Calling in the experts--urgent please

hbunny

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OK guys, I'm getting desperate.  I'd really like some advice from the experienced.  My apologies for the length of this, but I think it's important you know the whole timeline up until now.

My old grumpy guy, who is now 13, apparently had a spell of either severe constipation or GI obstruction over the weekend.  After many interventions at the vet, he is now home--in the hopes he will eat at home---and so far he will NOT eat anything.  He is on Zyrtec again due to allergies after not having taken it since last Autumn, so I wonder if the drying effect of this contributed.  When his allergies act up he is prone to more hairballs, so we brush nonstop it seems and watch him closely.  Long hair, allergies, washing more = occasional hairballs.  So a bit of hacking/gagging didn't surprise me.

Here's the timeline of events pared down to the short & sweet:

Saturday--eating only a few bites, slept more than normal, didn't interact with the rest of us much at all.  I suspected something was up.  Didn't pay a lot of attention when scooping the boxes, hubby and I had a busy hectic day, just scooped them twice and didn't pay attention.  He has always had his "off" days where he didn't eat much, but then ate like a hog the next day, so concerned, but not TOO concerned at this point.  A bit of gagging today.

Sunday--refused to eat ANYTHING at all.  I probably opened ten cans of different foods, got desperate and opened a can of tuna, he snubbed that too and left to go sleep on the bed.  He slept again most of the day.  Still drinking, peeing just fine---we noticed he had not pooped at all.  3 cats in the house, and yes, we can identify who's poo is whose very easily.  Chubby poos like a small dog---Tina poos tiny tiny---Wurp is somewhere in between and there were none of his.  Again, drinking and peeing as normal.  Bit of gagging/retching, but again, thought possibly hairball issues.  The not eating was my main concern.

Monday morning--he apparently ate during the very early morning hours and proceeded to vomit ALL of it up on the kitchen floor in 3 piles.  Pure undigested canned food.  It was like he did a binge-purge.  No hair at all in it.  No poop in the boxes, although lots of his pee (he doesn't cover and the other two do, so we recognize that as well).  His tummy was hard and tight.  Off to the vet we go.  Afraid of hairball impaction.

Vet interventions---

X-ray shows his GI tract is full, vet said on palpation it was very full

Enema @ 3pm--produced a very very hard 1/2 inch BM, hard feces, no hair, followed by more that was softer.  This enema made him vomit so profusely that the vet immediately said "he's staying with us".  It actually alarmed the vet.

Enema @ 5pm--produced softer stools

Gave him Cerenia injection, Flocillin injection, IV fluids

Enema again Tuesday morning--liquid only, they said mainly enema fluid only came out

Another X-ray Tuesday morning shows GI tract clear, air in the GI tract.  No indications of masses, no extended colon, no enlargement of anything, blah blah blah

I made them run the most extensive bloodwork panel they do ($200 one) and he came back all within normal range, with WBC slightly elevated, but they believe that is due to stress.  Everything else on his bloodwork was A+.  This included liver, kidney functions, all cell counts, thyroid, just freaking everything.  I insisted on everything.  Everything looks like a healthy cat, super-good for a 13 year old the vet said.

The vet and the vet tech that cared for him said he absolutely would not eat anything they offered him.  I warned them he was picky and wouldn't eat Hill's Rx diet wet food at all, that he would absolutely starve himself.  So they tried everything from Rx foods of various brands to Friskies canned.  Nope.

The hopes were that it was stress, so they wanted me to bring him home to see if he would eat.  Nope.  He acts hungry, goes to the food cabinet, goes to food bowls and looks at them, but then walks away.

His little bum looks inflamed, he walks gingerly, and has scooted his butt across the carpet like a dog with worms quite a few times.  He will be walking along, and plop his butt down and SCOOT.  He acts like it is bothering him immensely! 

He is very alert, purrs, was very VERY happy to be home when I let him out of his carrier yesterday, explored, and slept on my feet on the bed the majority of last night.   Up this morning very alert.  Refuses to eat.  They sent me home with EnerCal (guess another brand of Nutrical) and I have given him 3 dollops on my finger this morning that I had to smear in his mouth to get him to take.  Haven't seen him drinking.  His subq "hump" on the front of his chest has gone down, so apparently it's all absorbed.

I'm not sleeping, worried sick, don't know what else to do.  The vet told me if he does not eat after getting home, de-stressing, and resting a bit to bring him back for more fluids and possibly more intervention today.  Gave him a 1/4th of a tablet of plain pepcid last night per the vet and he will get another in a few minutes.  He also got a shot of Cerenia before he left there yesterday...although the vet told me he was going to give him an injection of famotidine (pepcid), it wasn't on my bill, and Cerenia was.

Oh one more thing--he hopped in the litter box this morning, sat there maybe 2 seconds, hopped out, and scooted on his butt from one end of the laundry room to the other.

Is there ANYTHING else I can do????
 

lily paddy

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not an expert.. had a very sick cat that would NOT eat a thing.. tried every single thing,. tuna deli meat .. anything please eat something.. this.. off a spoon.. all i could get in him.. the chicken and the beef. Beechnut baby food...  meat
 
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solomonar

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I am listing everything comes into my mind as a potential causes (please, take it as it is : a list of potential problems that I imagine and could be difficult to think on; please follow the vet advise):

- poison (look for: chocolate, detergents, grapes etc.)

- paw injuries (look carefully on his paws - whether dark or yellowish spots on the pink areas)

- something that can be swallowed (this is something you can only guess, as only the vet can check - please be noted that X-ray can be cheated)

- worms (did you check them?)

- food guarantee / food bacteria load  - you can check this if know someone having a bacteria-meter (used in checking bacteria on meat for human use). Some lots of food get contaminated - just happens. Can be checked in a laboratory as well, in classical cultures. 

===

My cat refused to eat 24 hours after transporting him 5 hours in the car. But started to eat eventually. 
 

artiemom

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I cannot think of the cause of the situation, but I think the not eating was because he was nauseous and full from being constipated. 

An enema can cause vomiting also. 

I assume they gave your cat some sub-q fluids ... I would check his gums for dehydration--they feel sticky if cats are dehydrated. 

My main concern would be not eating. Sometimes this happens after the enema.. they still feel off...

Did your vet prescribe an appetite enhancer?  Mirtazapine is usually the go to one.. There is also cyproheptadine which is also an allergy type of drug... that could be the way to go.. that has to be give twice a day...

I would ask the Vet about an appetite enhancer...

and try to feed this cat only wet food with some dry, as a treat.. Add extra water to the wet food.. once they seem to start with constipation, they seem to continue....

There is also miralax you can add to some water and mix in with his food.. but that is in the future.. for now, please re-contact the vet about an appetite drug...You need to jump start his appetite..

Try some Baby food.. like Beech-nut or Gerber,.. cats love them.. make sure there are no onions or garlic  or spices in the food...

or try some tuna water.. open a can of people tuna packed in water, put it in a container, add some extra water, mix up and try using as a topper to food.. or to get some water into him...

some cats eat crumbled treats on food... anything your cat likes could entice him to eat...

Not pooping after a total clean out, is normal... he is full of gas.. that is what he is letting out in the litter box.. 
 

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You said he had an xray, has an ultrasound been done?  My IBD kitty would be like this with a flare.  An ultrasound can't definitively diagnose IBD but the telltale signs of it can be picked up with an ultrasound.  My kitty would not eat either even after an enema.  He started with flares when he was only 18 months old and I did the  vet hopping thing with him for 6 years.  He was also hospitalized twice during those 6 years.  I finally found a vet that got him diagnosed but by the time I got him there he was in fatty liver from not eating even though he was not an overweight cat.
 

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Boiled turkey or chicken offer shredded plus he can drink the chicken broth make sure he has lots to drink assorted drinks

lots of fluids. Scooting Did they check his anal glands? would assume Vets would have covered deworming already though....
 
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artiemom

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Yes, I was thinking IBD also... but the main issue right now is to get him to eat....

and I was also wondering about pancreatitis... but that usually goes along with diarrhea.. but it could happen...

the Vet needs to take a closer look...
 

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I am so sorry this is happening. My Honeybee would go through bouts of not eating when she's constipated and full. Also she is prone to getting kitty colds=if they can't smell-they won't eat. you can try to run a hot shower and have him breathe in the mist...and warm the tuna a bit. don't buy white tuna=get the darker or light tuna=it has a more fishy smell. I also wonder if nausea is playing a roll. Zofran is another antinausea med. Pepcid helps for acid and is one of the treatments for pancreatitis. Also not all blood tests show the pancreas acting up=floey's was neg but we knew she def had it. Is he in pain in the belly? Gas can cause pain. also did they talk about miralax to be added to avoid this? I add it to hot water and wait until it's cool room temperature-I use a shot glass. I syringe it to Honeybee when she won't eat wet or tuna.

So very sorry-also it takes a day or so to get over the gas and everything from the enema...I would try the tuna-I take It and mash it with HOT water-so it's not runny but soupy so he can lick it...
 
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hbunny

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Thank you all!  Stay with me through this today please.

Well, he just ate 2 cat treats.  Those nasty Temptations chicken ones.  He actually chose those over tuna.  I got desperate!  But at least it's a sign of hope, to me, anyway....

I took off work today to work from home so I can be with him, and possibly take him back for more fluids.  The large bolus under his skin on his chest from the subq fluids has gone down now---but---I did catch him drinking water a few minutes ago in the bedroom, so that's good too!

Just put on two chicken breasts in the Instant Pot to pressure cook for him since he loves chicken.  He is still sitting in the kitchen floor giving me the look like he is starving. 

The vet didn't do an ultrasound just yet....he wanted to wait and see if things started resolving, but keeping him supported with the subq fluids and the nutrical goo mess, to see once he de-stressed at home and got over the enema thing.  I think the enemas not only pissed him off quite a bit but also made him feel drained.  The vet also is monitoring him for pancreatitis, but he said he really doesn't think that is it, with the great bloodwork and lack of other symptoms.

He hasn't eaten anything odd and never messes with anything as far as eating/chewing....he is so picky and refuses all people food other than just plain cooked meat.  The only "odd" thing I've ever seen him eat were BBQ pork rinds--he got his head stuck in a bag of them once.

He is VERY alert and prowling, has patrolled out the window from his perch--honestly he acts fine, just like his bum is very sore, and acts starving but won't eat.

He has a history of reflux.  A LONG history of it.  He was on the 1/4 tab of plain pepcid for quite a long time, but had done so much better, so hasn't taken it for about a year.  To combat that I started free-feeding him Royal Canin sensitive stomach, and his regular "meals" are wet food 3 x a day.  The addition of the snack food stopped his reflux, between that and the pepcid. 

I'm starting to suspect IBD myself.  The vet said he didn't see any enlargement on the x-ray, but the next step was U/S, and then on to further testing. 

Not sure if it is IBD what to do to manage it, but I will learn whatever I need to do.

Back to check the chicken cooking!
 
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hbunny

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@foxxycat   I tried the tuna trick.  No-go.  It was after I had tried that he ate the treat!  He has NEVER refused tuna, especially warmed up.  Now my kitchen smells like a wharf.

I would try baby food, but don't want to leave him right now to run to the store.  May try that later.  I'm going to try the shredded chicken when it's done, and give the vet a call.
 
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hbunny

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Boiled turkey or chicken offer shredded plus he can drink the chicken broth make sure he has lots to drink assorted drinks

lots of fluids. Scooting Did they check his anal glands? would assume Vets would have covered deworming already though....
They did.  A fecal was one of the first things they did, along with the anal glands.  All of that was negative and they did the anal gland thing.

Cooking that chicken in the pressure cooker now!  Ah, the things we do......
 
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hbunny

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Chicken has 12 more minutes...so I took him 2 more treats to the bedroom where he is under the highboy dresser (that's where his food/water is back there) and he ate both of those.

I'm hoping the chicken is appealing to him!!
 

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Keeping fingers and paws crossed for you guys! 
 

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Yay!  it's a start 
 if your cat is  seriously sick  he /she will Not eat Temptations  
 
 
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hbunny

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Well, he has now eaten a grand total of 6 of those treats....waiting now on his chicken to finish up!

I'm going to wait and see how this goes with the chicken before I call the vet to update and tell them what is going on. 

Do all of you think I'm doing the right steps???

I also worry about his little bootie being sore....anything I can do about that?  Do you think it's from passing the very hard stool and the enemas and the anal gland expression?
 

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I think he is just sore from everything that was done but I would ask the vet about it.  

I remember the last thing that Patches would quit eating was these Meow Mix cups.  They are seafood.  They come in yellow cups with a peel off foil lid.  I know it isn't great food but he would eat that when he wouldn't anything else.  The food looks and smells disgusting at least to me.

Fancy Feast is another one that cats will often eat when they won't eat anything else.
 

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I would let him eat as much of those treats as he wants=they have  a good amount of calories in them-maybe smash some up and put them ontop of the canned food?

By the way Honeybee-the cat in my photo lives on those nasty things. We also feed freeze dried treats but she likes the crunchies better. The funny thing is she won't eat grocery store cat food which is basicly the same ingredients.. Jon gives her treats all day long but only 3 or 4 at a time. I got her trained to jump up on the couch and run back and forth following my hand as I hold a treat in it. I have managed to get her to follow me all over the house just from one treat in the finger tips..and I of course let her eat them right out of my fingers-she has gotten so good at eating out of my fingers that she doesn't bite me anymore.

If nothing else maybe that will kick start the appetite.
 
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artiemom

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Great for the treats!!! Hooray!!

If he was seriously sick, he would not be playing.. and would not be so alert. HE would be crouching and meat loafing..

I think his bum is really sore from the enemas.. the scooting is from it. I found Artie doing it once, after an enema. You could perhaps put a little vaseline on a Q-tip to rub on his bum, but be advised that he will lick it off and he will be very sensitive to you touching that area.

I think his appetite needs to be jumpstarted.. Do you have any cheese in the house? My guy goes crazy for cheese! you could use that to start his appetite, or mix a bit with his food...wet food is better..

What about the tuna water? you could just add that to his food.

If he suffers from reflux, all the more reason to be on daily pepcid or cerenia or zofran.. all these are different drugs and work differently.. You need to ask your Vet and we can help you more, once they are prescribed.. some are injectable, most are not.. but you can get a pill gun and use it and some empty gel caps... give some water after pilling to make it go down easier.. a few cc's in a syringe.. 

I will be leaving soon, but as soon as I get to the hairdresser, I will be on line....that is what I do...

Good Luck... and breathe.. remember, we are here for you!!
 
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hbunny

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I think he is just sore from everything that was done but I would ask the vet about it.  

I remember the last thing that Patches would quit eating was these Meow Mix cups.  They are seafood.  They come in yellow cups with a peel off foil lid.  I know it isn't great food but he would eat that when he wouldn't anything else.  The food looks and smells disgusting at least to me.

Fancy Feast is another one that cats will often eat when they won't eat anything else.
Thanks!  Didn't think of those---I have some of those meow mix cups...I keep them for last-ditch emergencies, I will try that too

Fancy Feast is normally what he eats 3 x a day, but he's turning his nose up now.  I've even tried the super-stinky fishie ones.

So far, all he will actually eat are those treats, and now he is walking away from those.  Waiting on the chicken.....
 
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hbunny

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I would let him eat as much of those treats as he wants=they have  a good amount of calories in them-maybe smash some up and put them ontop of the canned food?

By the way Honeybee-the cat in my photo lives on those nasty things. We also feed freeze dried treats but she likes the crunchies better. The funny thing is she won't eat grocery store cat food which is basicly the same ingredients.. Jon gives her treats all day long but only 3 or 4 at a time. I got her trained to jump up on the couch and run back and forth following my hand as I hold a treat in it. I have managed to get her to follow me all over the house just from one treat in the finger tips..and I of course let her eat them right out of my fingers-she has gotten so good at eating out of my fingers that she doesn't bite me anymore.

If nothing else maybe that will kick start the appetite.
HAHA  he refuses foods mixed together.  Toppers turn him off for some reason, I even tried those bonito flakes in the past and he would eat them by themselves, and his food, but put them together and nope-nopey-nope.

He is a weird eater anyway.

I am wondering if that nutrical goo got his appetite started.
 
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