Older Cat Traumatized from Hospital Visit

[scteel24]

Hello all – quick backstory. My 15-year-old was recently diagnosed with kidney disease/failure. He was stage 2, but even with getting sub q fluids weekly, he is now stage 3 after just one month (3.3 creatin level). He was barely eating so I took him to the vet. Turns out he has pancreatitis as the Vet did not feel the kidney disease was causing his lack of appetite. I have always used a mobile vet at home because he is so scared of the vet - always pees in the carrier. He’s been to the regular vet office now about 4 times in 2 months, but always comes home and there’s no issues. They kept him hospitalized for 2 days and when I got him home he went under the bed. He came out on his own, but went back under after a minute or two. He came out to see me after being gone about 2 hours and then went back under after a few minutes. He came out for dinner and did eat some, but abruptly stopped eating and went under the bed. I put the bowl under with him and he finished the food. He came out when it was brushing time (our routine for years) and ate a few treats and back under. I’m trying to be patient and give him space. When I left for work this morning, I got on the floor and talked to him gently and petted him. He was purring and turned his head and chin where he wanted to be scratched. I’m hoping this will pass after a few days. I’m supposed to give him fluids now twice per week but I don’t want the first thing when he comes out to be me grabbing and poking him with a needle. He spent 2 days overnight and is now traumatized and I spent $4K which is fine if it helps, but he’s not eating much more than when I took him on Friday. I have to face that these may be his last months and I certainly don’t want them spent living under the bed. I also selfishly want cuddle time with him. I don’t think there any tips, just hoping someone has experienced the same and can give me some comfort that his hiding will pass soon.

Thank you all!

 

[Kris107]

Can be hard to know. I'd say just give him a little and he should come out. But there are other factors - the meds he's on or his pain or other feelings of sickness could cause him to hide too. It's just instinct. Just keep things calm, quiet, and routine and see if he comes around.

 

[Mamanyt1953]

If it comes down to it with the fluids, you can give them to him while he is on your lap. Not all cats will respond to that, of course, but it is certainly worth a try! Just be sure to take a potty break first (do not ask me how I know this).

 

[FeebysOwner]

Hi. How long has he been home? I presume they gave him fluids while in the hospital, so if you have to wait a day or two to let things settle down with him, that is what I would do. There are tons of things I could tell you about what I went through with my CKD cat, but first thing is first. Feed him however you can, as that is key with pancreatitis, and CKD - and see how the next 24-48 hours go.

 

[scteel24]

I came home tonight and he came out right away to see me and waited while I mixed dinner. Then he sniffed. It went back under the bed. I put the bowl under the bed and he still wouldn’t eat it. Only ate a half a pate packet, which is his favorite. He did come out on his own around 11pm and came up on the couch and sat behind my head. He moved around several times, then finally laid his head down. He was purring when I petted him, Then he abruptly left and went under the bed. He was out for about 40 minutes. This morning, he won't come out at all. At least last week when he was not eating much, his personality was the same, so now I regret taking him to the vet hospital. I’m feeling so down. I don’t understand why most kidney cats get at least a year or two if not early which I did back in stage one and started on fluids. If it’s not the kidney disease and it’s the pancreatitis, then nothing they did helped. He got fluids, pain meds, Cerenia and antacid and a B12 shot. He’s on daily appetite stimulant but it doesn’t seem to be doing anything. It’s now been 38 hours since he got home from the hospital. Maybe he just needs more time. If these are his last few weeks, I'd really like to spend them with him. I’d hate to have him alone and under the bed. He's normally super vocal and meows all the time. Not a peep anymore. I'm not sure now if he's hiding from trauma or not feeling well, or both. I'm so sad and stressed and frustrated. Not sure what else can be done if anything.

 

[FeebysOwner]

Although all CKD cats can vary in their progression with the disease, a creatinine of 3.3 does not necessarily signify your cat's last weeks. My cat maintained a creatinine of 3.5 for over two years. She was on daily sub-Q fluids though, and took a phosphorus binder for her high phosphorus level, which can also affect how a cat feels. Do you know what your cat's phosphorus level is?

However, Cerenia only lasts for about 24 hours, so if he has nausea, he may need either another injection or some oral meds of the same. Do you also have pain meds to give him as well? Both of these are likely crucial when dealing with pancreatitis. The appetite stimulant may not do much good without these two meds, if a cat is nauseous or in pain, it will certainly affect their desire to eat. I'd get these things taken care of with the vet ASAP. It is also crucial for cats with pancreatitis to eat.

Does he have any other favorite foods - even human ones - that he really likes? Have you tried any of them? Did you try to get him to eat when he came out from under the bed and sat on the couch with you?

The one thing my cat ate better than even her own food was baby food meat (Gerber Stage 2). I would also suggest you try that with your cat too. It isn't a food that is complete for cats, but it isn't going to hurt anything to give it to him for a while, just to try to jump start his eating again. There is also Beechnut Stage 1 baby food meat, but Feeby seemed to prefer Gerber.

He may still be bothered by the vet/hospital stay, so be patient with him, but by all means get him to eat something/anything - and make sure he has anti-nausea and pain meds.

 

[scteel24]

They sent home pain meds and I have cerenia tabs. But they said to use as needed. The vet thought he wasn’t in any discomfort from the pancreatitis from her physical exam. She also said if he’s not vomiting or drooling then he probably isn’t nauseated. It’s hard to medicate as needed when you aren’t sure if it’s needed. I also don’t know how to medicate him when he won’t come out from under the bed. And I don’t want to pounce on him and give pills and oral meds because he’ll never come out again or trust me. I’ve tried everything food wise – spent at least $200 on baby food, people food, treats, canned foods, cat’s milk, gravy toppers – he won’t eat any of it. He sniffs it all, but won’t eat it.

 

[FeebysOwner]

My motto for my CKD cat was 'when in doubt, don't rule it out'. You don't have to follow that, and right now you are in a vicious cycle because if he does need it and won't eat, it is hard to get him to take the meds so that he will eat.

Of all the data I have read about pancreatitis, it is treated with appetite stimulants, anti-nausea meds, fluids, pain meds, and food, food, food. I have never heard it doesn't cause at least some level discomfort. How did your vet diagnose pancreatitis? Was it determined to be acute or chronic?

I guess at this point, call the vet and tell them what is going on. And, find out his phosphorus level while you are at it. That would be part of a chemistry panel which is normally done along with a CBC.

 

[scteel24]

Well, his regular vet diagnosed him with pancreatitis a few years ago but he’s always been asymptomatic if that makes sense. So this could be a first time flareup. At his hospital stay they did a specific blood test and his pancreas was abnormal. They tried feeding him baby food with a syringe at the vet and he spit it out. I do think he was super stressed there so best to treat him at home. Next time he comes out from the bed as he is sleeping comfortably right now, I’m going to start the pain meds and Serrania. I have five days worth of pain meds and three days of Cerenia and he’s also due for fluids tomorrow. His CBC panel from 2 weeks ago had Phosphorus normal at 4.1. The Catch-22 is you want to do everything you can but at the same time if his body is failing and he has limited time left I don’t want him to be afraid of me and get poked and medicated every time he comes out. You know what I mean?

 

[FeebysOwner]

I totally understand your concern. But, if you don't try to correct his reason for not eating, then his body will most certainly fail - from lack of nutrition.

Sometimes, we have to take the 'bull by the horns' to protect our cats from hurting themselves, even if they don't see it that way. The better you can get him to feel, the more likely he is to recover from his hospital stay and from a bout of pancreatitis, if those are the reasons for his issues right now. Fortunately, I was always able to find a way to get the meds Feeby needed into her, and most of the time without much ado. But, I know it can be hard to make a choice on which is worse, worrying about making a cat afraid because they need the meds, or worrying about what will happen if you don't.

Since he was used to getting sub-Q fluids by you from before, then at least that would not be a 'new' thing to him. And, perhaps, if you can't get the pain meds or Cerenia down him orally, you could ask the vet if there are options of giving it to him via the Y-port on his sub-Q fluid line. I believe it would be possible with Cerenia, but not sure about the pain meds - it can't hurt to ask.

 

[scteel24]

You're right. I have his meds laid out. If he does not come out soon, I'll have to get him out so I can start. He did eat some on Monday when I got him home - about 5 hours later - a half can of wet food, 2 pate packets and a handful of temptations. I did not continue meds on Tuesday and he ate much less and now on Wednesday nothing at all. I will finish everything off and see how he does. I'll have to bite the bullet and orally medicate since he won't eat and hope he forgives me

 

[FeebysOwner]

It does sound like him not getting more meds on Tuesday, and now again today, could explain the drop in food consumption. I hope you can get them into him and that you start to see some positive change - at least from an eating standpoint. If he needs more time to 'sulk' under the bed, as long as he is eating, that would be OK if he were my cat.

Keep us posted, please!

 

[scteel24]

Thank you all - he came out on his own for an hour and was acting semi-normal - meowed at me, sat in his favorite spot and used the scratching post. He had a drink and made a very small number two. When he headed under the bed I picked him up and gave him the pain med and Cerenia. I'll give him the appetite stimulant later and only half the dose as it seems to make him too wired. I also need to clean his ears first - there's a lot of old residue. I didn't want to hit him with all of that at once. He's curled up under the bed now looking comfy - end of his tail slightly flicking. I will keep you all posted. Thanks again - maybe he will pull through!!

 

[FeebysOwner]

That is good! He sounds like he is headed in the right direction. Keep letting us know how things go!!

 

[scteel24]

Hello all - just an update. Came home from my workout and Houdini was in the living room. Not sure how long he had been out there. Waited for me to fix dinner and meowed. Ate about a teaspoon of actual meat plus all the juice from the can. Went back under the bed. Called him for teatime. That’s when he gets brushed and he came out had a half a pate packet. But stayed out on the couch next to me for three hours! I was up till 1:45 AM because I didn’t want to disturb him or make him feel scared. Got up this morning and, he had a drink and went back under the bed, but gave him food under there and he ate it almost immediately. Not much meat, but all the gravy. Didn’t have to keep shoving it under his face. Hopefully we’re moving in the right direction.

 

[FeebysOwner]

That is so funny/peculiar what he is doing, but it does sound like he is spending more time out from under the bed, so that is a good start!
Does he have some favorite blankets/bedding (hopefully, more than one, so as not to disturb all of them from where they currently are) that you could lay right next to the bed, but not under it? It might encourage him to at least start to use them instead of going under the bed. If he would, you could then start gradually moving the blanket/bedding a little farther away from the bed, in the hopes that he eventually will figure out he doesn't need to go under the bed anymore.

I am glad to see that it seems he is eating better! I trust he his using his litter box normally too?

 

[scteel24]

Hello - no favorite blankies - he normally sleeps on the bed with me or on the couch. He comes out to get a drink and use the litter box and then back under. So when he does come out for a longer time, I don't want to pounce on him and medicate or he will not want to come out at all. He's due for meds around 2pm and his fluids sometime today. Hoping he ventures out for a bit then when he's headed back I can grab him and get those things done. He ate half of a pate packet a few minutes ago under the bed. No solid food or dry yet. I'm hoping his appetite improves.

 

[scteel24]

Hello!

I have an update on Houdini. He is doing better and living out from under the bed finally! Seems to be over the pancreatitis. He has been eating, but not as much as I would like. He still licks all of the gravy or juice from the wet food and gets some of the meat and he’s been eating a few pieces of dry food 2 – 3 times a day. He’s so up and down. One day I came home to a half empty bowl and one morning he ate a solid handful of dry. Now he’s back to about 10 pieces a day. He stopped eating the pate packets which he loved, but now likes this freeze-dried tuna bites. He also has been eating canned tuna so maybe it’s a smell thing? I got these new soft treats and he loved them the first day, then walked away the next few nights Last night, after he ate some of the tuna treats, I tried those again and he ate some. Doing fluids twice per week which is really easy, dare I say without jinxing it. He is strangely much less vocal. He used to meow back anytime I said something to him and would follow me around meowing until I pet him. Now he only meows when I’m getting his wet food ready. He’s also lower energy, probably from not eating. One odd thing, he still LOVES BBQ flavored potato chips. He licks them clean and starts to try to chew them. I was thinking of buying powered BBQ seasoning to sprinkle on his dry food. Or I can crush up a piece of a one chip into almost a powder and try that – probably not the best for his stomach, but if he eats more, is it worth a try? The vet doesn’t think the kidney disease should be causing a lack of appetite and it seems the pancreatitis has cleared though I haven’t gotten blood test and don’t want to put him through another vet trip. He was off the pain meds after 3 days and the Cerenia is down to every other day with tomorrow the last dose. He comes to get me when he’s hungry, just doesn’t eat much. I work from home on Fridays so that day and weekends are easy to get him wet food 4 or 5 tomes a day, but when I’m at work, it’s only about 3 times per day. He seems happy overall and lays in his favorite sun spot and sits with me at night and purrs when I pet him. I feel like I’m doing my best and we’ll just have to see.

 

[FeebysOwner]

Overall, I don't think things sound too bad. It can take a while to fully recover from pancreatitis, so be patient about his eating, unless it takes a consistent nose dive. His little body has been through a lot!!

I don't know about the potato chips...I do think crushing up a very small piece and giving him that would be better than buying human powered BBQ seasoning, though.

 

[scteel24]

I suppose it's a marathon and not a sprint and it make take him more time like you said. I do think his decreased appetite might be related to smell. I read on Tanya's site that kidney cats can have weakened smell and taste buds. He new favorite fancy feast wet food is their version of tuna and it stinks!