Cat with kidney disease not eating

[kazanlak]

Infrequent poster here but I need help. I should warn that I’m a complete wreck from trying to handle this and this post may not be the most complete or well articulated. I’ll answer any questions I can to help fill in any blanks I may leave below

I just lost one of my cats this past Christmas Day and now following a sudden worsening of appetite his surviving sister has been diagnosed with kidney disease. My desire is to try to manage her condition until it cannot be, essentially.
The problem is that she still isn’t eating. She has only been consuming very small amounts of food, mostly baby food, or that nutritional gel in a tube, for about a week now. Sometimes she doesn’t even eat the baby food.
This all went down while I was on vacation so I was home and this able to offer her many small “snacks” throughout the day. Sometimes she would eat and sometimes she wouldn’t. However now that I’m back at work the need to get her back to eating actual meals is more urgent since I cannot be home to provide constant small food items
I have Mirataz however the vet initially advised a reduced dosage/frequency due to my cats kidney issue. So she’s only had one dose so far to no avail. However in a conversation yesterday the vet indicated that at this point upping the dose might be worth trying, since getting her to eat is becoming more critically important by the day. So that’s a possible avenue.

i also previously tried something called Elura, which is also supposed to be an appetite stimulant but have found it to be ineffective.

I suspect a nausea issue is at work here as she acts interested in eating, and will often approach the food offered, sniff it and walk away. With actual cat food, at best she will lap up the gravy or broth but more often she rejects it entirely. She seems particularly repulsed by anything fish-based.
Cerenia to control nausea did not seem to help her appetite at all. The vet noted that even following SubQ fluids my cat seems to get dehydrated again very quickly, which I guess indicates that her kidneys really aren’t working well. She’s had a lot of SubQ fluids over the last week. Her appetite does sometimes seem *slightly* improved following a fluid injection but the effect is minimal and short lived. So the SubQ appears to maybe be doing something to help dehydration-related nausea but not very much. I have the stuff to administer fluids myself at home, but have had a difficult time A. Being at ease with doing it and B. Not botching it when I try to do it, which is upping my anxiety about the situation.

im just seeking any input for possible solutions. Because she still seems happy and sociable and is still very mobile, I feel like her condition is manageable *if* I can get her eating reliably. While getting her to eat anything reliably and in sufficient quantity is an improvement, I really want her back on actual solid cat food for nutritional reasons, as I’m aware what she is eating now is not a sustainable diet.

anyone have any ideas, or solutions that worked for them in similar situations? I’m trying to do everything that I can but feel like I just keep hitting a wall.

 

[FeebysOwner]

Hi. There are other anti-nausea meds to try, as well as a couple of other appetite stimulants - ask your vet if you can try others. What are her kidney values/levels, and does she have any other medical conditions that could be impacting her situation? I am not yet to the point of having to give sub-Q fluids, but so many folks say that after a few times, it becomes easy to do/manage. So, keep that in mind.

It might be that your cat would do better on Mirtazapine (oral) vs. Mirataz (transdermal). Many folks have to give both an appetite stimulant AND anti-nausea meds at the same time to get results. So, that also could be part of your problem with getting her to eat. Almost all meds will have some impact on the kidneys, but that is better than having a cat starve to death and is worth the risk to prevent that from happening. So, I would forge ahead with this trying both meds at the same time to see if that might make a difference.

I have Feeby on Mirataz - 1/2 of the normal dose, every third day. So, far that seems to be working - but, not always. During those times it seems less effective, I am wondering if those are the days that she is experiencing nausea - more than what the Mirataz can help with. Mirataz has some anti-nausea effects, but not nearly as much as some of the more focused anti-nausea meds. Cerenia just may not be the answer for your cat.

While I hope you soon hear from others on this site with more experience than I have - there are two other places to go besides here for information and help 1.) Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org) and 2.) [email protected] | Home.

The first one has tons and tons of information about kidney disease and is a lot to read, but well worth the time to go through it. The second one is a forum you can join to ask questions, once you've had a chance to get through some of the basics on the first web site. These folks all have a lot of experience with treating cats with kidney disease and would be most helpful in making suggestions about other appetite stimulants, anti-nausea meds, as well as handling sub-Q fluids.

A couple of links to direct pages in the first web site - in case that helps to get the ball rolling with reading up the available information.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - How Bad Is It? (felinecrf.org)
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Treatments Overview (felinecrf.org)
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Fluid Therapy (felinecrf.org)

Will keep my fingers crossed you get many helpful responses - very soon!!

 

[kittyprincesss]

Infrequent poster here but I need help. I should warn that I’m a complete wreck from trying to handle this and this post may not be the most complete or well articulated. I’ll answer any questions I can to help fill in any blanks I may leave below

I just lost one of my cats this past Christmas Day and now following a sudden worsening of appetite his surviving sister has been diagnosed with kidney disease. My desire is to try to manage her condition until it cannot be, essentially.
The problem is that she still isn’t eating. She has only been consuming very small amounts of food, mostly baby food, or that nutritional gel in a tube, for about a week now. Sometimes she doesn’t even eat the baby food.
This all went down while I was on vacation so I was home and this able to offer her many small “snacks” throughout the day. Sometimes she would eat and sometimes she wouldn’t. However now that I’m back at work the need to get her back to eating actual meals is more urgent since I cannot be home to provide constant small food items
I have Mirataz however the vet initially advised a reduced dosage/frequency due to my cats kidney issue. So she’s only had one dose so far to no avail. However in a conversation yesterday the vet indicated that at this point upping the dose might be worth trying, since getting her to eat is becoming more critically important by the day. So that’s a possible avenue.

i also previously tried something called Elura, which is also supposed to be an appetite stimulant but have found it to be ineffective.

I suspect a nausea issue is at work here as she acts interested in eating, and will often approach the food offered, sniff it and walk away. With actual cat food, at best she will lap up the gravy or broth but more often she rejects it entirely. She seems particularly repulsed by anything fish-based.
Cerenia to control nausea did not seem to help her appetite at all. The vet noted that even following SubQ fluids my cat seems to get dehydrated again very quickly, which I guess indicates that her kidneys really aren’t working well. She’s had a lot of SubQ fluids over the last week. Her appetite does sometimes seem *slightly* improved following a fluid injection but the effect is minimal and short lived. So the SubQ appears to maybe be doing something to help dehydration-related nausea but not very much. I have the stuff to administer fluids myself at home, but have had a difficult time A. Being at ease with doing it and B. Not botching it when I try to do it, which is upping my anxiety about the situation.

im just seeking any input for possible solutions. Because she still seems happy and sociable and is still very mobile, I feel like her condition is manageable *if* I can get her eating reliably. While getting her to eat anything reliably and in sufficient quantity is an improvement, I really want her back on actual solid cat food for nutritional reasons, as I’m aware what she is eating now is not a sustainable diet.

anyone have any ideas, or solutions that worked for them in similar situations? I’m trying to do everything that I can but feel like I just keep hitting a wall.

So sorry to hear about your baby. CKD kitties really make your heart hurt...as so many of us have experienced this rough journey you are on now.

Here is a site many of us have relied on during crisis: Tanya's Comprehensive Kidney Kitties Guide

What helped my boy kitty who hated eating towards the end, was Omeprazole to lower his stomach acid, which in turn took away A LOT of his nausea. I had it compounded at the clinic so that it was liquid and tasted like chicken.

Some foods to try: Delectable squeeze tubes (they have senior special ones if your cat needs extra vitamins), Tuna water from a can on whatever wet food you have on hand, Delectables Bisque (this is like a soup and it comes in Salmon flavor)

Words of wisdom I found here were that once kidney kitties start refusing food, what matters is just getting them to eat whatever, no matter the phos %. When my boy got sick, I fed him Fancy Feast Gravy Lovers. Not the best food for a kidney cat BUT he would finally EAT. That is all we care about! They also sell a Fancy Feast Pate that has a Gravy Center, which I found at my local PetSmart. He would also eat anything I put FortiFlora on, I would sprinkle it on top and he would be crazy for it!

If she is constipated, that will also make nausea sky rocket, so be on poop alert and see if she needs some extra help

 

[kazanlak]

Hi. There are other anti-nausea meds to try, as well as a couple of other appetite stimulants - ask your vet if you can try others. What are her kidney values/levels, and does she have any other medical conditions that could be impacting her situation? I am not yet to the point of having to give sub-Q fluids, but so many folks say that after a few times, it becomes easy to do/manage. So, keep that in mind.

It might be that your cat would do better on Mirtazapine (oral) vs. Mirataz (transdermal). Many folks have to give both an appetite stimulant AND anti-nausea meds at the same time to get results. So, that also could be part of your problem with getting her to eat. Almost all meds will have some impact on the kidneys, but that is better than having a cat starve to death and is worth the risk to prevent that from happening. So, I would forge ahead with this trying both meds at the same time to see if that might make a difference.

I have Feeby on Mirataz - 1/2 of the normal dose, every third day. So, far that seems to be working - but, not always. During those times it seems less effective, I am wondering if those are the days that she is experiencing nausea - more than what the Mirataz can help with. Mirataz has some anti-nausea effects, but not nearly as much as some of the more focused anti-nausea meds. Cerenia just may not be the answer for your cat.

While I hope you soon hear from others on this site with more experience than I have - there are two other places to go besides here for information and help 1.) Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org) and 2.) [email protected] | Home.

The first one has tons and tons of information about kidney disease and is a lot to read, but well worth the time to go through it. The second one is a forum you can join to ask questions, once you've had a chance to get through some of the basics on the first web site. These folks all have a lot of experience with treating cats with kidney disease and would be most helpful in making suggestions about other appetite stimulants, anti-nausea meds, as well as handling sub-Q fluids.

A couple of links to direct pages in the first web site - in case that helps to get the ball rolling with reading up the available information.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - How Bad Is It? (felinecrf.org)
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Treatments Overview (felinecrf.org)
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Fluid Therapy (felinecrf.org)

Will keep my fingers crossed you get many helpful responses - very soon!!

thanks for the links!
I have a printout with her kidney info on it but I’m at work and don’t have it handy. As far as other issues that might be contributing to the lack of appetite, She has been prone to to IBD in the recent past, which I had gotten under control with a probiotic called Visbiome, which did a great job reducing both diarrhea and vomiting issues.

[Incidentally her deceased brother had developed intestinal lymphoma, which may have originated as chronic IBD, so I’m hoping that she hasn’t progressed to lymphoma as well. Her symptoms were not as severe as his. He actually died from a reaction to the drug the specialist vet - not my regular vet- prescribed to manage the lymphoma]

It seems like her bowel issues have begun flaring up again, either simply due to my inability to get the VisBiome into her because she isn’t eating or just because what she is eating is so poor quality. So that could be a contributing factor to her appetite problems, her stomach has been pretty “gurgly” of late.

1/2 dose of Mirataz, every three days is what my vet advised as well, although like I said she has floated the possibility of trying a “Hail Mary” and going with a full or more frequent dosage.
I can ask about oral Mirtazapine, however Olga has started refusing to eat pill pocket and pills by hand with extreme difficulty and I worry about making the pilling process traumatic for her.

Olga and her deceased brother have done pretty well on Cerenia in the past for regular nausea and vomiting issue but perhaps you are correct that it isn’t the right anti-nausea for this situation

 

[kazanlak]

So sorry to hear about your baby. CKD kitties really make your heart hurt...as so many of us have experienced this rough journey you are on now.

Here is a site many of us have relied on during crisis: Tanya's Comprehensive Kidney Kitties Guide

What helped my boy kitty who hated eating towards the end, was Omeprazole to lower his stomach acid, which in turn took away A LOT of his nausea. I had it compounded at the clinic so that it was liquid and tasted like chicken.

Some foods to try: Delectable squeeze tubes (they have senior special ones if your cat needs extra vitamins), Tuna water from a can on whatever wet food you have on hand, Delectables Bisque (this is like a soup and it comes in Salmon flavor)

Words of wisdom I found here were that once kidney kitties start refusing food, what matters is just getting them to eat whatever, no matter the phos %. When my boy got sick, I fed him Fancy Feast Gravy Lovers. Not the best food for a kidney cat BUT he would finally EAT. That is all we care about! They also sell a Fancy Feast Pate that has a Gravy Center, which I found at my local PetSmart. He would also eat anything I put FortiFlora on, I would sprinkle it on top and he would be crazy for it!

If she is constipated, that will also make nausea sky rocket, so be on poop alert and see if she needs some extra help

Yes, without going into too much detail, I’m not a guy who cries easily and this situation with Olga has devastated me and left me a total wreck. I have broken down in tears on the phone with the vet or in the vets office multiple times in the past ten days. I had her and her brother Boris since 2006, and just lost Boris this past Christmas Day. I haven’t been sleeping and I’ve been losing weight from stress, and I don’t have a lot of extra weight to lose. So basically this is killing me, and being back to work now, and being unable to tend to her like I was doing while I was off, is causing my anxiety to spike as well.

during last night’s vet visit (there’s been a lot of them this week…my vet has been very accommodating) my vet administered something called sulfacrate, that might help “coat” Olga’s stomach in the event she has ulcers. This didn’t go well, and Olga vomited like twenty minutes after her dose, and a couple more times after once a few minutes after the first time and again like an hour or so later after eating a small quantity of kibble. I administered a cerenia as I became concerned about repeated vomiting (I usually won’t administer Cerenia after only one vomiting or two widely spaced ones). After the events of last night I opted to skip the prescribed morning dose of the sulfacrate until I could reconvene with the vet, hopefully today.
My vet did also suggest Omeprazole. She noted that the cat version was extremely expensive but that I could use the over the counter version by splitting a 10mg tablet into fourths (so 2.5mg). So far all I’ve seen are 20mg, which I haven’t bought yet because trying to split the pills into eighths starts seeming a bit tricky, however if I remain unable to find 10mgs I guess I’ll have to figure out a way to make it work.

yeah, I’ve been worried about giving Olga crap food but my vet has echoed your sentiment of “right now just getting her to EAT period, is what we need”. I don’t believe I’ve tried the exact products you suggested but I’ve tried so many at this point. Anything “fishy” seems to really put her off right now.
early on and briefly, FortiFlora was nominally effective at spurring her to eat but it hasn’t really worked in a number of days now.
Her diet is still basically beechnut chicken or turkey baby food, when she’ll eat it (she’s inconsistent with this) Tomlyn nutritional gel, and a few Temptations treats or bites of kibble. I had her eating bits of sliced ham (suggested by the vet, I asked about pork not being good for cats and she again reiterated that *right now* we just need to get her eating) at 1am this morning, but then she refused it at 3am and 5am.

I’m trying to do anything I can but I honestly feel like I’m on the verge of a nervous breakdown.

 

[FeebysOwner]

I can ask about oral Mirtazapine, however Olga has started refusing to eat pill pocket and pills by hand with extreme difficulty and I worry about making the pilling process traumatic for her.

I don't think there is any reason you can't crush up the Mirtazapine and mix it with a bit of food/treat and then give her a meal afterward, just so you know she ingests it all. The smallest dosage of Miratzapine as far as I know (without compounding it) is 7.5mg. Technically, that means you would start out with no more than 1/4 of a pill (1.8 mg), so the amount to crush cannot possibly be that much and should be easier to hide in a bite of something she will eat. I will be honest though; most people try to go for half of that so you would be splitting a 7.5 mg into at least eight parts. Even then, it comes out a tad bit higher than the 1/2 dose of Mirataz (.75mg). I know of folks who actually crush the pill and then split the 'powder' into equal parts. I merely suggested it to you because it seems some have better success with the oral med.

However, having said all that, Mirtazapine would be more likely to cause digestive issues as opposed to Mirataz - so, given the IBD issue you might really be better to stick with the Mirataz and just increase the frequency if need be.

 

[kazanlak]

I don't think there is any reason you can't crush up the Mirtazapine and mix it with a bit of food/treat and then give her a meal afterward, just so you know she ingests it all. The smallest dosage of Miratzapine as far as I know (without compounding it) is 7.5mg. Technically, that means you would start out with no more than 1/4 of a pill (1.8 mg), so the amount to crush cannot possibly be that much and should be easier to hide in a bite of something she will eat. I will be honest though; most people try to go for half of that so you would be splitting a 7.5 mg into at least eight parts. Even then, it comes out a tad bit higher than the 1/2 dose of Mirataz (.75mg). I know of folks who actually crush the pill and then split the 'powder' into equal parts. I merely suggested it to you because it seems some have better success with the oral med.

However, having said all that, Mirtazapine would be more likely to cause digestive issues as opposed to Mirataz - so, given the IBD issue you might really be better to stick with the Mirataz and just increase the frequency if need be.

dosing her with anything that needs to be ingested orally is going to cause problems regardless right now I think, just because she’s not eating pill pockets right now and so pretty much any oral meds are going to have to be forced…which I hate doing. And since I’ve already got *other* stuff that might need to be administered that way I’d love it if maybe just upping the Mirataz to a more normal dosage would help it’s effectiveness. Just to avoid having to force feed her yet another medication.

you probably can’t tell based on reading what I type but I’m actually pretty much in a full blown 24/7 panic over this.
It would be one thing if Olga were giving me signs that it is her time, that she is suffering etc…I think I would be more at ease with the state of affairs, but aside from the not eating her demeanor is still that of a cat who wants to live so my heart is breaking that I apparently can’t manage this.

 

[FeebysOwner]

I totally get it!

Re: Cerenia - injection or pill? If not injection, you could go that route (they have a sub-Q, so you could do it yourself). One less pill forcing session. Re: Omeprazole - this can be compounded into a liquid form, which I believe could be added to a bite of anything she will eat, before her first meal of the day. But Amazon does carry the 10mg version, if you can't find it at that dose elsewhere. Have you tried local drug stores? I am pretty sure CVS and Walgreens, as well as Rite Aid all carry that dosage - most likely ones in their own brand. Re; Sulfracate - if you should ever consider trying this again, these tablets can be dissolved in water and administered via oral syringe, if that would be a better route for your kitty.

Try the Gerber Stage 2 baby food meats - if for no other reason than to see if this gives her a change of pace. Feeby eats these as a supplement (calorie booster) to her regular food. Gerber does contain corn starch, but it isn't a problem with many cats, so may be another option for you. Any of these baby food meats can be made into complete meals for cats if there are a few your cat would eat at least regularly. See attached file below for how to accomplish that.

Btw, Feeby 'ditched' FortiFlora very quickly, so you are not alone on that one!

 

[kazanlak]

I totally get it!

Re: Cerenia - injection or pill? If not injection, you could go that route (they have a sub-Q, so you could do it yourself). One less pill forcing session. Re: Omeprazole - this can be compounded into a liquid form, which I believe could be added to a bite of anything she will eat, before her first meal of the day. But Amazon does carry the 10mg version, if you can't find it at that dose elsewhere. Have you tried local drug stores? I am pretty sure CVS and Walgreens, as well as Rite Aid all carry that dosage - most likely ones in their own brand. Re; Sulfracate - if you should ever consider trying this again, these tablets can be dissolved in water and administered via oral syringe, if that would be a better route for your kitty.

Try the Gerber Stage 2 baby food meats - if for no other reason than to see if this gives her a change of pace. Feeby eats these as a supplement (calorie booster) to her regular food. Gerber does contain corn starch, but it isn't a problem with many cats, so may be another option for you. Any of these baby food meats can be made into complete meals for cats if there are a few your cat would eat at least regularly. See attached file below for how to accomplish that.

Btw, Feeby 'ditched' FortiFlora very quickly, so you are not alone on that one!

Its the pill form of Cerenia. Olga did get an injectable Cerenia dose once but it’s generally the pills because I typically keep a supply of them on hand.
I just spoke to my vet and she is going to look in to other anti-nausea options

So far all I’ve found is 20mg omeprazole but since I was just informed about it last night I haven’t conducted a super thorough search yet. I’m going to have to physically go to the stores I guess vs just calling and asking because over the last two years getting a live person on the phone at a CVS or Walgreens pharmacy has become next to impossible. Liquid compound could be an option but in the short term I’d like to have something on hand to deploy over the weekend when my regular vet is closed. (She did give me her personal cell in the event of an emergency situation this weekend but I only will use that if something goes really wrong, so as not to abuse the privilege) Worst case scenario I guess I’ll get 20mg tablets, try to cut them into eighths as best I can and err on the side of giving too *small* of a dose vs too large.

dissolving the sulfacrate in water and administering by syringe is actually how my vet did it and how I was directed to do it, so either it was just a fluke or Olga may be intolerant of this stuff. Because I forgot to ask during the conversation we just had, I’m waiting on clarification from my vet whether I should try it again
We did also decide to go up to a *whole* dose of Mirataz, every three days. As opposed to just half.

I’ll give the Gerber foods a try for a change of pace. I’d been avoiding Gerber because of the corn starch in them and sticking with Beechnut, but if the corn starch isn’t really a concern maybe adding some variety would help. Because she’s really starting to not eat the Beechnut particularly well either.
I’ll definitely read through that how to guide. One of my main concerns with leaning so heavily on baby food is the insufficient nutritional content.

 

[kazanlak]

I actually got word from home that Olga just threw up, which shouldn’t be happening if she’s still inside the 24hr window since she received the Cerenia last night. So that’s worrying. I’m going to try and get back in touch with my vet and relay this info to her

 

[fionasmom]

I am so sorry that you are going through this and have nothing else constructive to add except to say that my cats greatly prefer the Gerber's baby food meats over Beechnut and it has never hurt anyone. I use the ham flavor in extreme situations.

As for the sucralfate, my dog throws it back up no matter if I make the slurry or use it in pill form. This is supposedly very rare, but it does happen.

 

[kazanlak]

I am so sorry that you are going through this and have nothing else constructive to add except to say that my cats greatly prefer the Gerber's baby food meats over Beechnut and it has never hurt anyone. I use the ham flavor in extreme situations.

As for the sucralfate, my dog throws it back up no matter if I make the slurry or use it in pill form. This is supposedly very rare, but it does happen.

yeah in light of the update that Olga threw up, the vet has advised me to just administer the new anti-nausea for now when I pick it up in about a half hour and to hold off on re-administering the sulfacrate for the time being.