Senior kitty not interested in cat food, has lost weight

[runekeeper]

Thanks very much for all the advice and info, Chloespriestess. And I don't think I can use the "my cat is sick" excuse since I used it for both my cats before, and this is a thesis, so I don't think I've got as much leaning room. It has to be done and in their hands no later than the 24th and I'm already very far behind on it, not sure if I'll even get it done as it is.

I feel bad, Kip seems worse since I began the syringe feeding, which I think is due to the feeding and not his illness. Before yesterday, he was happy and perky despite eating very little. I began force feeding him and now he seems depressed, out of it, he hides from me, and doesn't even try eating or drinking on his own, and he shakes a lot when I feed him. The vet is now saying that she isn't 100% sure Kip has fatty liver disease, but she said that's what it probably is based on his blood tests. I am to bring him back on Tuesday to get his liver values re-tested, but that seems much too soon to see any results from force feeding. I almost want to just quit with the force feeding and let him love however long he can with his current eating habits if it means he'd be happier.

And I also have to consider the possibility that Kip won't get better, and I don't feel as sad as I think I should feel. But losing two other cats only months ago might have de-sensitized me to another possible loss.

I also asked the vet how much a small meal is for him, and she didn't really say. First she said a tablespoon of catfood/water slurry, but then said that wouldn't be enough to sustain him. She said that there really is no way I could feed him too much given that the whole reason he's got this problem is because he wouldn't eat. I tried sticking my finger in his mouth, but it just makes a bigger mess because the food falls right back out again. The syringe gets more in, but I also have to thin out the food more, meaning longer feeding times.

Also, he is not vomiting. He might toss up an occasional hairball or food he ate too fast, but it's definitely not an every day or even every week thing. Maybe 1-2 times a month? If that? RIght now he's got meat baby food, a few cans of A/D and this stuff called EnerCal. I tried putting the EnerCal on his paw and he licked it off, but not before running and hiding in the basement where I couldn't find him. Honestly, I find his behavior now more concerning and I'm convinced it's from me force-feeding. He doesn't understand why I'm doing that, just that someone he trusts is doing something he doesn't like. He still purrs, but he's no longer cuddly or perky, most likely because he's now afraid of me. But he won't eat on his own and he needs something in his belly. I don't even know if this will work. If his liver is worse, it may not even be fatty liver disease.

I feel bad that I just want to throw in the towel, but experience has shown me that I can spend thousands of dollars I don't have trying to help my cats, nothing I do helps and they just get too sick to live anyway. I don't know where to draw the line for Kip if force-feeding doesn't help; I don't want to subject him to loads of invasive tests and overnight stays if it will do nothing at all for him. Knowing my luck, Kip probably has some kind of bizarre condition that cannot be treated or he has terminal cancer. It's never just as easy as something that can be cured, sadly. I want him to live, especially if he can be helped, but another part of me wants to just not even bother with force feedings and let him eat whenever if it means he'll be happier.

 

[runekeeper]

I honestly wonder if force-feeding poor Kip is doing more harm than good. Force feeding is putting him under stress, which is what's making him so withdrawn and lethargic and wanting to hide (at least I think it is, seems like too much of a coincidence that his liver issues just happened to get worse right after I began syringe feeding). Plus I worry him being under stress is going to put him off eating even more. I think tomorrow I'm going to not force feed at all unless he absolutely refuses to eat the chicken I cooked him (which he ate more than once on his own today). I tried giving him a bit after syringe feeding him earlier and he wanted nothing to do with it. And he seems to get annoyed with me when I smear EnerCal all over him (but he does lick it off).
I know force feeding is necessary to sustain him, but isn't it a bit counterproductive when it might make him lose what little appetite he has? After just three days of force-feeding, he's eating even less on his own than he was before, and he is no longer the bright-eyed and bushy-tailed kitty he was just a few short days ago. Poor kitty shakes in my arms when I feed him, so I know he's stressed and I don't know if that mixed with his heart murmur makes him feel worse or not. I don't know if I should stop force feeding and let him just eat however much he wants (which may be nothing at all) or keep going to get some nutrition in his system and risk having him develop a food aversion and also hating me. I've heard I need to force-feed to encourage him to eat again, but it's doing precisely the opposite. At this rate, even if he gets better, he might be so scared off his food that he refuses to eat altogether and then descends back into fatty liver disease.

 

[chloespriestess]

If you think force feeding is doing more harm than good, then perhaps you should put it off for now. You know your kitty better than anyone. If he is eating chicken, that's good, but I would also feed him his regular food as well; muscle meat only diet lacks some important nutrients for cats. That he is interested in food is a good sign. You just have to make sure he is actually eating, and eating enough, though.

You can also try giving him EnerCal in a saucer, so he won't be annoyed with you. (My cat would not lick it off a saucer or herself, only from my finger. Go figure.) You can "accidental" leave a drop on a saucer and see what happens. Sometimes, they like to lick it off it if it's a very small amount.   

My vet prescribed Cyproheptadine as an appetite stimulant when my cat wasn't eating.  I don't think it worked really well, but there are other meds they use to stimulate appetite in cats: (see here)

http://www.felinecrf.org/persuading_cat_to_eat.htm

Good-Luck!

 

[runekeeper]

Unfortunately, I can't put off force feeding. I was going to today and just feed him chicken, but Kip decided today he's not going to eat anything on his own at all. He turned down chicken and milk, two things he happily consumed not even 24 hours ago. I tried and tried to get him to eat the chicken on his own, but he wanted nothing to do with it. So I had to force feed. Kip also does not like the Enercal and he actually runs from me when he sees me approaching him with the tube.
I don't understand, why after days of force feeding and most likely getting more calories into him a day than he's had in weeks is he getting WORSE? Is this supposed to happen when cats get force-fed? I really wanted to lay off the syringe feeding today, but when he's not even drinking on his own and I have to force water down his throat too, I couldn't just stop. The worst part is he doesn't look too sick; he's lethargic, but still cleans himself and uses the litter box on his own and I can get him to purr. Am I doing something wrong? I didn't expect him to just snap back to perfect health overnight, but I also didn't expect him to get worse. It doesn't make any sense.

 

[chloespriestess]

Liver disease is no picnic, so I'm sure Kip feels pretty bad. I heard fluid accumulate in the stomach and it makes them feel full in some cases. Kip must feel well enough to eat on some days, and other days, not so much. Problem is cats must eat every day.

In my cat's case, I force fed her on top of the food I left out (which she hardly touched), plus daily sub-Q fluid for a week at the vet's when she was at worst. After that, I did sub-Q at home as needed. I think I did about three times in the following month. Sub-Q was more for the constipation that caused liver disease to begin with. Like you, I also gave her water by syringe. She also received pepcid and prednisolone by injection, according to my records. If I remember, she would perk up right after the visit, but she wouldn't continue to eat. As I said, I gave up on the syringe and finger fed her instead.

Would Pepcid AC tablet help? (I still give my cat 1/4 tablet twice a day even to this day, now for her CRF.)

 

[runekeeper]

I wonder if I should get him a thyroid panel. The vet did suggest it since he has elevated liver enzymes and a heart murmur, but doesn't have the trademark huge appetite that hyper-T cats have. Unless he's an anomaly and loses his appetite instead of getting more hungry. Today was definitely not good in terms of eating; he refused all day to eat anything on his own, but not too long ago he ate a few of his Whiskas treats, and he did that nose-bobbing thing cats do when they're interested in the food before them. Granted, he only ate maybe four, but he ate something on his own. He also got syringe fed a few times and for some reason put up more of a fight during the most recent feeding. Unfortunately, I don't think the local vets administer fluids, neither overnight nor in just one sitting. This is a tiny town with small veterinary facilities, so unfortunately, fluids are not easily accessible. Too bad I didn't know how to administer them - my mum works at a hospital and I bet she could steal some fluid bags for me (she takes stuff all the time like medical tape and gauze and empty boxes/envelopes anyway).
I don't know if Pepcid would help, but I could give it a try. I've heard that sometimes a shot of steroids can get a cat's appetite going. I wonder if the vets here would have some kind of appetite stimulant. I don't know if Kip is nauseous, but he's not vomiting. He did today because the syringe plunger got stuck and I ended up accidentally squirting food down his throat (and that vomit was rank, honestly if I didn't just see it come out of his mouth, I'd have thought he had diarrhea). But if the vet here can administer fluids for a bit and not overnight, I'll do that and see if it helps.

 

[chloespriestess]

As far as I know, all vets do subqutaneous fluids. It is an easy procedure, done in less than 3 minutes. It gives minimal discomfort, almost painless, and can make your pets feel better almost immediately. 

Each case differ, so consult your vet to see if he thinks you should give him fluids. 

In my case, the vet let me buy a bag of fluid, a couple of needles and a giving set to take home. Most vets nowadays let you do this. In the U.S., (and in U.K) you can also get fluids (lactated Ringer's solution is often used) and other supplies can be ordered on Internet. It's prescription only, so your vet will have to call it in.

Here is a list of reputable companies that have affordable prices: http://www.felinecrf.org/cheap_supplies_usa.htm

If you don't foresee that you would be doing this a lot, you might just want to get one bag from the vet.

As far as actually giving him fluids yourself, you can ask vet's tech to teach you at the office. There are youtube videos too. Here is one:
Prednisolone did seem to help my cat, specially right after. She would come home from the vet and start eating. (She just couldn't keep up the appetite, so I still had to force feed her.) I don't think Cypro as an appetite stimulant worked very well for her though.

All things considered, since he is still somewhat interested in eating, why don't you try Pepcid AC first (Just make sure it's Famotidine if it's generic)?

 

[lcat4]

Along with fluids and an appetite stimulant, you might also ask about getting a B12 shot. It might perk up his energy. I'm sure you're aware that nausea does not have to go hand in hand with vomiting. When my cats go to the food or water bowl, sniff, and either stare at it or walk away, i know they're nauseous.

When my cat had his feeding tube, It took at least a week of feeding through the tube before he started being interested in feeding himself. Then he would eat a bite or two, and I'd figure how much to supplement via the tube. All the while, he was being given the appetite stimulant, an antibiotic, and anti-nausea meds. After the tube came out, he continued with an appetite stimulant and pepcid for a couple weeks. They also gave him Budesonide for awhile. I'll tell you, the feding tube saved us all. Even though I was very nervous, my cat no longer had feeding stress. After awhile, I calmed down, and we got into a regular routine.

With respect to the thyroid, one of my cats was hungry all the time. My other cat showed no symptoms at all, other than a murmur. The first had a higher thyroid number, don't know if that had something to do with his appetite. The second always ate his food though.

 

[runekeeper]

@Chloespriestess, I'll have to give the local clinics the memo! When I took Caspurr in last year and she was dehydrated, I asked if they could administer fluids. They said no because no one was there 24/7 to monitor the IV. I didn't mean constant fluids, but from what I was told, no fluids at all. Which is funny because when Rolly was there years ago for bladder stones, he was put on fluids. Also, when I tried to save my old tabby cat, he was put on fluids during an emergency visit. So either that clinic lied to me in December or they stopped giving fluids for some reason. But if this new clinic does them, I'd gladly get Kip some. He's definitely a little dry. Thankfully I got the force feeding of water figured out; using the 3 mL syringe was freaking him out because he felt the water too much, but I found a 1 mL syringe that just squirts a few drops at a time in his mouth and he can handle that. I wish he'd drink on his own so I don't have to shove extra things down his throat, but alas, he won't. Le sigh.
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@LCat4, he got the B12 shot on Saturday, but I don't think it made a difference. In fact, his energy levels have gone down since his appointment last Thursday. I intend to go to the store later and get a little carton of heavy cream to feed to him. I know dairy is not the greatest thing for cats, but Kip loves it and tolerates it quite well (as in it has never made him sick, vomit, or have diarrhea). And with all those calories in cream, I think it will work nicely in thinning out the A/D. I understand that recovery from HL is not an overnight thing, but I also didn't expect him to get worse seemingly overnight either. Though today he made me laugh. I picked him up when he was kind of half asleep and he rested his head on my shoulder. About five seconds later,he realized he was being held and started scrambling to be let go. Delayed reaction much, kitty?

 

[snorfldorf]

Hi RuneKeeper,

I'm so sorry to hear you've had so many losses recently. It must be really emotionally intense to learn to do so much care, and invest that much time on your little guys. I totally understand feeling tired at this point!

I have a couple of things to contribute. One is just anecdotal and opinion-based, and the other is entirely factual.

My sister's cat Rusty has stomatitis, which is described here. Basically it manifests as really nasty gingivitis. Has your vet considered it as the cause of Kip's progressive loss of all of his teeth and his current refusal to eat or accept anything by mouth? Rusty's breath was astoundingly, grievously bad, he drooled, and his gums were red and inflamed. Because of the extent of the inflammation and the fact that, when he was sedated for the third tooth cleaning in a year, most of his teeth were found to be dead, all of his teeth were extracted. This is an established treatment for stomatitis. He was about 7 1/2 pounds before the surgery and is now a slender 9 pounds. We didn't know how much pain Rusty was in until he recovered from his tooth extractions and began to eat like a normal cat. We thought he just wasn't interested in food!

I understand that the vet is currently focusing on treating the hepatic lipidosis, but based on how seriously the dental specialist vet (and his regular vet) took Rusty's mouth inflammation, I am very surprised that Kip's vet isn't considering the tooth pain the root of his refusal to eat and of his response to the syringe feedings. I am certain I don't have the whole picture of her perspective or Kip's condition, but the difference between the perspectives seems stark.

The factual part:

Here is a link to a well-respected site on cat nutrition, written by an experienced vet who uses feeding tubes routinely for her own cats and foster cats. I know that you had a bad experience with your Caspurr rejecting a feeding tube, which would make me quite leery of them as well. It's so hard to know what will be best for each individual cat, especially since they are such unique, independent creatures.

Thanks for reading,

Polly

 

[runekeeper]

@Polly, thanks very much for the info! Honestly, the vet has considered the possibility of dental issues (it was my initial thought too), but they want to get the liver issues under control first.
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A little update, took Kip tot he vet today for his blood work where the liver enzymes were tested and also he got tested for FIV and FeLV...which he was tested for back in 2004 when I got him at another clinic, but for some reason it wasn't in his records. But anyway, negative for feline leukemia and the liver enzymes looked a bit better, but I some other thing was worse. The message the vet left me was really static-y so I didn't catch what it was, but I'm gonna guess his white blood cell count (he had a little fever) or maybe his kidneys (since he hasn't been drinking). Despite me feeding him every single day, he somehow managed to lose more weight. I don't know how that works, but he lost six ounces in the last week. I thought he was getting heavier too. I don't know if cats can lose water weight like humans can. Maybe?

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Also, there is now no doubt in my mind that Kip's worsening condition these last few days was from force feeding. Not only did he go downhill exactly after I started syringe feeding, but yesterday I wasn't home all day and he only got one feeding and he was actually acting relatively normal. He was waiting for me at the door and meowed for food. He didn't eat much, but he did take some cooked chicken, which is great. This vet (different from the lady who saw Kippy last week) said to stop the force feedings because Kip could develop food aversion. Apparently if cats are force fed, sometimes they will get so upset that they starve themselves to death. Now that's determination. While I was told to stop the force feedings, I was not told what to do in the event Kip still refuses to eat and drink on his own. I know he's going to need a considerable amount of calories and a little chicken isn't going to help him recover, and he won't touch cat food.

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I'm to watch him for the next few days to see how he does. He received a shot of antibiotics for the fever, he got a bag of fluid (180 mL), and the vet sent me home with various kinds of canned Hill's foods (which I know he won't eat). The vet was also talking about dental work and the like, but honestly, if his teeth aren't the problem, I don't see the need to have them removed. He's always had bad teeth and they never slowed him down. Kip seems sleepy, he's been in his bed all day long, but he purrs and eats a bit. I just don't know what to do about him not drinking water, he dosn't need kidney problems on top of liver problems and he freaks out when I water him.

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I don't know why, but Kip absolutely loves my boyfriend. He was lethargic all week and he saw my boyfriend yesterday and perked right up, meowing and rubbing his head on things and wanting to be snuggled. It's the most active I've seen him since he started not feeling well. Meanwhile, BF's cat hates me. Go figure.