16 year old female cat not eating and we are told it’s hyperthyroidism?

[Lisannez]

I know in a small percentage of cases hyperthyroidism can cause a cat to lose their appetite. We have a 16 year old cat that was always a big eater, think take food off of your plate eater. She was always healthier other than last year they gave her a liver supplement and said her liver levels were off but she finished it and it returned to normal.

About a year ago we noticed she had become a messy eater. It was like when she was eating wet food it was coming out of her mouth. Then a week and a half ago, she stopped eating and started to lose weight. She continued to drink water and use the litter box. We took her to the ER vet and all the labs were normal but the thyroid, so they gave us some pills and a shot for nausea. There is nothing wrong with her mouth. She has regular dental cleanings. The only other symptom is that she does this thing (has been doing it for a year ) where she twitches her eyes and head, i’s almost like she’s seen something that surprises her. It’s not a seizure or a tick and we cannot relate it to any one cause .

She has been on the meds for a week today. She still won’t eat on her own. We are feeding her high protein gels and food through a syringe every hour and it does seem to be helping. When we put food in front of her she moves away. We take her for follow up. On Saturday but I think it’s something more. She does not appear to be in pain but something is going on.

Any ideas? Thanks.

 

[gitabooks]

I'm sorry to hear your kitty isn't feeling well.

I've worked with hyperthyroid cats and they have always had a good appetite unless they didn't feel well. Hyperthyroid can cause kidney disease (the high blood pressure) which can lead to nausea and pain. Look for a squinting expression, loafing (not stretching out or laying ont heir side when sleeping), and a more withdrawn personality.

Did the vets do a dental X-ray? My Nocturne had a resorbing tooth which bothered her (she ground her teeth).
Nocturne also has IBD and an appetite stimulant and cerenia (anti-nausea/pain relief) really helps her eat regularly.

Cats not being able to smell can also have a big impact on their willingness to eat. I've heard warming up the food so it smells more is enticing?

I'm not sure about the ear/head flicking. I've seen cats do it who have ear infections, skin allergies, or one who had what appeared to be a nervous-tic after another cat in the household passed away. It could also be ear mites?? I'm assuming the vet checked all that though. Maybe irritation/frustration? Pain? Even neurologic symptoms? Maybe even an esophagus issue such as a stricture?

For cats with appetite issues getting a temporary feeding tube placed can really help and is less stressful than syringe feeding for many cats.

I hope your kitty feels better soon!

 

[FeebysOwner]

Hi. How high was her T4 (thyroid) level, and what dosage of thyroid meds was she placed on? If her thyroid level was out of whack for a reasonably long time, it can - as mentioned above - lead to high blood pressure. But high blood pressure can lead to other issues, up to and including a stroke/neurological issues.

I think you are right that there is something else going on and it would be wise to consult with an internal med vet, ideally one who is part of a larger specialty group who could confer with colleagues such as those in neurology and cardiology.

Two other things to note - typically a shot for nausea only lasts for 24 hours. Secondly, a too high dose of thyroid meds all of a sudden can bring about its own issues.

 

[gitabooks]

I found this free, recorded webinar really helpful when my Nocturne wasn't eating. She had to spend a couple days at the vet. She had a fever and bad IBD flare-up at the time but Cerenia and a very special diet has helped a lot.

ISFM webinar (free access): Inappetent Cats: Don’t hope they will eat tomorrow, act today! (2022) | International Cat Care

icatcare.org

 

[neely]

She still won’t eat on her own.

Did the vet recommend giving her Mirtazapine to help increase or jumpstart her appetite? As FeebysOwner noted, I would also be curious to know her T-4 level. And I agree you may want to consider taking her to a Veterinary Internal Medical Specialist. Is your present vet a feline only vet?

 

[Alldara]

From what I understood as my vet explained to me, it's not that a hyperthyroid kitty is not hungry, but being hyperthyroid changes the taste of food. Lily was always a good eater until she suddenly stopped eating her food. She was on a weight loss diet so we didn't catch hyperthyroid quickly.

So they might not like their regular food and you might have to give other foods until the hyperthyroidism is under control. Then she should go back to liking her regular food.

While we tried to control Lily's, she liked Stella and Chewy's freeze dried food. I could tell when it got out of control as she would start eating that again and refusing her regular food.

Freshpet "kibbles" were a great option for her as well. She loved to eat that.

Lily had to have her levels retested every month until she was "stable" and then every 3 months.

 

[Furballsmom]

The only other symptom is that she does this thing (has been doing it for a year ) where she twitches her eyes and head, i’s almost like she’s seen something that surprises her.

If possible, see if you can get this on video before your next visit, so the vet can see it.

 

[jmichaelp]

From my experience, I'd get her on a feeding tube ASAP. Twice I've tried the gels/syringe & it wasn't enough. I think my last cat might've lived had I gotten him on the feeding tube while we diagnosed him.

 

[Lisannez]

Did the vet recommend giving her Mirtazapine to help increase or jumpstart her appetite? As FeebysOwner noted, I would also be curious to know her T-4 level. And I agree you may want to consider taking her to a Veterinary Internal Medical Specialist. Is your present vet a feline only vet?

Her T4 is 14.0 I just checked the test results. No the present vet is not a feline only vet. The emergency vet gave her Maropitant citrate which I believe is an anti nausea medication.

 

[Lisannez]

I'm sorry to hear your kitty isn't feeling well.

I've worked with hyperthyroid cats and they have always had a good appetite unless they didn't feel well. Hyperthyroid can cause kidney disease (the high blood pressure) which can lead to nausea and pain. Look for a squinting expression, loafing (not stretching out or laying ont heir side when sleeping), and a more withdrawn personality.

Did the vets do a dental X-ray? My Nocturne had a resorbing tooth which bothered her (she ground her teeth).
Nocturne also has IBD and an appetite stimulant and cerenia (anti-nausea/pain relief) really helps her eat regularly.

Cats not being able to smell can also have a big impact on their willingness to eat. I've heard warming up the food so it smells more is enticing?

I'm not sure about the ear/head flicking. I've seen cats do it who have ear infections, skin allergies, or one who had what appeared to be a nervous-tic after another cat in the household passed away. It could also be ear mites?? I'm assuming the vet checked all that though. Maybe irritation/frustration? Pain? Even neurologic symptoms? Maybe even an esophagus issue such as a stricture?

For cats with appetite issues getting a temporary feeding tube placed can really help and is less stressful than syringe feeding for many cats.

I hope your kitty feels better soon!

They did not do a dental x ray just a mouth exam. She just had her teeth cleaning in January, but I realize that something could have changed. They gave her a shot of cerenia but it did not seem to help. She may have nausea (can’t tell) but no vomiting in fact she rarely does no diarrhea. Warming up the food does not help. Interesting that you mention about the ears, because in the past year she has had a build up of wax in her ears and the vet cleaned it out. We have to clean her ears and put drops in them. As far as the head thing I wonder if it’s due to high blood pressure as mentioned by another commenter that sometimes there is an eye squint. Now that you mention it she is not laying on here side at all and is loafing. Thank you so much.

 

[Lisannez]

From my experience, I'd get her on a feeding tube ASAP. Twice I've tried the gels/syringe & it wasn't enough. I think my last cat might've lived had I gotten him on the feeding tube while we diagnosed him.

Thank you for this. We were able to get an entire tin of food into her today through a syringe we blended it up. She does not fight us when we are feeding her, she licks and swallows but wants nothing on her own. We will look into the feeding tube.

 

[Lisannez]

If possible, see if you can get this on video before your next visit, so the vet can see it.

Thanks we are trying.

 

[Lisannez]

From what I understood as my vet explained to me, it's not that a hyperthyroid kitty is not hungry, but being hyperthyroid changes the taste of food. Lily was always a good eater until she suddenly stopped eating her food. She was on a weight loss diet so we didn't catch hyperthyroid quickly.

So they might not like their regular food and you might have to give other foods until the hyperthyroidism is under control. Then she should go back to liking her regular food.

While we tried to control Lily's, she liked Stella and Chewy's freeze dried food. I could tell when it got out of control as she would start eating that again and refusing her regular food.

Freshpet "kibbles" were a great option for her as well. She loved to eat that.

Lily had to have her levels retested every month until she was "stable" and then every 3 months.

Oh this is interesting to know that the food tastes bad to her. I did not realize that could happen. Thanks so much for the food suggestions.

 

[Lisannez]

Did the vet recommend giving her Mirtazapine to help increase or jumpstart her appetite? As FeebysOwner noted, I would also be curious to know her T-4 level. And I agree you may want to consider taking her to a Veterinary Internal Medical Specialist. Is your present vet a feline only vet?

T4 was 14.0. No they did not give us the mirtazapine but an anti nausea med in a shot. Thanks so much.

 

[Lisannez]

Hi. How high was her T4 (thyroid) level, and what dosage of thyroid meds was she placed on? If her thyroid level was out of whack for a reasonably long time, it can - as mentioned above - lead to high blood pressure. But high blood pressure can lead to other issues, up to and including a stroke/neurological issues.

I think you are right that there is something else going on and it would be wise to consult with an internal med vet, ideally one who is part of a larger specialty group who could confer with colleagues such as those in neurology and cardiology.

Two other things to note - typically a shot for nausea only lasts for 24 hours. Secondly, a too high dose of thyroid meds all of a sudden can bring about its own issues.

T4 was 14.0 and yes we were told about the thyroid meds could cause this but she is on the lowest dose possible. .25 every twelve hours. Thank you so much.

 

[FeebysOwner]

Is that T4 number in μg/dL or nmol/L? The normal ranges for each are around 0.8–4.7 μg/dL and 10.0–60.0 nmol/L. So, it makes a big difference which one we are talking about. If the latter, she is really not hyperthyroidic.

Normally, anti-nausea shots are only good for about 24 hours.

 

[Lisannez]

Is that T4 number in μg/dL or nmol/L? The normal ranges for each are around 0.8–4.7 μg/dL and 10.0–60.0 nmol/L. So, it makes a big difference which one we are talking about. If the latter, she is really not hyperthyroidic.

Normally, anti-nausea shots are only good for about 24 hours.

I think ug/DL. I attached it. Thank you.

 

[FeebysOwner]

OK. Thanks for that. When you say 0.25mg of thyroid meds - do you mean 1.25 mg? Is this methimazole/felimazole? I have never heard of 0.25 mg. The ideal starting dose is 1.25mg every 12 hours. Then re-testing is done usually within 3-4 weeks to see where that has lowered the T4 to, and the dose can be increased by a small amount as needed until within normal range, with re-retesting 3-4 weeks after each dosage adjustment. With a T4 of 14, she might need a higher dose, but it is good to start low and increase the dosage over time.

I noticed in the labs you posted that her some of her liver enzymes are still elevated.

 

[Alldara]

Thank you for this. We were able to get an entire tin of food into her today through a syringe we blended it up. She does not fight us when we are feeding her, she licks and swallows but wants nothing on her own. We will look into the feeding tube.

This was my experience with Lily when she first started medication too. Eventually she ate the blend on her own.

I hope the vet is able to check the other things out for you also!

 

[Lisannez]

OK. Thanks for that. When you say 0.25mg of thyroid meds - do you mean 1.25 mg? Is this methimazole/felimazole? I have never heard of 0.25 mg. The ideal starting dose is 1.25mg every 12 hours. Then re-testing is done usually within 3-4 weeks to see where that has lowered the T4 to, and the dose can be increased by a small amount as needed until within normal range, with re-retesting 3-4 weeks after each dosage adjustment. With a T4 of 14, she might need a higher dose, but it is good to start low and increase the dosage over time.

I noticed in the labs you posted that her some of her liver enzymes are still elevated.

I just pulled up the instructions and this is what it says: "Give 0.25 tablet by mouth every 12 hours unless otherwise directed by a veterinarian as treatment for hyperthyroidism. Obtain refills, do not discontinue. " So it's .25 and we are to follow up in two weeks. So we made an appointment with the regular vet for Saturday which is almost two weeks. But also because we are concerned she is still not eating on her own. I also noticed the elevated liver levels and thought it could be from not eating? Maybe they were not high enough to matter? I am not sure. Thanks again.