13yr old cat losing weight and appetite... food suggestions??

[Peteythefurrycat]

I will try to keep it short instead of a novel... we adopted our kitty when he was 8 and is now 13. In the past 14 months or so he has lost weight from 10lbs down to 7.5lbs. We brought him to the vet ~4 months ago and got blood work which came back all good. We tried switching his diet up and switched to a variety of wet food, he loved fancy feast. He was eating that like crazy for a couple months and got back up to 8.8lbs, but slowly stopped eating that so we tried switching back to kibble, and he was chowing on FF kibble like crazy for a bit. But only for about a month and now he's barely nibbling kibble here and there and doesn't seem interested in wet food. He still is super interested in human food!
He has been vomiting clear or yellow fluid weekly, sometimes a couple times a week. He has been on cerenia for a few days and hasn't vomited in probably a week now. I am taking him in for an ultrasound tomorrow.
Does anyone have any food suggestions?? I have tried about everything I can find and he just isn't interested. He sometimes will eat things once but when presented a second time, he is not interested. He loves tiki cat stix

here are his most recent lab results and a couple pics. Just want to make sure we are doing all we can at this point. In hindsight I am upset we didn't do an ultrasound earlier but his mood has always been normal until recently he has been sleeping more

 

[daftcat75]

Please ask your vet about the high PSL value on the second page. That, considering the other symptoms, could be indicative of pancreatitis. Pancreatitis needs to be treated aggressively. Let's also see what the ultrasound reveals because pancreatitis rarely happens by itself.

Vomiting clear or yellow liquid sounds like stomach acid. Are you feeding him twice a day? Can you give him smaller, more frequent meals? You may need to get a timed feeder or two to offer him meals while you are asleep or away. I recommend the clamshell design over the wheel design. The wheel will rotate uneaten portions away when it's time for the next meal. But the clamshell, there's no time limit on a portion once it has opened.

Does he also vomit food? Any stool issues?

I also recommend wet food only as dry food is much harder to digest and thus harder on the pancreas. What proteins has he been eating? Probably chicken and fish. Any others? Can you try a different protein with him like turkey or beef? Some cats are suspicious of new food and will only eat a few bites the first time. Anything he eats more than a taste of, offer it again. He may be waiting to see how it treats him before he digs in. You can also leave wet food out for hours (if he's your only cat) to see if he wants to nibble throughout the day.

But if he does have pancreatitis, that's enough for him not to want to eat much of anything. He may need additional supportive medicine besides the Cerenia like an appetite stimulant and possibly pain medication. Pancreatitis is painful.

Please post an update after the ultrasound and also what your vet says about the high PrecisionPSL result.

 

[daftcat75]

If he can still tolerate chicken well (he's not vomiting food or having stool issues), you can give him some cooked chicken on a short-term basis. Meat alone isn't nutritionally complete. But just to keep him eating, I hear an inside piece (no skin or seasoning) of rotisserie chicken or fried chicken (not the skin though) is popular with cats even when they're not feeling so well. Healthy cats can eat an unbalanced diet for a few weeks without issue. Petey probably needs something nutritionally complete sooner than that. But for now, until you have a better plan from the vet, it's better to eat well at McDonald's (or KFC as the case may be) than to starve at Whole Foods.

 

[Peteythefurrycat]

If he can still tolerate chicken well (he's not vomiting food or having stool issues), you can give him some cooked chicken on a short-term basis. Meat alone isn't nutritionally complete. But just to keep him eating, I hear an inside piece (no skin or seasoning) of rotisserie chicken or fried chicken (not the skin though) is popular with cats even when they're not feeling so well. Healthy cats can eat an unbalanced diet for a few weeks without issue. Petey probably needs something nutritionally complete sooner than that. But for now, until you have a better plan from the vet, it's better to eat well at McDonald's (or KFC as the case may be) than to starve at Whole Foods.

Thank you for the responses!! I was actually wondering about this earlier, I am going to pressure cook an unseasoned chicken breast and see if he's interested in that. I think he will be. Just to get something in his system for now!

I asked the vet about pancreatitis, she said thay could potentially be what's happening although she suspected IBD or lymphoma, but will know more after the ultrasound. I will post an update after we get the ultrasound results.

I have always just left his food out, so he can eat freely at any time. But I am thinking about mixing it up and pouring fresh food into the bowl each meal, sometimes he is more interested if he sees me pour the food, rather than it just sitting there in his bowl. Yesterday I bought some wellness core rawrev turkey liver dry food, he ate a handful of so of that but hasn't wanted any today. I will of course try again. He loves the tiki cat stix but those are a treat, and doesn't seem to like the tiki cat mousse which is similar texture but more of a meal.

 

[daftcat75]

I asked the vet about pancreatitis, she said thay could potentially be what's happening although she suspected IBD or lymphoma, but will know more after the ultrasound. I will post an update after we get the ultrasound results.

These are not mutually exclusive. In fact, pancreatitis is often a result of IBD/lymphoma. Remember I said pancreatitis rarely happens by itself. Usually inflammation from another process like IBD/lymphoma backs up into the pancreas. Because of how tight everything is there, it's not uncommon to also have liver involvement. But that isn't proving out in the blood work you posted above. The only liver enzyme out of range, ALT, is only mildly so. Although I'm not a vet, my reading and experience suggests that ALT is a trailing indication of inflammation elsewhere (unless it goes really high like the 1400 value that my Krista had that got her a ten day hospital stay on IV fluids.)

The good news is that pancreatitis can resolve if the IBD/lymphoma is also addressed. He can eat himself back to health. The bad news is that because of the nausea and pain involved in pancreatitis, it can make it very difficult to get him to eat. You're already seeing how he doesn't want to eat. I'm guessing (partially from experience) that he'll need either an appetite stimulant, a course of steroids, or possibly both to have him eating again. If he does need a course of steroids, give that a try before adding an appetite stimulant. In Krista's case, the steroids alone were enough to make her very hungry. But she was dealing with lymphoma at the time. We somehow made it through pancreatitis without steroids. Lots of Tiki Cat fish flavored foods which probably didn't do her IBD any favors.

Let's see what the ultrasound says. But I would press further on the pancreatitis. Ask her if there's any harm to treating this like pancreatitis in addition to whatever the ultrasound suggests.

 

[daftcat75]

When I was trying to get Krista through pancreatitis, I often presented only a small amount of food. Sometimes I hand fed her. Often I sat with her and powdered up her favorite treats into that small amount of food. If she finished that, I would add a little more, and bribe her to finish with treats. We would do this little by little until she walked away and called it done. Most days it took about six to eight "meals" (sometimes only 1/2 oz or 14 grams) to get enough calories in her. Hopefully a course of steroids will make this all so much easier for you and Petey.

 

[daftcat75]

Have you had his teeth check recently? Teeth issues are common in older cats. Cats are very stoic about dental pain. Often the only clues you get of a dental issue is that he becomes more reluctant to eat until the pain exceeds his hunger. If they are going to sedate him for the ultrasound, perhaps you can also get some mouth x-rays and a dental exam done at the same time.

 

[Peteythefurrycat]

These are not mutually exclusive. In fact, pancreatitis is often a result of IBD/lymphoma. Remember I said pancreatitis rarely happens by itself. Usually inflammation from another process like IBD/lymphoma backs up into the pancreas. Because of how tight everything is there, it's not uncommon to also have liver involvement. But that isn't proving out in the blood work you posted above. The only liver enzyme out of range, ALT, is only mildly so. Although I'm not a vet, my reading and experience suggests that ALT is a trailing indication of inflammation elsewhere (unless it goes really high like the 1400 value that my Krista had that got her a ten day hospital stay on IV fluids.)

The good news is that pancreatitis can resolve if the IBD/lymphoma is also addressed. He can eat himself back to health. The bad news is that because of the nausea and pain involved in pancreatitis, it can make it very difficult to get him to eat. You're already seeing how he doesn't want to eat. I'm guessing (partially from experience) that he'll need either an appetite stimulant, a course of steroids, or possibly both to have him eating again. If he does need a course of steroids, give that a try before adding an appetite stimulant. In Krista's case, the steroids alone were enough to make her very hungry. But she was dealing with lymphoma at the time. We somehow made it through pancreatitis without steroids. Lots of Tiki Cat fish flavored foods which probably didn't do her IBD any favors.

Let's see what the ultrasound says. But I would press further on the pancreatitis. Ask her if there's any harm to treating this like pancreatitis in addition to whatever the ultrasound suggests.

The vet called just now with Petey's ultrasound results, and your input was spot on! The ultrasound showed inflammation in the pancreas and mild inflammation in lymph nodes. It did not show thickened walls in the intestines, so the vet said it was unlikely to be lymphoma at this time or IBD. She said hopefully the lymph node inflammation was reactionary from the pancreas inflammation. She said he may have chronic pancreatitis and to continue what we're doing with cerenia and appetite stimulant to manage his symptoms. He hasn't vomited in over a week and has been eating more the past couple days. We will probably follow up with another ultrasound in 6 months or so to see if anything has changed with the lymph nodes or anything else. In the meantime I hope he just continues to be like he has been eating and happy the past couple days, otherwise we will have to try finding another diet if he stops eating again

 

[daftcat75]

If he's eating well now, he's not vomiting, he doesn't seem lethargic, he doesn't seem pained after meals, then keep doing what you're doing. I would plan to have his blood re-tested in a month to make sure the pancreas number is back in range. Chronic pancreatitis can do permanent damage to his pancreas if it's not managed. I'm surprised the vet is being so casual about it.

 

[Peteythefurrycat]

If he's eating well now, he's not vomiting, he doesn't seem lethargic, he doesn't seem pained after meals, then keep doing what you're doing. I would plan to have his blood re-tested in a month to make sure the pancreas number is back in range. Chronic pancreatitis can do permanent damage to his pancreas if it's not managed. I'm surprised the vet is being so casual about it.

Petey has been eating well and overall doing pretty well but today he vomited for the first time in almost 2 weeks, has been sleepy all day, and hardly eating. Ugh. Thought we had rounded a corner! Hopefully just having an off day, but I'm afraid he's not going to like this food any more.
I am a little annoyed that the vet didn't give any type of conclusive response or direction other than continue doing what we're doing and managing symptoms. What we know is he has inflammation in the pancreas and lymph nodes, everything else (intestines, kidneys, etc) looked fine.

What worked best for you with managing pancreatitis?

 

[daftcat75]

I was stubborn and thought I could help Krista through pancreatitis using alternative medicine and home remedies. I'm not sure I would recommend that. It was very intensive and it may have caused allergy issues. Because it took us three vets just to find one who thought to test for pancreatitis, I was sort of fed up with vets by the time I finally got the diagnosis. In Krista's case, I calculated how many daily calories she would need. I set up a Google Sheets with different foods and how many calories per gram they provided. Then I setup weekly sheets that helped me track nearly every bite she took. I weighed the food that went on to the plate and how much was taken off when we were done. Some meals she only ate 10 grams. We would have as many feeding sessions per day as I thought she would tolerate and inched her slowly back to "full portions". I tracked every vomiting and stool using different colors in the cells and attached notes to each cell with commentary about how she seemed to be doing and what it took to get her to eat. I used different supplements to help her gut feel better (slippery elm bark was one) and different treats like fish flakes to entice her to eat. I used Tiki Cat fish-based foods because they didn't contain gums and she would still eat fish despite how poorly the pancreatitis was making her feel. If I had to do it over again, I would have gone with an internal medicine specialist. She would have been on some appetizing compounded form of Cerenia and transdermal mirtazapine. And if that didn't work, I would have asked for a course of steroids to get the inflammation under control. If you can't find a specialist, or can't afford to work with one, I would at least keep a food journal of what you feed Petey, how he seems to be doing, and whether he vomited or had abnormal stools. Try to establish if there is any pattern, any trigger foods to his vomiting, and then eliminate those.

Speaking of vomit, what kind of vomit did Petey have? Was it with food or without? If without, was it white and foamy? Different kinds of vomit and regurgitation can point to different kinds of problems.

• With food, undigested: regurgitation. Probably ate too fast or there is something wrong with the food like spoilage.
• With food, partially digested or mostly digested: Probably the trickiest on this list. This can be something wrong with the food but of the allergy or intolerance sort. These are the ones you want to track the most closely to see if you can figure out what ingredient is causing it. It will likely be a protein or a gum. But if it's kibble, it can be just about any non-animal ingredient. This is what makes kibble and IBD/lymphoma/pancreatitis incompatible in my mind (among other reasons.)
• Without food, white and foamy, possibly with yellow tinge: Stomach acid, possibly also with bile. He probably went too long between meals. With older cats and especially with pancreatitis, it's much better to split up daily calories over several smaller meals throughout the day (and possibly the night.) You can get timed feeders to serve wet portions when you aren't available.

I'm sure there are more. But these are the three most common.