The vet has given up on my 16 year old cat

[kskatt]

Please go to the feline assisted feeding site and join. I don't know if I clarified but the name says it all, assisted feeding (not just tube), every kind of feeding imaginable. This is a site with very many people and has been around a long time. I truly doubt there is any kind of feeding (eating) issue and form they haven't come across. They can tell you about how to get nutrition and fluids in. Please let them help you.

 

[sadiesdad]

Thanks, I already joined up the other day, but I thought it was tube stuff mostly...so I haven't really got on there.

 

[cat nap]

How has Sadie been doing for the past couple of days?

There are some good videos on youtube about giving sub-q fluids to cats. (Don't feel too frustrated about giving the sub-q fluids. It takes some practice to get your own routine going. The first time I had to, I panicked and thought I was going too fast, so fluid went everywhere, as well.)

This video is from a vet that has some videos posted: http://www.iwillhelpyourcat.com/videos/#/give-sq-fluids-like-a-pro-and-save-your-cat/

Other sites that might be helpful:

https://pethelpful.com/cats/Giving-a-cat-subcutaneous-fluids

But I find searching the Youtube sites very helpful.

As far as food, the only other type of food besides Hills Critical Care A/D, from the vet, was Wellness Chicken or Turkey pate style foods, that could be watered down and syringe fed.

I'm not sure if any kitten type foods, would be okay to use, for extra nutrients.

Also, if Sadie does have some type of allergy to certain ingredients in the foods, then as @sidneykitty had mentioned, ...keeping a daily food diary of what she eats, how much, and if she can keep it down, might help to see what works.

I hope Sadie is doing better, and that you were able to get more info from any of those other groups, or your vet.

 

[red top rescue]

The same vet that @Catnap just mentioned above having a video about giving subQ fluids has also written an excellent piece about the use of the e-tube.  It is not uncomfortable in a cat @Geoffrey because it doesn't come out of the belly like it does in a human, it actually comes out at the back or side of their neck.  This would give her time to heal from the ulcers caused by the doxycycline if they are somewhere above where the tube would go.  Here is a great article by Dr. Kris about that.  For a cat, an e-tube is not an end of life thing but a way to give them enough nourishment so they won't go into hepatic lipidosis, which is something humans don't do.

http://www.iwillhelpyourcat.com/blog/2015/3/8/feeding-cats-that-wont-eat-at-all-pina-the-e-tube

Another concern is that if the doxycyline was discontinued too soon (it's supposed to be given a minimum of 21 days) then the mycoplasma may start to grow again and the anemia will return if this is indeed Feline Infectious Anemia a/k/a hemobartonella felis, as I suspect it is since they are calling it a blood infection -- and she had it before, and they are using doxycycline to treat it.  Obviously this cat is sensitive to the tetracyclines and should not have any more, but this organism is susceptible to a couple of the fluoroquinolones too.  Some of them can cause blindness, but there is one that does not.   I can't remember it right now but I'm sure a vet could find it.  (I've been reading a lot about this because another member has lost a cat to it and has another one being treated for it.)

 

[Geoffrey]

Originally Posted by Red Top Rescue  
 
The same vet that @Catnap just mentioned above having a video about giving subQ fluids has also written an excellent piece about the use of the e-tube.  It is not uncomfortable in a cat @Geoffrey because it doesn't come out of the belly like it does in a human, it actually comes out at the back or side of their neck. 

Many thanks for the information, I was not aware of this.

With regards to my comment about rehydration of a cat, I had completely forgotten about subcutaneous injections of saline. 

Many years ago my Siamese cat, Simon, was hit by a car and this fractured his shoulder.  This was successfully pinned but, like most Siamese, the injured Simon refused to eat or drink.  Luckily it was clement weather and I constructed a chicken wire cage for him on the Veranda where I kept him until he could drink. 

I obtained normal saline solution from my Chemist and every day for eight days I gave Simon 20 ml. of the saline subcutaneously in his flank.  This kept him alive and adequately hydrated until he began to drink for himself and I could cease the injections. 

I cannot understand how I could forget this, it must be Benign Forgetfulness of Old Age!! 

 

With best wishes,

Geoffrey

 

[jennyr]

Have you heard about Nutri-cal? It is a high calorie paste/gel that comes in a tube that you can rub on their gums and gives some nutrition when they can't eat. I think you can get it online.

 

[maggiemay]

I've been following Sadie's thread since I came across it two days ago.  I know you are doing your very best for Sadie and I'm so sorry that you all are going through this.  Illness in a beloved pet effects every person and animal in the household.  I am reasonably sure, from the sound of things, that Sadie does need Sub-Q fluids badly.  I've never gone through the same thing that you're going through with Sadie, but I have taken care of a very sick cat for several months.  I will leave advice on the vomiting, feeding tube and the anemia to those with more experience.

I can only tell you that when my cat was so ill and would not or could not eat by himself, I syringe fed him a mixture of baby food (Gerber 2nd has no onion in it) and unflavored Pedialyte (found in the babies and infants section of the grocery).  I second the idea of a high-nutrition gel which @JennyR  recommended.  I have used both NutriCal and EnerCal, with good results, just put it on their gums.  If you are unable to get to the grocery for Pedialyte, here is the recipe for making it at home.  It must be refrigerated and warmed to room temperature (NO higher and no colder) before giving it to Sadie.

I have two homemade Pedialyte recipes.

Pedialyte recipe #1:

4 cups water

1 teaspoon sugar

1 teaspoon salt

Depending on weight of cat, give 2-3 tablespoons of solution with eyedropper slowly (a few drops every 10 minutes - do not shoot this down her throat) per hour at room temperature.

Refrigerate up to 3 days OR store unused solution in ice trays in freezer.

Pedialyte recipe #2 from World Health Organization:

One cup water

2 teaspoons sugar

1/8 teaspoon salt

1/8 teaspoon baking soda

This recipe is the one I use for extremely ill cats, as the sugar content is somewhat higher and gives energy, and it contains baking soda to make the system less acidic.  Make new after 24 hours.

Pedialyte feeding instructions:

Give 2 tablespoons per hour, slowly with an eyedropper (I give a few drops at the front of the mouth every 10 minutes) at room temperature. If you cannot get the entire 2 Tbs. into her in the hour, don't beat yourself up, just try to get some of this into her every 10 minutes for an hour.

Next hour, dilute some canned food or baby food with enough water to make a slurry and dropper feed slowly.

Repeat the Pedialyte hour and the baby food/slurry feeding throughout the day, stopping occasionally to see if she will eat or drink on her own.  If she will drink water, add some Pedialyte to her water (half and half).  I would repeat this for no more than 6-8 hours (3-4 hours of Pedialyte).  There is such a thing as giving too much, but I have given you a low to moderate dosing schedule for Sadie.

This should get you through the day and hopefully, you can take Sadie back to the vet or get your vet's input tomorrow.  If Sadie throws this up as well, my only other suggestion is to offer her ice chips to lick on.  You two and Sadie will be in my prayers.

 

[sidneykitty]

You're getting some great advice from others here, so I've stepped back but still thinking of you and Sadie. Trying the Hill's A/D watered down and syringe-fed might help, though I am not sure given the sores on her esophagus. Kitten food is a good alternative as its high calorie, too. Otherwise, the pedialyte and Nutri-cal are both excellent suggestions.

I am sorry you and Sadie and your wife are having to go through this and I hope her condition improves soon.

 

[red top rescue]

 
The same vet that @Catnap just mentioned above having a video about giving subQ fluids has also written an excellent piece about the use of the e-tube.  It is not uncomfortable in a cat @Geoffrey because it doesn't come out of the belly like it does in a human, it actually comes out at the back or side of their neck.  This would give her time to heal from the ulcers caused by the doxycycline if they are somewhere above where the tube would go.  Here is a great article by Dr. Kris about that.  For a cat, an e-tube is not an end of life thing but a way to give them enough nourishment so they won't go into hepatic lipidosis, which is something humans don't do.

http://www.iwillhelpyourcat.com/blog/2015/3/8/feeding-cats-that-wont-eat-at-all-pina-the-e-tube

Another concern is that if the doxycyline was discontinued too soon (it's supposed to be given a minimum of 21 days) then the mycoplasma may start to grow again and the anemia will return if this is indeed Feline Infectious Anemia a/k/a hemobartonella felis, as I suspect it is since they are calling it a blood infection -- and she had it before, and they are using doxycycline to treat it.  Obviously this cat is sensitive to the tetracyclines and should not have any more, but this organism is susceptible to a couple of the fluoroquinolones too.  Some of them can cause blindness, but there is one that does not.   I can't remember it right now but I'm sure a vet could find it.  (I've been reading a lot about this because another member has lost a cat to it and has another one being treated for it.)

Regarding the fluoroquinolone that can be used against the organism that causes Feline Infectious Anemia (Mycoplasma haemofelis, formerly named Haemobartonella felis), one of these drugs (enrofloxacin) has been known to cause blindness, but two others, marbofloxacin (2.75 mg/kg daily) and pradofloxacin (5 mg/kg orally once daily) have not.   Since this cat cannot tolerate the doxycycline, possibly one of these drugs might be used to wipe out the infection.

Quite simply, how this parasite works is by sticking to the red blood cells, and that causes them to change shape, and then the spleen eliminates them, so basically the cat's own body causes the anemia by destroying the red blood cells that have the parasite stuck to them.  Often cats are given steroids to slow down their elimination reaction and blood transfusions to replace the cells that are being destroyed faster than the body can replace them.  As the parasite is eliminated by the antibiotic, less red cells are destroyed and eventually the cat can produce enough cells on its own to bring the hematocrit up to normal in about a month. Most cats that recover become carriers of the mycoplasma but their immune system keeps it in check and they don't generally relapse.  Since this organism is transsmitted through ticks and fleas and sometimes mosquitoes, they can still pass it to others if they are outside cats.

 

[sadiesdad]

 I was getting worried by Tues, Sadie wasn't eating or drinking much at all... I went to the vet with her to get her fluids, and told them how she was.. they said give the drugs more time, so I have just been bringing her every day to get her fluids. I almost think she might enjoy, or at least don't mind the trips. It's 40 minute drive to the vet, I put Sadie in the floor passenger side and she lays over there. Though the last 2 days she has wanted to get in my lap, and she will just look out the window at everything going by so fast, especially the oncoming cars.

 Yesterday she ate a little after we got back and kept it down. This morning, it's almost like someone that their fever has broken, she is eating and drinking like a hog, which isn't great either, because eating or drinking so fast and much, she throws up. She has eaten 4 times this morning, small amounts, from 4am to 7:30 and only got sick from the food once. She has drank water several times and threw up twice from that.... poor girl is as skinny as a rail. But she was very active and loving us yesterday evening, and this morning. She come in our room where our computers are because me and my wife were both in there discussing some things, then she went outside with us... later she kept wanting to get in my wife's lap, then in mine, back and forth. But she was doing some weird sounding vocalizing, going into the dark bathroom by herself and making these weird meowing sounds, almost like she does when she realizes she is alone sometimes... almost like she is hollering, "Where is everyone? Why am I by myself?"

 I just went out on the enclosed porch and she followed, then I heard her hollering, I waited a few minutes and went to check on her, she was in the wash room laying on the rug, but wanted to rub her face on my hands, then got up and came in and ate some more.... I was wondering how long it was going to take for the meds to stimulate her appetite to work, she only has one more pill for tomorrow.

 I just haven't posted lately as I feel exhausted... I get up at 5, get Sadie's meds at 6am, 7am and 7:30, water the veggie garden, eat breakfast, get my shower and head to the vet, it's usually about 2 hours later by the time I am back home. Plus me and my wife are trying to get some income to carry us through to Dec. 28th, that's when my disability kicks in... things were getting too tight, but I think we may have gotten approved for a loan.

 I had about given up Tues., I told the vet, I guess we need to see about putting that tube in her nose, but I do not like that idea at all. But she seemed to be just withering away, that's when they said let the meds have time to work a little more. Then yesterday and today (so far) she seems better. I just hope she can keep that food down long enough to gain some of her weight back. I have been prying so hard every day, I know the Lord is about ready to put on some ear muffs because he's so tired of hearing me. I feel better about her from yesterday and today, I hope I'm not wrong.....

 Well, I wrote the above this morning before I went to the vet, now things are not so good.... Sadie is almost back to not being able to keep anything down again, except water. After we got back from the vet, about 12:30, she threw up again, and it had a little food in it, but she hadn't eaten since about 9am.She is looking and acting weak... She was meowing at me a lot today and especially at the vet, but her voice wasn't croaky or squeaky like she has been.

 The vet didn't like that she is still throwing up, so she asked to do another test at $200... She said this test will determine if Sadie has irritable bowel syndrome or intestinal lymphoma. We should know something in 3-5 days, and she told me to just keep taking care of her like I have been doing. She came in the kitchen hungry about 3:30 and I made a little turkey porridge for her. I only gave her about 3 tablespoons on a plate, she seemed to like it pretty well... but by the time she walked around the corner it came back up.

 

[ginny]

 Poor kitty!  

 

[kskatt]

Okay. Have you discussed the tube with the vet? About the throwing up? How about the folks at FaF?
I know nothing about the nasal tube, got some some questions about safety if she does throw up with the tube in. I could be way off, but the only thing I can envision; the tube goes in the nostril, which is a breathing port, maneuvers into the passage to the stomach.  There is a flap, or something that closes depending on if we are breathing or eating, keep food and water out of the lungs. If there is a tube, doesn't that keep the flap from closing? 

If all food and water goes through the tube, no problem. But, wouldn't that mean she can't eat or drink on her own? God forbid throw up!

Can somebody help me with that? I was very happy with Sky's E-tube, it didn't interfere with anything.

 

[cat nap]

 
 I was getting worried by Tues, Sadie wasn't eating or drinking much at all... I went to the vet with her to get her fluids, and told them how she was.. they said give the drugs more time, so I have just been bringing her every day to get her fluids. I almost think she might enjoy, or at least don't mind the trips. It's 40 minute drive to the vet, I put Sadie in the floor passenger side and she lays over there. Though the last 2 days she has wanted to get in my lap, and she will just look out the window at everything going by so fast, especially the oncoming cars.

 Yesterday she ate a little after we got back and kept it down. This morning, it's almost like someone that their fever has broken, she is eating and drinking like a hog, which isn't great either, because eating or drinking so fast and much, she throws up. She has eaten 4 times this morning, small amounts, from 4am to 7:30 and only got sick from the food once. She has drank water several times and threw up twice from that.... poor girl is as skinny as a rail. But she was very active and loving us yesterday evening, and this morning. She come in our room where our computers are because me and my wife were both in there discussing some things, then she went outside with us... later she kept wanting to get in my wife's lap, then in mine, back and forth. But she was doing some weird sounding vocalizing, going into the dark bathroom by herself and making these weird meowing sounds, almost like she does when she realizes she is alone sometimes... almost like she is hollering, "Where is everyone? Why am I by myself?"

 I just went out on the enclosed porch and she followed, then I heard her hollering, I waited a few minutes and went to check on her, she was in the wash room laying on the rug, but wanted to rub her face on my hands, then got up and came in and ate some more.... I was wondering how long it was going to take for the meds to stimulate her appetite to work, she only has one more pill for tomorrow.

 I just haven't posted lately as I feel exhausted... I get up at 5, get Sadie's meds at 6am, 7am and 7:30, water the veggie garden, eat breakfast, get my shower and head to the vet, it's usually about 2 hours later by the time I am back home. Plus me and my wife are trying to get some income to carry us through to Dec. 28th, that's when my disability kicks in... things were getting too tight, but I think we may have gotten approved for a loan.

 I had about given up Tues., I told the vet, I guess we need to see about putting that tube in her nose, but I do not like that idea at all. But she seemed to be just withering away, that's when they said let the meds have time to work a little more. Then yesterday and today (so far) she seems better. I just hope she can keep that food down long enough to gain some of her weight back. I have been prying so hard every day, I know the Lord is about ready to put on some ear muffs because he's so tired of hearing me. I feel better about her from yesterday and today, I hope I'm not wrong.....

 Well, I wrote the above this morning before I went to the vet, now things are not so good.... Sadie is almost back to not being able to keep anything down again, except water. After we got back from the vet, about 12:30, she threw up again, and it had a little food in it, but she hadn't eaten since about 9am.She is looking and acting weak... She was meowing at me a lot today and especially at the vet, but her voice wasn't croaky or squeaky like she has been.

 The vet didn't like that she is still throwing up, so she asked to do another test at $200... She said this test will determine if Sadie has irritable bowel syndrome or intestinal lymphoma. We should know something in 3-5 days, and she told me to just keep taking care of her like I have been doing. She came in the kitchen hungry about 3:30 and I made a little turkey porridge for her. I only gave her about 3 tablespoons on a plate, she seemed to like it pretty well... but by the time she walked around the corner it came back up.

@SadiesDad   Thank you for the update on your Sadie. I did read on these boards, that a certain appetite stimulant, mirtazapine, might cause increased vocalization in cats, and restlessness, but I'm not sure if that is what Sadie is on, or causing her to meow loudly. Older cats can lose their hearing, too, so she might just be loudly meowing, indeed wondering where everyone is.

I do hope you get some answers in 3-5 days, regarding if Sadie has Irritable Bowel Disease (IBD) or lymphoma. At least that way, you'd know what you are dealing with.

You are taking such excellent care of your Sadie. Sadie knows that.

Also please take good care of yourself and your wife, because we do all know how exhausting taking care of our sick cats can be.

Will be sending some more prayers, healthy thoughts and vibes for Sadie, your wife and you.

 

[plan]

You and Sadie are in my thoughts. I'm inspired by how much you've done for her and the lengths you're going to in order to save her. You're a devoted dad and she's lucky to have you! I hope she starts feeling better soon.

 

[rubysmama]

I'm also thinking of you and Sadie and hoping she starts to feel better soon. 

 

[maggiemay]

Thinking of you, your wife and little Sadie.  You are such a wonderful parent to her.  All of you are in my prayers, every day.

 

[kskatt]

Your little family of three are in my thoughts and prayers.

 

[sidneykitty]

I keep thinking of you and Sadie. I hope you get some more information from the vet after the tests to help get her better. You are amazing for what you are doing for her. I know how hard it is to take care of a sick kitty, how draining and exhausting emotionally and otherwise. Hang in there and remember to look after yourself, too.

 

[foxxycat]

Sending positive thoughts and hope you find some answers for Poor Sadie. Make sure to take care of yourself too.

 

[sadiesdad]

Thank you all for the prayers well wishes and love.... Well when we went to the vet for fluids yesterday, and I told them how Sadie was throwing up everything again, they said they wanted to give her a shot and some different meds to take home. So they gave her a shot of Ondansetron, and pills of the same, for every 12 hours. She tickled me "trying out" her new privileges...like when my wife let her sit in the recliner on a towel, and she would get in the recliner and then step over onto the arm of the couch by me, then go back to the chair for a few minutes, then come back to the couch... But this time, she likes getting in my lap and looking out the window as we are going to and from the vet.   She did it about 3 times, come get in my lap, looking out the window a few minutes, go back and lay in the floor on her towel on the passenger side, then come get in my lap a few minutes, then go back to the towel..  lol!

 As soon as we got home she was starving, as always now... I gave her a little food and she ate it, a little later and she ate again... she came and ate 4 or 5 times from about 12:30 to 4pm, no vomiting. Then at 4, I was going to sit on the front porch and asked her if she wanted to go with me, when she went to stand up, all that she had eaten came up, I felt my hope just wither away... but she still wanted to eat and drink, but after that, almost every time it would come back up shortly. We had gotten some Hill's gastrointestinal type food, it was soft kibels in gravy, I gave her just a tiny bit, maybe 5 pieces with the gravy, as she walked away it came up immediately...  I have noticed some type of food does her like this, while is seems the Hill's prescription stuff I got from the vet, a/d and another was Royal Canin urgent care or something, seem to stay down a lot longer. I took the kibels and gravy and put them in the food processor and made mush out of it, put a dab on the plate, she wolfed it down, two minutes later it came back up... then she tried drinking a bunch of water right before we went to bed and that came up also.

 This morning, she drank a good bit of water and it didn't come up, but she wasn't hungry. Later, miss sneak, disappeared. She had been on the patio, then I couldn't find her, I looked all in the house and around her normal places outside... finally an hour and a half later, she is up in the window. I don't know what she was doing, I got a feeling where she was, but she was filthy. We had a little rain this morning and she got in some dirt and then it got wet... her feet are filthy, her chest, she is gray instead of white. I took a plate and put a little food on it and she ate it... I waited 30 minutes and put another little bit of another kind on the plate, she ate a little bit of that, but not all.

 The vet called this morning and asked how she was, so I told them, and they/we are hoping once she gets these meds in her system, it will stop the vomiting..... They said we should hear back about the test by Monday.