In late December/early January, we decided to switch Missy (indoor, age 6, spayed) to wet cat food for her health after years of dry. We did not have any issues switching her to wet over a period of a week or so. We had always free-fed dry, so I didn’t really know how much Missy was eating. When her bowl got low, someone would give her more. A bag of food lasted a long time, but she’s only one cat eating it. As we switched to wet, I realized she ate less than I expected. She isn’t overweight, but she isn’t a small cat (she usually weighs around 9.5 lbs). I was feeding her three times a day. She was always excited to eat but never ate all her food. She was eating about 2 3 oz cans of cat food per day spread over several meals.
I checked in with MedVet several times throughout the week. We were not able to talk to the vet unless we paid for a telehealth appointment, which I guess I understand- they’re busy, but it was frustrating considering her appointment was almost $2000 for her ultrasound and appointment. It has been very rough giving her medication twice a day. She has become more reclusive. Since she spends so little time in the rest of the house, it seems like every time she is out, we have to give her medicine. She frequently hides when we come toward her. We have tried to make it as non-traumatizing as possible, but it hasn’t been very good for our relationship. She foams at the mouth whenever we give her medication, which makes me wonder how much of the dose she is actually getting. It gets everywhere.
We used all the capromorelin they prescribed, and she still ate very little. MedVet called in miritaz pills, which we started on Thursday. MedVet called earlier this week to schedule a follow-up appointment and another ultrasound for $1000 and to talk about doing a feeding tube ($1200-$1500) and a scope/biopsy ($3000-$4000). I feel like the tech has been kind of pushy about it. I want Missy to get better, and I don’t even understand what is wrong with her. But at this point, we are at like $3500 in vet costs and still don’t know what’s wrong. I am fine with spending money at the vet as we try to treat her, but we don’t have unlimited funds. We can’t spend another $6500 at MedVet… and that’s not even including any treatment. We finished tapering off the steroid on February 8th, but Missy’s weight has not decreased. This is confusing to me- she is not eating as much as she should be, and certainly not too much. I don’t understand. Would she feel better if she were eating more?
This brings us to now. I had an appointment with my regular vet on Thursday. We discussed her doing a surgical biopsy and feeding tube but haven’t decided anything for sure. I tried to see if MedVet would do an outpatient ultrasound (since their machines would be much more advanced and the radiologist would be much more experienced than a regular vet), but they wouldn’t. Since MedVet will not do outpatient ultrasounds, my vet had another vet in the same practice do one yesterday since he has the most experience. He said there was a lot of white on the images, but couldn’t say what it was, just that it was more dense than her organ tissue. He advised against the feeding tube since she isn’t losing weight but said he would do the biopsy if it were his cat. He advised trying anxiety medication for her, which my regular vet agreed would be worth a try.
The internal medicine vet has talked to my regular vet on the phone about Missy and what to do. A biopsy could give us some answers so we know how to treat her. My regular vet and the internal specialist both agree that even if we are going to do a biopsy, we should still start prednisolone again for a longer duration with a slower taper and feel if it is lymphoma, it will still show up with tissue samples. One of the positives of the tube would be medicine administration since we are having such a hard time giving it to her, and it’s been so stressful. If she were getting full doses at the times she was supposed to, it would be easier to see if it was working.
At this point, I don’t know what to do. Missy is only six, and I thought we would have many more years with her. I wonder about starting an IBD diet, but she is so finicky with food. I have been feeding her whatever she will eat. I try to feed her often and try multiple things. Please believe me that we have tried everything with food. So many brands, varieties, flavors, extras (churus, little soups, weruva mousse, broths, etc), baby food, chicken, scrambled eggs… and so on. Today, she has eaten more than she has in days (more than a whole can of 3 oz food, and it’s only 2 pm), but she hasn’t left her bed a single time. I have been bringing it to her.
I'm sorry, I know this is long. Too long. But I was hoping maybe someone would have an idea or suggestions I hadn’t thought of. All three vets say she looks healthy when examining her, and her bloodwork is pretty good overall. There isn’t really anything obvious that they can say is causing her not to eat or hurt. I don’t want to put her through anything she doesn’t need. But I don’t know how to help her. It seems like a biopsy is the next step here, but I worry about recovery if she already won’t eat and has no energy.
- 01/10/24: I took her to the vet to make sure she was okay and to discuss her eating. The vet said she looked great. Her teeth weren’t bad, but it was suggested we schedule a tooth cleaning soon. I was a little reassured but still a little concerned. I increased her feedings, but she started eating even less over the next few weeks. She wasn’t acting quite like herself. She is usually very close to wherever everyone is, particularly in the evening, but she was spending more time sleeping in another room. I was getting more worried, so when the office opened on the 22nd, I made an appointment to have her seen again, but I couldn’t get in until the 24th.
- 01/22/24: Missy was very lethargic all day. She would not eat any of her food but would eat a treat. As the day went on she became more and more listless. When she looked at us, it was like she wasn’t even there. That evening, she would not get up and wouldn’t even eat treats. Her meow was quiet and weak. I was scared she was dying, so I took her in for an emergency appointment.
- 01/24/24: Went to the vet for an exam and blood work. Her GLOB (5.3 g/dL, normal 2.8-5.1) and ALT (138 U/L, normal 12-130) were high. GGT was at the upper end of normal (4 U/L, normal 0-4), and so was her TP (8.7 g/dL, normal 5.7-8.9). The vet did an abdominal ultrasound and said that there was thickening in her stomach wall. We talked about the option to do a biopsy, but the only option at their office was surgical, which is very invasive. She said there were endoscopic scope/biopsy options at MedVet, but she said that they were very cost-prohibitive. She had only had a few clients get them done, and it had been several years ago, but they were around $2000 then. We decided to try medication and scheduled a recheck on 01/30/24 for a follow-up ultrasound. She gave a cerenia injection and prescribed topical miritaz for her appetite, cerenia tablets, and prednisolone.
- 01/27/24: Missy continued to eat very little, roughly a 3 oz can total per day, despite the appetite stimulant. She had stopped drinking any water and was just getting the liquid from her wet food. I was very concerned that she was getting dehydrated. Her gums looked pale and sort of sticky. I was concerned that waiting over the weekend was a bad idea. The vet said she wasn’t dehydrated but understood my concerns. We had been having a very difficult time administering the cerenia tablets because they made Missy foam at the mouth, so she prescribed Zofran. Missy gained over half a pound from her visit a few days ago, but I was told this was likely a side effect of the steroid.
- 01/27/24: (After-hours visit) Throughout the rest of the day, Missy’s stomach became visibly bloated very quickly, and we were extremely concerned. She acted like she was in pain. Her meow sounded different than it usually does. She had x-rays that showed a lot of gas in her stomach and CBC. All her values were in the normal range except MCHC was high (36.8 g/dL, normal range 28.1-35.8). The vet prescribed gabapentin and told me to start mylicon. She seemed woozy/unstable after her first dose of gabapentin, so we reduced the amount to X. Missy improved a little over the next several days, though her appetite was still very low, and so were her energy levels. We started to see more of her personality again.
- 01/30/24: Check in with the vet. Had a follow-up ultrasound after about a week on prednisolone. The vet said she could see improvement, and there wasn’t the inflammation there had been previously, and that if she hadn’t seen the first one, she wouldn’t know that Missy had been inflamed. However, Missy was still not eating very much, maybe 1 ¼- 1 ½ cans of 3 oz cat food a day. I started intentionally choosing cat foods with the highest calories I could find. She always had access to her dry food but wouldn’t eat it. She would still eat treats, though. She continued to drink no water, only the liquid from wet cat food, even though she has a fountain and clean water all over the house. Missy’s weight was up more. She weighed about 1 lb more than her normal weight (10.5 lbs vs 9.5 lbs). Later that day, Missy started having lots of watery diarrhea. I took a sample to the vet for testing, but it came back negative for everything, including giardia. I started her on probiotics with S. Boulardii (Bark & Whiskers), which helped, and I made an appointment at MedVet with an internal medicine specialist. She has not had any more diarrhea since 02/02/24.
- 02/05/24: I took Missy to MedVet Animal Hospital to see an internal medicine doctor for an ultrasound, exam, and bloodwork. Bloodwork showed Globulin was raised (5.2 g/dL normal 2.8-5.1) and ALP was low (13 U/L normal 14-111). Ultrasound showed no thickening of the stomach wall, stage 1 kidney disease, and abdominal steatitis surrounding the stomach and right pancreas. The conclusion was that Missy had had pancreatitis, but it was resolving. The IM vet noted a fluidy sound in her neck when palpated. She speculated that it could be reflux related to her other current issues. She ordered additional testing to check her pancreas, kidney function, and how well her intestines absorb nutrients. We discussed the possibility of a feeding tube if she continued not eating well. She had us stop the Miritaz (it had started to irritate her ears), Zofran, Gabapentin, and Bark & Whisker probiotics. I had been using a bit of FortiFlora on Missy’s food to get her to eat, which she said we could continue but stop the other. She started Missy on metronidazole twice a day, metoclopramide twice daily, and capromorelin once daily.
- 02/06/24-02/12/24 After her visit, her mood did improve for a few days. She was still very tired, but she was spending more time out with the family, even if she was sleeping. Her eating did not improve, though. She started eating less and less and was not drinking any water. We got the results from the B12/Folate, urinalysis, and pancreas tests. Her pancreas test showed no inflammation. Her B12 was good (633, should be >400). Her urinalysis showed a low concentration (1.025, should be >1.04) despite Missy drinking very little. Other elevated values were Urine Protein (1+), Blood/Hemoglobin (2+), and Red Blood Cells (>100). I was told that because of the cystocentesis, these numbers weren’t alarming.
I checked in with MedVet several times throughout the week. We were not able to talk to the vet unless we paid for a telehealth appointment, which I guess I understand- they’re busy, but it was frustrating considering her appointment was almost $2000 for her ultrasound and appointment. It has been very rough giving her medication twice a day. She has become more reclusive. Since she spends so little time in the rest of the house, it seems like every time she is out, we have to give her medicine. She frequently hides when we come toward her. We have tried to make it as non-traumatizing as possible, but it hasn’t been very good for our relationship. She foams at the mouth whenever we give her medication, which makes me wonder how much of the dose she is actually getting. It gets everywhere.
We used all the capromorelin they prescribed, and she still ate very little. MedVet called in miritaz pills, which we started on Thursday. MedVet called earlier this week to schedule a follow-up appointment and another ultrasound for $1000 and to talk about doing a feeding tube ($1200-$1500) and a scope/biopsy ($3000-$4000). I feel like the tech has been kind of pushy about it. I want Missy to get better, and I don’t even understand what is wrong with her. But at this point, we are at like $3500 in vet costs and still don’t know what’s wrong. I am fine with spending money at the vet as we try to treat her, but we don’t have unlimited funds. We can’t spend another $6500 at MedVet… and that’s not even including any treatment. We finished tapering off the steroid on February 8th, but Missy’s weight has not decreased. This is confusing to me- she is not eating as much as she should be, and certainly not too much. I don’t understand. Would she feel better if she were eating more?
This brings us to now. I had an appointment with my regular vet on Thursday. We discussed her doing a surgical biopsy and feeding tube but haven’t decided anything for sure. I tried to see if MedVet would do an outpatient ultrasound (since their machines would be much more advanced and the radiologist would be much more experienced than a regular vet), but they wouldn’t. Since MedVet will not do outpatient ultrasounds, my vet had another vet in the same practice do one yesterday since he has the most experience. He said there was a lot of white on the images, but couldn’t say what it was, just that it was more dense than her organ tissue. He advised against the feeding tube since she isn’t losing weight but said he would do the biopsy if it were his cat. He advised trying anxiety medication for her, which my regular vet agreed would be worth a try.
The internal medicine vet has talked to my regular vet on the phone about Missy and what to do. A biopsy could give us some answers so we know how to treat her. My regular vet and the internal specialist both agree that even if we are going to do a biopsy, we should still start prednisolone again for a longer duration with a slower taper and feel if it is lymphoma, it will still show up with tissue samples. One of the positives of the tube would be medicine administration since we are having such a hard time giving it to her, and it’s been so stressful. If she were getting full doses at the times she was supposed to, it would be easier to see if it was working.
At this point, I don’t know what to do. Missy is only six, and I thought we would have many more years with her. I wonder about starting an IBD diet, but she is so finicky with food. I have been feeding her whatever she will eat. I try to feed her often and try multiple things. Please believe me that we have tried everything with food. So many brands, varieties, flavors, extras (churus, little soups, weruva mousse, broths, etc), baby food, chicken, scrambled eggs… and so on. Today, she has eaten more than she has in days (more than a whole can of 3 oz food, and it’s only 2 pm), but she hasn’t left her bed a single time. I have been bringing it to her.
I'm sorry, I know this is long. Too long. But I was hoping maybe someone would have an idea or suggestions I hadn’t thought of. All three vets say she looks healthy when examining her, and her bloodwork is pretty good overall. There isn’t really anything obvious that they can say is causing her not to eat or hurt. I don’t want to put her through anything she doesn’t need. But I don’t know how to help her. It seems like a biopsy is the next step here, but I worry about recovery if she already won’t eat and has no energy.
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