Sassy - 17yr Old Cat - Appetite Issue (early Ckd)

FeebysOwner

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But to your point about the meds...lets say in mirtazapine, how's that really making her feel better? I guess scientifically I can't fathom it beacuse to me its just stimulating her brain to eat, sorta like forcing her to eat regardless whats going on inside. Right?
It is not forcing her to eat, it is allowing her to feel like she wants to eat. It's not curing the cause, but it is enabling her to feel like eating so that she can keep up her strength with nutrition.

I know you don't like the meowing side effect, but have you asked your vet if that is an issue for her as much as it is for you? It distresses you, but other than Sassy telling you that she is hungry, is it distressing her? Mirtazapine also has anti-nausea properties, as well as anti-depressant effects.

That's why the vet said to not give her Mirtazapine since she wasn't responding too well as to the side effetcts only. But instead to be on the cerenia and fomatidine.
You need to follow the whatever routines the vet advised. If this vet didn't want you to give Sassy Mirtazapine, then you need to let them know that without it she isn't eating and see what they say. Btw, Cerenia and Fomatidine are not anything more than Mirtazapine - in terms of resolving symptoms of an underlying problem.

The other thing to consider is: if Sassy is not taking the Cerenia and Fomatidine as she should and what impact that is having on her - that is why I suggested before about compounding the meds to make it easier for her to ingest/absorb them. And, that leads to your next comment...

I mean also, the costs. I mean at the rate she was prescribed...Id have to spend like $45-$60 a week to keet up with the meds? Since that is what I paid for a supply for what seemed a week. I can't be doing that cost on a weekly basis like that.
I totally understand, but I have no answer to this. You have to weigh out the pros and cons - there is no one that can do that for you.

I feel for you, but I just offered my layperson's opinion knowing what you've told us based on what you know.
 
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miguel99nyc

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It is not forcing her to eat, it is allowing her to feel like she wants to eat. It's not curing the cause, but it is enabling her to feel like eating so that she can keep up her strength with nutrition.

I know you don't like the meowing side effect, but have you asked your vet if that is an issue for her as much as it is for you? It distresses you, but other than Sassy telling you that she is hungry, is it distressing her? Mirtazapine also has anti-nausea properties, as well as anti-depressant effects.


You need to follow the whatever routines the vet advised. If this vet didn't want you to give Sassy Mirtazapine, then you need to let them know that without it she isn't eating and see what they say. Btw, Cerenia and Fomatidine are not anything more than Mirtazapine - in terms of resolving symptoms of an underlying problem.

The other thing to consider is: if Sassy is not taking the Cerenia and Fomatidine as she should and what impact that is having on her - that is why I suggested before about compounding the meds to make it easier for her to ingest/absorb them. And, that leads to your next comment...


I totally understand, but I have no answer to this. You have to weigh out the pros and cons - there is no one that can do that for you.

I feel for you, but I just offered my layperson's opinion knowing what you've told us based on what you know.
Yeah im going to proceed on going through with ultrasound, just got to speak when vet is in tomorrow to see if she really recommends it and how much anesthesia she would be under. I just cant imagine what could have went under or happened since June to cause her to change like this. Its soooo confusing and depressing. And as mentioned, she was eating ok in past week since returning back from trip and just suddenly again 2 days ago she didnt want to eat.
 
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miguel99nyc

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But its sooo confusing. Outside of not eating, she acts completely fine! Like as if nothing is wrong with her. :( thats what kills me
 

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If compounding the meds by the pharmacy is too expensive. I did my own compounding at home when I had to give my boy up to 7 pills a day, 3 times a day. I was able to give him one or two gel caps, with all the doses ground up, instead having to do them all separately.
If you go to a pharmacy that does compounding, you can ask them for empty gel caps (they're pretty cheap - I paid about 6 dollars for 100), then put the portion of pill in the gel cap, close it up and pill her that way. It won't stop you from having to pill her, but she won't taste it anymore.
If you decide to try this, you need to make sure to follow up with a bit of water, and also ask the vet if putting it in the gel cap would compromise how it is digested first.
 
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miguel99nyc

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Goodmorning everyone,

I wanted to add/mention something else I dont think I did...though not sure if this relates to this or give anyone else possible hints what could be wrong with Sassy...but I would say this have developed over past....maybe several months if not longer, but whenever she would drink water, a decent amount, once she would be done she would release some kind of burp? Internally. Kinda like a burp/hiccup. Though of late in past month or so since this appetite issue arose, it seemed a bit more louder/intense, sometimes to the point where right after she would burp, maybe she felt the water coming back out? Then she would do that licking off her face tilting head sideways as if something was pouring out of her mouth, similarly to the action a cat does immediately right after throwing up with their tongue. Not sure if this relates to anything? But oddly enough after giving her the mirtzapine yeserday, she would drink water last night and this morning, quite a lot, but yet no burp or feeling of throwing up that water at all. Again, not sure if this means anything or any clue.

She obviously ate this morning, but once she got to that full feeling I guess, she just looks up from her plate and sprints away. It's really strange now shes doing this, only if Im in her presence. If im not near her, once she's done she walks away gently. So I don't know what that means either.
 

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I'm only suggesting this because of MY OWN symptoms.
But is there a chance that your kitty could have a hiatal hernia? I often get burps that seem "stuck" and are more like hiccups, and they can hurt. I also am prone to regurgitating food/water with my poor excuse of a burp. Not full on throw up, it just comes back up before going back down again - and yes it can be gross :barfgreen:. The thing is, when I have a burp that won't come out at all, it can make me feel nauseated and cause breathing issues. I'm lucky that I don't FEEL heart burn, I have what is called "silent reflux", so I just get a bad taste in my mouth without the burn.
Of course, testing in the form of a scope or ultrasound would be necessary, I'm not really sure how they would test this in cats.
 
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miguel99nyc

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I'm only suggesting this because of MY OWN symptoms.
But is there a chance that your kitty could have a hiatal hernia? I often get burps that seem "stuck" and are more like hiccups, and they can hurt. I also am prone to regurgitating food/water with my poor excuse of a burp. Not full on throw up, it just comes back up before going back down again - and yes it can be gross :barfgreen:. The thing is, when I have a burp that won't come out at all, it can make me feel nauseated and cause breathing issues. I'm lucky that I don't FEEL heart burn, I have what is called "silent reflux", so I just get a bad taste in my mouth without the burn.
Of course, testing in the form of a scope or ultrasound would be necessary, I'm not really sure how they would test this in cats.
Well her burp would literally be just once a day and only after drinking a good amount of water, not like a little amount. But would the mirtazapine she took yesterday afternoon affect that? To the point where she drank a ton of water this morning but not one burp/hiccup? Yeah it kinda sounds like both a burp or hiccup, but its only with water and not any food.

Yeah it's looking likely she needs ultrasound. Yeah Scoping, no way, sorry. I know I think it's another test but my cat can't just for test after test after test, I'd just imagine how stressful it is on her, let alone the scope. I've gone through it myself, and the risks it poses i think is no different then humans imo with scoping. And see that's the problem. If ultrasound doesn't reveal anything, then I get to feel vets will try to just offer more and more tests for the money. But that point I will just stick to meds...until her end life. Because if reverts to scoping? I would think whatever, if anything shows up through that, would require surgery and not a fix by any medication. Of course if this ultrasound does reveal something that requires surgery...I'm going to have to think hard...I just dont know at that point if my 17yr old cat can take such thing you know? But of course I hope sort of for the best...and ultrasound doesn't reveal anything serious?

And yeah to me, I feel like she gets this acid reflux which would make her not eat at times, which Is what the fomatidine is for? Ive been sayign I'm against pilling her, but it was soleyl meant for the mirtazapine because how she reacts to it. Maybe I can try cutting the pill into quarters of its 1mg it already is, but, I rather have her on Fomatidine/Cerenia as that would reduce her nausea same as mirtazapine, just minus the vocalization.
 

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I rather have her on Fomatidine/Cerenia as that would reduce her nausea same as mirtazapine, just minus the vocalization.
Isn't that what the vet recommended to try right now?

As for the burping when she drinks a lot of water, she's probably just getting air in her and it needs to come out. Especially if she's drinking fast.

I honestly would just give her her meds on the daily schedule that was prescribed and continue to do so until her appetite has returned consistently. At that point you could stop the mirtazapine and see if she continues to eat without it, while still being on the cerenia and famotidine. Then, because the vet said "as needed", IF she continues to eat well, taper down on the other two meds. But at the FIRST sign of loss of appetite, not after two or three rejected meals, give her her meds again.
She has to eat as you try to get answers as to what is causing all of this. If these meds work consitently, and you wont know that unless you give them to her on the prescribed schedule, you won't know what the best course of treatment is for her unless you follow the schedule and do an elimination.

NOTE: When I say to try an elimination, it would still be advised to talk to your vet. Also, I'm suggesting an elimination of the meds because these meds were prescribed as an "as needed" basis, so if out of the three, if there is one that "usually does the trick" you may be able to get away with not having to give her all three if she starts to get fussy, and stop the process of her losing her appetite all together, which would require going back to using all three. Am I explaining myself OK?????
 
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miguel99nyc

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Hello Everyone.

So here's another update. It's actually been going just fine the past 2 weeks or so since last post. Only gave her that one instance of Cerenia, Faomatindine and Mirtazapine weeks ago and within that week (weeks ago) shes been eating just fine, normal amounts she used to back many months ago!! Still did not opt for an ultrasound because well, I tried but there was a wait of a week? So I made that appointment originally but literally Sassy was acting completely normal even without the pills. Even until today shes doing just fine!

But, I still think now this is more a neurological issue some kind...because these past days , only in the mornings too, remember I menetioned she would lick food like few times and then quickly walk away? Now she won't even go near her plate, as soon as I just place the can near her, she just like stares blankly into her can and just runs away. Literally acts like shes scared? She'd just give this like wide open look stare into some other direction oddly, then manages to sprint away out of kitchen, and hide under table for like few minutes. Then she just walks back to my room where she sleeps. But she doesnt lay down, she just sits on this box she sleeps on and THEN I bring the food to her and she eats just fine. Question is, if it was nausea or some sickness initially thought before, doesn't it mean she wouldnt want to eat at all? She eats so comfortably in my room as if nothing is wrong wit her, she just some reason gets scared in mornings to eat, esp the past few days. I dont know what would scare her because she wakes up with me, and nothing happened to have scared her like that. This running away from food has been happening on and off past months...but I never attempted to feed her elsewhere that same morning. I just let her be. But now that i feed her in my room or wherver she goes off, she eats.

Then funny thing is in the night when everyone is home, dinner time, and she eats just fine from her plate in kitchen. So that's the only issue now with her. Any thoughts? Unless it's still something in her stomach? Its just strange.
 

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Neurological issues would show up in other aspects of Sassy's behavior, not just at the food plate in the morning. I gather you feed her at the same location for both morning and dinner meals? Are there more people nearby when she eats at dinner time? Anything specific going on around her food area in the morning - something that is not happening at the dinner meal? Those are the things I would be looking at first.
 
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miguel99nyc

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Neurological issues would show up in other aspects of Sassy's behavior, not just at the food plate in the morning. I gather you feed her at the same location for both morning and dinner meals? Are there more people nearby when she eats at dinner time? Anything specific going on around her food area in the morning - something that is not happening at the dinner meal? Those are the things I would be looking at first.
Hello there.

Yeah I mean in mornings just myself I feed (which I do same in Dinner too) but my cats eat same time we all eat dinner at table too (4 of us). In the mornings, just my grandma is around but elsewhere in apartment, not near the kitchen.

She's usually licking some plastic bag in the kitchen or tries to find some plastic sort to lick? after she gives licks she would usually come back to her plate in the kitchen to eat...but past 2-3 days shes been acting all scared for some reason that as soon she sees her food or the can she runs away underneath table. Past 2 mornings Ive fed her there, under the table. But now today she was just acting scared until she eventually went to my room to her box and ate there. I don't see anything else happening different during both meals other then being just few more family members around...but no noise or actions as such to scare her. Maybe it will just go away in time or maybe because she old she forgets?
 

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Hi again! I was trying to edit my post to also tell you that I am glad she is doing better overall, but had some computer issues midstream.

Anyway, even age isn't going to make her forget how to eat/etc. just in the morning. Unless, that is the only time of the day/night that she is awakening from a deep, deep sleep and isn't yet quite fully awake.

It might be that for some reason she doesn't feel as well in the morning, but she will eat for you because you bring it to her.

Continue to feed her in the morning at her normal location, but then move it if you have to - for now. Watch to see if this behavior starts to happen during the dinner meal too. If it does, I would say you might have to consider restarting some of her meds.

I still am not convinced it is neurological, unless you begin to see other strange behaviors - but they would have to be things that cannot be explained by the possibility that she may need to go back on meds for a while.
 
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miguel99nyc

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Hi again! I was trying to edit my post to also tell you that I am glad she is doing better overall, but had some computer issues midstream.

Anyway, even age isn't going to make her forget how to eat/etc. just in the morning. Unless, that is the only time of the day/night that she is awakening from a deep, deep sleep and isn't yet quite fully awake.

It might be that for some reason she doesn't feel as well in the morning, but she will eat for you because you bring it to her.

Continue to feed her in the morning at her normal location, but then move it if you have to - for now. Watch to see if this behavior starts to happen during the dinner meal too. If it does, I would say you might have to consider restarting some of her meds.

I still am not convinced it is neurological, unless you begin to see other strange behaviors - but they would have to be things that cannot be explained by the possibility that she may need to go back on meds for a while.

Yeah I mean even in the afternoons, she would ask for dry food as her like mid snack/meal and she comes out to her plate just fine to eat. Maybe because I got agressive with her a while back month ago or so when she acts like that, she got scared and still remembers? It upsetted me back then to have seen her just lick and give me a stare so wierdly (months ago) and I guess also since then the way I reacted maybe she got scared. But then again, she would be fine days after , and it would be on and off. Now' its been consistent past 3 mornings. Her feeling sick would also make her like that? But still yet she would eat at her own place in my room? I guess at that point she's forcing herself to eat if she's feeling unwell?
 

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I have had Feeby (15+ yo) eat for me when I am not sure she really wanted to - I think it was to appease/please me that she did it. So, perhaps, Sassy is eating for you in a similar manner.
 
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miguel99nyc

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I have had Feeby (15+ yo) eat for me when I am not sure she really wanted to - I think it was to appease/please me that she did it. So, perhaps, Sassy is eating for you in a similar manner.
Im guessing theres not pill to calm her down would there be? Mirtazapine would just make her hyper and meow a lot...but I don't give her that since shes been eating well with no throwing up or nothing.
 

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Short of calming products like Feliway or Bach Rescue Remedy drops, I don't know about any pills.

There are a number of members who have had to give their cats Mirtazapine and everyone of them that I know of had to endure very similar behavior to what you experience with Sassy. However, I don't think I remember anyone of them thinking that it was hurting their cats in anyway. From what you have explained, I am not sure she needs the Mirtazapine just yet anyway.

But, just so you know - I did find a previous post from a member (@Azazel) who said: I swear by FortiFlora as an appetite stimulant. I would never recommend it as a probiotic but the smell works wonders for getting kitties to eat. Perhaps, you might want to look into this as an possible alternative?
 
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miguel99nyc

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Hello Everyone,

So it has been now about 2 months or so since I've posted on here, and since Sassy has been eating quite fine! Normal amount if not more, plus I got busy with work since as well so I did not get chance to post reporting Sassy been doing very well.

The only thing now is that as some of you been replying back may know, she's an early stage CKD cat but up to this point ( july checkup) It hasn't really progressed (bloodwork wise) since 2017. She been having on and off appetite issue with vets not finding a real cause for it or reason why since bloodwork and physical exams in past did not show anything. even with xrays now done twice this year, nothing has shown. So the last step was ultrasound...but I decided to not do that as I feared the anesthesia and considereing her weakened kidneys , etc. Long story short though since this past July 2019 check up, well really since late August, shes been completely normal of eating up to the past day or so where she just been nibbling at her food bit then walk away. Her go to meal morning is Fancy Feast gravy lovers (different falvors rotated), then night time friskies Prime fillets. Night them she been eating just fine up to last night...but in mornings she would just eat very little, walk away, then come to my bedroom and eat in my room new food I introduced to her several weeks ago - Sheeba Pates. She likes the fish one so I give her that in morning as backup if she doesnt finish her Fancy Feast. Thus been fine up to this point, and this morning she ate that one portion as well.

Last night she drank water before going sleep...but she threw up right after but it also seemed like the little dinner she ate prior she also threw up because there were chunks of food there as well. Now this morning she ate little again plus bit of her Sheeba, then I tried giving her Cerenia pill to combat her possibly nausea/vomitting, Iopen her mouthby her jawline and pop pill (like in youtube videos Ive seen). but the wieredest thing happen. Although she did not spit it out...she might have stored itin her mouth and like a minute or so after she walked around and was literally drooling spit all over for like few minutes. It was quite disturbing almost seemed like she was foamoing at the mouth. But once all that spit came out she went back to her box and went to sleep. Maybe she kept the pill in her mouth and the taste got ot her and produced excess saliva?

As for her appetite, well this is an ongoign issue for like past year or so. As I've asked in the past, or questioned, is Ultrasound really needed? Like, what could it be that makes her bit ill....for say days/weeks/month that cause her appetite to be poor, but then like in this case as this past late AUgust to now, she been eating like completely normal and drinking just fine up to few days ago again? What could it be that would bother her for some time then like, goes away for some time? Back in August when she started eating, all I did was give her one pill of Cerenia and Fomatidine, then from there she was good.

Anyone has thoughts? I'd appreciate it.
 

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Maybe she kept the pill in her mouth and the taste got ot her and produced excess saliva?
It sounds like it, my boy foams a bit and gets really drooly if I don't get his med mixed in well enough.

I don't have any good ideas about her inconsistent appetite, hang in there!!
 
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miguel99nyc

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It sounds like it, my boy foams a bit and gets really drooly if I don't get his med mixed in well enough.

I don't have any good ideas about her inconsistent appetite, hang in there!!
Oh ok, thank goodness it could be just the pill. Like I don't give it to her with food since she spits it out/avoids it. So in the past year I've learned to do it by tilting her head up opening her mouth and popping the pill as far back as possible in her throat but maybe she blocked it with her tongue and pill stayed somewhere in mouth and dissolved, causing her to drool. But it was crazy, it was like a sticky goo that came out from her mouth as it was just hanging out of her mouth, the freaky part. Like right after the pill, she kept like moisturize/lick her mouth? For a minute then she began drooling.

Yeah for the appetite, I'm not sure what it can be. Like, others on here were saying to get Ultrasound, but Im no vet but I'm not sure what kind of illness/disease could it be where it would make her lose appetite for a "X" amount of time then come back again for several months or so. It's very stressful because I always think it's her CKD progressing but each time I take her to vet, all we get is XRAYS normal, bloodwork normal, her Kidney levels though still all in normal just bit on the higher end of normal range, and only thing left was ultra sound. Even went with a second vet opinion, she too deemed it was not her CKD at all, and either to ultrasound or have her on Cerenia, Fomatidine and Mirtazapine to get her appetite going. I mean i guess all I've done was to hang in there, and she would turn around in due time to eat...
 
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