Sick older cat (diagnosed with hemobartonella)

[costello]

I gave Dexter a tiny bite of food and a sip of water at 8 am this morning, then another at 8:30. Shortly after the second 'feeding,' he started retching. He finally brought the food back up at about 9:30. I called the vet who told me to stop the doxy to see if that was upsetting his stomach.

At this point I'm less worried about tempting his palate than getting him to hold anything down at all. It seems the only thing he hasn't vomited back up recently is the medicine.

 

[ldg]

Hun, the vet is in a position to know whether or not his anemia was so bad that he can stand to forego the antibiotic for a while here. Perhaps a couple of days off the antibiotic isn't a bad idea, because clearly we haven't conveyed how important it is to get food into him. Cats livers are not designed to manage for any length of time if a cat is not eating. When the vet told you he was "anorexic," apparently they did not convey how important keeping food moving through a cat's system is.

So from what I can tell, he's eaten no significant amount of food for at least a week - and perhaps longer. For a few days now, he's not been able to keep anything down. His liver is very stressed at this point. This can be life-threatening in and of itself.

If he cannot keep food down after one day off the antibiotic, DO NOT WAIT UNTIL MONDAY OR TUESDAY TO GET AN ANTI-EMETIC (a medicine that makes him not throw up). You are approaching what I would consider to be an emergency situation.

Having him off the antibiotics for a few days may be a good idea, given they only stress his liver further, and at this point, without food, his liver may fail.

I am not trying to scare you, but I am trying to convey just how important it is that food get into him and stay down. Whether you have to figure out a way to wrap him up so you can syringe feed him, or whether he needs to go to your vet - or an emergency vet - to get a shot of an antiemetic so he can keep food down and you offer him a bite of food every 10 minutes for the next few days..... something has to change here.

The liver can heal and repair any damage that has been done by this extended period of no food being processed. But to do this, he needs food.

He started with two conditions: anorexia and anemia. The anemia is caused by a very treatable situation - a parasite. The anorexia is something over which YOU have control. He doesn't want to eat? You assist feed him. These are both very treatable and survivable, but both take management.

And if he does not eat on his own, but is able to keep food down without the antibiotic - or he is able to keep food down with an anti-emetic, and you cannot assist feed him, there is an option. It is called a feeding tube. There are several types. The easiest is a port installed in his neck. It is a very quick (10 minute) procedure. This enables you to use a syringe to feed him via a tube that bypasses his mouth, and typically is much easier to manage with a cat that fights assist-feeding. But right now, food is his medicine.

But not eating becomes a cycle the cat will not or may not break. As you say, you may be to the point where it is not about tempting him with food he'll eat. They become completely unmotivated to eat. Their bodies start to literally eat themselves, and their mind doesn't signal their mouths to want anything, no matter how good it normally smells to them. This is only complicated by the anemia. !!!! The only way to break that cycle is by you figuring out a way to get food into him, whether it is with your finger, swiping food into his mouth that he swallows (and it is VERY difficult to get ENOUGH food in him this way to make the difference that needs to be made), or via syringe, or via a feeding tube.

And, ultimately, he needs the antibiotic to kill the parasite that is destroying his red blood cells. It may be that this extended period of not eating has made his stomach reject food, and being off the antibiotic for a few days will help.

But one way or another, whether it's stopping the antibiotic temporarily, or using an anti-emetic, he needs food to stay down now. Not Monday or Tuesday.

And if the antibiotic makes him throw up again when you start giving it to him, you can chat with the vet about an alternate antibiotic. The only one I know that my work for hemobart is Baytril. But using an anti-emetic along with the antibiotic may be necessary.

 

[feralvr]

He does need that antibiotic BUT IF he is not eating in this many days, he must eat or no amount of medicine will help. I believe that right now his eating is the best medicine at least for a couple of days and then restart the antibiotic that he needs to kill the blood parasites. Baytril may be the drug of choice over the Doxy. :dk: He may even be at the point of needing hospitalization (fluids) and the medicine can be given IV too. I am very worried about your Dexter so I can only imagine what you are going through. All my best for Dexter and sending prayers/vibes.