Cat suddenly very picky about food & losing weight

[cowkittymom]

I often read these wonderful forums, but rarely post. Unfortunately, I'm posting because I'm seeking advice about my girl cow cat (the one on the right in my profile).
She is losing weight (7.6 lbs on August 11 per the vet and now 7.06 lbs according to my scale) because she is not eating enough. She picks at food, eats a little more when I give her something new, but then goes back to not eating much. She will approach her microchip feeder repeatedly, sniff the food, and then not eat. No vomiting or diarrhea, and no obvious behavior changes, although she is really skittish, so it may be hard for me to tell if she is not feeling well. She had her annual exam on Aug. 11th and a senior screen urinalysis/blood test. The vet said she had early Stage 2 CKD, but that would not be a reason for loss of appetite. All other blood values were good. Internal organs seemed fine based on physical exam. Teeth also fine. (In fact, at this point she only wants her dental kibble.) Her urinalysis had a strange glucose value, but the vet thinks it's an artifact because the blood glucose value was fine. We're going to re-run the urinalysis.

The vet has suggested trying Cerenia and Mirataz to see if there is some subtle GI upset going on that is bothering her. Does this seem like a reasonable plan? Or should I be taking her in for an abdominal ultrasound immediately given her significant weight loss? I am someone who tends to panic, so I'd really appreciate any advice.

Details in case they're helpful
I feed her a combination of kibble and wet food (constant supply of urinary wet food because that is what her brother needs to eat). She's always gobbled up the kibble (1 oz of Dr. Elsey's Cleanprotein) immediately after I put it out at night. However, starting 2 months ago, she started to only eat half of the kibble. I tried a new bag of kibble and it made no difference. She currently seems to prefer her brother's urinary kibble and dental kibble, so I've been giving that to her, but she's still not eating enough.

 

[maggie101]

I would see a different vet and get an ultrasound. Some vets will do what you ask them to do so he will probably agree if you tell him what's going on.

If my cat does not eat it is because she is inflamed. If it's inflammation,cerenia will not help.

 

[Terri Moore]

The vet has suggested trying Cerenia

My cat quit eating and I could see the weight loss in her. Vet treated her for parasites, no change. She is on Cerenia for nausea because she was throwing up every day. She's on Prednisolone for inflammation.

 

[emocatowner]

I think stage 2 CKD can cause this. Some cats show symptoms a lot earlier than others, and it sounds like classic nausea, that most cats with CKD get.

If she has CKD though, urinary food is particularly bad for her. It's kinda the complete opposite of renal food. Urinary food is more acidic to dissolve the stones and kill bacteria or something, whereas renal food tends to be more basic, to protect the kidneys. Did the vet mention anything about giving her renal or early renal food? If not, I'd at least consider switching her to senior food, it has lower protein levels than normal food, it should help preserve her kidneys, and reduce the uremic toxins that build up in the blood from breaking down protein, thus reducing the nausea.

Cerenia and Mirataz are also good ideas. They are also given to cats with CKD, and often it helps kickstart them into eating again.

I'm reluctant to suggest going for that abdominal ultrasound, if she'll require sedation for it (which I imagine she would, if you say she's skittish). That does more damage to the kidneys, and it sounds like the likelihood of providing extra useful info is low. But you should talk this part through with the vet, see if the benefits outweigh the risks.

 

[cowkittymom]

Hello, thanks so much for your helpful replies about my girl Phoebe. emocatowner , I see that you also have a cow cat! Good point about the food. I did ask the vet specifically about whether it was OK to let her eat the urinary food and she seemed to think it was OK, but I'll look into that. It is interesting that she's been eating the high-protein Dr. Elsey's kibble, and her brother has not, and does not have any CKD signs.
The vet said she wanted to wait to prescribe renal food, since most cats don't like it, but I will look into senior food.
Phoebe freezes when she's at the vet, so she may not need sedation for an ultrasound. However, I will try the Cerenia/Mirataz first.

 

[emocatowner]

Hello, thanks so much for your helpful replies about my girl Phoebe. emocatowner , I see that you also have a cow cat! Good point about the food. I did ask the vet specifically about whether it was OK to let her eat the urinary food and she seemed to think it was OK, but I'll look into that. It is interesting that she's been eating the high-protein Dr. Elsey's kibble, and her brother has not, and does not have any CKD signs.
The vet said she wanted to wait to prescribe renal food, since most cats don't like it, but I will look into senior food.
Phoebe freezes when she's at the vet, so she may not need sedation for an ultrasound. However, I will try the Cerenia/Mirataz first.

Omg I didn't even realize, our kitties definitely look alike

Great that you asked the vet about it already about the urinary food. It probably isn't super harmful or anything, just not great.
The thing is, high protein food is generally good for cats. You don't want to give low protein stuff preventatively, that can lead to diabetes or other issues. Though once the kidneys start wearing out from age, they'll keep working a bit longer if you put less strain on them, as it will make them live longer (2x longer on renal food, according to several studies), but not long enough to actually experience other problems from getting just the bare minimum proteins.

It is a balance, you don't want to give it too early, it's more of a judgement call in stage 2. There is the "early renal" variety too, that has a bit lower protein than senior stuff, but not as low as the regular renal food.
Renal food is designed to be extra tasty and appetizing, because cats with CKD struggle to eat as is, so it can vary wildly whether cats like it or not. My old dude loved it even more than his previous food. And you can switch back if they don't like it, so I don't quite follow the vet's thought process here.

Either way, it does sound like you have a good plan to move forward with, for now.

 

[Twylasmom]

My CKD cat won’t eat renal foods. Wet is best, but if your cat eats better on kibble Hill’s 11+ dry food is lower in phosphorus and has moderate protein. The regular version is what you want, not the indoor version, especially if your cat is losing weight.

 

[waddle]

I hate to make you worry, but my Henry had the same eating issues with nothing unusual in blood work or physical exam. Four days after her last exam she started breathing oddly, and they had me bring her in for an X-ray which showed cancer. I would get some extra testing done if you can.

 

[cowkittymom]

emocatowner thanks for the additional guidance re: how deciding what to feed. These are my first cats, so I don't know much about food options. I will check out both senior and early renal foods. She is eating some of the Tikicat mousses and her Hills Science Diet dental kibble.
waddle , it's going to take me about a month to get an appointment with one of the experienced internal medicine specialists in town. I'll start with the appetite stimulant and see how it goes. If she continues to lose weight, I'll try to book an appointment with one of the less busy specialists.

 

[cowkittymom]

Just wanted to update this thread, in case it is helpful to someone in the future, wondering whether it makes sense to take their cat to a specialist for loss of appetite with no other GI symptoms, sooner rather than later.

We saw an internal medicine specialist & Phoebe went through the full diagnostic work-up: ultrasound (no obvious thickening of intestine or other issues), GI panel (normal B12, low folate), endoscopy with biopsy. Standard histology showed "Duodenum: Minimal, chronic, lymphoplasmacytic enteritis with minimal lymphocytic epitheliotropism". The PARR analysis of the immune cells in the biopsy showed "clonal spikes in a polyclonal" background, which the vet characterizes as the transition between IBD and small-cell lymphoma.

Phoebe has been on 5 mg of prednisolone/day since the biopsy. She is hungry and gaining weight. The vet recommends keeping her on the prednisolone for the rest of her life to prevent the IBD from progressing. I know there are long-term effects from continued steroid use & will be discussing how to minimize these. I'm very grateful that we caught it before it was full-blown lymphoma.

 

[fionasmom]

Thank you for letting us know. Others often look for updates to threads in Health, but also let us know how Phoebe is doing!

 

[waddle]

My presumed IBD kitty was on prednisolone for many many years without any complications so hopefully the same will be true for your kitty. She was on 2.5 mg every day as she would lose too much weight if we went any lower.

 

[cowkittymom]

fionasmom , Phoebe is doing very well. She is hungry and gaining weight. So far, I'm having success with putting the pill in an empty capsule and giving it to her in a lickable treat. We'll see how long that works.

waddle , thanks for letting me know. I hope the same for Phoebe. She's only 9.5 years old.