Worried about cat with IBD and CKD... not eating enough

[Sillycat41]

My Jengo is 16 years old and was been diagnosed with IBD a couple of years ago and CKD a year ago. He also has mild inflammation of the pancreas. Medications:
- 2.5 mg Prednisolone 2 X day
- 1/4 Ondansetron pill 2 X day - occasional Cerenia
- Porus One 1 X day
- 75 ml sub-Q daily and also drinks lots of water

He has only eaten canned foods for years and has always been a fussy eater... likes a variety of flavors. Unfortunately I haven't been able to switch him to a novel protein for his IBD but he was eating lower phosphorus foods until a week ago. After eating several low phosphorus foods for months, he now turns his nose up at them.

He still has an appetite and sits by me begging when he's hungry but he often just eats a few licks or sniffs the food and walks away. He even turns his nose up at baby food now. Sometimes I have 6 or 7 opened cans in the fridge before I find a flavor that he'll eat. And yes, I tried warming the food. I'm so afraid that he'll lose more weight since he is already thin at 8.4#.

The vet prescribed Mirtazapine to improve his appetite but said to only give it twice a week because it's hard on the kidneys. Besides it only works for a few hours and then it wears off. I don't think he is in any pain but probably has nausea a lot and occasionally soft stools that make him whine in the litter box.

Some days he just acts like an old cat... chases the 3 yr old cat... other days he is lethargic... lately more of the later. Wish caring for him was stable and smooth... I panic when it's not. It seemed like we were doing okay for a couple of months but now I'm very worried. Are these signs of end stage renal disease or worsening IBD (thickening intestine) when he only eats small amounts? I'm getting very depressed.

My vet is off this week, but will check with him soon about doing an ultra-sound. He'll also need a checkup in a couple of weeks to check his kidney numbers. Has any one had similar experiences with a IBD/CKD cat? Thanks. Barb

 

[Furballsmom]

Hello -
Can I ask what food brands you've been giving him?

Have you tried handfeeding him? It's possible to support and/or even maintain a cat by handfeeding.

Because my angel Poppycat was picky enough that he wouldn't eat any food with supplements in them and he required several plus the last six months he needed a food for his Hyper-Thyroid which he wouldn't eat, he and I had a several-times-daily regimen of "mix up the food, get him on the counter, scoop the food onto the end of a tongue depressor/popsicle stick, open his mouth and scrape the food in".

 

[Mac and Cats]

What foods have you been giving him? I have a hyperthyroid cat with possible IBD (had an ultrasound, but did not do a biopsy to rule out small cell lymphoma) and low grade chronic pancreatitis, he also has the beginning stages of CKD. Before he had the ultrasound, I thought he was just extremely picky. The reason I took him to urgent care/ultrasound was because he had stopped wanting more than a bite or two of any food I offered him. I probably have upwards of 12 different kinds of food (not even counting different flavors of the same type) on hand. So, I had the same thing going on, plates of different foods and too many open cans in the fridge. I had tried all of the tricks too, warming it up, adding warm water, baby food, etc. etc. After we took him in and started him on pred, that is when he started eating a lot more and he is now willingly eating the Purina EN food, which is not super low in phosphorus, but there are worse offenders. I'm not in love with the EN based on their ingredients, but at this point I am willing to feed him just about anything if it means he will eat. I think with my cat what was/is happening is, I would introduce a new food because he was getting picky about any of his older foods, so he would eat the new food with enthusiasm for a couple days and then he realized that that food made him feel sick too. He was associating the food with making him feel crummy, which is likely the case. So, perhaps you need to introduce another food? I know that is so hard with IBD, especially if you don't know what is actually causing the inflammation. I'm not sure if anyone has suggested Weurva's Phos Focus to you or not, but it's much lower in phosphorous than even the prescriptions. You can use their "Where to buy" link at the top of the website to see if there are any stores locally that carry it. That way you can get it now to see if he likes it before ordering a full case. There is also this database that has helped me a lot. I don't know if finding a higher phosphorus food that he is willing to eat and using a phosphorus binder is ok for your cat, but you may want to ask your vet if it is an option too? Are you able to take him into another vet while yours is away or to an urgent care? You may need to do another ultrasound. Was he diagnosed with IBD through a biopsy or just via the ultrasound?

 

[Sillycat41]

Hello -
Can I ask what food brands you've been giving him?

Have you tried handfeeding him? It's possible to support and/or even maintain a cat by handfeeding.

Because my angel Poppycat was picky enough that he wouldn't eat any food with supplements in them and he required several plus the last six months he needed a food for his Hyper-Thyroid which he wouldn't eat, he and I had a several-times-daily regimen of "mix up the food, get him on the counter, scoop the food onto the end of a tongue depressor/popsicle stick, open his mouth and scrape the food in".

I have a variety of brands because he's always been fussy.... everything from Fancy Feast and Friskies to Wellness and Instinct. Tried syringe feeding him a couple of times the other day but he hates it and it was a mess. :-( I can't add anything to his food because he detects it so he is just not eating regular food. Have to put pills in capsules. I'm so afraid that he'll lose more weight and that he is failing now. He is on anti-nausea meds so that shouldn't be an issue. ???

 

[Sillycat41]

What foods have you been giving him? I have a hyperthyroid cat with possible IBD (had an ultrasound, but did not do a biopsy to rule out small cell lymphoma) and low grade chronic pancreatitis, he also has the beginning stages of CKD. Before he had the ultrasound, I thought he was just extremely picky. The reason I took him to urgent care/ultrasound was because he had stopped wanting more than a bite or two of any food I offered him. I probably have upwards of 12 different kinds of food (not even counting different flavors of the same type) on hand. So, I had the same thing going on, plates of different foods and too many open cans in the fridge. I had tried all of the tricks too, warming it up, adding warm water, baby food, etc. etc. After we took him in and started him on pred, that is when he started eating a lot more and he is now willingly eating the Purina EN food, which is not super low in phosphorus, but there are worse offenders. I'm not in love with the EN based on their ingredients, but at this point I am willing to feed him just about anything if it means he will eat. I think with my cat what was/is happening is, I would introduce a new food because he was getting picky about any of his older foods, so he would eat the new food with enthusiasm for a couple days and then he realized that that food made him feel sick too. He was associating the food with making him feel crummy, which is likely the case. So, perhaps you need to introduce another food? I know that is so hard with IBD, especially if you don't know what is actually causing the inflammation. I'm not sure if anyone has suggested Weurva's Phos Focus to you or not, but it's much lower in phosphorous than even the prescriptions. You can use their "Where to buy" link at the top of the website to see if there are any stores locally that carry it. That way you can get it now to see if he likes it before ordering a full case. There is also this database that has helped me a lot. I don't know if finding a higher phosphorus food that he is willing to eat and using a phosphorus binder is ok for your cat, but you may want to ask your vet if it is an option too? Are you able to take him into another vet while yours is away or to an urgent care? You may need to do another ultrasound. Was he diagnosed with IBD through a biopsy or just via the ultrasound?

I have a variety of foods from Fancy Feast and Friskies to Wellness and Instinct... also bought Weruva low phosphorus which he liked for the first couple of meals then turned his nose up. We don't have an urgentcare or any specialty vets around here and the regular ones aren't taking new patients so I have to wait for his vet to return. You're probably right... if he feels sick after eating a certain food he probably doesn't want it again. He is on anti-nausea meds though so I that they would help... maybe they stop working after he has been on them for a long time. I do put a little Phos-Bind in his food but he stopped eating before this was added. He never had a biospy for IBD... too old... nor an ultrasound... so he was diagnosed from symptoms and put on Prednisolone. Maybe it's time for an ultrasound. I'm very worry about him. :-( Thought we were doing okay untll he stopped eating enough.

 

[Mac and Cats]

I have a variety of foods from Fancy Feast and Friskies to Wellness and Instinct... also bought Weruva low phosphorus which he liked for the first couple of meals then turned his nose up. We don't have an urgentcare or any specialty vets around here and the regular ones aren't taking new patients so I have to wait for his vet to return. You're probably right... if he feels sick after eating a certain food he probably doesn't want it again. He is on anti-nausea meds though so I that they would help... maybe they stop working after he has been on them for a long time. I do put a little Phos-Bind in his food but he stopped eating before this was added. He never had a biospy for IBD... too old... nor an ultrasound... so he was diagnosed from symptoms and put on Prednisolone. Maybe it's time for an ultrasound. I'm very worry about him. :-( Thought we were doing okay untll he stopped eating enough.

An ultrasound might be a good idea at this point, unfortunately. Can you go buy him a few other options of food that he hasn't had before? The Cerenia may be working for the nausea, but his reaction of not eating might be because of something else and not nausea? The Cerenia wouldn't necessarily cause him to eat even though it may be helping his nausea. For a little while before I took our cat to urgent care, I was able to get him to eat some of the fancy feast petites and sheba perfect portions. However, that only lasted a few days. But a few days may get you through until you can get him to the vet? Have you tried these or these? They also have a seafood variety. There are also lots of other brands that have similar products. They aren't a complete food or very many calories, but it may be enough to use it as a food topper or simply to help jump start his appetite? I'm so sorry you're going through this. I've dealt with this several times with other cats and I know how hard it is to deal with.

 

[Furballsmom]

I'm so afraid that he'll lose more weight and that he is failing now. He is on anti-nausea meds so that shouldn't be an issue

Have you tried any of the Weruva brands? Maybe even some meat baby food, or bonito flakes to help entice him?

Sometimes people find things in this thread that helps;
Any Good Tips To Get Your Cats To Eat? Share Them Here!

 

[Sillycat41]

Have you tried any of the Weruva brands? Maybe even some meat baby food, or bonito flakes to help entice him?

Sometimes people find things in this thread that helps;
Any Good Tips To Get Your Cats To Eat? Share Them Here!

Yes, he like the Weruva at first but not any more. Same with baby food. Only take a few licks and walks away. :-(

 

[Sillycat41]

An ultrasound might be a good idea at this point, unfortunately. Can you go buy him a few other options of food that he hasn't had before? The Cerenia may be working for the nausea, but his reaction of not eating might be because of something else and not nausea? The Cerenia wouldn't necessarily cause him to eat even though it may be helping his nausea. For a little while before I took our cat to urgent care, I was able to get him to eat some of the fancy feast petites and sheba perfect portions. However, that only lasted a few days. But a few days may get you through until you can get him to the vet? Have you tried these or these? They also have a seafood variety. There are also lots of other brands that have similar products. They aren't a complete food or very many calories, but it may be enough to use it as a food topper or simply to help jump start his appetite? I'm so sorry you're going through this. I've dealt with this several times with other cats and I know how hard it is to deal with.

He has been on Ondansetron twice a day but I switched to Cerenia today to see if that made any difference. Didn't seem to help. I have lots of varieties of food... Sheba, Tiny Tasters, Morsels. etc. in addition to Fancy Feast and Friskies... some seafood, chicken, turkey, etc. nothing seems to interest him. He has has episodes like this in the past but usually they only last a day or two and then he's back on his food. This time it's been several days and I'm worried... he's so skinny now. :-(

 

[Furballsmom]

Would there be anything in this thread that might entice him?

Any Good Tips To Get Your Cats To Eat? Share Them Here!

 

[Twylasmom]

Many people with CKD cats use Mirtazapine long term to keep their cats eating. Have you tried the transdermal form (Mirataz)? Is your vet saying it only works for a few hours or is that your personal experience? My CKD cat gets a half dose of the transdermal every three or four days and it helps to maintain her appetite. If she goes longer than that her appetite lessens to the point where she will begin to lose weight.

Cyproheptadine or Elura are other options for appetite stimulanuts.