, but I will see.( I live in Montreal, Canada. )

I am sorry to hear you went through this for 6 years, it must've been very exhausting. May I also ask what tests you did for the diagnosis? From what I've searched, an ultrasound of $250 to $500 would be hard to manage but not impossible.

I would believe in parasites again (even if we just got rid of them few weeks ago) if it weren't for his "hate" of food in general. He just doesn't find eating a must-do. He is merely eating a slight amount to not die. (is how I tend to see things)

Thank you very much again.

Can you find NutriCal in a local pet supply store? If your cat likes it, it might help some. I had a VERY thin cat myself, too, once, and the vet recommended it. It did help my cat. It's not a cure, but it's really calorie dense, and my cat liked it.

Have you tried kitten food? It is usually higher in calories than adult food.

Have you tried spoon feeding, like a baby?  I have to do this with my cat periodically.  It seems she has a difficult time getting some of the food into her mouth.  It's weird. 

@misterwhiskers
Thank you very much for the recommendation!  I will search the petshops, it has to be around here. 

@lizzi Thanks a lot!  I will try kitten food as well. At this point everything I give him will have to be force/spoon-fed until we go for xrays/biopsy. Yay for calories!

Gilbert005 said:

 
@lizzi Thanks a lot! 

I will try kitten food as well. At this point everything I give him will have to be force/spoon-fed until we go for xrays/biopsy. Yay for calories!

Click to expand...

Mixed up replies, sorry! D:

@lizzi I will try spoon-feeding as well, thank you!

@Grrr Cat Thanks a lot!  I will try kitten food as well. At this point everything I give him will have to be force/spoon-fed until we go for xrays/biopsy. Yay for calories!

Just on the off-chance that it is behavioral and not medical, your cat might just not want the foods you are giving him. He might be a picky eater like my cat baby is. As you mentioned above, your cat was eating something before and then got bored of it and stopped eating. If this is the case, you have to try many different brands and types of foods in order to find one that he will like and start eating, then he may get bored again and you will have to try others, etc. Same with the dry kibble. My cat has refused to eat or even try many cans of different wet cat food (also pre-packaged raw and also Freshpet refrigerated fresh cat food), but sometimes I find one or two and she will eat a bit until she is bored and will then refuse it. Then, I have to try other cans of wet cat food...

As for dry food, she eats that usually but also gets bored after a while. I knew she was picky, but I didn't even realize exactly how picky she is until lately. I had five different types of dry kibble out for her to try to get her off some bad Hill's Science Diet kitten kibble that the vet specialist fed to her. She decided after barely eating for ~2 days to start eating one of the kibbles. When I ran out of that dry kibble, she barely ate for the next ~2 days until I brought more of it home. Then, she ate it like normal. But even though she had the four other dry kibbles to eat, she didn't want them so she was barely eating. If you have such a picky cat, then you'll have to try different foods when they start barely eating. They are so picky that they'd really rather starve and barely eat to get by. 

@Bonitababy

Thank you very much for the info and encouragement!

I had a period when I believed he is a picky eater, he might be, he might not be. It is hard to tell. I tried buying every can I found at the store, he chose few and continued buying those for him. However, his eating amounts are small whether I change/rotate the can or not. He had his first "weird" period of "one can eating per day" I was so happy, but we found out his weight dropped, even with this. He never reached 3 Kg on the (140~180 cal) food he liked best. He might get bored of them and end up not eating, but was never a good eater to begin with. (with a good variety of foods from the market) If he is just plain picky then this would be a catastrophe.

As dry kibble he only eats his Royal Canin urinary SO. He had one time when he liked Purina, but no longer.

If all tests (xray or on that level) show us nothing, it'll be quite the despair. We know a cat who is picky on a junk level and won't eat anything but junk. And she is very thin as well.

We don't like Hills either!

Thank you very much again! I appreciate the suggestions, will try out with more variety.

I didn't mention that my extremely picky cat also hardly eats wet food. The very first time she tried Iams kitten pate, she loved it and ate almost a whole can, but after that first time, she ate less and less. She would only eat about ~1/4 can of her wet food per meal. Even less. 

She is however, very into dry kibble. She is a very small kitty and weighed 7.2 lbs at her highest measured weight. I think she maybe got to a little more than that, but wasn't weighed. I feed her Orijen and Acana dry kibble and she will free feed them, eating a little, then coming back later to eat a little more, etc. She lost a lot of weight because she was ill and dropped down to 5 lbs 11 ozs. But then she got some appetite stimulants and was eating Hill's Prescription a/d for a while along with that awful Hill's Science Diet kitten kibble and she gained some weight back, but is still not up to her normal weight. Her spine still feels bony when I pet her. Not as bony anymore, but still bony. If your cat didn't have any medical issues or you still can't find any, I'd also try switching his dry kibble to see if there is a flavor he loves and will eat more of. When I introduced my cat to Orijen cat & kitten kibble, she loved it and ate a lot of it and got up to a weight where I thought she might be just a tiny bit overweight. She gradually ate less and became a nice, normal-sized weight. So you could try different kibbles. I like the Orijen since it's got high protein and seems high quality. Good luck!

Are his teeth ok?

KMR or full fat goat's milk (raw if possible) might be worth trying as a supplement to his regular food. If he likes one of them, it's an easy and highly digestible source of calories.

It's awful when you have a cat that won't eat enough. I've only experienced it with terminally ill cats (not that I'm suggesting that yours is, btw). I've found that dipping my finger in the food and smearing a little on the tounge/lips can help spark enough interest in food to hand feed. I used to use Sheba flakes in gravy (not the best nutritionally, but it was what Cali liked). I'd literally sit for up to half an hour feeding flake by flake, repeating the gravy smearing process if necessary. If the Sheba didn't work, I'd use plain chicken breast - sure, it wasn't balanced, but it was better than no food at all.

It might be worth offering plain cooked meats, or even plain meat baby food (just make sure it doesn't have onion or garlic in it) as a supplement to the cat food. Yes, you need to find the cause, but in the meantime you need to get the calories in him in whatever way works!

I hope you can get to the bottom of his problems soon, and that treatment is straightforward

Bone broth might be another option worth trying. This video shows how to make it
[VIDEO][/VIDEO]

It sounds like you've really done your homework.  I'll just throw out three ideas on the off chance you haven't thought of them.

1. Dental problem?  Maybe you've had your kitty's teeth cleaned and examined/x-rayed, but maybe not.  Maybe his mouth hurts when he eats.  

2. Food allergy?  One of my babies gets the runs if I feed him a particular brand of food.

3. There's a prescription canned food by Science Diet called A/D which is for sick animals who won't eat.  It's a liver pate.  It's not for long-term use, but to get calories into an animal by making the stinkiest, most liverish finely ground food possible.

Has the vet suggested Fortiflora? I understand it's an appetite stimulant. I also hear that sprinkling dried tuna flakes on the food will entice a cat to eat.

When Mr. Grimsby was very ill, the vet fed him Royal Canin Kitten Formula. He loved it - he even licked it out of the can while the vet was treating him. It was so funny (and endearing and heartening) to see! When I got him home again, I bought more of the kitten formula, and he continued to enjoy that food until near the end.

Good luck with your kitty.

Best regards.

Gilbert is now 3 kg, the (3rd) vet suggested to wait more and see if it goes back to 2,8 and then she'll refer me to a specialist. I can ask for a specialist anytime, of course, but I hardly have the hundreds / thousands for that now. I weigh him monthly at the vet place for free. We received pills (finished them as described) for acid reflux and since then he didn't take any food breaks in "days". I hardly believe this is helpful for the whole situation, but it fixed his extreme period of not eating. He is also now hooked in the junk called Temptations. I observed that sometimes it triggers his appetite.

He's a beauty!

Just a thought - if he's hooked on Temptations, use it to your advantage. Pound some up and use them as toppers. It's got to be worth a try.