Freya isn't eating

Antonio65

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I have what it seems it's a rather serious problem with my cat Freya.
She's a tortie cat, 23 months old, spayed, fully vaccinated. She's mainly indoor, apart from those short walks in the backyard on leash and harness. She eats high quality wet and dry food. She's always been fine, eaten fine and used the litter box regularly, even a few times a day.

In the last 8-10 days she's been having a reduced appetite, and this put me in alert. She started eating a bit less in July, but I thought it was the excessively hot weather of that period.
A consistent lack of appetite started on August 18th, when she didn't finish her meals throughout the day.
A bit of a timeline.

August 18: she didn't finish breakfast and dinner (both wet food, chicken)
August 19: she didn't finish breakfast and dinner (both wet food, chicken)
August 20: she didn't finish breakfast and dinner (both wet food, chicken)
August 21: she didn't finish breakfast and dinner (both wet food, chicken)
August 22: she didn't finish breakfast and dinner (both wet food, turkey), didn't touch her lunch (dry) and she only ate a few kibbles at night
August 23: I took her to the clinic. They run a blood test (all fine), did some X-rays that showed some feces in her colon and a slight broncopathy, but I didn't notice any respiratory issues, though she sneezed a few times in the early days of the month. The vet gave her a shot of Cerenia, and prescribed Cerenia and an antacid. Freya didn't eat anything for the whole day (wet was chicken)
August 24: Freya ate fine all meals (wet was fish)
August 25:
She didn't eat apart from half portion of her breakfast (wet was fish)
August 26: She only ate a small portion of her breakfast (wet was fish). I took her in at the clinic and they did an ultrasound scan to her abdomen and found a slight gastritis and inflamed uterine horns, one of which with a small amount of fluid in it.
August 27: She didn't eat anything so far (2:30 pm)

I tried several kinds and brands of wet food.
She used to get her daily water intake from her wet food, she rarely drinks, so now that she isn't eating, she isn't getting her daily water amount either. I'm giving her some water with a syringe, and I'm giving her 1.5 ml Lactulose twice a day.
She isn't visiting the litter box as she used to do either. She is pooping every 36 hours, and peeing every 24 hours.

Freya was spayed in early August 2021, but I had the suspicion that the surgery didn't go well from the very moment she came back home. I discussed this possibility with the vets, but they said it wasn't possible. Then, in May 2022, I managed to have an hormonal test done and this came positive for ovarian remnants in her abdomen. The report from the US scan says something about a possible pyometra, this to be further investigated.
I wonder whether this possible condition may be the culprit for the whole situation. The vets seem they didn't want to take responsibility for the incident and are thinking about what to do.

All the rest seems fine, she plays, even if she's less active, she's affectionate, cuddling, interested in the world outside the window. Sometimes she looks for food, but when I give her something she turns away lip smacking.

Any advice is welcome. Thanks!
 

neely

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The vets seem they didn't want to take responsibility for the incident and are thinking about what to do.
I know how conscientious you are in caring for your cat(s) and will leave no stone unturned when it comes to Freya's health.🤗 From what you mentioned in the above quote do you think it might be time to get a second opinion? Thinking of you and sending healing vibes to Freya.:vibes::vibes::vibes:
 

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I can't be of any real help, but since she ate fine the day after the Cerenia injection, it would seem to have helped. Are you giving her the Cerenia that was prescribed for you to use at home? If so, you might ask the vet for a different med as the oral version just may not be as effective as the injectable one. It is worth looking into until you get more response/information from the vets' investigations.
 
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Antonio65

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From what you mentioned in the above quote do you think it might be time to get a second opinion? Thinking of you and sending healing vibes to Freya.:vibes::vibes::vibes:
I'd really love to hear a second opinion, but I wouldn't know where to go.
I have a few clinics here around, but the one I am currently going to is the one I think is the "less worse", if I can use this term.

The thing is that it's August and all the vets I usually refer to are on holiday and won't be back for a few days.

Anyway, the ovarian remnants is a sure thing, because the LH test we did in May was positive. And the fact that she had cyclical and recurrent episodes of disorientation gives a further certainty to the diagnosis.

The vets proposed an subcutaneous implant to keep her heat cycles at bay, but I am very reluctant.
 
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Antonio65

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Are you giving her the Cerenia that was prescribed for you to use at home?
Yes, I forgot to say that she's taking the Cerenia pills (today was the last pill), along with the antacid, the Lactulose, and the metoclopramide.
Also the vet added a supplement of fibers and psyllium to help the bowel movement.
 

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Antonio65 Antonio65 Do Freya's blood tests show any signs of infection? If it is the inflammation that has been noticed, I wonder if a short course of prednisolone or Onsior/Metacam could help her feel better? A short course in an otherwise healthy young cat wouldn't be dangerous. Is Freya getting any pain medication for the inflammation by any chance? If her abdomen is inflamed, she might be in discomfort and not want to eat (or be as active as usual). The Cerenia can also be given at 1mg/lb of kitty, in case your vet isn't prescribing up to the full dosage. The lip-smacking is a sign of nausea so more Cerenia or some Zofran (ondansetron) would help her. Cerenia is not just anti-nausea but also anti-inflammatory and can help with the visceral pain in her GI system. Increasing her fluid intake (maybe even getting one sub-q session at the vet office) might also help with her litterbox usage.

I know you definitely went all over Europe to get help for your other kitties, and if Freya can get over this hump with supportive care, perhaps you have time to seek out a second opinion about her ovaries and the mistake with the spay surgery at another facility further away. I hope little Freya does feel better soon.
 
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Antonio65

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W WMM201 , no sign of infection or imbalance whatsoever. All values are exceptionally perfect. All values but the creatinine being at 1.8 where 1.8 is the max range, but I blame this on the fact that probably Freya was a bit dehydrated from not assuming enough water.

Freya isn't taking anything else from what I mentioned. She doesn't seem in pain, she acts like herself, has happy eyes, the third eyelid isn't showing, no temperature. She's fine otherwise.
The only thing is that she's refusing all food.
 

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These are all good signs from her tests. Maybe some sub-q fluids will help with the possible dehydration--especially if she isn't eating--and get her feeling better enough to want to eat again. A B12 injection could also help perk her up a bit. Good luck and I hope Freya eats soon!
 

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Yes, I forgot to say that she's taking the Cerenia pills (today was the last pill), along with the antacid, the Lactulose, and the metoclopramide.
Also the vet added a supplement of fibers and psyllium to help the bowel movement.
Fibers and psyllium will inhibit absorption of other concurrent medications and supplements. Are you separating the doses by a few hours?

And B12 is a great idea, it can only help!
 
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Antonio65

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All medications are separated.
The Lactulose 20 minutes prior to the antacid, which in turn is 20 minutes prior to metoclopramide. Then I wait for 5 minutes and give food.
Fibers and psyllium are given along or right after food.

In the past, with another cat, I would give psyllium seeds along with wet food.
 

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Are Freya's medications and supplements given within about 45-60 minutes of each other? That won't be enough time for her body to absorb the antacid and metoclopramide before she has the fiber and psyllium. I'm wondering if you should wait longer between medications and/or consider changing some of Freya's prescriptions.

Antacids can reduce the effectiveness of lactulose. And metoclopramide has the same functions as some of her other meds and supplements: it's anti nausea like Cerenia (but I have read Cerenia is more effective in cats than metoclopramide), it promotes gastric motility like fiber and psyllium (I've also read metoclopramide is less effective at motility than cisapride), and it decreases acid like antacids.

I also just read that metoclopramide crosses the blood brain barrier and can have the following side effects:
Side effects are infrequent in cats, but clients have reported disorientation, frenzied behavior, and hiding tendencies associated with the medication.
Diagnostic strategy for vomiting in dogs and cats (Proceedings)

She seemed to eat well with the Cerenia, so you may want to ask your vet about continuing the oral Cerenia at home. Ask your vet if a combination of Cerenia, antacids and fiber & psyllium could be a more effective regimen and if any of those should replace medications she is taking now.
 
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Antonio65

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Are Freya's medications and supplements given within about 45-60 minutes of each other? That won't be enough time for her body to absorb the antacid and metoclopramide before she has the fiber and psyllium. I'm wondering if you should wait longer between medications and/or consider changing some of Freya's prescriptions.
I suspended the metoclopramide on Saturday, that taste was too terrible for her to stand, and I feared it could make Freya lose trust in me.
The antacid course ended yesterday morning.
I'm still using the lactulose, to which I am adding 5 ml of water 10 minutes prior to and after it. Also I'm giving her a supplement of fibers and psyllium.

As for the separation of meds, I spaced them by about 20 minutes each. The whole process, from water, to supplements, to meds, was already long enough, and it was delaying the meal time by an hour and a half.

She ate something this morning, only half of her usual breakfast, but it's better than nothing. Yesterday she barely ate 15 grams of wet food and 15 grams of dry food throughout the day.
She pooped Saturday night and this morning, and she peed twice in the last 36 hours, far from what I was used to, but it's something.

This morning she is more active, but since yesterday she isn't recognizing her name. This happens often, about every 15 to 20 days.
 
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Antonio65

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In the meanwhile, although you may have seen this other readers may not have so I'll post it;

Any Good Tips To Get Your Cats To Eat? Share Them Here!
So far I would like her to eat on her own. I wouldn't like to mess with her habits, she looks very fragile in this moment and I fear that every change in her habits could tip her off.
I tried to warm up her food a little, like I used to do in colder months, but this didn't help.
Adding stuff like Fortiflora, cheese, tuna water might get her suspicious.
Even syringe-feeding her is something I would like to avoid now, I wouldn't like her to see the food as a torture, or associate a taste to a torture.
The vet said he doesn't want to use the appetite stimulant (Mirtazapine) yet, because it would be a false hunger without understanding what the cause of her lack of appetite is. In my opinion this new vet knows very little about cats! I can't wait for my usual vets to come back from their holiday.
 

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Freya was spayed in early August 2021, but I had the suspicion that the surgery didn't go well from the very moment she came back home. I discussed this possibility with the vets, but they said it wasn't possible. Then, in May 2022, I managed to have an hormonal test done and this came positive for ovarian remnants in her abdomen. The report from the US scan says something about a possible pyometra, this to be further investigated.
I wonder whether this possible condition may be the culprit for the whole situation. The vets seem they didn't want to take responsibility for the incident and are thinking about what to do.
When will your regular vets return from holiday? There are some other discussions on this site about ovarian remnants that may be very helpful.

The vets proposed an subcutaneous implant to keep her heat cycles at bay, but I am very reluctant.
It may be wise to be reluctant, it sounds like surgery to remove the remnants is probably the best option.

Cat Is Spayed, But Acts Like She Is In Heat
If this truly is an ovarian remnant then surgery is the only answer and your vet is correct the ovarian tissue might be difficult to find. Having said that, the long term risk of leaving that ovarian tissue intact, is greater than the risk of another surgery. If this was my cat I would go into the abdomen and find the ovarian tissue.
Ovarian Remnant Syndrome in Cats | VCA Animal Hospital
Cats with an untreated ovarian remnant are subject to the same risks as cats that are not spayed. The continued presence of estrogen predisposes cats to mammary gland tumors (breast cancer), ovarian tumors, and pyometra (infection of the uterus). Pyometra is a serious and life-threatening condition that requires urgent veterinary care.
 
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Antonio65

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When will your regular vets return from holiday? There are some other discussions on this site about ovarian remnants that may be very helpful.
I was told that the US scan tech should be back on Thursday, September 1st. I guess my other vet is back within this week too.

It may be wise to be reluctant, it sounds like surgery to remove the remnants is probably the best option.
Cat Is Spayed, But Acts Like She Is In Heat
Ovarian Remnant Syndrome in Cats | VCA Animal Hospital
Yes, I know. And a possible Pyometra is what they mentioned in the report from the last scan. But I want to wait for my trustworthy tech, I trust him much more than the one who ran the scan last week.
 

Furballsmom

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What about trying something like using a flat paper plate, or getting her to eat off your finger, or even off the floor. She has to eat.
 
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Antonio65

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I also tried to put some food on a flat surface, but she's just not interested in food too much. She is nibbling, but not eating.

When I would prepare their dishes, they were both at my feet, meowing, rubbing and even scratching my legs, then they would both run to their positions (apart from each other) and would scarf down the meal.
Now Freya looks at me preparing the dishes from a distance, or sometimes she walks around me, but then she doesn't follow me, and when she does, she just sniffs the food, eats some, then walks away.

Yesterday she ate 20 grams of wet food and 20 grams of dry food. From the nutritional tables of those foods, I know that Freya got 100 kCal throughout the day, rather than the 200-220 she should get.
And yesterday was a good day... ☹
 

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Oh dear, I'm sorry 😞.

I apologize I haven't looked through your entire thread, but what did the vet say?
 
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