Old cat not eating.

[Psalcal]

16 and with IBD or intestinal cancer. We declined the invasive evaluation since treatment was essentially the same we were told.

Has been on chemo and steroids since for about two years and doing fine. Little bits of not eating here and there. Last week though she has eaten little. Vet says options are e-tube, invasive surgery or keep trying and hope.

 

[Psalcal]

I guess I can’t edit pushed the button too early. She is on anti nausea and appetite stimulants. Nothing is working. She has dated a little every day but has lost around a pound in a week.

Has anyone been in a similar place? Wondering if stopping the stimulant might make a difference given it’s no longer working? Specialist vet is hard to reach so talking through this with her is hard.

Also heard about another stimulant called Entyce but vet doesn’t like it for cats.

Anyway just trying to brainstorm. Wishing for a miracle or other idea we haven’t thought of.

 

[MissClouseau]

Not really what you are looking for but have you seen this on-going thread about daftcat75 's girl Krista? Krista's Care

 

[FeebysOwner]

Hi. I actually think the thread that MissClouseau suggested for you might help more than you might think. It is a long thread, but I am sure daftcat75 would be more than happy to try to help you with your girl, given the similarities.

 

[Psalcal]

Yes I started to read that and wow.. it's a lot.. I will indeed read. Thank you both.

 

[Psalcal]

One thing I notice my cat doing... when she eats (baby food is the only thing she'll take and even then she has to be convinced)... she will tilt her head in one direction, the same direction. This seems new to me. Any ideas if that's a known symptom of something?

 

[FeebysOwner]

Could be a dental issue (which also applies to Krista, btw), but it could a lot of other things as well - the beginnings of an inner ear infection, just to name a pretty common one.

Edit: Also this article with eating tips you could try.
How To Get Your Cat To Start Eating Again

 

[daftcat75]

Could be a dental issue (which also applies to Krista, btw), but it could a lot of other things as well - the beginnings of an inner ear infection, just to name a pretty common one.

Edit: Also this article with eating tips you could try.
How To Get Your Cat To Start Eating Again

I was just going to ask about her teeth. Since having Krista's remaining teeth removed last fall (resorptive lesions and tired of waiting for them to go bad individually) and putting her on steroids for her IBD/lymphoma, I have not had appetite issues at all. Occasionally she'll walk away from a meal early, but she always finishes it before her next meal.

An e-tube isn't a bad option. It's much lower risk than a biopsy. A little sedation, a small incision, tube placement confirmed by X-ray, sutures, and done in about 30 minutes. (If you have the stomach for it, you can watch the procedure on YouTube.) The vet will want to keep her all day to do the first feed about six hours after tube placement (about how long it takes for the sedation to wear off.) The tube doesn't preclude her from eating on her own and it will buy you both time while you explore other diagnosis and drug options. My two feeding tube recommendations are to get a Kitty Kollar to protect the insertion site and secure the tube out of the way and ask the vet to leave a longer piece of tube out of her to make sure it will stretch far enough across for the Kitty Kollar to secure it. You can always cut a too long tube but there's nothing to be done about one too short. As you'll read in the first few pages of Krista's thread, it was the length--or lack thereof--of the tube (and the flying cap--get extra caps!) that was really the only challenge of the feeding tube.

If it were my cat, I'd schedule her for a dental examination under sedation with mouth x-rays. While she's sedated, they can also check her ears.

Depending on how long her eating has been reduced, you may want to go with the feeding tube as well. It's been my experience with Krista that when she stops eating, it takes an intervention of some sort to get her to restart. Krista responded well to mirtazapine. Cerenia, on the other hand, made her anorexic--counterproductive! And Entyce? I think it worked once for her and not much longer than that meal.

You've been doing the steroids and chemo longer than I have with Krista. She started steroids in January and chemo in February. I don't know what the long-term will hold for them with her. Right now, our biggest struggle is what I now believe is constipation from the chemo. If I don't give her anything for it, she'll go longer than 24 hours and then it's a multi-box disaster with some carpet bombing and throwing up after passing that much poop. I'm shifting from psyllium to Miralax (she doesn't need any more bulk!) and that's been getting her closer to a regular two a day (which is what she needs for how much she eats.) She still has bonuses and the occasional carpet bomb. Not nearly so bad or frequent. And she hasn't been barfing as much afterwards. I think that's also because I give her a B-12 shot each time she does barf and that buys us four or five days until the next time. She is not on any appetite stimulants or anti-nausea. She has no issue with appetite and the barfing is only a response to the pooping. When she can eliminate properly, she doesn't barf.

So, in summary, I would recommend a dental exam and ear exam as soon as you can manage it. If her eating has been "off" for more than a couple of weeks, I'd also strongly consider the feeding tube.

 

[daftcat75]

You might think the feeding tube is just prolonging the inevitable. But if she hasn't given you signs that she's ready to cross, then the feeding tube gives you an active hand in helping her through this. If I gave up at the first signs of struggle, Krista wouldn't have made it past thirteen. If I didn't put the tube in her last year, she wouldn't have made it to 15. She's so resilient that I'll do just about anything for her as long as she tells me she's not ready. I joke that she just may be immortal for how much she's been through and keeps on going. She may just outlive us all.

 

[Psalcal]

I guess that's the other thing, I can't tell if she's ready... so hard with a cat. I have a feeling she might be suffering. She has arthritis and has a limp in one of her legs though it comes and goes. But being on steroids and chemo for a full two years is a lot on the organs I hear. Her last blood test came out fine, the vet was surprised.

I appreciate the answers. I will answer more in a bit. Feeling stressed about it.

 

[Psalcal]

We are now resorting to syringe feeding her and she is responding fairly well. She barely eats on her own and then only if we force the issue by putting a spoon or finger in her face and getting her to lick it off which sometimes convinces her. But we’re not getting enough in her, either syringe or otherwise.

We are wondering if after a week on Miritaz plus plus Cerenia and another anti nausea with a long “o” name, and no improvement if it’s time to try something else. I’ve read assorted reports of Cerenia sometimes causing anorexia.

There is one more appetite stimulant the vet recommends which maybe we will start tomorrow. Neither Vet (local person or specialist) like the Entyce idea.

Last night something happened and I have no idea what it was. Out of nowhere she jumped off the couch and was acting if there was something on her or right behind her scaring her. She ran strangely looking back scared. I caught up with her and got her to calm down after a minute or so, just holding her down while she shook. Not sure if it was a seizure or just extreme fear. Her eyes were not moving just staring off while she shook. She calmed down in a few minutes and initially seemed to have some trouble with one side of her legs. But within a minute she was moving all legs ok. A slight bit unsteady. She meowed very loudly and seemed to be restless for maybe 20 minutes, more vocal than normal. Eventually she seemed herself and slept it at least rested all night fine.

This morning she seemed like her old self... normal and even more engaged than she had been previously. Later in the day she has been pretty much sleeping the entire time. Par for the course for the week.

Anyone have any thoughts on this, I would greatly appreciate them. It all seems so mysterious. Wish she could tell us what’s up. Thanks for reading.

 

[Psalcal]

Oh one more thing... We’re going to take her in tomorrow for a mouth inspection to see if that’s a factor. She just had a work up a week and a half ago and we assumed that was part of it but not sure. So they will look at that.

 

[daftcat75]

I’m not a fan of syringe feeding by mouth. Because that’s still on the cat to eat enough. And it really takes a lot of time and effort to get enough food in her that way.

It still takes a lot of time and effort to get enough food in a cat through a feeding tube. But most of that is on you. All the cat needs to do is sit still. (And throw up a little if you feed too fast, too much, or too cold. But this is good feedback and you’ll learn quickly.)

I recommend a full dental exam under sedation with mouth x-rays rather than just a visual exam. Lots of painful problems can begin below the gum line.

 

[FeebysOwner]

I would certainly try the other appetite stimulant, just to see. Have you tried mixing any of her food with Gerber baby food meats - just to see if that might help her be more interested in food? And, are you giving any more consideration to the feeding tube, as daftcat75 just mentioned again?

I have heard of fluid build up causing problems in inner ear infections in humans (who can tell us what they are feeling), something to do with noises/unusual sounds related to the fluid movement. It might have caused her behavior. So, please have them check her for that as well. That goes along with the head tilting you mentioned before.

The other thing you might want to ask is what are the long term side effects for chemo and steroids. It does seem like you are right in considering her behavior could have been seizure related. But, please also ask the vet if her eating being down so much might also cause enough of a nutritional/chemical imbalance that could create a seizure like effect. I have heard of that as well.

Please keep us posted.

 

[Psalcal]

For sure it’s not enough, we are just biding time hoping we can solve it all before deciding on feeding tube.

 

[Psalcal]

We have indeed tried baby food, that’s all we have been doing the last few days. Not gerber but Beechnut which has no corn syrup. She initially responded to it but not so much last couple days. We also tried gerber too but no difference. Also tried to sprinkle flotiaflora to see if that helped. Seemed to a few days ago but nothing now.

Thanks for the guidance and advice on xrays of her mouth. Will see if they can fit her in tomorrow sometimes our vet is very busy.

 

[Psalcal]

Our vet is examining her today, and in the meantime we're going to stop the Cerenia for now and see what happens.

We have been able to syringe feed successfully, got nearly an ounce in this AM, so we're going to try doing that throughout the day.. she takes it surprisingly well, doesn't spit it out, and has always been easy to pill too. Doesn't have any animosity and happily sits on laps and connects immediately afterward.

She is at the vet now waiting for an opening for the vet to examine her... hoping maybe they find something in the teeth/mouth..

 

[FeebysOwner]

She is at the vet now waiting for an opening for the vet to examine her... hoping maybe they find something in the teeth/mouth..

Hope they are considering an inner ear issue as well! Thanks for the update, continue to keep us posted!

 

[Psalcal]

No inner ear problems, no mouth problems, etc. So nothing there.

Distended belly and some pain/discomfort there according to vet, as well as some dehydration, and constipation. Also noticed whiteness to her mouth and recommends a white blood cell count, which we're moving forward with. Vet is recommending fluids too.

Vet also agrees we should try the other stimulant, Cyproheptadine. I have yet to do any research on this but it appears we have little choice.

Vet recommends we consider ultrasound to try and determine root cause of distended belly... suspects it might just be her cancer acting up and there might not be a remedy. Ugh...

We have to get the ultrasound done by specialty vet, hoping we can get that in tomorrow. A little worried about that as we recall it was very uncomfortable for the cat to get the ultrasound especially given the conditions. But it sounds like it's the only way to try and get to the better of it.

So not any answers yet but at least a road toward getting answers. I feel like the last 1.5 weeks with no answers has been so much harder, at least having answers would help a great deal.

We will continue with our syringe feeding as that has been going very well, at least until we get the ultrasound scheduled and results... hoping it's not bad news with the ultrasound but after two years we have been on borrowed time with her... "house money" for sure, she has been the perfect cat. Hoping though for good news still..

 

[Psalcal]

Vet appt for ultrasound tomorrow. Blood counts all good.

I hate that they must have the cat almost all day for an ultrasound. She’s going to be waiting there for hours.