Cat doesn't eat and has started having tremors

[mr1992]

Hey there,

I'm afraid this post will probably be a bit longer. If she doesn't kill herself, I'm not sure I won't at some point; anyway, here it goes:

I've outlined some already in a previous post (Cat Diarrhoea), but unfortunately, while the diarrhoea is gone, so is her appetite.Or rather, she won't stick with a food for more than a day before she shuns it. It worsened severely when my girlfriend had left for a bit over a week and our cat decided it was a fine idea to stay outside (moment of inattention and she slipped out; we wanted to control her environment to rule out other factors) for 4 or 5 days. And wouldn't come in; she probably didn't have anything/very little to eat during that time, evidenced by her loss of weight.

After that stunt, she slowly started developing some sort of tremors/spasms, similarly to the cat in this video ( ; the user has more videos of his cat twitching/having tremors/spasms). I.e. weird involuntary shaking of the paw but also all over her body. We naturally took her to the vet who x-rayed her (everything's fine) and had a blood test done (all values are normal, no markers for diseases present at all). We've ruled out neurological or nervous issues since these tremors don't affect her gait and don't happen all the time. Perhaps I should mention that she's never had a fever throughout any of this. The vet did find pain in her lower back of unknown origin and a minor irritation on the back of her throat; he prescribed her painkillers both to take away the pain and for their anti-inflammatory qualities.

Based on the symptoms as a whole, we presume it's due to lack of food/regular food intake and some sort of anxiety she's developed. She's had bouts of constipation/diarrhoea on and off, alternating between the two - maybe it's because her stool may be too hard and she's sensitive to that? It's fairly odd considering that her weight is the same since the last time she was at the vet's and was on the scales; while there is no weight loss noticeable between these two instances (she's at perfect weight at 4.1kg/~9lbs), we can tell she had gained weight in the meantime and lost it accordingly. Moreover, the blood levels are fine, which doesn't quite add up, either. The tremors were better after we fed her some special food against adverse food reactions we got from the vet - however, our little idiot thought it fair to shun it, thus forcing us to change the food once again (we were supposed to feed her that exclusively, yet she didn't touch it in two days and she'd have continued starving herself).

Has anyone of you ever had to deal with such an issue? I know it's likely best to prepare food ourselves (she's VERY into human food; we didn't feed her scraps often though, only the odd piece of sausage/meat here and there perhaps once a week at most), as was recommended by Mamanyt1953 in the other thread - given the uncertainty of what was going on, we didn't go ahead with it yet. Also, it's still unclear what this is and how to best address it without worsening it. Any advice would be very welcome on how to best approach this; I fear cats' diets are easy to disimprove and I'd hate to do something wrong.

Thanks in advance for your replies :-)

 

[stephanietx]

You need to get your kitty to the vet for a thorough check up and blood work. My kidney kitty did this and it was not a good thing for her.

 

[Jcatbird]

It does seem that something is being missed here. My first thought is hypoglycemia. Blood work might or might not catch that. It might take a fasting with blood work test. I noted you called her your little idiot. Is that a fond nickname or due to her doing things like jumping and missing her mark? Things most cats would not mess up on? That could be an indicator. If it is hypoglycemia, depending on the cause, it may be relatively simple to handle. Things like feeding small meals very often. I definitely would do as you mentioned, keep her inside for observation. Very good instincts on your part! Hypoglycemia can lead to blacking out. If that were to happen in your presence, immediately get her to the vet. Seizures as well. ASK your VET now if putting a bit of Karo syrup on her gums or honey would be okay if she gets worse. Do ask the vet for further input. Any chance she has had an injury to head or spine? Blood work may show up nothing but an ECG or EEG May give you an answer if hypoglycemia is not the issue.
mentat may have some good information for you.

 

[mr1992]

Hypogycemia sounds like an interesting option for this; strangely, her glucose levels were fine, though - you said it'd be easy to miss it, however, its level was 118, thus well in the middle range, even on the higher end of the middle range (upper limit is 140) which may be explained by the fact that we had to give her something (really not much, but probably enough to show in the results) to get her into her transport box. May such a fairly stable level already rule it out?

On the same note, the only thing that was a little higher was calcium, at 3.1, being 0.2 over the normal range - might be indicative of something, the vet didn't see it as too out of the ordinary, though. As basically anything else; my mum's working for him so he wasn't just telling us something to "be done". The blood work report read pretty much the same; interpretation of the results didn't find anything suspicious and represented a healthy cat. MCH was marginally lower than normal (by 0.1), and the thrombocyte count was 133 (lower end usually is 155), as well as two other values I don't know, though apparently, given the slight deviation from the norm, it doesn't signify anything wrong

"Little idiot" is a fond nickname ; in this case referring to her not bloody eating, but generally because sometimes she's a dumb dumb and what you'd probably call a klutz - don't get me wrong, she still gets everywhere and generally does fine, but when she's jumping off the bed for instance, you'll hear a loud "thud". Of late, she has begun to look for steps to get places, though. Personally, it appears as if this may be connected to general fatigue she's experiencing, thus not exerting or being willing to exert herself too much. She's certainly never missing anything, her eyesight is the same, as far as we can judge it. Regarding little meals; of late, we've provided her with a tray full of dry food, and even before, she'd rather eat multiple times a day than wolf it all down in one go - may that be connected?

As a side effect of this all, she's become far more cuddly. Before that, she'd generally shun me for the most part and stick to my girlfriend; now she's actively seeking us out multiple times to have us stroke her. As fun as that may be, it's sadly not normal; she's purring loudly, though I presume in contentment of being stroked. A few times now, she was particularly fond of me stroking and actually massaging her belly (no-go zone before); I took the opportunity to check if anything feels abnormal and massage the area in case of trapped gasses/stuck food. She did take a dump, no idea whether that was connected.

As a result of this, she's also hardly playing anymore. When she ate recently, she did start playing again for a while, which makes us even more certain that it's food-related. I'll ask the vet about the honey or Karo syrup, as well as whether he thinks an EEG or ECG may be workable here. All he told us so far is keep observing her as this could be anything.

Regarding injuries to her head or spine - we don't know. The x-ray didn't show any signs of trauma; she did have pain in her back of unknown origin, however. That the vet found by going along her spine. Yet, I presume if it was a neurological cause or effected by damage to her spine, it'd show up more often and not when in a resting position. Or rather, it should be there all the time, and not get better or worsen, at least so far correlating with her food intake.

All in all, I'm still puzzled by her blood work. How is it even possible that her values are not completely out of whack considering the already significant period of self-starvation? She's got absolutely no other sources of food, unless she's a secret conjurer and makes it appear from thin air. Which may not be all that bad considering lockdown, may save a trip to the supermarket. Perhaps I should've mentioned her age, she's ~3 years old, bit early for any such things to happen I should think.

Thanks again for your answer, you did give us some things to think about =)

 

[Jcatbird]

A thud? She landed hard? I am wondering about the hypoglycemia. It may not show without repeated checks as blood sugar goes up and down. A fasting blood work should show it. As your vet said, it could be many things. The tremors are indicative of something though. Being less playful may be a clue. Purring can be contentment but also self comforting. Cats rarely want to show pain or weakness. Since that can make them appear vulnerable. I’m the wild that would leave them more noticeable to predators. Hiding it is a good instinct but leaves humans guessing. With any cat related thing it’s a matter of putting all the pieces of the puzzle together. The thing I suggest most often is to write down everything you notice. Sort of a cat diary. This will really help the vet. They can connect the dots better than we can. So far it sounds like, lethargy, change in appetite and behavior, tremors, the results of the tests and staying closer to her human. Rubbing her tummy resulting in a poop could be a clue but that could also be a normal reaction to moving things in her intestine. Add anything I failed to mention that was in your post and any additional clues you can think of. Keep it simple and maybe number the items so the vet can easily scan and read the list.Also add eating, drinking and litter box habits. Pay special attention if she is drinking differently. I think you are going to figure this out and it may just be something simple. Sending her some extra healing purrs! I can tell she is adorable!

 

[mentat]

Video of her walking, slow ambulation, video of her eyes, her pupils, up close, very close.

I've been unwell, forgive my late response.

Electrolytes, value please, of chloride, potassium, and sodium? Is her potassium the low end of normal range by your vet's particular diagnostic chemistry analyzer? List the ranges. If possible, a copy of the labwork, an image, a pdf, any file, I am able to open and view. PDFs take more memory in attached files. You can do a single response with a PDF attached, for time sparing of loading and opening the response message.

Jcatbird is correct, blood glucose changes every few minutes, and can changes from one extreme to another in less than an hour. Which is why diabetics, pancreatitis patients, and patients like myself, check our BG every 4-6 hours if mildly symptomatic for our particular illness(es). Cats fluctuate EVEN FASTER, MORE EXTREME. They are obligate carnivores and their metabolism is extremely fast. They move their stomach contents within 2 hours, if healthy GI motility. Their heart rate and blood pressure norms are exponentially higher than ours.

Her tremors are concerning. Spasms involuntarily. Neuromuscular, or only neurological, as source of symptom.

Tremors that are persistent can be due to mild mycotoxicity, as fungus can infect nerves, reduce action potential across muscle cells, reduce neurotransmitter function across synapses. Most cats don't eat fungus voluntarily the way dogs do; they don't taste "sweet" flavors, but mycotoxins can accumulate in aged dairy especially, if one is feeding it to an animal, toxicity can occur this way; it happens in homemade diet feeds and accidental compost ingestion, such as when dog is left in yard, and becomes hungry enough to invade a spot they usually leave alone. It happens during disasters, when animals are left at home with access to their enclosed yard while owners evacuated temporarily, or staying in nearby hotel, checking once daily on pet. Gut wrenching, those cases of families, finding their pet, at first now knowing why they appeared so weak, so ill, tremoring and spasming, less than this cat, but still a concern.

Tremors can due to other neurotoxicity, such as application permethrin or pyrethrin-containing topical medication meant to treat ectoparasites, aka fleas, lice, ticks, biting insects. A bath, a very foamy, deep follicular flushing bath, for many minutes, warm water, can remove such possible topical toxins.

Fluids are important. Her water intake, her euhydration. If very immobile and inappetant, she is not ingesting enough moisture in water drank or moist food consumed, to maintain her hydration. What she is actually eating, protein source, micronutrient supplement source, and the volume of any said ingredient, is important to consider, to report, to analyze as a source of deficiency or toxicity contributing to her tremors and spasms. Her weakness, less ambulation, less energy, her lethargy, her inappetance.

Were her reflexes checked, at each joint/limb juncture? Her eyes, did the pupils constrict normally in response to light exposure, then darkness? How are her pupils when you look directly in her eyes for at least 15 sec? Any "bounce" or shift, a jiggle side to side, or up and down, while her head is stable?

Prolonged diarrhea is very taxing to homeostasis, both of the gastrointestinal tract and liver and pancreas, but also of the blood, circulating micronutrients, oxygen capacity, energy (ATP) circulating, lower and lower, concentration. Low appetite can lead to hepatic lipidosis, even while eating very small consistent volumes, as it is insufficient to maintain metabolic function of all glands, of the endocrine system, hormones controlling all functions of the brain, of digestion, of energy, of age/cell replication. Chronic diarrhea can be indicative of inflammatory bowel diseases, of which there are specific ones, specific etiology, specific cause, determined by biopsy, endoscopy, abdominal ultrasound imaging, and to distinguish GI lymphoma from chronic irritable bowel disease, an endoscopic surgical biopsy. My ole girl and one prior dog bounced back from these procedures very well, as symptomatic management was immediate once we had a diagnosis and effective treatment plan for the actual cause of malnutrition, malabsorption.

I saw her body weight. What is her age? What imaging has been done? Most vets, incl radiologists, send copies home with you, perhaps on a disc or jump USB drive, or attached in an email?

Her tremors are likely from long term malnutrition and malabsorption, leading to dietary, now systemic, deficiency or toxicity of an electrolyte that is reducing her muscles' ability to normally electroimpulse, send calcium to initiate contraction, ATP to move those myofibrils, action potential to follow through, and movement passively of sodium and potassium at cells' ion-gated protein passage way, disrupted, imbalanced, water pulled toward the side with greater sodium. Possibly total protein deficiency, Albumin deficiency (hypoalbunemia). Severely low albumin leads to edema, as fluid in cells, rushes/leaks into interstitial space, all the space between cells, with imbalanced protein and electrolytes, poor hydration, poor use of any administered rehydration, as the body spaces into tissues intercellular space, rather than within the cells, where it is needed.

So. Bloodwork copy. Age. Imaging diagnostic results. Diet, specific volume of specific ingredients, using frozen thawed, or fresh, when doing homemade, and specific nutritional supplementation, for dietary calcium (cat food is very fortified with this, as the calcium : phosphorus ratio is so important to homeostasis), for dietary electrolytes, and protein supplementation when eating inadequately.

I hope she is well, I know I am late to the game here.

 

[mr1992]

Wow, that's quite a response; I've redacted the report to protect my privacy; I'll provide a translation for the section "Interpretation und Anmerkungen" since the report is in German:

"Interpretation and Remarks:

1.) The sample's lipaemia level shows no significant influence on the analysis of clinical-chemical parameters. (Measuring method: photometry).

2.) The sample's haemolysis level shows no significant influence on the analysis of clinical-chemical parameters. (Measuring method: photometry).

3.) Cats with a T4-concentration above reference range and typical symptoms are highly likely to suffer from hyperthyreosis. [N/A, section on older cats]. Cats with lower T4-concentrations generally suffer from a non-thyreoidal disease (NTI), or are overdosed when treating hyperthyreosis. Repeat T4-concentrations in the lower reference area mostly exclude the presence of hyperthyreosis. [N/A, section on medication effects; cat doesn't receive any medication].

4.) SDMA as well as creatinine concentrations are not increased, kidney function is presumably good. If a disease of the kidneys is clinically suspected, we further recommend a comprehensive urine analysis.

5.) Not accredited."

I'm afraid I don't have her x-ray image; as is probably the case everywhere around the world, her entire body was x-rayed (guess it's bloody well impossible to do a localised one given cats' small size). I did see it, and the vet did go over it with me, my girlfriend, and my mum; there was nothing out of the ordinary, nothing enlarged, all organs are where they are supposed to be, bones are fine as well. I hasten to add that if he suspected something out of the ordinary, he's got access to an exceptionally good vet working at a clinic whom he could have consulted had the test results shown anything he couldn't interpret.

I suppose the rest of the report can easily be read with dict.cc or a similar website; most values should be the same or similar enough to be understood.

As stated before, we had her stool tested and it came back equally inconclusive, i.e. normal. I don't have the report, though, yet the assessment reads pretty much the same.

Regarding the physical evaluation; I don't remember whether he checked eye reactivity; he did definitely check her joints, though, which were all fine. I suppose he did check her eyes since we told him that her pupils sometimes dilated when she spasmed; he interpreted it as surprise and/or pain associated with it. Yet, there was never a stuttering in her eye movements and no undue dilation/narrowing of her pupils that we could see.

Sources of mycotoxins could perhaps be found in the cellar or the garage; we've cut her off from both for the time being, though that didn't change anything about her tremors. On the same note, if she ingested them some way, it was probably airborne; there is nothing edible in the cellar. We do keep rubbish in the garage (stupid system in Germany where certain wrapping needs to be in yellow bags; a real pain to store those), but those are fetched every ~2 weeks or so. That being said, I didn't notice any tears or openings from which she could've got anything from inside; the moud issue in said garage stems from a leaky roof and a pond which, upon refilling, sometimes has the nasty habit of flooding the garage. That's happened last year, though again, no edibles apart from regularly discarded rubbish bags. I don't know what else she may have found in the area, obviously; we did give her lactose-free milk (~1 a month), but always ensured it was still good, keeping it in the fridge (my girlfriend is lactose intolerant and she drinks the same milk, hence, I'm sure the milk wasn't spoilt at any time).

Her lethargy has improved substantially of late, ever since she has been eating more. We've now adopted a regimen of offering her various foods and giving her the one she picks; she doesn't stay with a particular kind for longer than a day or two. Obviously, we alternate between them, but that's the best we can do for now. It is therefore impossible to specify how much exactly she eats; it fluctuates and her food changes. Though her tremors still happen, she's playful and far less cuddly, running around the flat, at least she did so yesterday. She has definitely taken to have us stroke her tummy each night, really rolling herself on her back so it's easy to access. I really don't know whether it's related or just a co-incidence; she does purr loudly as a result (note that most of her deep purring before generally happened when we stroked her, which makes me think it was not pain-related). She's also now less interested in me, which may sound sad but is closer to her usual self

At the risk of sounding esoteric, there's something I've generally noticed among animal owners, regardless of species: animals tend to mirror their owners. Out of a nearly inexhaustible number of instances I've observed, the most striking are our stallion (my dad had a stroke two years ago, affecting the right side of his body - shortly thereafter (days, actually), the stallion became lame on his right front leg), a deaf dog (acquaintance went abroad to get a dog; he himself is nearly deaf; on the way back they discovered the dog was as well), and another horse developing gastro-intestinal issues along with its owner. My girlfriend happens to have issues with her gastro-intestinal system as well, for whatever this information is worth. I don't know your thoughts on this, or anyone else's on this forum as such, but I've seen too many incidences of this happening for it to be mere chance (generally with horses; I practice and occasionally teach Natural Horsemanship). I'm not saying it's causative, but we all know the animal chooses the owner rather than the other way around. Let's say I wouldn't be surprised if the issues turned out to be similar; those two exhibit quite similar characteristics as it is as well as sharing a deep bond. IBS or an IBD would fit like a glove (or, to trouble a literal translation of the more brutal German version, like the fist on the eye).

We're now looking into preparing food ourselves and reading up on how to do so properly. Until then, I guess we'll keep with the food rotation, even if it makes it impossible to gauge how much she's actually eating. We were advised not to go for ready-made raw food since those apparently are full of multi-resistent germs which would probably wreak havoc on her if she caught any of them (can't imagine prolonged starvation had positive effects on her immune system).

Thanks again for your detailed and long reply, I'm looking forward to your assessment of the report :-); I'll see to uploading videos later today/tomorrow.

 

[mr1992]

Didn't work with the videos today; sorry, also forgot about responding to Jcatbird; the "thud" thing happened all the time - she looks graceful but lands a bit, well, hard when jumping off things; you tend to hear her before you see her, but that has always been the case. She doesn't have any issues running into things or mistaking distances, however. Personally, I don't suspect a medical condition but rather a character trait - my parent's cat for instance is the complete opposite of her in character: she looks ungraceful (she's honestly a fat blob who doesn't like to move - energy saving cat really [put on a really low diet, no snacks, she's really got trouble losing weight worsened by the fact that she doesn't want to move, it's not because people actively overfeed her or don't care]) but whenever she does run/jump off things, you don't hear a thing. She's spent more time in the "wild", which we suspect may be connected; she has become less caring about being silent as time progressed, though she's still stealthy. As for the purring, I think that was mainly connected to us stroking her since that's when she'd really start purring loudly - she didn't just lie there purring to herself that I saw, usually only ever when she sought either of us out.

Thanks for the advice with the vet, that's what we've been doing so far; I usually let my mum who's working for him know so she can relay it the next day. My girlfriend had kept a diary for a while regarding what we fed her when she alternated between diarrhoea and constipation, but that didn't really show anything useful; there seemed to be no correlation safe for fish which she can't take (and hasn't got for over a year now). Litter box habits are somewhat fluctuating; we keep a close eye on her stool; water intake corresponds with her eating (less when "fasting", more when eating dry food). It's hard to tell how much she's drinking exactly since we've got a fountain and another water source plus dry air from the heating, causing water to evaporate, so we judge by the frequency we observe her seek those two out.

I truly hope it's something simple; thanks for your reply and the healing purrs! She's indeed quite adorable, though at times I feel she's the devil in disguise; I reckon most cat owners feel that way about their own little devil-spawn(s) every now and then

 

[mr1992]

Update:

Cats being cats, their ways are unknown to man. She's suddenly taken a liking for cat food designed for indoor cats and has fully regained her appetite and activity, even demanding more to the point that we have to watch her rations to prevent overfeeding her. Also, she's back to stealing human food when I negligently left some fat trimmings on the coffee table the other day (usually doesn't happen, but since she didn't eat, I grew a bit careless). She's playful and active, running around and being annoyed because we can't devote all of our day to playing with her. As her food intake normalised, so did her shivering subside; it rarely ever happens now - it's not fully gone, but went down drastically to the point that it doesn't even stand out. I hope it'll fully disappear. Her stool is likewise regular and of normal consistency.

As to what it was, we still have no bloody idea. It definitely seems to originate from starvation and thus her gastro-intestinal system. We've let her in the cellar again (finally identified the cause of the mould and will fix it soon) and her symptoms didn't worsen in any way, causing us to discard it being the cause. Once I've got some free time, I'll take a look and see what's different about the food she's currently eating as opposed to what we've fed her before, perhaps this will elucidate the matter further.