I posted here back in April about my now 3 year old Bengal who had lost interest in food - you can view the thread here. I wanted to write an update to help others in the same boat as me.
Mika's regular vet put her on the oral form of mirtazapine, ondansetron for nausea, and prilosec for acid reflux. She also referred me to an internal medicine specialist. The mirtazapine slowly lost effect on her appetite, and I did my best to get her to eat during this time. At the vet's recommendation, I tried a variety of rx and non-rx limited ingredient diet (LID) foods.
I took her in to the specialist in June, and had an ultrasound, more bloodwork including a GI panel, another urinalysis, and toxo test done. The toxo test came back negative, and the other tests indicated chronic enteropathy, as well as possible early stage kidney disease. The specialist said that enteropathy in young cats is most commonly caused by a food allergy or intolerance. As for her kidneys, at that stage, he recommended continued monitoring with UA and bloodwork done every 4-6 months. The plan moving forward was to transition her over to a strict diet of a single novel protein. Well, nevermind that I'd probably already tried every commercially available protein, but I'll do my best! He gave me Nutramax Proviable probiotics to give her. And we planned to take her off her meds once she settled into a new diet.
The following ~5-6 months have been a saga in going to all the different pet stores in the area every week or so to see what else I could find to offer her. There was one food that she ate for about a month before completely losing interest in it. But most of the time, she rarely ate any given food for more than a week. Due to her possible kidney disease, I wanted to focus on wet foods, so I was even more limited in my search. The vet suggested letting her starve a little bit - that did not work, she'd rather starve than eat something she doesn't like. He suggested mixing in the goal food with her previous food - that did not work, and she stopped eating her previous food entirely. There was definitely a behavioral component, since she was often clearly hungry when refusing a food. It was impossible to tell whether it was due to associating some foods with feeling ill, anxiety as a result of all the fuss, or some combination of both. But sometimes, she seemed to truly lose appetite.
At times, I had to give her calorie supplements. For a while, I used Nutrical, but it quickly became a massive inconvenience - not cost effective, super messy, and difficult to monitor the exact quantity given (consumed). I switched to a combination of Miracle Vet weight gainier, Lexelium weight gainer, Oxbow carnivore critical care, and Fortiflora. (I can give more details on those if anyone's interested).
By the time fall rolled around, I'd tried almost everything available to me except for some brands I knew she disliked (for example Tiki cat) and stuff that was ridiculously expensive (for example Ziwi peak). She was anxious, and both of us needed a break. So I expanded my search to just finding any reasonable food that she would eat consistently. Thank the cat gods she was still kind of eating her original kibble through all this, so I knew she was getting some calories and nutrients.
The vet suggested I bring her back in since nothing I'd tried had worked. He suggested starting around with another round of ultrasound, bloodwork, and UA, to see how things had changed since June, then going from there. I agreed, and brought her back for those in mid November.
Around that time, she stopped eating almost entirely. She was eating maybe 50 cal a day on a good day. I was syringe feeding her most of her calories, which of course wasn't helping anything.
The results of the tests showed that her enteropathy had slightly improved, but her kidneys had gotten worse. The vet also asked to do a UTI test just to be sure, and that came back negative. Based on the results, IBD, food allergy/intolerance, and uremic gastritis were on the table. We could either scope her to take biopsies for a definitive diagnosis, or proceed with a treatment plan based on our best guess. I was tired of trial and error, and went with the endoscopic procedure.
I got the results back just before Christmas. She has IBD, a possible food allergy, and secondary dysbiosis. We've started her on prednisolone, will be starting her on a new probiotic called visbiome as soon as it arrives in the mail, and are keeping her on her other meds for now. Once her appetite stabilizes, we will take her off the mirtazapine, ondansetron, and prilosec, and put her on a strict diet.
So far, I haven't seen a change in her appetite. But maybe, just maybe, it increased a little bit. Tonight, for the first time in a long time, she finished her wet food (~60 cal) in ~2 hours. Interestingly, it's day 2 of this particular food, and she was more interested in it tonight than she was last night. That basically never happens. Fingers crossed!
I am happy to answer any questions anyone has. This has been a really rough road for me and Mika. If I can make the journey a little easier for even just one person/cat, I will be satisfied.
Mika's regular vet put her on the oral form of mirtazapine, ondansetron for nausea, and prilosec for acid reflux. She also referred me to an internal medicine specialist. The mirtazapine slowly lost effect on her appetite, and I did my best to get her to eat during this time. At the vet's recommendation, I tried a variety of rx and non-rx limited ingredient diet (LID) foods.
I took her in to the specialist in June, and had an ultrasound, more bloodwork including a GI panel, another urinalysis, and toxo test done. The toxo test came back negative, and the other tests indicated chronic enteropathy, as well as possible early stage kidney disease. The specialist said that enteropathy in young cats is most commonly caused by a food allergy or intolerance. As for her kidneys, at that stage, he recommended continued monitoring with UA and bloodwork done every 4-6 months. The plan moving forward was to transition her over to a strict diet of a single novel protein. Well, nevermind that I'd probably already tried every commercially available protein, but I'll do my best! He gave me Nutramax Proviable probiotics to give her. And we planned to take her off her meds once she settled into a new diet.
The following ~5-6 months have been a saga in going to all the different pet stores in the area every week or so to see what else I could find to offer her. There was one food that she ate for about a month before completely losing interest in it. But most of the time, she rarely ate any given food for more than a week. Due to her possible kidney disease, I wanted to focus on wet foods, so I was even more limited in my search. The vet suggested letting her starve a little bit - that did not work, she'd rather starve than eat something she doesn't like. He suggested mixing in the goal food with her previous food - that did not work, and she stopped eating her previous food entirely. There was definitely a behavioral component, since she was often clearly hungry when refusing a food. It was impossible to tell whether it was due to associating some foods with feeling ill, anxiety as a result of all the fuss, or some combination of both. But sometimes, she seemed to truly lose appetite.
At times, I had to give her calorie supplements. For a while, I used Nutrical, but it quickly became a massive inconvenience - not cost effective, super messy, and difficult to monitor the exact quantity given (consumed). I switched to a combination of Miracle Vet weight gainier, Lexelium weight gainer, Oxbow carnivore critical care, and Fortiflora. (I can give more details on those if anyone's interested).
By the time fall rolled around, I'd tried almost everything available to me except for some brands I knew she disliked (for example Tiki cat) and stuff that was ridiculously expensive (for example Ziwi peak). She was anxious, and both of us needed a break. So I expanded my search to just finding any reasonable food that she would eat consistently. Thank the cat gods she was still kind of eating her original kibble through all this, so I knew she was getting some calories and nutrients.
The vet suggested I bring her back in since nothing I'd tried had worked. He suggested starting around with another round of ultrasound, bloodwork, and UA, to see how things had changed since June, then going from there. I agreed, and brought her back for those in mid November.
Around that time, she stopped eating almost entirely. She was eating maybe 50 cal a day on a good day. I was syringe feeding her most of her calories, which of course wasn't helping anything.
The results of the tests showed that her enteropathy had slightly improved, but her kidneys had gotten worse. The vet also asked to do a UTI test just to be sure, and that came back negative. Based on the results, IBD, food allergy/intolerance, and uremic gastritis were on the table. We could either scope her to take biopsies for a definitive diagnosis, or proceed with a treatment plan based on our best guess. I was tired of trial and error, and went with the endoscopic procedure.
I got the results back just before Christmas. She has IBD, a possible food allergy, and secondary dysbiosis. We've started her on prednisolone, will be starting her on a new probiotic called visbiome as soon as it arrives in the mail, and are keeping her on her other meds for now. Once her appetite stabilizes, we will take her off the mirtazapine, ondansetron, and prilosec, and put her on a strict diet.
So far, I haven't seen a change in her appetite. But maybe, just maybe, it increased a little bit. Tonight, for the first time in a long time, she finished her wet food (~60 cal) in ~2 hours. Interestingly, it's day 2 of this particular food, and she was more interested in it tonight than she was last night. That basically never happens. Fingers crossed!
I am happy to answer any questions anyone has. This has been a really rough road for me and Mika. If I can make the journey a little easier for even just one person/cat, I will be satisfied.
