Re: Sassy - 19yr old (close to 20) - Not eating / Very Lethargic + losing balance

[miguel99nyc]

Hello Everyone,

It definitely has been a while since I last posted about my cat Sassy. She's been known to get on and off appetite issues which usually ended up getting resolved on its own or after some digestive medications. (Cerenia, appetite stiumlant, etc) But what occurred since yesterday morning has concerned me greatly.

Basically, Monday night and all of Monday and days/weeks prior, she been acting normal, eating like normal, etc. In my past posts, I wrote how Sassy's eating habits and shchedule changed 2 years ago since passing of another cat. She went from eating twice a day or so, to eating smaller meals every 4 hours or so and been at it for the past 2 years. So yesterday morning (Tuesday) I noticed she was sleeping in bit longer than usual. She would eat meals at 4am and 7am approximately. Though yesterday she slept through. I sort of forced her to get up yesterdya morning so she could eat something before i head to work. She kinda struggled to get up, she seemed tired. Eventually came down from my bed, and then ate a little. Less than she had been all these months and years, but was still something. She then went to drink water and came back to bed to sleep. So it sort of seemed fine.

Fast forward hours later in afternoon, she would ALWAYS be at the door waiting for me to get home from work and ask for food as she would be quite hungry for not eating in 6 hours or so. But yesterday as feared upon returning from work, she wasn't at the door door. In fact, she was still on my bed. When I got in, she took a glance at me but made no effort whatsoever to get up or ask for food. nothing. so at that point I realized she was sick. Keep in mind how sudden this came about from being good all day Monday, to Tuesday morning being the start of it. I had been sick with a cold past days...and she sleeps with me on bed. I wondered if i Gave her some kind of sickness?

So I took her to a vet, not her main vet because it was too late in the day. This other vet did checkup, blood and urine sample. Noticed her fever was "slightly" high at 104.5 I believe. She then said she it may be from an infection or inflammation. So she said she would get some antibiotic shot and some fluids to help fever and infection. According to the invoice, the shot she got says Convenia. When I read that up it shows its primarily for skin infection? That was only shot given. No medication or anything sent home. So Sassy just slept thru the night last night. At around 10pm she finally got up in effort to try to eat but just gave her food few licks thats it again and went back to sleep.

Today was more of the same story just woke up few times, walked barely as her front paws seem to be sliding or wanting to slide out beneath her? She looks weak, but gave few more licks to her food and went back to sleep.

I had contacted my primary vet by email today. He mentioned her fever of 104.5 is quite high, not just slightly high. And asked if any antipyretic to bring down fever or antibiotic for infection was given by an injection? I wasn't sure so i sent invoice. He got back to me and said he doesn't see any of those shots listed in the invoice...so I was left to wonder now what this other vet really inject? My primary vet willing to take her in tomorrow morning as she isnt eating, and I know she can't go days without eating but at least she drinking some water. I hope its just some kind of infection, as based of her bloodwork, her Neutrophils is quite high. I don't know. At first i thought again if her kidney disease progressed further to suddenly get her so weak and ill and just want to sleep. But this latest bloodwork still doesn't show it.

Attached is bloodwork and urine test. If anyone can possibly give suggestions I'd greatly appreciate it. She still very lethargic and not wanting to eat, but again shes drinking good amount of water now compared to yesterday.

Thank You

 

[FeebysOwner]

Hi. I remember Sassy! And, for her age those numbers look spectacular, IMO. It does seem to be an infection and/or inflammatory issue - but I have nothing else to offer - so hence I am useless to help you. The only other thing 'sticking out' is glucose, not only in her blood work, but in her urine as well - a good subject to discuss with the vet.

Any chance of arthritis advancing? Sometimes if there is pain involved, the appetite and willingness to move around are impacted. I am not sure how/if that affects the blood work, but perhaps it does from an inflammatory perspective. You might also talk to the vet about an ultrasound to look for abnormalities that might offer some insight. (I didn't re-read your previous thread, but seem to think you might have done an ultrasound already?)

If nothing comes from any of this, ask the vet about consulting with a specialty group and see if they have other ideas on tests to run. This could really be something related to her age and her compromised immune system - just like what happens to humans when they age. The ability to fight off viruses/illnesses just becomes a whole lot harder.

Keep us posted please.

 

[Furballsmom]

Hi
See if something here helps, either in the two articles or in the many posts from members;
Any Good Tips To Get Your Cats To Eat? Share Them Here!

 

[miguel99nyc]

Hi. I remember Sassy! And, for her age those numbers look spectacular, IMO. It does seem to be an infection and/or inflammatory issue - but I have nothing else to offer - so hence I am useless to help you. The only other thing 'sticking out' is glucose, not only in her blood work, but in her urine as well - a good subject to discuss with the vet.

Any chance of arthritis advancing? Sometimes if there is pain involved, the appetite and willingness to move around are impacted. I am not sure how/if that affects the blood work, but perhaps it does from an inflammatory perspective. You might also talk to the vet about an ultrasound to look for abnormalities that might offer some insight. (I didn't re-read your previous thread, but seem to think you might have done an ultrasound already?)

If nothing comes from any of this, ask the vet about consulting with a specialty group and see if they have other ideas on tests to run. This could really be something related to her age and her compromised immune system - just like what happens to humans when they age. The ability to fight off viruses/illnesses just becomes a whole lot harder.

Keep us posted please.

Thanks so much for reply!

So I have applied the mirtazapine gel nearly an hour ago but she yet is still sleeping...not sure how long supposed to take to take effect?

I contacted my primary vet and will be taking her tomorrow. It was suggested she stays there for the day to put in IV and supply her with fluids and such since she hasn't really eaten anything since yesterday morning. Vet said to see if she gets more energy that way and responds or remain the same. One thing the primary vet agreed with me was if the ultrasound MIGHT be unecessary to an extent since she isn't vomiting at all and taking in water just fine so it may not be anything in the digestive tract...but then again maybe she isnt vomiting because she really isnt eating? He mentioned while she remains there, she could get Xrayed see if that sheds light on any growth or inflammation? and to check on arthritis as well.

He kinda also agreed in the sense it might be some viral infection...though I wouldn't be sure how she'd get it considering we live an apartment and always is indoors? Hard to know. I did mention to him I was recently sick with a cold of some sort, and Sassy would sleep with me each night - So I wondered incase I gave her some kind of illness in the past days? Thought the primary vet did say its extremely rare to give a cat our own sickness, especially for it to cause a fever. He also mentioned it could be cancer as to why the Neutrophils are high? But i don't know. I get her age might make it more difficult for her to recover from such infection...but i also hope an Xray can show that or shed further a little more light. As the vet says, the bloodwork DOES show an infection, we know that much. But as to where we don't know he said.

It's a real tough one for sure

 

[FeebysOwner]

Mirataz can take anywhere from a few hours to much longer. That pretty much depends on the cat. Check back with her by offering her foods where she is sleeping and see what happens.

Ask the vet to check for dehydration (neck scruff test) and ask them to show you how. Nonetheless, the standard 'go to' is sub-Q fluids, but the normal amount is about 100ml and takes about 10 minutes to administer, so perhaps they want to do IV instead (different than sub-Q) and add some nutrition to it. If they keep her for the day, the x-rays can't hurt (except for your pocketbook).

Viral infections can live dormant in cats forever, but sometimes can cause issues in older cats whose immune systems are weakened with age (just like humans). I would talk to your vet more about this aspect as well.

 

[miguel99nyc]

Mirataz can take anywhere from a few hours to much longer. That pretty much depends on the cat. Check back with her by offering her foods where she is sleeping and see what happens.

Ask the vet to check for dehydration (neck scruff test) and ask them to show you how. Nonetheless, the standard 'go to' is sub-Q fluids, but the normal amount is about 100ml and takes about 10 minutes to administer, so perhaps they want to do IV instead (different than sub-Q) and add some nutrition to it. If they keep her for the day, the x-rays can't hurt (except for your pocketbook).

Viral infections can live dormant in cats forever, but sometimes can cause issues in older cats whose immune systems are weakened with age (just like humans). I would talk to your vet more about this aspect as well.

Coincidentally just few minutes ago, my cat just suddenly woke up, got out of her bed, and went straight to me as if she wanted food. I figured was the gel working a bit. So I ran out quickly to fridge to get her canned food, but by time i got back to my room she had gone back to bed. I was like, common really?? So she laid down, and i figured let me try to hand feed it, and that's how she ate, laying down. But she could barely stand, was so hard to see her like that, so wobbly. Most likely from not eating much since yesterday morning and all.

Yes I definitely plan to leave her there to get nutritioned some way because she hasn't eaten hardly anything except until just a moment ago and I think that's what my primary vet alluded to. To see how she responds to nutrition throughout the day.

I also plan to get her Xrayed at least to see if her arthritis has progressed or gotten severe...though i doubt suddenly? But I will def ask vet about the viral infection and living in cats forever. That Neutrophils is just so high. I checked her bloodwork from Novemer 2021, sort of recently, and it was in the 3,000's so within normal range. I'd like to hope and pray its just an infection she can come back from as opposed to actual cancer...

Attached was her bloodwork from november 2021

 

[miguel99nyc]

Ok here's an update as of this morning.

She attempted to eat, or seemed like wanted to eat but she'd just go straight back to bed. I can't recall how much bits of dry food I left out in her bowl last night but it seems she ate some from there, though of course not her normal amount. Then I tried feeding her two more times this morning as she got up from her bad and came to her plate. But again just few licsk of food then back to bed. Maybe I didn't put enough of the Mirataz gel in ear? Since I was concerned how vocal she may get (from the past - the pill itself), the other vet mentioned that I could less of the required amount shown on box (tape measure) into Sassys ear, but it may be less affecting. Perhaps thats why it seemed it didn't really help? I plan on just getting the pill at this point even if it makes her vocal, just to get her to eat.

I did bring her to my primary vet this morning and had a lengthy discussion. Her weight had dropped quite a bit from Tuesday visit...but that should be from her barely eating anything at all. One thing I noticed was she appeared somewhat to walk a little better as opposed to her front paws trying to slide out beneath her, but she still seemed very wobbly. That could be from not eating in 2 days. So our primary vet checked her. Said nothing in the mouth that would stop her to eat... and her fever now has reduced greatly and in fact was a degree cooler around 99 the vet said. But he believed its from her just primarily sleeping and not eating and moving around much. They will do Xrays on her and he will call me any moment to see if it shows anything. But for fever to have gone away and reduced from 104.5...said is a good thing but for her to still be sleeping and not eating and losing balance isn't, however he didn't believe its a neurological issue based on physical exam.

Upon physical exam, while he felt/squeezes her digestive parts, she'd be growling and get angry around the abdomen/kidney area he said. The intestines and colon seem to be fine he said, but as he'd go back up towards the abdomen she felt a lot of discomfort . However I told him, usually every check up Sassy had in the past maybe 3-4 years, whenever they'd feel her organs, especially around abdomen area, she'd always growl. Maybe she just felt it uncomfortable or maybe it was pain? But they never really got concerned with it back in those past visits. Just now our vet was bit concerned because she seemed to feel more pain and react when he felt nearby the abdomen. He mentioned he almost felt as if there is some kind of thickening or inflammation somwhere in her upper digestive tract just based from the feel of it., but no mass. So they are keeping her on IV fluids to giver her nutrition, will inject her with anti - nausea medication and pain mediation to see if it alleviates any pain she might be feeling. She's remaining there until end of today, to see how she responds to all of it.

The vet recommended maybe ultrasound - but not as urgent IF she feels a bit better after todays treatment and begins to eat on her own after today. If she doesn't, then he said ultrasound should be done as an emergency as it can't wait until next Thursday (thats when sonographer comes into vet's office). The vet did recall my last cat Charlie's cancer situation - colon adenocarcinoma which he explained was a rather large mass in his colon that was very aggressive but was definitely felt. So he said unlike Charlie, he didn't really feel any large mass/tumors in Sassy as he felt her. But doesn't mean of course there's no cancer/tumor. He again mentioned the High Neutrophils (13,300) is due to either some time of viral infection , triaditis, or cancer. I just can't imagine how cancer especially, can develop suddenly or cause a sudden stop of being active AND stop eating/drinking nearly all together. My other cat Charlie, with the worst kind of cancer, over time gradually ate less and became less active. Not just in one shot. Plus he was having hard time passing stool and all. Sassy been overall fine in days prior passing stool and urinating. I still have to ask about the high glucose, but the other vet location who did the blood test said that it could be from just the stress Sassy felt being taken into vet place.

Overall as for Sassy being a bit more alert, she did seem like that today compared to the past 2 days, especially Tuesday where she slept all day. But that was because of her fever on that day. But now that it's practically gone, yeah it is worrying why she would still want to sleep and eat very little. Vet mentioned he doesn't want to give her prednisone or anti inflammatory medication yet to not put much stress on her body due to age and her kidney disease. She will get sent home with Cerenia and pain reliver liquid medication to see if that will help after she leaves vetplace later.

This is really confusing. Scary that she lost quite a bit of weight from Tuesday alone but I know its from not eating at all. The gel seemed like it didn't do much so I may just go back to the mirtazapine pill. Or maybe she is just nausea and needs that Cerenia. I just keep thinking if it was some digestive issue, since Sassy did eat a bit more of her Pate food last night then just few licks, she would have thrown that up. But no throw up. So not sure. Vet says Sassy could still have some issue in digestive tract but still not throw up, its very well possible he said. Again, emphasizing on the ultrasound. But for now, I await vet's call.

 

[FeebysOwner]

The gel seemed like it didn't do much so I may just go back to the mirtazapine pill. Or maybe she is just nausea and needs that Cerenia. I just keep thinking if it was some digestive issue, since Sassy did eat a bit more of her Pate food last night then just few licks, she would have thrown that up. But no throw up. So not sure. Vet says Sassy could still have some issue in digestive tract but still not throw up, its very well possible he said. Again, emphasizing on the ultrasound. But for now, I await vet's call.

I would wonder about the nausea part too. Although mirtazapine does have a bit of an anti-emetic property, it probably isn't enough to ward off nausea. And you can just imagine what it must be like to be hungry and nauseous at the same time. That could be the issue as to why the mirtazapine doesn't seem to be working. Btw, hopefully I am not jinxing Feeby by saying this, but she does not vomit either.

 

[miguel99nyc]

I would wonder about the nausea part too. Although mirtazapine does have a bit of an anti-emetic property, it probably isn't enough to ward off nausea. And you can just imagine what it must be like to be hungry and nauseous at the same time. That could be the issue as to why the mirtazapine doesn't seem to be working. Btw, hopefully I am not jinxing Feeby by saying this, but she does not vomit either.

And actually was just wondering. You think if it was cancer, the fever would have gone down after the Convenia injection? Vet said that it appears its working, and its a long lasting antibiotic of about 2 weeks he said. Like what makes sense to me is being literally some infection that she feels so sick - not allowing her to eat. Thus the fever at one point. But now that the fever is gone, wouldn't that mean the infection is gone? Should her blood get checked even though it was just drawn on Tuesday evening? Maybe her WBC indicators have gone down, and its just leftover symptoms of possibly feeling nausea and not wanting to eat? Then again, Cancer say in the stomach or digestive part wouldn't cause her to be so wobbily days ago and lose her balance right? One other thing I noticed this morning in stark contrast to Tuesday other vet visit, when our primary vet stuck the thermometer into her to get her temperature, she didn't growl or get aggressive as she did on Tuesday. In fact the vet today place thermometer in twice but she didnt get angry.

I also brought up to the vet how - I would scratch Sassy under her chin, she'd usually enjoy it so much she'd tilt her head up and close her eyes as she must have thought it feel good. But I told the vet when I did it these past days as it seemed she didn't want to really lift her head up until today finally, I'd be scratching her neck but she still put pressure to keep her head straight or down. Vet said well of course - because she isn't feeling well. But that was another thing I noticed with Sassy these past days. Also, despite how long she been sleeping and all, she hasn't groomed her self at all the past 2 days. Usually she'd awaken a bit to lick her paws or herself wherever she can reach, but I just realized she hasn't at all.

 

[Tigger's Mum]

There is one thing that no vet can cure - old age and at 20, Sassy is a very old girl.

 

[cat nap]

Hi...can you ask your Vet,... about the lower magnesium part in her bloodwork, too.

(Not sure, but read that sometimes too low will cause issues, and too high will cause them, too.)

Hoping the best for your Sassy.

 

[miguel99nyc]

Alrighty.

So Sassy is currently back home. She did stumble greatly coming out of the bag...but walked much more quickly and went straight to her water bowl to drink water. She drank quite a bit. Then just sat around for a little.

Usually she would drink water but rarely eat right after....mostly because shes filled with water? Especially after drinking alot? She came to me to my room where she always eats and to her bowl. I said ok let me try to give her food. She just stared at it then went to her bed to sit. Not lay down. I nudged the plate to her, after maybe few minutes she begain to lick her food again...but not really eat the meat. Just the gravy portion. On and off licks. She stopped and showed no further interest. Placed the food away. She then got back out of bed and walked to her water bowl to drink more. Waited maybe 10 minutes or so then finally walked her normal pace to her bed and laid down. For about 30 minutes or so she just been laying there and lookign around the room, not really sleeping yet. Im figuring the IV stuff they put in her gave her some energy as again, she walks so much better, but I know its only a result of the IV stuff. She was also given an anti nausea shot and pain reliving injection. Don't know if its really helping her to eat...as so far she only licking the gravy only for a bit. The vet did say to email him later tonight to see how shes doing. And if she still isnt eating, then to put the full required amount of the transdermal gel of Mirtazapine. I admitted to him, perhaps because I haven't put as much as instructed into her ear last night, perhaps thats why it seemed it didnt work? So I would try the full amount tonight see if it helps. Or maybe I should just rely on the pill broken up like I used to give her in the past and just don't mind her getting hyper or vocal? The thing is she need to eat of course and I just dont know how proven this gel is. Even just now as I typed this, she got off her bed wanting food, she walked quickly to me, looks down into her bowl and walks straight back to her bed without wanting to eat.

She underwent an Xray. Some arthritis was detected in her spine discs and hind legs but nothing too worrysome or contribute to her weak stance. However, there was something resembling a mass, though the vet was not sure what it is, near her heart and right below her Trachea? He showed me the images and what was concerning was her actual Trachea tube once in the chest area, curve upwards a bit then goes back down to normal position, as if something growing inside is pushing up against her Trachea causing that upwards curve. Vet mentioned its generally supposed to be a tube that goes straight through and showed me other cats xrays as examples. So the vet will be sending the images to radiologists to further interpret it and see if its some kind of mass or if its really nothing to be concerned about and should get a response maybe in 1-2 Business Days. Vet mentioned perhaps that is a reason she doesn't want to eat at all, the way her Trachea shifts inside her chest. But My thing is and I asked him, if it was a mass that grew there, could it really grow overnight and cause her not only to get fever (which is now gone) but also suddenly/immediately cause her to not want to eat? Doesn't add up. He mentioned cats hide their illnesses well and certain diseases/illnesses can act up but this sudden not eating? I get it maybe Tuesday from her fever...but to his point, her fever is gone now. Why she still isn't eating who knows.

At this point, should I just hold off on the gel and get the stronger pill of Mirtazapine? She was given Anti Nausea injection but yet that still didnt help or motivate her to really eat. Granted she ran quickly to her water bowl to drink alot of water as soon she got back home... but I don't know. I gave the gel last night around 9:45pm so I got to wait Im sure at least 24 hours. But she really needs to eat. This is just so stressful and confusing. Her not wanting to eat..even with all this help just makes it seem so hopeless even though vet said today I shouldn't rush to put her down as she still seems ok. But just don't know what else to do.

 

[FeebysOwner]

I am in a similar situation, so all can offer is emotional support.

 

[miguel99nyc]

I am in a similar situation, so all can offer is emotional support.

How do you get your cat to eat? That's all I really want for now. Even though realistically, giving her mirtazapine or any other medication...is really just sort of hiding the issue otherwise she'd eat on her own? And really thought these injections given today would allow her to eat. I guess she wasn't really nausous for one of the shots to have no effect. The weight loss was very disturbing to me. Maybe it was because two different locations maybe slightly different scales/methods but Tuesday she was at 9.4lbs. Of course she hasn't eaten since too, and this morning weighed 8.7lbs Really heart breaking.

 

[Furballsmom]

However you do it, but you can't continue to leave it (eating) up to her. Take a look at these articles, and the many posts that members added.

http://[URL]https://thecatsite.com/...-get-your-cats-to-eat-share-them-here.396694/

[/URL]

One thing I do is take some pate style food, lift him on the counter, spread a few paper towels around, get a little food on the end of a popsicle stick and scoop that into his mouth. Over and over.

There's nothing quick or easy about this, but you must help her.

 

[miguel99nyc]

However you do it, but you can't continue to leave it (eating) up to her. Take a look at these articles, and the many posts that members added.

http://[URL][URL]https://thecatsite...-get-your-cats-to-eat-share-them-here.396694/

[/URL][/URL]

One thing I do is take some pate style food, lift him on the counter, spread a few paper towels around, get a little food on the end of a popsicle stick and scoop that into his mouth. Over and over.

There's nothing quick or easy about this, but you must help her.

Right, that is what I did last night, i hand fed my cat Pate food while she was literally laying down. I don't know if has anything to do with bending down or pain because she'd still drink water from her water bowl like she just did few minutes ago. She been drinking nothing but water throughout the past 3 hours. I tried uploading a video here I took of Sassy attempting to eat/lick but I don't think videos are allowed here? Should I post a link?

 

[Furballsmom]

i hand fed my cat Pate food while she was literally laying down.

This is great, you need to do this more frequently

Licking just the gravy is fairly common, I don't think that we necessarily need a video. They're allowed, you need to load it to YouTube or another video site and then post the link here.

EDIT - updated how to post a video here

 

[FeebysOwner]

I give Feeby whatever she will eat, which means a lot of food gets tossed. I add FortiFlora on occasion, I also crumble (to a near sawdust texture) some of her favorite treats to add to her food. I supplement her with baby food meat as snacks, for the calories and because she will eat them. I have added nutritional gel/pastes, especially when given her PM meds. Lickable treats. I have even recently resorted to taking her pill masker paste and heating it in the microwave with some water to make a soup and then add that to her PM meds.

I offer her food when she is not in the mood to eat in her kitchen station - wherever she is. If she eats some, great. Whether or not, I do it multiple times over the course of her evening.

Feeby has had an injection of Cerenia followed by 5 days' worth of pills - with no appreciable difference - but that was before this last nose-dive by her. Going to try Cerenia again and if not that Elura.

 

[mrsgreenjeens]

I use the topical Mirataz and it works really well for my non-eater. If you use the directed amount, that is. My guy will practically kill for food when we use that 1.5 inches of the stuff.

I definitely recommend it over the pill form, as it doesn't seem to have the same side effects like the yowling, etc. Another thing you might try is offering her a different food right now. When my guys gets his Mirataz, he'll eat pretty much anything, but really goes for something different.

 

[miguel99nyc]

I'm actually holding off on the Mirataz for now. Little by litttle she been eating bit more and more dry food at least. Not so much wet food.

One thing I noticed is she hasn't slept AT ALL since coming back from the vet. Yes she seems so alert, but too awake. She just sits in her bed doesn't even try to sleep. Could that be from the IV and fluids given most of day today while at vet?