Is this medical or behavioral?

simbly

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Hi my cat Simba is about 7 years old and has for the last three or so weeks become severely constipated, only having bowel movements every 4-6 days. For the last two weeks he has also become very picky with what he'll eat. Over the course of six weeks he has slowly become fed up with his regular food and two weeks ago stopped eating it altogether. But he will eat something novel for a bit, only for 2-3 meals of it though. So I've had to change his diet over and over again in the last two weeks. This has caused diarrhea twice but he goes back to being constipated for days afterwards. He's also more depressed and lethargic and no longer jumps on the bed or tables and is also less affectionate and energetic.

For the constipation, I put him on a fiber supplement for a bit called Vetasyl which seemed to help at first but then he went back to bad constipation. He's getting miralax now and is a little more regular, going every 3 or so days but that's still far from ideal. I've taken him to the vet three times now in the last two weeks, having bloodwork, urinalysis and xrays done. His bloodwork was abnormal for pancreatitis but he has no vomiting, diarrhea or weight loss. All other tests were fine but xrays did show some mineral deposit possibly in his kidneys. He's on buprenorphine, gabapetin and Prozac, the latter two long term and buprinex for about 10 days now to manage pancreatitis discomfort. I did give him Cerenia for a few days but it did not improve the pickiness with food. I've tried two appetite stimulants and neither have improved the pickiness. He won't eat his prescription food for neither pancreatitis nor urinary issues (got FLUTD back in January and had PU surgery after two blockages). He has been recovering with me in my parents basement for the last three months from a second surgery to remove skin folds that caused bacterial growth in the PU site that was not going away despite weight management and anti bacterial cream and chlorihexidine wipes. I am wondering if he has become depressed being in this small basement or if the issue is medical and I should get an ultrasound done next. He has one scheduled for next week but I wanted to know if anyone's cat has experienced this food pickiness and chronic constipation as well? The vets all seem perplexed what could be causing these issues because pancreatitis does not seem like a satisfactory explanation, and the typical treatment for pancreatitis hasn't helped him. He has been assessed for osteoarthritis as well and the xrays did not show any joint inflammation.

I feel terrible for how much he's been through this year but up until recently remained in good spirits. Seeing how depressed he's become is making me consider letting him go if I can't figure out how to get him to enjoy life again. I still have to move back to my apartment so I'm going to do that in a few days after he's had time to recover from this most recent vet visit. Also going to try putting him on a raw diet after consulting with a nutritionist next week. Will do an ultrasound if both of those things fail but wanted to see whether anyone has had similar issues with their cat and also if I should get the ultrasound done first before moving him back to my place where he has more space and can run in the halls of the building.
 

silent meowlook

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Hi. I wouldn’t do the raw diet right now. I would make sure to feed only canned. Do the ultrasound. Something is going on and he probably feels like crap not depressed other than depressed because he feels bad. I would also continue the Cerenia. Why was he put on Prozac? How much time do you spend with him?
 
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simbly

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He was put on Prozac to manage overgrooming of the PU site. I've been trying to wean him off of it but when I get below 7.5mg (bringing down to 5mg) he starts having bad side effects. I spend a lot of time with him, most of the day. I try to get him engaged with string or toys for 30 min- 1hr per day. He doesn't get too playful but he will at least follow with his eyes and head. The vet won't prescribe him more Cerenia because it hasn't helped his symptoms and he doesn't have any vomiting. He does seem to benefit from the buprenorphine because he will seem uncomfortable once that starts wearing off by hiding more.
 

fionasmom

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While I believe that depression might be part of this, making some of it behavioral, there is also a lot of evidence that something is going on medically. Going back to your own place might cheer him up, but I would still do the ultrasound regardless. I am not a raw feeder, which I am going to disclose up front, but even if you want to proceed with it, this may not be the time to bring it into the picture. Is this nutritionist a veterinarian or affiliated with a practice and is your vet who has been treating the cat on board with proceeding with the raw diet?
 
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simbly

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So Simba had the ultrasound done and it didn't reveal anything. He's been breathing more heavily after I brush him or play with him but it's not typical breathing heavy, it's more labored and lasts for a few minutes after he's done playing or getting brushed. Then, yesterday after I let him out into the halls of my building and then played with him inside for a bit, and he hunched over and made a strange coughing sound that I've never heard before for 5 or so seconds and had heavy breathing for several minutes afterwards. About two months ago, he also gagged without producing anything. Did not do that again. He also has had a bit of dried discharge in the corner of his eye for a couple of weeks, it's just a little more than he usually has had his whole life. He's lost some weight too despite eating a bit more than usual.

I'm really concerned he may have heartworm. He hasn't been on the preventative and I'm really kicking myself for it now. He's going to get tested for it tomorrow but I've been reading that heartworm is difficult to diagnose in cats. He had a full body x-ray done three weeks ago that didn't reveal any issues in his lungs or heart. But I know that they don't always present on x-rays. What are the odds that it may be heartworm? He's been more lethargic with finicky appetite for at least 6 weeks now. Both got somewhat better once his environment changed but he still doesn't have great energy and appetite seems to be on the decline again a bit.
 

fionasmom

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Heartworm in Cats - American Heartworm Society

I am sure that you probably read this article. Where I am, there is no appreciable heartworm and I have never even treated a dog with a preventative although I know it can be widespread in other parts of the country.

How much more effective is an ultrasound in diagnosing heartworm in cats? Does the vet suspect any other heart condition although the poor boy has faced so much I hope it is not that.

Did you move back to your apartment?
 
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simbly

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Yep, read the article and basically like 15 others. :-) It's low occurrence where I am and I did move back to my apartment. That did lift his spirits but I'm worried now with the coughing and rapid breathing. Maybe I'm jumping to worst-case-scenario here. I think because the respiratory issues come up after activity or positive stimulus, I'm worried it's heartworm because that's what others are saying online. I didn't see it on any articles though. So I wanted to know if the knowledgeable folks on here knew what is or isn't typical for heartworm.
 

FeebysOwner

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As you have read heartworm doesn't seem to be nearly as common in cats and many cats can clear heartworms on their own. I am glad that you are getting the blood test done though just to be on the safe side.

Has the vet done an echocardiogram? Not for heartworm, but for other heart conditions.
 
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simbly

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No they have not done an echocardiogram. I am hoping that it's calicivirus or something even more minor, he may have had it this past February when he had a mouth ulcer but no one would test him for it for some reason. I don't know what I'm going to do if it's heartworm. He's been through so much already and I don't want him to suffer if he has HARD.
 

silent meowlook

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Hi. I’m sorry. Time for a reffer to a specialist. Go with an internal medicine specialist.

He could have asthma. I would worry about that more than heart worm. To test for heart worm in cats it is complicated as it isn’t all that accurate. It is a species specific test that must be sent to the lab. If they offer to do one in house decline as those don’t work in cats. Heart worm is rare in cats and often they show no symptoms.

You should have a fecal tested as there is lung worm in cats but also very rare.

Was the ultrasound done with a specialist?

Full body xrays are great, but you will probably need 3 view chest rads to diagnose asthma.
 
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