My 12 year old chubby cat has suddenly lost her appetite and is sleeping constantly

denice

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When Patches had flares things like Pepcid and anti-nausea meds never seemed to help.  The flares would last anywhere from several days to well over a week, when they were especially long he would be hospitalized on an IV and it was always a chore to get him eating again.  The only thing which brought him out of his last big flare and has kept things under control is the steroid.

He has been on a steroid for almost four years now.  There is definitely a difference in steroids.  He started on Prednisolone, then there were supply issues that lasted quite a while and he was switched to dexamethasone.  We kept him on the dex until on his last biannual blood work his blood sugar was high, not diabetic high but higher than normal.  He went back to the pred and on a blood sugar test a month later his blood sugar was normal.
 
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catwoman707

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Maybe its time for a second opinion?
I've sorta been going to Dr. Kris too, but he was away for a bit and just got back.

I have also started looking at a holistic vet phone consult too.

Then I deal with a recent graduate of UC Davis vet school who is now a vet, I thought I would chat with her to see if she is willing to look at her records. Not sure if she will be experienced enough though with these issues. Can't hurt to ask.
 
When Patches had flares things like Pepcid and anti-nausea meds never seemed to help.  The flares would last anywhere from several days to well over a week, when they were especially long he would be hospitalized on an IV and it was always a chore to get him eating again.  The only thing which brought him out of his last big flare and has kept things under control is the steroid.

He has been on a steroid for almost four years now.  There is definitely a difference in steroids.  He started on Prednisolone, then there were supply issues that lasted quite a while and he was switched to dexamethasone.  We kept him on the dex until on his last biannual blood work his blood sugar was high, not diabetic high but higher than normal.  He went back to the pred and on a blood sugar test a month later his blood sugar was normal.
Interesting. I read somewhere yesterday that a short term treatment of pred won't do any good, because as soon as it's stopped the inflammation returns......seems to me that if the cause is removed, then it would be a good thing to get the inflammation down and it should stay down. (?)
 

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Hi

I am sure they don't want to give her steroids because she is already drinking allot of water and that will make it much worse. Also if you start steroids you are kind of stuck with them. You shouldn't stop and then restart because the second time you won't get as good a result. Another thing is if you do decide to get an endoscopy done it would be a waste of time if she is already on steroids. If she did wind up having lymphoma GI it is best to start the leukeran at the same time as the steroids.
 
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catwoman707

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Well the night before last she did vomit a bit of digested food.

She hasn't hardly done that at all, except as I mentioned, when it reached it's peak and from the clav, otherwise it's quite rare for her.

Yesterday I gave her a dose of pepcid and baby food, then she did eat some dry, but today has a great appetite again and seems to have settled back into her normal unsettled state.....

I feel so darn anxious........! Like hurry up and get right, but knowing it won't be anything that will happen fast. Hate this feeling.

Thanks for asking :)
 
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catwoman707

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You know I have been thinking, maybe I will get lucky and Krissy's inflammation and reaction is due to fish or grains, more likely fish since I haven't really given her much in the grains dpt.

But she no longer is getting fish at all.

Her treats I saw contain fish, so out they go too.

Who knows? Huh, nothing is ever that simple now is it?! Wishful thinking.....
 
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catwoman707

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Update on Krissy, nothing new sadly.

I am living life everyday now, holding my breath basically, it's been 2 weeks and 3 days since she started on the BB basics turkey/potato dry food.

I did chat with my vet about it being acceptable to give her fancy feast turkey/giblets classic, she looked up the ingredients and thinks it should be fine.

Fish and chicken are eliminated completely.

I see my girl, still feeling the same.

Occasionally, (like last night again) I hear her vomiting, but often times there is nothing that comes up, unless of course she goes and eats a blade or two of grass, which she did this am, sure enough, barfed up water and the blade......just telling me she is still not on the mend.

I am barely holding out with this waiting crap, oh, how I feel like I am waiting for nothing. Why is it that I believe just changing her dry food (she was already on grain free but with chicken) is going to make her well again?

I keep thinking, maybe we should not have gone the turkey route if it is chicken that's the allergen causing diet. Granted, they are different, but not that much, I mean they are both poultry, birds, and how do we know that turkey isn't part of the allergy? We don't.

So hurry up and wait is very frustrating to me............

I wonder if I should make a gradual switch to another protein, like rabbit or venison?
 

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@catwoman707 -- i understand, the waiting and watching (and hoping to see progress) is very hard. i would say that it's a very good sign that your krissy hasn't had worsening of symptoms.

you might want to discuss switching to a novel protein with your vet (again?). it may take a month or longer on a new diet to start seeing krissy's gastro system settling down -- it took my two a full month for me to start seeing gastro systems settling, lessening of symptoms. but that's only a possibility if your krissy will eat it. on the other hand, it sounds like krissy definitely doesn't like the BB canned so maybe she would like rabbit or venison. it might help distract you and help you feel like you're working on something (towards a solution) if you were to start looking into different brands of canned/dry rabbit and venison cat foods.
 

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Update on Krissy, nothing new sadly.

I am living life everyday now, holding my breath basically, it's been 2 weeks and 3 days since she started on the BB basics turkey/potato dry food.
I did chat with my vet about it being acceptable to give her fancy feast turkey/giblets classic, she looked up the ingredients and thinks it should be fine.

Fish and chicken are eliminated completely.

I see my girl, still feeling the same.
Occasionally, (like last night again) I hear her vomiting, but often times there is nothing that comes up, unless of course she goes and eats a blade or two of grass, which she did this am, sure enough, barfed up water and the blade......just telling me she is still not on the mend.

I am barely holding out with this waiting crap, oh, how I feel like I am waiting for nothing. Why is it that I believe just changing her dry food (she was already on grain free but with chicken) is going to make her well again?
I keep thinking, maybe we should not have gone the turkey route if it is chicken that's the allergen causing diet. Granted, they are different, but not that much, I mean they are both poultry, birds, and how do we know that turkey isn't part of the allergy? We don't.

So hurry up and wait is very frustrating to me............

I wonder if I should make a gradual switch to another protein, like rabbit or venison?
[/quoteIf your cat goes out like mine used to when she vomited, keep her in and try worming her and use the revolution drops for worms and fleas. Try switching to to pride rabbit (rabbit & pork) no carageen. My girl stopped vomiting almost immediately. Most important I stopped ANY dry food. Prior to worming fecal samples were negative. I wormed her and changed to revolution anyway. She does not go out now, eats no dry, and never vomits.
 
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catwoman707

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@catwoman707

I know I asked this vefore, but looking back i didn't see a clear answer.  Have you tried Cerenia?  And if not, would you and your vet consider this?
Not sure, she hasn't mentioned it at all to me.......
 
@catwoman707 -- i understand, the waiting and watching (and hoping to see progress) is very hard. i would say that it's a very good sign that your krissy hasn't had worsening of symptoms.

you might want to discuss switching to a novel protein with your vet (again?). it may take a month or longer on a new diet to start seeing krissy's gastro system settling down -- it took my two a full month for me to start seeing gastro systems settling, lessening of symptoms. but that's only a possibility if your krissy will eat it. on the other hand, it sounds like krissy definitely doesn't like the BB canned so maybe she would like rabbit or venison. it might help distract you and help you feel like you're working on something (towards a solution) if you were to start looking into different brands of canned/dry rabbit and venison cat foods.
Really? That she doesn't get worse is a good sign?

I can tell you one thing for sure, unknowingly I have actually done her harm rather than good, several nights ago Krissy was in the kitchen yelling at me for some baked chicken, I've been worried about her not eating enough sometimes, so I gave her a bit of white meat, she loved it.

The next day she had a not feeling well day......that was the point where I realized it may very well be chicken that is the culprit. Which in turn helps me think that turkey is NOT necessarily the go-to protein for her to get right on. 

I wish I could get a clear answer that chicken and turkey are too similar, or not similar at all. My vet says not similar, but my brain says otherwise, plus someplace I read that when you are working on fixing an allergy, that it is best to eliminate all birds for instance, or all fish.

Okay I found it! 

http://healthypets.mercola.com/site...012/05/07/protein-diets-for-pets-allergy.aspx

This is a very clear, helpful page, this is where I read that about chicken allergy means it's best to avoid all fowl. 

I'm also thinking that if I go rabbit, she might like the canned. Now to find a good rabbit dry and canned......................ugh! NOT easy.
 

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Not sure, she hasn't mentioned it at all to me.......

Really? That she doesn't get worse is a good sign?

I can tell you one thing for sure, unknowingly I have actually done her harm rather than good, several nights ago Krissy was in the kitchen yelling at me for some baked chicken, I've been worried about her not eating enough sometimes, so I gave her a bit of white meat, she loved it.

The next day she had a not feeling well day......that was the point where I realized it may very well be chicken that is the culprit. Which in turn helps me think that turkey is NOT necessarily the go-to protein for her to get right on. 

I wish I could get a clear answer that chicken and turkey are too similar, or not similar at all. My vet says not similar, but my brain says otherwise, plus someplace I read that when you are working on fixing an allergy, that it is best to eliminate all birds for instance, or all fish.

Okay I found it! 

http://healthypets.mercola.com/site...012/05/07/protein-diets-for-pets-allergy.aspx

This is a very clear, helpful page, this is where I read that about chicken allergy means it's best to avoid all fowl. 

I'm also thinking that if I go rabbit, she might like the canned. Now to find a good rabbit dry and canned......................ugh! NOT easy.
oh, i'm sorry if what i said wasn't helpful. i try to look at the positive side of things, because that helps me deal with upsetting or stressful things better. so i would tend to think of symptoms not getting worse as a good sign. but i'm sure that not everyone else looks at things the same way i do. i'm sorry if i offended you.

ahhh, dr becker. i'm a fan of hers, her thinking.  many times, i'll bring to my vet's attention and discuss other options/possible treatments for my snick. yes, that's a very clear, helpful page! it does make sense (to me) to avoid all fowl. but reading that page further, it also suggests to not stay on one novel protein for too long (because a sensitivity/allergic reaction could develop with that new/novel protein too, so suggests to rotate novel proteins) and to add a probiotic.

there are several brands of rabbit canned cat food that i found when doing a quick search, but you're looking for ones that also don't have any fowl in them. the two i found in my quick search were natures variety instinct rabbit and ziwipeak rabbit and lamb. the ziwipeak rabbit and lamb has two different proteins in it, and in dr becker's page she said something about lamb not being considered a novel protein these days (like it used to be) -- if i remember what i read correctly, because lamb is an ingredient in more cat foods these days.
 
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catwoman707

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oh, i'm sorry if what i said wasn't helpful. i try to look at the positive side of things, because that helps me deal with upsetting or stressful things better. so i would tend to think of symptoms not getting worse as a good sign. but i'm sure that not everyone else looks at things the same way i do. i'm sorry if i offended you.

ahhh, dr becker. i'm a fan of hers, her thinking.  many times, i'll bring to my vet's attention and discuss other options/possible treatments for my snick. yes, that's a very clear, helpful page! it does make sense (to me) to avoid all fowl. but reading that page further, it also suggests to not stay on one novel protein for too long (because a sensitivity/allergic reaction could develop with that new/novel protein too, so suggests to rotate novel proteins) and to add a probiotic.

there are several brands of rabbit canned cat food that i found when doing a quick search, but you're looking for ones that also don't have any fowl in them. the two i found in my quick search were natures variety instinct rabbit and ziwipeak rabbit and lamb. the ziwipeak rabbit and lamb has two different proteins in it, and in dr becker's page she said something about lamb not being considered a novel protein these days (like it used to be) -- if i remember what i read correctly, because lamb is an ingredient in more cat foods these days.
Oh my gosh no!! I wasn't being sarcastic at all! Actually was thinking since you know more about this than I do, that maybe not getting worse IS a good thing! Okay cut it out :))) Your advice is extremely helpful!

Yeah I liked the way she looks at things and describes. 

I have def. read on several different sites about not staying with one for too long as it may create a reaction in time as well.

But if I can get her settled down and normal on one type of food then I will be very grateful, and surely she will be too.

So for now, or at least the next several to 6 months, I'm hoping to get her all better with her diet change.

I sure hope that is realistic. IDK......this inflammation is surely from an unfixed allergic reaction, but over a period of time to make her this messed up inside.

Right, I found just what you did, the only dry food is natures variety limited ingredient rabbit. Looks like a goodie though!

Their canned has another protein though :( So still need to do some digging around to find one, and then see if she will even think about eating it...................thanks!

Oh! Also, the probiotic? My vet thought she should be on fortiflora too, but this is for her poop, and that is still okay. So not sure what the benefits are other than that. (?)

What I think bothers me the most about Krissy these days is how she acts like a loner. I've been closing the doors to the other bedrooms otherwise she will go and lay in there, and after dark will just be in there alone in the dark.

Hate it...:/
 
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stephenq

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Ok three things:

- My vet told me that companies that make OTC novel protein diets use the same cooking vats for their regular foods and that DNA testing has shown contamination of non-novel proteins in the novel protein formulations and for that reasons she suggests only prescription diets that come from companies that do not mix the two.

- Have you ever tried a hydrolyzed protein diet (kind of smashed beneath molecular recognition by the gut) like Z/D?  It sometimes causes diarrhea in cats but when it doesn't it can be very effective.

- Back to the Cerenia question - it may not be indicated in Krissy's case, but it is a miracle drug for nausea that is due to things like inflammation or "feeling poorly", but if the root cause of the nausea is allergy, then it may not be indicated. But my IBD/Pancreatitus cat hasn't thrown up once since he's been on it 7 days a week.  And its been weeks.....
 

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Probiotics actually reduce inflammation, not just in the intestines but anywhere in the body. I would think it's worth a try for Krissy even though her stools look okay.
 

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Oh my gosh no!! I wasn't being sarcastic at all! Actually was thinking since you know more about this than I do, that maybe not getting worse IS a good thing! Okay cut it out :))) Your advice is extremely helpful!

Yeah I liked the way she looks at things and describes. 

I have def. read on several different sites about not staying with one for too long as it may create a reaction in time as well.

But if I can get her settled down and normal on one type of food then I will be very grateful, and surely she will be too.

So for now, or at least the next several to 6 months, I'm hoping to get her all better with her diet change.

I sure hope that is realistic. IDK......this inflammation is surely from an unfixed allergic reaction, but over a period of time to make her this messed up inside.

Right, I found just what you did, the only dry food is natures variety limited ingredient rabbit. Looks like a goodie though!

Their canned has another protein though :( So still need to do some digging around to find one, and then see if she will even think about eating it...................thanks!

Oh! Also, the probiotic? My vet thought she should be on fortiflora too, but this is for her poop, and that is still okay. So not sure what the benefits are other than that. (?)

What I think bothers me the most about Krissy these days is how she acts like a loner. I've been closing the doors to the other bedrooms otherwise she will go and lay in there, and after dark will just be in there alone in the dark.

Hate it...:/
@catwoman707 -- i didn't think you were being sarcastic. it's just sometimes hard to know the feelings behind things that are posted/written, as opposed to when the same things are spoken. like i said, i look for the positives in situations.

i think it's good to have a goal and to work towards that. i'd caution that setting a time frame may or may not be helpful, or realistic.

my two IBD cats ate a mixture of several grain free dry cat foods, including natures variety instinct rabbit, for many years and did well on it. currently i've got snick and jasper (our new foster, who is being transitioned over to the dry food snick eats) on a 50/50 mix of natures variety instinct grain free duck and turkey and holistic select grain free indoor health and weight control dry cat foods. it's not the weight control part of the holistic select that i like, it's the proteins/flavors -- turkey, chicken, and herring.

you might want to make a list of the canned rabbit cat foods you find that are close to what krissy needs. and make notes next to them about what else they have in them that aren't exactly what she needs, like the natures variety instinct rabbit canned has a second protein in it. then discuss what you found and the pro's and con's with your vet.

an excerpt from purinaveterinarydiets dot com --

Dietary Considerations


FortiFlora[emoji]174[/emoji] is a nutritional supplement for cats and has been formulated to achieve the following characteristics:
  • Contains a special strain of probiotic that has been proven to promote intestinal health and balance
  • Contains a guaranteed amount of live active cultures
  • Promotes a healthy immune system
  • Contains high levels of antioxidant Vitamins A, E, and C
  • Excellent palatability

How does FortiFlora work?


FortiFlora may help nutritionally manage cats with diarrhea in many situations, including:
  • Stressful situations such as boarding or change in home environment
  • Diet change or consumption of inappropriate foods
  • Soft stool in kittens
  • Antibiotic therapy
The probiotic in FortiFlora, Enterococcus Faeceium SF 68 , has been shown to promote immune health. Situations where FortiFlora may help include:
  • With young kittens before and during immunizations
  • With aging pets with weakened immune systems
  • With pets experiencing weakened immune systems due to illness or treatment

Ingredients (Dry)


Animal digest, Enterococcus faecium, brewers dried yeast, L-ascorbyl-2-polyphosphate (source of Vitamin C), Vitamin E supplement, beta-Carotene, zinc proteinate, taurine, salt, manganese proteinate, ferrous sulfate, copper proteinate, calcium iodate, sodium selenite. D-4583

D-4583

Contains a source of live (viable) naturally occurring microorganisms. *Not recognized as an essential nutrient by the AAFCO Cat Food Nutrient Profiles.

i  believe it was on dr lisa pierson's website that i read that she uses fortiflora just for the taste of it (that her cats like).........ahhhh, found it --

an excerpt from catinfo dot org --

FortiFlora is a probiotic that I use to entice cats to eat.  I do not use it as the label states since I am not using it for its probiotic properties.  Instead, I am using it as I would if I wanted to season my own food with salt and pepper.  As little as 1/10th or 1/20th of a package sprinkled on top of food can go a long way to entice a cat to eat something new.  This is because  FortiFlora is formulated using animal digest which is the same substance that pet food manufacturers coat dry food with to make it very palatable for cats and dogs.

for your krissy, fortiflora could be used as both the probiotic it is (i think of a probiotic as something to keep the gastro system "happy", promote "good" bacteria in it -- not sure if i'm correct in thinking this) as well as a flavoring (to help entice your girl to want to eat the food). but it will depend on krissy's tastes, if she likes the taste of fortiflora. my snick gets a cosequin sprinkle capsule mixed into her wet food every morning, and snick absolutely loves the taste of it -- it's tuna and chicken flavored. fortiflora isn't flavored like tuna or chicken, but (per dr pierson) it's the animal digest that cats like.

i understand. i really hate seeing my snick isolate when she's having a flare up too. you have been and continue to work on easing your krissy's symptoms. and you're not just going by what your vet suggests without thinking about that being the best option either, you're looking into things further/researching. by doing that, you're making sure that the most effective treatment(s) are being considered.
 
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catwoman707

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Ok three things:

- My vet told me that companies that make OTC novel protein diets use the same cooking vats for their regular foods and that DNA testing has shown contamination of non-novel proteins in the novel protein formulations and for that reasons she suggests only prescription diets that come from companies that do not mix the two.

- Have you ever tried a hydrolyzed protein diet (kind of smashed beneath molecular recognition by the gut) like Z/D?  It sometimes causes diarrhea in cats but when it doesn't it can be very effective.

- Back to the Cerenia question - it may not be indicated in Krissy's case, but it is a miracle drug for nausea that is due to things like inflammation or "feeling poorly", but if the root cause of the nausea is allergy, then it may not be indicated. But my IBD/Pancreatitus cat hasn't thrown up once since he's been on it 7 days a week.  And its been weeks.....
That's interesting and good to know!

No, the only thing about a hydrolyzed diet I have found was that it's not all that highly regarded, as it is giving the same food that she reacted to but tricking her body into thinking it's really not. Not sure but while it does make sense, I really don't know enough about whether or not it's something I should try or not.

As for cerenia, while I see she does have an upset tummy occasionally, I don't see her vomit very often at all, in fact now that she is on only this food, and I am NOT giving her chicken or treats, etc she is eating well and haven't had any upset tummy signs.

As I mentioned though, she is always not feeling good, but who can blame her, she has all kinds of inflammation, and fluid/water retention too that causes her to be bloated. That's where my anxiety is coming from really, knowing she is either uncomfortable, or in some amt of pain, no telling, but her hiding away and becoming a loner/antisocial-ish tells me she hasn't felt well in a long time.

But thinking cerenia would be more if she was vomiting more than maybe once a week if even.

Very glad it works perfectly for you!!

How long has your cat had pancreatitis/ibd?

Does the inflammation go away?
 
@catwoman707 -- i didn't think you were being sarcastic. it's just sometimes hard to know the feelings behind things that are posted/written, as opposed to when the same things are spoken. like i said, i look for the positives in situations.

i think it's good to have a goal and to work towards that. i'd caution that setting a time frame may or may not be helpful, or realistic.

my two IBD cats ate a mixture of several grain free dry cat foods, including natures variety instinct rabbit, for many years and did well on it. currently i've got snick and jasper (our new foster, who is being transitioned over to the dry food snick eats) on a 50/50 mix of natures variety instinct grain free duck and turkey and holistic select grain free indoor health and weight control dry cat foods. it's not the weight control part of the holistic select that i like, it's the proteins/flavors -- turkey, chicken, and herring.

you might want to make a list of the canned rabbit cat foods you find that are close to what krissy needs. and make notes next to them about what else they have in them that aren't exactly what she needs, like the natures variety instinct rabbit canned has a second protein in it. then discuss what you found and the pro's and con's with your vet.

an excerpt from purinaveterinarydiets dot com --

Dietary Considerations


FortiFlora[emoji]174[/emoji] is a nutritional supplement for cats and has been formulated to achieve the following characteristics:
  • Contains a special strain of probiotic that has been proven to promote intestinal health and balance
  • Contains a guaranteed amount of live active cultures
  • Promotes a healthy immune system
  • Contains high levels of antioxidant Vitamins A, E, and C
  • Excellent palatability

How does FortiFlora work?


FortiFlora may help nutritionally manage cats with diarrhea in many situations, including:
  • Stressful situations such as boarding or change in home environment
  • Diet change or consumption of inappropriate foods
  • Soft stool in kittens
  • Antibiotic therapy
The probiotic in FortiFlora, Enterococcus Faeceium SF 68 , has been shown to promote immune health. Situations where FortiFlora may help include:
  • With young kittens before and during immunizations
  • With aging pets with weakened immune systems
  • With pets experiencing weakened immune systems due to illness or treatment

Ingredients (Dry)


Animal digest, Enterococcus faecium, brewers dried yeast, L-ascorbyl-2-polyphosphate (source of Vitamin C), Vitamin E supplement, beta-Carotene, zinc proteinate, taurine, salt, manganese proteinate, ferrous sulfate, copper proteinate, calcium iodate, sodium selenite. D-4583

D-4583

Contains a source of live (viable) naturally occurring microorganisms. *Not recognized as an essential nutrient by the AAFCO Cat Food Nutrient Profiles.

i  believe it was on dr lisa pierson's website that i read that she uses fortiflora just for the taste of it (that her cats like).........ahhhh, found it --

an excerpt from catinfo dot org --

FortiFlora is a probiotic that I use to entice cats to eat.  I do not use it as the label states since I am not using it for its probiotic properties.  Instead, I am using it as I would if I wanted to season my own food with salt and pepper.  As little as 1/10th or 1/20th of a package sprinkled on top of food can go a long way to entice a cat to eat something new.  This is because  FortiFlora is formulated using animal digest which is the same substance that pet food manufacturers coat dry food with to make it very palatable for cats and dogs.

for your krissy, fortiflora could be used as both the probiotic it is (i think of a probiotic as something to keep the gastro system "happy", promote "good" bacteria in it -- not sure if i'm correct in thinking this) as well as a flavoring (to help entice your girl to want to eat the food). but it will depend on krissy's tastes, if she likes the taste of fortiflora. my snick gets a cosequin sprinkle capsule mixed into her wet food every morning, and snick absolutely loves the taste of it -- it's tuna and chicken flavored. fortiflora isn't flavored like tuna or chicken, but (per dr pierson) it's the animal digest that cats like.

i understand. i really hate seeing my snick isolate when she's having a flare up too. you have been and continue to work on easing your krissy's symptoms. and you're not just going by what your vet suggests without thinking about that being the best option either, you're looking into things further/researching. by doing that, you're making sure that the most effective treatment(s) are being considered.
Okay so you have convinced me I need to get her on fortiflora. Thanks! I really thought it was more of a balancing out thing when there is diarrhea present.

I'm getting a bit stuck now on the rabbit food, there is dry, nature's variety limited rabbit, but their canned as well as all the other brands I see all have other proteins. Why would they go and do that?! 

Crap, I have to be able to feed canned too not only dry. Treats too even :)))) 

Should I wait it out on the turkey thing for another 2 weeks? IDK....  makes my head spin. I really do think though that turkey is not really the novel protein go-to for Krissy since it's looking more like the chicken may be the culprit and I SURE hate to waste more time, finding out that she is not getting well on turkey, then switching her and waiting it out another month.....I am asking for trouble, you know what I mean, too long she has been like this already and scarring her pancreas and can even cause small cell lymphoma. I can't even stand to think about this......
 
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