Kitty not eating on her own

My 14 yo Maine coon mix kitty and I moved to Europe from the U.S. about a month and a half ago. The whole experience has been stressful, to say the least but the first couple of weeks I thought she was adjusting well.

Miso has never had designated feeding times but nibbles on her dry food many times throughout the day. She also gets the occasional canned food treat but never any table food. Since we've moved I've been quite busy and hadn't paid much attention to the changes in her eating habits until about a week ago when I noticed her food was untouched.

She would have some interest in food when I was around so I didn't think much of it. But then she wasn't her normal self...not grooming, very sluggish, and I saw a lack of poop in her litter box. I also noticed that her normally pink ears were now turning a yellowish hew. So we went to the vet!

The only open veterenary office in my area (in August everything shuts down here) seems absolutely clueless to me. I'm sure she has fatty liver but the only thing they've done for us is give her some fluids in IV, which have helped, and basically told me that she's just too old and I should put her down (not in those words).

I've been force feeding her for a week and with the help of the IVs I've noticed a bit of an improvement in her demeanor. She doesn't fight me (I scoop up pâté canned food onto my finger and shove it in her mouth) and she doesn't vomit or spit it up after so I know she's getting some nutrition.

I'd like some suggestions on what to ask the next vet for when I take her in. This one refuses to give us any medication and I don't know what she needs. Going in for fluids every day is next to impossible since it takes 3+ hours.

I believe this happened because if all the sudden changes and me not being around much. I think she stopped eating due to depression since all her tests were fine and she was in good health when we left the U.S. When I told the doctor this he looked at me like I was a crazy cat lady and only once again told me that my baby girl is old.

Oh, I'm so sorry your cat is so ill. It does sound like it could be liver related. Did this vet run any bloodwork at all? [emoji]128533[/emoji]

As for questions...Id call a potential vet--or visit their office--and ask how much experience with cats they have, ask if they run bloodwork, and just come right out and ask if they know how to treat a possible case of feline fatty liver. You might also ask neighbors with animals who they recommend.

Did anything traumatic happen during the flight? Did your cat have access to food or water during this time?

Put it all on a piece of paper--chart dates of last exam in the U.S. and write down what happened and what last vet did (and did not)do. If possible get her old US vet to mail you her chart. That might help.

Good luck, keep up with the force feelings. Can you try nutrical?

I am so sorry you're in this position. Where in Europe are you? It may be easier to help you (even to help you find a vet who's more understanding about cats) if we know where you are.

Mega vibes that your baby feels better soon

They did several blood tests and the prelims came back normal. They said they did some biochemical tests which showed liver problems (I didn't really understand too much because it's in Greek) and X-ray showed an enlarged liver. I knew It was probably HL before the vet visit. I just don't know why it happened. Aside from emotional issues I don't have a reason to suspect another illness since her extensive blood, urine, etc tests were normal back in June.

I have access to my vet in the U.S. and her test results are easily accessible so I'll have those before I visit the new vet on Monday. I'm just wondering if there's any medication that can help and I should ask for. The language barrier is an issue. I do speak Greek but I'm lost on the medical terms.

I wondered if you were in Greece - its the only country that sprung to mind when you mentioned everywhere shutting down for August. I'm afraid I can't give you any specific help. I hope your old vet is able to help straighten out the communications aspect for you.

You could get a feeding tube put in for your cat to treat the fatty liver which should resolve in a couple of weeks to a month or two. They also offer special prescription food that is high in calories and nutrients that you may want to inquire about if you are syringe feeding. 

I would ask for Denamarin, if they have that over there.  Or if you can just get Milk Thistle and Sam-E and add it to her Food

Here is a list of meds another cat here on TCS was on during his crisis.  This was cut and pasted directly from this very long thread:  http://www.thecatsite.com/t/215150/bear-is-at-the-vet-hes-very-sick-liver-looks-horrible/210

"He is on:
Ursodiol 50mg/once a day
Famotidine (I think this is Pepcid) 5mg/once a day
Metronidazole 1/4 of a 250mg tab/ twice a day
Pred 2.5mg/once a day
Amox liquid 1cc/twice a day
SubQ fluids/100 units per day, if he is vomiting I give him 200 units.

And I give him about 200mg of Milk Thistle per day, if he is not vomiting. I try to divide it up, I read that it's best if you divide the dose into 4 times a day."

So those are some other options you can ask about.  You know you can do the sub-q fluids at home, don't you?  Many of us do them at home for our kidney cats.  It's not the same as IV fluids, but LOOKS the same.  The difference is that the needle goes just under their skin in their scruff, rather than in a vein.  Takes just a few minutes.  One bag of fluids is usually good for about  5 - 10 times, because you normally don't give much more than 100 ml per day. 

Also, if you don't get an E-tube installed for easy feeding, I would suggest getting several large syringes for feeding her.  Makes it easier than just plopping food into her mouth.  You can thin out good quality canned food (hopefully  prescription recovery food) with water, then suck it up into a needleless syringe, then slowly give it to her.  But it's so much easier with an E-tube (feeding tube), since it may take several weeks.   Here is a video of feeding using a syringe:  http://www.thecatsite.com/t/227858/syringe-feeding-lucky-video-if-your-cat-is-not-eating

Thank you! I'll ask the new vet on Monday about the specific drugs mentioned and see what happens.

We've tried the syringe but she's not a fan of it. It's much easier for me to use my finger and just put the food in her mouth. It's taken a few days but she's now eating about one small can of wet food per day. I'm not sure that it's enough however. She weighs about 9.5lbs and there's no nutritional info on the food cans so I'm not sure if it's helping her at all at this point but it's better than nothing I guess.

We do have Greek member here who may be able to help you with translations/terminology - grizzlysapien . She's not promising anything, but is happy to try.

I am HERE! 

Hey, @KitKat2015!!

I haven't read the whole post, but I did see you wrote that you couldn't understand all the words of the tests cause they were in Greek? 

Just curious: in what language were you speaking to them? Cause if you spoke English and they printed the results in Greek.. well... 

Never mind.. Do you have an electronic form of the results so to copy/paste them here in a post and see if I can help you? Even if I can't help you, I will contact 2-3 vets with whom I cooperate (or have cooperated before) for my pets and ask them to help.. 

Mind you: I had my Grizzly tested, not long ago... I got the results in English.. 

 wanna trade?? 

 

**edit**

In what area in Greece do you live? If you are in Athens, I have several respectful vets I can recommend.. If not, I'm afraid I can't be much of a help, but I will check if you want me to..

I feel so ashamed for the treatment you got from the vet and the way they behaved towards you. I must inform you, not all vets act like that in Greece. As for everything shutting down in August, yeah.. well.. it's tradition.. We can't help it. But usually vets and pharmacies tend to close when some others remain open and then the later close when the others open.. Like rotating shifts in a way.. Also, that's why I cooperate with several vets.. If one is closed, the other will be open. Also for 2nd and 3rd opinions. I don't mind if they're not close to where I live. As long as it doesn't have to be a 2hour trip, for example.. 

@GrizzlySapien

I speak Greek and that's how I communicated with the vet, but some of the technical stuff is hard for me to understand. Besides, they didn't explain anything, just said "the numbers aren't good". From what I can make out, these are the test results:

Ουρια - 24

Κρεατινινη - 2,2

Τρανσαμιναση SGOT (AST) - 486

Τρανσαμιναση SOPT (ALT) - 722

LDH (ΓΑΛΑΚΤΙΚΗ ΑΦΥΔΡΟΓΟΝΑΣΗ - 1909

ΧΟΛΕΡΥΘΡΙΝΗ ΟΛΙΚΗ (TBIL) - 7,4

ΛΕΥΚΩΜΑΤΑ ΟΛΙΚΑ (ΤΡ) - 6,0

ΑΛΒΟΥΜΙΝΗ - 2,2

I'm in Heraklio, not in Athens so I doubt you can make any vet suggestions. I was born here and after 30some years decided to return and stay for a while. The move is stressful enough without Miso's health issues. Finding things I'm used to buying at the supermarket in the US (like Milk Thistle for example) is proving difficult. I did order Denamarin from Amazon and paid an extra 20€ for expedited delivery but it won't be here until Wednesday.

I don't know how much I should be feeding her, but she does keep it all down. She now lays in the littler box which is something she's never done before, and in a puddle of water outside on the balcony which accumulates from the air-conditioning unit....she has a little difficulty walking on the marble floor but her head is up and her coat looks much better than it did a few days ago. I keep trying, except working 12 hour days makes it hard for me to monitor her behavior.

I feel exhausted and helpless so any advise you can give me will help a great deal.

Ok, first of all, do not feel helpless cause we're all here for you

 And I will do everything in my power to help you break down those terms, so to understand what the numbers are all about.

From the indexes I am reading:

Ουρία = Blood Urea => 24  should be between 10 and 40

Miso's in the middle - Blood Urea indicates the kidney function. If it is higher than the normal levels (uraemia), it means that the kidneys may not work properly. Also referred to as BUN (Blood Urea Nitrogen). 

Κρεατινίνη = Creatinine (not Creatine) => 2.2  should be between 0.8 and 1.9

Creatinine is a waste product, generated by the body while creating energy in muscles. The kidneys (when they work properly) manage to discard it almost completely from the body. High Creatinine levels usually mean some kidney disease. BUT how much is Miso's Glucose (blood sugar) level? It should be written as 'Γλυκόζη' or as 'Σάκχαρα Αίματος'. I am asking this cause sometimes High Glucose can trigger High Creatinine. Did Miso take any antibiotics? Vit C supplements? This could also cause the same thing.

Τρανσαμινάση SGOT (AST) = Transaminases SGOT (AST) => 486 should be between 8 and 52

OK.. This is what Transaminases SGOT (AST) are.. https://en.wikipedia.org/wiki/Aspartate_transaminase  

High AST can be caused by an infection, or other severe diseases.. Like cancer, heart failure or some severe muscle damage. But could be a reaction to vaccination, as well.

Τρανσαμινάση SPOT (ALT) = Transiminases SPOT (ALT) => 722 should be between 8 and 52, as well as AST

This is what I found on ALT: http://www.2ndchance.info/dxme-ALT.htm  

Γαλακτική Αφυδρογονάση (LDH) = Lactate Dehydrogenase => 1909 should be between 35 and 225

Here's link I found on LDH: http://www.2ndchance.info/dxme-LDH.htm

Χολερυθρίνη Ολική (TBIL) = Total Bilirubin => 7.4 should be between 0.2 and 0.7

Here's a link for TBIL: http://www.petplace.com/article/cat...g-blood-work-the-biochemical-profile-for-cats

Λευκώματα Ολικά (TP) = Total Protein => 6.0 should be between 5.8 and 8.1

The same link as above, refers to TP as well: http://www.petplace.com/article/cat...g-blood-work-the-biochemical-profile-for-cats

Αλβουμίνη = Albumin =>2.2 should be between 2.6 and 4.0

The same link as above, refers to Albumin: http://www.petplace.com/article/cat...g-blood-work-the-biochemical-profile-for-cats

I hope I've helped a bit. I only gave you details on the indexes I actually know more about, due to personal experience.. On the indexes I don't know much about, I gave you links to check them out, so to understand more about what they indicate. The reference values vary from lab to lab. I reckon they must be written on the blood results of Miso.

Here's also a link that contains general reference values and sublinks to several indexes, so you can read more about: http://www.2ndchance.info/normaldogandcatbloodvalues.htm

Just a friendly suggestion: If you are not content with the current vet, you should switch to another one ASAP. I think I remember you saying that they only gave her fluids? I don't know if that's enough. I am no doctor. But if my cat had indexes like that, which suggest liver and kidney issues and they only gave fluids, I'd hit them with the cat carrier.. Again.. this is just a friendly suggestion.. 

Did you by any chance have Miso tested before you moved to Heraklion? Maybe at some other point in time? It would help if you could compare them. And maybe place at what point after those indexes went off the charts for some reason. Maybe that way you could detect the reasons? Please, seek a 2nd or even a 3rd opinion over this. 

I do have a couple of recommendations. Some friends of mine gave me the best reviews on the following 2:
 

1. http://www.cretavetclinic.gr/  on 4 Nikou Restivaki St. at Heraklion. Tel: 00302810 341698 and 00302810 341690 email: [email protected]
2. Milathianakis Constantinos at 2a Strimonos St, in Therissos. Tel: 00302810 318880 and his cell number is 0030 6932471580

You have all my hopes and prayers for Miso and you to overcome this, as soon as possible. 

**edit**

I also wanted to let you know, that if you need any help with communicating with the vets, or can't seem to understand what they say, or need ANY KIND of help, please pm me your phone number and I'll call you whenever you want. Or if you want me to contact those vets to help, again, in any way feel free to ask me to. Anything to help Miso back to be healthy again. 

I really hope you're able to find a vet you feel confident in for Miso. My heart goes out to you - I can't imagine how frightening and overwhelming this must be

I hope Miso comes through this scare, and is back to full health soon

I just want to point out that when you look at these number individually, some of them appear awful, but I think we already knew going in there were issues with her liver, since she was already jaundice .   Keep in mind, though, that most of these figures work together, so you cannot judge how bad the situation is or isn't based solely certain numbers.  I'm not saying it isn't bad, Hepatic Lipidosis is always bad, but I have seen worse.

One thing I would advise, though, is to somehow make sure that whatever you are feeding her is 100% nutritionally complete. Again, see if the Vet has a "recovery" food like Hills A/D.  That's what most H/L cats get fed, and TRY, TRY, TRY, to give her at least a 5.5 oz can per day..  I see you are working 12 hours per day .  That's going to make it tough, because H/L cats really need food more often than once every 12 hours.  Usually every 4 - 6 hours.   Do you have anyone who can give her some food while you're away? 

Keep us posted after your Vet visit coming up.  Are you going to go to a different Vet?

I'm not sure how nutritionally complete the food is but this is all she seems to tolerate right now

I searched for nutritional info online but couldn't find anything.

KitKat2015 said:

I'm not sure how nutritionally complete the food is but this is all she seems to tolerate right now

I searched for nutritional info online but couldn't find anything.

Click to expand...

What is the food?  Maybe another of our European members will be familiar with it.  (Maybe even Columbine) (or GrizzlySapien)

Well, usually when they're sick, they like foods that are just tasty and smell delicious but are not nutritional. This doesn't mean that nutritional foods are not tasty.

First talk through it with the vet and ask them to tell you what kind of nutrition Miso needs at this point. If she needs more protein than carbohydrates (which is very likely) I have a few brands I can recommend that are sold in Greece.. If the vet is interested enough in fighting to bring Miso back to health! Because for now, I have my doubts.. Forgive me for saying this, but I truly wish you took the results and consult with another vet and discuss a suitable treatment. 

@mrsgreenjeens  is right. Most of the indexes "interact" with each other. One triggers the other, sorta speak. So, we cannot conclude clearly on what exactly is wrong with Miso, or how serious it may be.

I am so sorry you're going through this and Miso is having a hard time.. I am convinced that whatever Miso is suffering from is treatable. 

 

Thanks for the support guys! I thought I posted a picture of the canned food she's eating now but I guess I didn't do it correctly. The only things that I've found with the right consistency and that I can easily get into her system are something called Simba Pate...salmon and shrimp as well as tuna and white fish. They're easy to scoop up and she doesn't have a hard time swallowing them.

We are trying a different vet tomorrow and I hope he has more experience with cats. I have come to understand that around here most pet owners have dogs and vets cater to those. When it comes to cats they seem clueless. Hopefully this new guy will have more experience with felines, otherwise I will try the ones GrizzlySapien recommended. I am also adjusting my work schedule starting this week so I have some time during the afternoons to feed her.

On a good note, we've had 3 solid bowel movements today which is something I haven't seen in over a week. She had not been pooping at all and I feel a little better knowing that the food is moving through her. I also tried a tuna water recipe I found on here earlier today and she drank some of that. At this point, it seems more like she's too weak to eat on her own rather than not having the desire to do so.

@KitKat2015  I am familiar with Simba pate.. Actually any kind of pate will work. Try to read the ingredients written on the can and determine if they are nutritious enough (not too many fats, sugars etc). I've read that Simba is an OK wetfood and not pricy. But try to look around to find petshops that might have other brands that can be better for Miso.. Don't trust too much foods that are sold in the supermarkets. Simba is sold in supermarkets and thankfully it's a bit better than others.

You are right about the vets in Crete. Most people over there have farms and they also hunt. So, yeah.. they own dogs mostly.. The 2 recommendations I gave you were from "cat parents" - especially the 2nd one. Milathianakis is totally trustworthy. It was the exact phrase they used.

The fact that Miso "went to the bathroom" is a very positive sign.. It seems like her anxiety is wearing off, so it can only be good. Try Greek Yogurt as well. See if Miso likes it. There's got be plenty where you live 

 It's even softer than pate and it has all sorts of nutrients.

I'm glad that Miso is doing a little better. Simba patés look fine to me, though in these circumstances I really would look into Hills a/d or Royal Canin Recovery though. They don't HAVE to be syringed, and they're specifically designed for these situations. I would have though most vets would have them in stock, but they are also available from specialist pet stores too. I can't read Greek, but http://royalcanin.gr/ and http://www.hillspet.gr/ have a search function that will help you find local stockists - both vets and pet shops.

Goat's yogurt/raw goat's milk is wonderfully restorative, and is often used as a KMR alternative for hand rearing kittens. In these specific circumstances though, I think I'd stick to nutritionally complete foods...and least until Miso is more stable. Once the worst is over and she's eating again, they could make a really useful addition to her diet until she's back to full health.