Ongoing issue with not eating

[TabbyCatandMe]

Hi. Please bear with me! This is my first post. Oliver just turned 12. He’s got a few health issues - fhv (herpes), allergies and constipation (on meds) but all manageable.

But for the last 3 years he’s always have days where he refused to eat. Each time I’ll bring him to the vet, which they either do a full exam and blood test or at least a full checkup. And every time they could never find anything wrong with him. Send him back home with anti inflammatory and nausea injection. And he starts eating. The last time it happened was 3 months ago. Yesterday he ate less and today he refused food completely. He even ran away from his food when I tried to coax him to eat. He’s sleeping more but it’s winter over here. I have Mirtazapine on hand but I don’t want to give it to him unless I really need to.

I am at my wits end! Anyone have or had the same problem with their cats? Or ideas what it may be? I am thinking Ibd but he doesn’t vomit or have diarrhoea. Thanks!

 

[ellen m]

If the steroid and nausea injections got him to eat, he is nauseous. He sounds nauseous, even without hearing about that. Does he head towards food and then turn away from it? Act hungry but then only take a few bites? I would work with your vet to find the cause of the nausea. If all the bloodwork is normal, it may be a GI problem. IBD, which you mention, is a possibility, but so is lymphoma, especially at his age. Those don't show up in normal blood panels (as, for example, would kidney disease, liver disease, diabetes, infection, etc.).

I would discuss with your vet for a pancreatitis test, a cobalamin/folate blood test to check for primary GI disease such as IBD or lymphoma, and an abdominal ultrasound. You could wait to do the ultrasound until after the cobalamin/folate test, which is sometimes called an absorption panel because it checks for problems in the areas of the small intestine where those are absorbed. The ultrasound is also a way to check for problems in the intestine.

In cats, because of their anatomy, pancreatitis often occurs simultaneously with infiltrative bowel diseases (IBD and lymphoma), so one doesn't rule out the other and you want both tests. In the meantime, I see no reason not to give the Mirtazapine, even if he nauseous. It also has an antinausea effect and is safe.

Is he losing weight?

 

[TabbyCatandMe]

If the steroid and nausea injections got him to eat, he is nauseous. He sounds nauseous, even without hearing about that. Does he head towards food and then turn away from it? Act hungry but then only take a few bites? I would work with your vet to find the cause of the nausea. If all the bloodwork is normal, it may be a GI problem. IBD, which you mention, is a possibility, but so is lymphoma, especially at his age. Those don't show up in normal blood panels (as, for example, would kidney disease, liver disease, diabetes, infection, etc.).

I would discuss with your vet for a pancreatitis test, a cobalamin/folate blood test to check for primary GI disease such as IBD or lymphoma, and an abdominal ultrasound. You could wait to do the ultrasound until after the cobalamin/folate test, which is sometimes called an absorption panel because it checks for problems in the areas of the small intestine where those are absorbed. The ultrasound is also a way to check for problems in the intestine.

In cats, because of their anatomy, pancreatitis often occurs simultaneously with infiltrative bowel diseases (IBD and lymphoma), so one doesn't rule out the other and you want both tests. In the meantime, I see no reason not to give the Mirtazapine, even if he nauseous. It also has an antinausea effect and is safe.

Is he losing weight?

Yes! That’s exactly what he does! Wants food but walks away and even runs away from it! I think the vet did test for pancreatitis as well. She did mention it. That’s good to know about cobalamin/folate blood test, I will ask the vet about it. Thanks!
And also good to know about Mirtazapine. I won’t hesitate giving it to him now.

 

[ellen m]

Definitely, 100% it's nausea. I would ask your vet for a prescription for ondansetron (zofran), which can be sent to any drugstore if your vet doesn't stock it. Be aware that it lasts only about 4 hours in the cat's body so at least until you have a diagnosis and can start treatment for whatever this is, you will need to give it a few times per day. If it's pancreatitis, treatment is just supportive anyway (nausea meds, etc.). So you want the nausea med now, in addition to the Mirtazapine.

 

[ellen m]

Forgot to ask, which test did your vet do for pancreatitis, what was the name of the test? There are some that won't really diagnose chronic pancreatitis, just acute. The best tests for that require fasting. So unless your cat was fasting for the bloodwork, you may need a more definitive pancreatitis test. I would ask what the name of the test was and go from there.

 

[TabbyCatandMe]

Forgot to ask, which test did your vet do for pancreatitis, what was the name of the test? There are some that won't really diagnose chronic pancreatitis, just acute. The best tests for that require fasting. So unless your cat was fasting for the bloodwork, you may need a more definitive pancreatitis test. I would ask what the name of the test was and go from there.

Actually I didn’t see the results. I’ll ask! He didn’t have to fast for it. Forgot to mention that no he hasn’t lost weight. At least not yet. Thank you so much. Your information is very helpful!

 

[Kris107]

The Mirataz is fine to give - gave it to my girl fairly frequently over several years. Towards the end it was every day. Hope they can get to the cause of things!

 

[TabbyCatandMe]

The Mirataz is fine to give - gave it to my girl fairly frequently over several years. Towards the end it was every day. Hope they can get to the cause of things!

I gave him one three months ago. Thanks so much Kris. I hope so too. So annoyed that we can’t get to the bottom of it yet.

 

[TabbyCatandMe]

I just want to give an update on Oliver, I was away for a few days. Cat feeder messaged to say he has not eaten for 24 hours. So I had to change my flight to get back early and take him to the vet! It was that or I will have to take him to the emergency vet over the weekend as my vet clinic is fully booked on Saturday! So we finally got a diagnosis for Ibd. He’s been given B12 and Cerenia shots. We’ve been given Cerenia tablets to take home. Vet says to hold off on Mirtazapine and see how he goes. He ate about half his daily intake of food today (I didn’t get to bring him to the vet till later this afternoon). But when I tried to give him more, he still seems a bit nauseous. It’s been 4 hours since he had the shot of Cerenia. Should I give him a Mirtazapine tablet tomorrow morning? I’m so new to Ibd!

 

[fionasmom]

IBDKitties – Helping Save Lives…One Paw at a Time
If you have not seen this site, it may give some help with the ongoing diagnosis of IBD.

Since he had a shot of Cerenia 4 hours ago, what did the vet say about starting the tablets? Mirtazapine has some anti nausea component, although it is not routinely used for that alone. If possible, call the vet and ask for clarification about the Cerenia. Secondly, I would say to try to follow the vet's recommendations but let them know if something seems really off, even if it is Saturday.

 

[TabbyCatandMe]

IBDKitties – Helping Save Lives…One Paw at a Time
If you have not seen this site, it may give some help with the ongoing diagnosis of IBD.

Since he had a shot of Cerenia 4 hours ago, what did the vet say about starting the tablets? Mirtazapine has some anti nausea component, although it is not routinely used for that alone. If possible, call the vet and ask for clarification about the Cerenia. Secondly, I would say to try to follow the vet's recommendations but let them know if something seems really off, even if it is Saturday.

thabks @fionasmum. I’m to give him Cerenia tablets for next four days. Oliver is already eating so much better this morning!

 

[FeralHearts]

T TabbyCatandMe I'm so glad to read that Oliver eating again. Good sign. What a relief that must be.

As for the pancreatitis test, please be aware that it can give a false negative. I have one cat the the ultrasound shows pancreatitis but the fPLI test said negative. Another one that shows the ultrasound as being no pancreatitis but the fPLI came back positive. In his case it probably means he had an acute attack so I have to be mindful that it does not become chronic. In the first kitties case - the ultrasound doesn't lie - regardless of what the test came back as.

xo

 

[TabbyCatandMe]

T TabbyCatandMe I'm so glad to read that Oliver eating again. Good sign. What a relief that must be.

As for the pancreatitis test, please be aware that it can give a false negative. I have one cat the the ultrasound shows pancreatitis but the fPLI test said negative. Another one that shows the ultrasound as being no pancreatitis but the fPLI came back positive. In his case it probably means he had an acute attack so I have to be mindful that it does not become chronic. In the first kitties case - the ultrasound doesn't lie - regardless of what the test came back as.

xo

Sorry for not replying sooner. Had just been caught up with Oliver having a long flare up of flu virus! He’s almost back to normal now. Thanks for the heads up about pancreatitis tests F FeralHearts . I’ll need to be aware when I speak to his vet next.