Hi cat friends, Here I am again--when I'm at my wit's end and not sure what to do I'm glad I can come here for support, if nothing else. Our 15 year-old tabby Princess (P) has a host of problems: HCM (hypertrophic cardiomyopathy) diagnosed in Feb Medications to treat: Enalapril/enoxaparin sodium by injection Most recent diagnosis: Hyperthyroid (diag. 10/6) which we initially treated w/ methimazole. The methimazole robbed her of her appetite so after 2 weeks we discontinued w/ intention to have her receive radioactive iodine therapy. She has been off methimazole since 10/24/18 and has not regained her desire to eat. She seems hungry/interested in food but turns it down 9/10 times. Have tried multiple brands, dry, wet, expensive, cheap, healthy, junky, baby food, tuna, whole 9. Sometimes she eats a little but we've been "keeping her alive" with syringe feeding Hills a/d recovery occasionally as tolerated (per vet). She has rec'd x-rays and an abdominal ultrasound (last week). Ultrasound showed "mildly" inflamed liver/pancreas. Bloodwork showed elevated liver levels and high calcium. Vet has recommended -needle aspiration biopsy to check for cancer $300 at minimum -$500 test to inquire about the cause of ^ calcium levels She is currently taking her heart meds plus: mirtazapine for appetite stimulation (1 tablet/3 days) Cerenia for anti-nausea (1 tablet/day but we're almost out--EXPENSIVE; $30 for 4 pills) Received a long-acting antibiotic on 10/31. More importantly: NEITHER ARE WORKING and Cerenia makes her drool. I'm afraid with her liver what she really needs is a corticosteroid and an anti-inflammatory. I'm also wondering about giving her Denamarin to help w/ liver function. She is eating small bits here/there and I understand she's nauseous--our regular vet has told us no more they can do and we are exclusively seeing a referral vet. We asked the vet about installing a feeding tube (she had one 4 yrs ago when she had hepatic lipidosis) but they won't do it since they want to know the "root cause" of her inappetence. It's also somewhat risky to put her under for that due to her heart and complications from anesthesia. It's so frustrating bc we know she needs to eat in order to get well. The loss of appetite and changes for the worse happened when she was given the methimazole. I've been reading up about methimazole hepatic toxicity in cats (and humans!) and apparently it can happen; methimazole is hard on the liver. The vet doesn't seem to acknowledge the connection between the methimazole and her current liver condition (as yet diagnosed only as "mild to moderate inflammation of liver and pancreas") and wants to run all these tests. We spend $300/month on her heart meds and around $500/every 6 months for her echocardiogram checkups. We're in the hole $1400 from last week's vet visits. Of course, we don't want her to suffer and are not nearly ready to let her go. She is my heart and soul. Husband and I can't fathom our home/life without her. I am just at my wits end. She does seem "sick" but she is still ok with litter box, drinks water, can jump up/down on the bed/couch, still friendly and cuddly but does want to sulk for a fair amount of time. What to do?