Decreased senior appetite, normals labs & imaging

CatLover49

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I have a tendency to write essays so I will try to keep this brief.

Back in April, I noticed my cat Amber (15) was eating less wet food than normal. I noticed she only wanted it fresh from the can, not leftover (even warmed up) from the fridge.

My original expectation was constipation, she's had issues before and needed an enema just over a year ago.

Day One
I took her to the vet in May. They found no abnormalities other than cranial abdominal pain. Her caudal colon was empty. Took blood & urine to send to lab. The blood/urine was NOT sent that day so we had no results the next day. That day, they gave her a Simbadol injection for pain. She had a bad reaction to it (ataxia, anorexia, restlessness, would not eat/drink). It was awful.

Day Two
The next day we brought her back for SQ fluids and Cerenia injection and Mirtazapine. We opted to do x-rays since her stomach still hurt. The x-ray showed abnormal intestines, appearing bunched similar to foreign object. Vet though possible cancer so then we did an ultrasound same day. Since the lab work was never sent, they did stuff in house (but neglected to do urine) and all results were normal.
The ultrasound showed all normal findings except for a benign liver cyst, they called it a cystadenoma.

After this, we brought her home and she still didn't eat for 48 hours following the Simbadol injection. I noticed when she finally did eat she had some trouble getting food in her mouth.

Day Three
Brought her back to have her mouth looked at. Vet thought everything looked fine but her jaw was tense so she thought she had TMJ or arthritis in her haw and Rx'ed 3-day trial of Onsior.

Amber did very well those three days and ate a ton of wet food.

But I was not very satisfied with the whole experience or diagnosis so last week I brought her to Vet 2 - a cat-only vet.

Last Monday
Their exam findings included a grade 4 heart murmur, cataracts and abdominal pain. She had lost some amount of weight from 8.9 to 8.5 lbs. Mouth/teeth looked good. Everything else was good. They did a very thorough exam as they found a scar on her tongue she's always had and dark gunk at her nailbeds that I have noticed but never worried about. (Vet thinks the gunk could be related to inflammation somewhere in the body)

Blood tests so far have been normal - includes T4, cardiac pro BNP (snap and external lab), Snap and Spec FPL, kidney/liver/CBC.
Urine test is pending
Vitamin D and magnesium levels pending
Fecal for lungworm pending - have not collected poop yet. (doing this because she snores, vet heard "wheezing" from her throat. she went outside until 2018)

I am feeling BEYOND frustrated and very worried about her. I've spent $2,000 and have no answers why her stomach hurts, why she has been periodically hiding under the bed since the Simbadol incident, why she still does not want to eat her wet food. She seemed to improve for a while in between the two vet visits, but the last few days have been bad - not eating much, hiding under the bed more, not pooping every day.

Could the liver cyst actually be causing her pain? (Vet 1 said this was not anything to worry about) What else could be invisible (not appear on tests) that could cause stomach pain?
Vet 2 (cat only) wants to treat her for biliary colic whatever that means and start her on heart supplements, but she doesn't want to add stuff to her food when she isn't eating it already. She recommended we start CBD oil last Monday and I started it, but today I stopped in case that is causing her to not eat.

I just feel I am at a point where I just don't even know what to do now. Does anyone have ANY ideas about what it could be?

Right now she is under the bed again. I sprayed Feliway and playing calming cat music for her in case she is stressed. I cooked up chicken thigh for her this morning, which she did eat but she has not pooped since Saturday and now I'm worried about constipation on top of everything else, butt she is NOT vomiting.
Please get them to check lungs and other organs
My vet couldn't find anything either til i requested an ultrasound of his abdomen
And they found the problem
My babys lungs were deteriorating
He passed away on 7/15/20
The vet put him to sleep
Sometimes things aren't what they seem
:(:whitecat:😟😔😭
 
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sidneykitty

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Here's today's report. She ate some wet food (tuna/trout mixed with beef) overnight as well as some Go! kibbles.
I split the wet food between 2 bowls - one upstairs and one down. She nearly emptied the upstairs bowl last night.

Again, today, I gave her 2 wet food bowls and she licked the upstairs one clean! This is confirming my feeding location dislike theory. Not that I am loving having smelly cat food in my bedroom, but if it works, then I'll deal! She also ate most of her downstairs wet food today. That totalled over half a can of turkey if I include the wet food she also had her supplements and meds in. (Those were given in Applaws chicken.)

SUCH a good idea to add more bowls around the house, Furballsmom Furballsmom ! :)

She had a more formed poop this afternoon, still soft and a bit sticky. Didn't see any blood this time. She did her normal meowing routine this morning, another good sign. No orange ball yet, but I'll take the baby steps!

Smelled some kitty farts today, but I hope that's a good thing? as it means the gas is moving through instead of getting stuck....

Picked up the Mirtaz today from the vet just in case we do need it. She's sitting on my lap right now.

CatLover49 CatLover49 - thank you for sharing your experience. I am terribbly sorry you lost your cat this way. :( Amber has had an ultrasound and nothing was found aside from a liver cyst. She has also had multiple x-rays over the last few months, so I am hopeful they would have seen any lung issues.

I lost my first kitty to lung cancer and it was awful so its something I always keep in the back of my mind. I'm sorry you had to say goodbye to your cat and I appreciate you sharing your experience. Thank you for coming by my thread.
 
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sidneykitty

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Good news tonight! I was holding back til we had more than one good day.

Yesterday, she must have eaten 1 3/4 of a can of wet food just during the day! She played with her orange ball. She did her morning meows at me.

One of her bowls of wet food left overnight was licked clean this morning (her upstairs bowl)! She even left some kibbles behind overnight. Today she has eaten almost a whole can.

I'm really happy with her progress...Its honestly more than I ever expected! I am crossing my fingers this wet-food-eating trend lasts and looking my cupboard thinking "boy I need to get more of this wet food if she's eating it at this rate which is totally fine with me!"

Another good sign - she's been stretching out and laying stretched out for longer periods of time. The vet was interested in whether she was doing this as curling up all the time could signal tummy pain.

Go Ambie!
IMG_20200713_190721(1).jpg
 
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sidneykitty

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aaaand this morning she sounded like she was throwing up but produced nothing. She hasn't had a properly formed poop since Tuesday and now I am worrying she is getting constipated again.

She hid under the bed briefly this morning after I gave her cisapride in some food.

If she is, I just don't know what to do. but I don't understand how she could be constipated while on cisapride and eating primarily wet food (only giving 1/8 cup of kibble now). Its not sustainable to keep spending 200-300 every 1-2 weeks bringing her to the vet.

The only other reason I could think of if she gets constipated now is that she has some physical stricture or tumor or something which they somehow didn't see on her ultrasound... <Edit: or something neurologic?>
 
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sidneykitty

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addendum to my prior post - ..or that certain foods are giving her tummy pain?

This morning she got her cisapride in a small amount of tuna, then hid under the bed. She came out briefly to eat some wet turkey.

Yesterday, she ate 1/8 cup Go kibble, turkey wet food and beef wet food and cisapride in tuna.
Tuesday, she ate just under 1/8 cup Go kibble, salmon wet food and beef wet food and cisapride in tuna. Tuesday evening I gave her two RC hypoallegenic treats.

But both of those days her behavior was good and was not hiding under the bed. Is it possible the salmon or tuna is having a delayed effect? But in that case why would she be ok the last two days with the tuna? Could it be the salmon from Tuesday? I'll try giving cisapride in something else next time...

Or could it be removal of her Royal Canin fiber response kibble?
 

mrsgreenjeens

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:sigh: Darn it! I was so excited when I read your post from last night, then I read your posts from this morning and my heart just sank. Honestly, I guess it could be any of the items you proposed, and the only way to know which is to stop them one at a time to try to figure out which might be the culprit, if any. Or add back in a little of the Fiber Response. BUT, I wouldn't really do that without consulting with your Vet, becaue I don't know which way they want you to go with fiber....cut back or add more. And perhaps they might like you to try adding it in a different way, like canned pumpkin since she is eating wet food well now. Are you feeding her the fishy food to hide the taste of the Cisapride? How about lamb? It's got a strong smell. Maybe that would work. (I'm going to try that tonight with Darko, who's on medication himself right now and I'm having a heck of a time getting it into him. He can even smell it through salmon food with dried salmon sprinkled on top, that rascal. And it's supposedly a flavored pill.)

So, is Amber back under the bed, or does she act like she feels ok now? This is just a thought, and something else to ask the Vet about, but have you ever tried Slippery Elm Bark? It can't be used within two hours of any medication, but is supposed to be really helpful for digestive issues and also coats the tummy which would be helpful for pain I would imagine.
 
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sidneykitty

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I do sometimes feel like every time I post a positive update, things go downhill which is why I waited two days before updating with the good news. Guess I spoke too soon.

She came downstairs around 10am, so I assume she was under the bed from 8-ish to 10-ish though I didn't check on her because I don't want to bother her. She was under the bed at 8-ish for sure but I don't know if she came out earlier than 10.

I'm giving cisapride in tuna because I want to have a guarantee she'll eat it and get it. I had used Applaws chicken before so I'll go back to that now instead. Its just a small amount of food, <1 tsp.

I stopped the Fiber Response under my own suspicions of too much fiber giving her gas and being hard to digest and because the vet said there are better kibbles we could feed her. I have sprinkled a small amount of crushed fiber kibble on her new kibble to encourage her to transition, but its a very small amount. I am not sure what the vet thinks about fiber for her at this point. I just spoke to the vet tech yesterday with the good news. :ohwell:

That is an interesting idea. I have some of this Animal Essentials Colon Rescue Herbal GI Support Dog & Cat Supplement, 2-oz bottle - Chewy.com which is mostly SEB. I got it a while back for her constipation issues but didn't use it all up. If it lines the coating of the stomach, I guess it might help?

The only trouble is how to give it 2hrs after meds. Right now, she is getting:
2.5 mg cisapride in <1tsp wet food
followed shortly by her wet food (if she eats it)
this is twice a day.

So I'll have to add a middle small amount of something + SEB if I decide to go that route.
 

mrsgreenjeens

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I'm not sure if that product would require the 2 hour wait since it's not full strength SEB. I read all about it and no where does it say to wait before or after giving other medications, although it does say to run it past your Vet if giving medications.

BTW, if she'll take her meds with the Chicken Applaws, I'd probably go with that to see if it's the fish causing issues.
 

daftcat75

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If her gut is moving slowly, it would be better to give her more meals of a smaller size. So you could certainly add a smaller SEB meal somewhere between the other two.
 
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sidneykitty

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BTW, if she'll take her meds with the Chicken Applaws, I'd probably go with that to see if it's the fish causing issues.
I'm planning to do exactly that starting tonight! Just got more of the Chicken Applaws today.

Tonight's update- she finished most of 1/2 can today and stayed out from under the bed the rest of the day.
Spoke to vet - advised to give Cerenia and Mirtaz, so I did so. She has not seemed any extra-interested in food since then, but we'll see.

daftcat75 daftcat75 - yes for sure! I do think smaller meals will help.
I usually put out 1/2 can at once, but she usually only eats 1/4 of a can at a time. She has always been a grazer and comes and goes from her bowl. She almost never sits down and just finishes it in one go. These days, she's been eating 1/4 can around 8-9am, 1/4 can around lunch time and then grazing on what I put out overnight. Its hard to say what she's doing then since I'm sleeping.
But tonight I've just put out some wet food earlier in the evening than I normally do, so we'll see what happens...
 

daftcat75

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Krista gets fed seven meals a day. She gets two breakfasts (5am and 8am) and two dinners (6 pm and 10 pm). Those are 45 grams of food for the first and 50 grams of food for the second. I'm trying to grow her portions now that we've solved the poop issues. (The fish flakes I was wrapping her pred pill in were causing an inflammatory reaction. All the more reason to avoid fish if you can.) She pesters me for food more often during the day than at night. So she gets a lunch at noon (37 grams) and a snack at 3 pm (32 grams.) She also gets an overnight meal (35 grams) usually around 2 am. I don't have a scarf and barf cat. I have a snack and yak cat. She will eat herself fat then keep coming back as long as there is food left. That's why her portions are measured and taper off between the main meals. Her gut has been inflamed for so long that I've had to pace her input to avoid overflowing her output (in one direction or the other.) Since figuring out the fish flakes inflammatory trigger, I'm hopeful we'll finally get a meaningful remission and some weight put back on her.
 

daftcat75

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I have found that Mirtaz, the transdermal, took a little longer to kick in than the pill. I also found that I could get away with a smaller amount with Krista. Because the ruler on the box is awkward, I first converted the 1 inch to millimeters and then would half or quarter it by inking up the edge of an index card or envelope--something I could put up against my gloved finger to provide a more reliable measurement.
 
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sidneykitty

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Amber's got a few more frequent smaller meals today.

The mirtaz definitely kicked in last night. She delighted in her allotted 1/8 cup kibble around 9pm. Overnight, she ate 1/2 can of beef (served in 1/4 can upstairs and 1/4 can downstairs). Then came and meowed very loudly at us over and over very early in the morning as it was not dark but not light out (didn't check the time) while sleeping for more food so I stumbled out of bed to serve her another 1/4 can beef. All the bowls were licked cleaned when I got up this morning.

I gave 0.5 inches of Mirtaz per the vet - they said that you definitely don't need as much as the instructions on the box say anyway.

I also dialed back her Miralax to 1/4 tsp per vet in case its causing diarrhea.

There was a pancake poop in one litterbox and a very small formed poop in the other litterbox as of this morning. So, I am cautiously hopeful...? I did find a little droplet of poop on her butt today that I wiped off with a warm moist paper towel that I'm not sure what to think about.

She was very chatty this morning (she is usually chatty so its a good sign).
 

daftcat75

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Mirtaz can also make her chatty. The drug in it, mirtazapine, is fondly called by many "meowzapine."
 
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sidneykitty

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I think that it was the Mirtaz in the end.

She did really well this weekend. Ate 2 cans of wet food per day. Had an amazing poop Saturday night - Sunday morning.
Meowed at us in the middle of the night for more food.... except for last night. No poops since that amazing one.

And very little appetite today. Still hasn't finished her breakfast 1/2 can. She hid under the bed again for two separate chunks of time today. :(

Debating if I should give her more Mirtaz or not. I don't want to fill her with food if she's in pain or has nowhere to put it...
 

daftcat75

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Mirtaz is an anti-depressant with appetite stimulation as a side effect. Give it a chance and give her a chance to build a baseline with it. Otherwise it's reasonable to assume that it will be uncomfortable to her to start and stop it abruptly. If Mirtaz is helping with her eating and her behavior, keep giving it. Especially because you can probably reduce or eliminate inflammatory foods (fish and kibble.) This, in turn, should be even more useful than laxatives. 🤞
 
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