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

[fionasmom]

I would try everything at this point.

I do see interest in food, not a cat who is so nauseated that she can't eat. The dry food may be a step too far for whatever is going on with her.

Try to elevate the dish so that she does not have to bend her neck as much and see if you can find a more shallow bowl or plate.

 

[miguel99nyc]

Here is the link to new album:

Sassy Meal 2 - Eating Issue

As you can see, I do put some dry food to the left side of her bowl. So anytime she reaches that side she goes to eat a bit. In these videos you will she starts of fine and either chews or swallows dry food fine (as she has in all these times in the past weeks,months,etc). But towards the end, she took one dry food bit in and that's when that gagging/licking commences and then ultimately walks away.

I kinda feel it was the big chunk maybe she couldn't swallow completely? But if that's the case, something obstructing her throat? She wasn't like this say before last week. Might have appeared once every few days maybe but not so often like today.

I could try to elevate it more. She seems to like however deep bowls like that. I tried ones more shallow but somehow despite being blind, she isn't interested in those type of bowls. I know...she's very picky.

 

[fionasmom]

What I see now, which does not mean that this is what is happening, is chewing as a cat does if they have something bothering their mouth. With a true obstruction, I think that you would see either an inability to swallow or a much more pronounced response. It seems as if she hesitates and then does swallow. Is the gagging more extreme than what is pictured here?

 

[miguel99nyc]

No I don't think the gagging is any more extreme. I mean as mentioned, there are times though a single instance of it, she would gag enough that liquid/saliva or something thick comes out from her mouth and it's just hanging from her mouth, doesn't fully exit the mouth. But that may be if its a more extreme gag that kind of forces her to spit out. Most of the times it's just exactly as the videos. It's just odd because it doesn't occur right from the get go as she eats. After a minute or two or so of eating, more so when I add the dry food off to the side. She would either bite the dry food bit and chew or just swallow it whole, and then proceed to licking her wet food on the other side. And as in the video, it's when she returns to dry food then hesitates and stops, then that licking/gagging occurs. If it isn't too severe she would resume eating, but if its like in the video, she would walk away form plate but act normal though.

This morning, gave her fancy feast can twice and she didnt gag or anything at all. Seemed normal. Just didnt add dry food this time. Plus she ate some of her fancy feast dry food I left over night as well - no throwup or spit or anything in that bowl either. Maybe that's because those dry food bits are much smaller than the friskies dry food? I will attempt later after work to feed her only Friskies canned food and see if without dry food she doesn't cough/gag or spit as in videos.

I had my girlfriend tell me although I don't think its accurate in my opinion, that potentially as cats or animals get older, the muscles in their throat get weaker so their swallowing strength isnt what is used to be - thus her seeming to choke or want to spit out the food or lick her mouth in video? Just all seems somewhat connected or its just too coincidental how her exaggerated breathing, random coughs, and now this gagging spitting out at meals is occurring all at once.I don't think she's nauseaous either...so I don't think she got the urge to actually throw up.

I actually sent these videos to vet and he only said he can't tell much from videos...and to see what the exam shows. I managed to make an appointment for first thing tomorrow morning...Im sure she will need Xrays at least but the way she is at the vet, extremally aggressive and all that they get somewhat afraid, not sure they will be able to even hold her still for Xrays and all.

 

[fionasmom]

Your girlfriend is not wrong in general. The weakened throat muscles can happen in humans as well and it can affect swallowing. However, I don't know that it is what is going on with Sassy and I don't think that it would be the entire explanation for all of what you have videoed.

It is good to hear that the gagging is not more extreme. I had visions of Sassy staggering across the room gagging up her food, so it is a relief that it is not of that nature.

Cat dry food, oddly enough, varies in size. I have purchased some that would frankly be too big for a small breed dog...and these from reputable manufacturers. If there is any mouth issue, including from the sore on her face, the size of the dry food might be a problem. How much does Sassy want to eat dry food in the first place?

Your vet is probably being honest that he can't diagnose from the videos, but it is still good that you have them. Sassy was not going to eat a meal in front of him, so he can at least see how she approaches food. I hope that you can get whatever diagnostics you need at the vet.

 

[FeebysOwner]

I swear that I feel it is a 'mouth thing'. If you want to give her dry food, I agree with your idea - give it to her in a separate dish/bowl. Maybe there is something about placing both wet and dry in the same bowl that is causing an issue now. As stated before, you need to try just about everything.

EDIT: Sassy is on Amlodipine, correct? Just a wild guess but ask the vet to check her gums. Gum inflammation is a very, very rare side effect, but it can't hurt seeing what her gums look like. Tbh, Feeby is exhibiting similar behavior to Sassy's with some of her foods (no drooling), but for her it is mainly pills hidden in gooey pill maskers.

 

[miguel99nyc]

@ fionasmom
Well, her desire for dry food has been kind of diminishing, especially of the smaller bits of Fancy Feast thus eating less and less. And today, for first time in about a week I'd say, I came home from work and saw she spit back out some dry food into her bowl, although was dried up so happened at an earlier point.

I am confident she isn't like nausea or have feeling to throw up - she makes the effort like normal self to want to eat. Just that gagging/throwing up sensation gets to her either randomly or specific moments I don't know. One thing for sure, seems her coughing has been winding down. She has gone today so far without coughing, though I don't know while I was at work, but def not coughing while asleep nor awake.

@ FeebysOwner
I think I may have to just stop with the dry food for some time. The reason I been giving it to her for years like this, is because it somehow entices her to eat more of her canned food. I know, its wierd. And ive always been putting it to the opposite side of her wet food in same bowl and always been fine. Without it, she wouldn't eat near as much of her wet food. As to how much dry food? Nowadays since its smaller meals throughout the day, I literally just put a teaspoon worth of dry food to the side. And even that she won't always finish - but it's enough to entire her to further eat her wet food. She been swallowing her Friskies dry food (larger chunks) over the past year or so I noticed but hasn't had issues with it. But today, gave her 3rd meal about an hour ago, she ate her first 2 meals with no issues at all, but 3rd meal, was eating just fine too, wanted to eat more, swallowed few dry food bits but then reached that point again, I can hear her like trying to swallow or that sound effect when one swallows, but then shes stuck there, and begins to like lick her mouth like in the videos. This time though, it was bit more intense and she coughed out saliva and few dry food bits. I took picture...not sure if I should upload it of the spit? But this spitting doesn't happen TOO often as the other times its just her licking her mouth like in the videos and thats it. Even as she licks her mouth, I can hear her tryign to swallow but maybe its that saliva or something thats coming back up? Maybe acid reflux or something?

But I think i may start to just leave out dry food or find maybe smaller sized ones because she's now starting to stop her eating and do that lick/gagging phase whenever I add the dry food to the side. This morning gave her pure wet food, and no issues. She doesn't chew her food, just licks and swallows whatever she picks up so thats why i try to cut up her Wet food as much as i can so she can just lick it and not struggle with larger pieces.

And yes she's still on Amolodpine transdermal. I checked her teeth, they don't look so white, looks darkish somewhat greyish/whiteish but her gums are like light pink though. Nothing seeming unordinary nor blood or swelling inside.

She got an appointment tomrrow at 830am. I know its going to be very difficult for her, stressful and all. Feel like she will need xrays at least. But hoping can get some answers.

 

[miguel99nyc]

Just got back from vet. Bad news from what i was told.

Abscess on cheek isn't tooth related - her teeth are ok just some periodontists. Lost some weight, and vet noticed her labored breathing. They did some bloodwork which will come back tomorrow. They ran Xrays on her and that's where the issue came about.

She has Pleural effusion around her chest. What is the cause? Vet believes some form of cancer that might be spreading. The worse news is that based off xrays, it also shows she has 1 or 2 nodules in her lungs? So that makes him believe there's cancer in the lungs.

Essentially according to him, nothing can be done. Maybe a needle to drain the fluid in chest but that would only give her few days of breathing easier for one. Then would just build up again he said. And could be the cause why food is wanting to come back out because her esophagus has this weird shape of it going upwards (which I thought I saw that in last xrays) like up like a hill or a curve upwards, so its probably why she has troubles swallowing sometimes.

Overall, he didn't suggest going to specialist. Given her age and all, he said it would too much financially to go thru, stress for Sassy, and most importantly, would in all likelihood issue would come back to affect her while spending thousands of dollars he said. There is no current medication like an antibiotic or anti inflammatory that would help her he said as it wouldn't help. And to just take her home and think it over as he suggested to put her to sleep .

I'm just devastated at this moment. I can't believe something like this could come up so quickly and seems that it will only get worse to the point she will stop eating and all. Yet she keeps on trying to function normally all these days in the midst of this going on in the background. I asked the vet how could she still be trying to function normally and not act so sick with this so called cancer. But just doesn't seems there's any hopes to this at all and it just pains me. He mentioned he's just a very sick cat at the moment.

Should I request Xrays to post here?

 

[FeebysOwner]

Thanks for the update about the vet visit. You are welcome to post the x-rays here if you want. Most of us are not that good at reading them, but perhaps there are a few members who can. Does Sassy have a cardiologist/pulmonary specialist that she has seen in the past? If so, it might be worth sharing the x-rays with them to see if they draw the same conclusion as your vet.

I am sorry the vet thinks this is lung cancer. The pleural effusion could be heart related too, but I understand with the nodules why the vet would tend to think it is lung related. No one knows how long it might take for the fluid to re-build, so it could be worth it to drain it and see what happens or wait until it impedes her breathing more than it is now. Lung nodules don't always have to be cancer.

The ultimate call is yours, but if there is no reason to think Sassy is in pain, euthanasia at this point might be premature given her desire to 'carry on' with life as it is right now. I know eating is not the only criteria for determining QOL, but I am using it as one of the primary guides with Feeby.

 

[fionasmom]

I agree with everything that FeebysOwner has said. I would not give up this minute and would continue to assess quality of life.

If Sassy were my cat, I would go for a consultation with a specialist. Your vet is probably not trying to discourage you from doing this, but does want to be upfront about the money that might be involved. A consultation does not mean that you have to agree with any treatment or allow any further diagnostics if they do not sound right to you. My guess, based on LA prices, is that the consultation will run between $250 - $500. I did this with my very elderly dog several years ago in order to get some definitive answers. I was 99.9% sure that I would not have allowed any procedures even before we got there.

Pleural effusion is usually treated by draining the fluid; however, furosemide (Lasix) is sometimes used, especially in cats who have the fluid buidup due to HCM or CHF. We are not vets, but you might ask about that and see if it applies to Sassy.

 

[miguel99nyc]

Ok so about the specialists, no she does not have it. I know once last year for Sassy, she had that not eating issue and they did xrays, they sent it out for further consultation to a radiologist. Then got a further review/analysis and then got a radiology report with like more detailed findings and such. Do you think I should have her Xrays sent out for that Radiologist review?

The thing is, he didn't say specifically it was cancer 100% but alluded to it again because of those nodules in the lungs or there being some metastasis

He mentioned of draining the fluids but that would only last her a few days or so.

Thing is, with cancer like the colon one with my previous cat few years back, do they not act sick(er)? Or if this was some form of cancer, wouldn't she be completely struggling to breathe, coughing more frequently, and/or coughing up blood? We don't even know if its 100% cancer right now, and I am awaiting on blood work - which would that show anything? I will hear back on that tomorrow. I just don't think I can make her go through another type of testing that may involve sedation for one as they fear there more risks given her situation. So ultrasound or any other imaging I don't think would be feasible.

The sole reason I won't want to give her up instantly is only because how she's been trying to be her regular self overall - sleeping pattern, being awake and all. Just of course noticed her breathing and such over the past week and of course in the past days, the gagging of her food when eating. But we just don't know 100% what is causing that pleural effusion and he just made it sound that it wouldn't even be worth nor gaurantee that drainage of fluid as it would just come back again. And that her overall condition would deteroriate if it is cancer that progresses. Also mentioned could be metastasis where it coudl be cancer that has originated elsewhere and has spread. But could something like this occur so quickly? Weeks ago she been totally fine, and months prior and all. I was hoping it was just a mouth issue that something I could deal with and get by - not this terminal potential outcome that vet had to recommend to go home think it over or suggested her going to sleep.

 

[FeebysOwner]

You could ask the radiologist if they would review the x-rays. Maybe they are in a group that also has cardiologists and/or pulmonary specialists that they could consult with? I know when I took Feeby to a specialty group, the IM Vet consulted with an orthopedist on staff regarding Feeby's arthritis. Those specialists, if they are available, might also shed some light on draining and fluid return.

It is hard to say one way or the other regarding how sudden this might or might not be. Sometimes, illnesses just need to reach a certain level before there are any outward signs. I am not a vet, so I don't know what the vet saw that would enable them to suggest metastatic cancer, unless that is just more common with what they have seen in their past.

Ultrasounds are often done without sedation. Feeby has had three of them and the only thing she required - with just one of them - was a calming agent called butorphanol. It did not put her to sleep, just relaxed her so they could shave her belly. She really didn't even need it for the actual ultrasound - or the echocardiogram they did at the same time as one of the ultrasounds.

 

[fionasmom]

You are the one who makes the determination of Sassy's day to day life and quality of health. Even if this is a worst case scenario, there is no guarantee that anything will progress that quickly. At this point, no one is entirely sure if there is cancer or not.

I would definitely send the xrays out for another opinion if you are able to do that.

Depending on the stage and type of cancer, you may or may not notice a sudden decline. General blood tests will possibly point the doctor in the direction of a suspicious diagnosis, so they do have some value. There are a few more specific ones like a chemistry panel, but usually a blood test alone is only indicative, not conclusive.

 

[miguel99nyc]

Right that's what Im trying to arrange, if my vet can send it to their radiologist to further analyze the Xrays and see if they come to a conclusion on their findings.

What gets to me, prior to this visit and all, she seemed totally fine. Not lethargic, throwing up her entire meal, or wanting to sleep all day, etc. Aside from the asbcess and cough which seems to have been going away for now, was just that gagging of food. Not even her teeth are as bad or a cause for that reaction when she eats.

Just now she ate moments ago just fine after sleeping for liek 4 hours. Now shes walking around the living room and all like her self. I don't know. Vet said shes a very sick cat but yet doesn't show it. I wouldn't have even guessed there was some cancer going on due to her day to day life has been relatively the same as ever before - waiting for me at door, wanting eat and drink water, etc. I did notice she was somewhat vocal about 2 weeks ago or so, crying randomly and such while she sat out in living room, but that crying/meowing has diminished over the past several days/week. She been more quiet if anything.

I just keep envisioning with cancer like my past cat, they'd act really sick and why? Cancer. If i saw her throwing up each day, refusing to eat at each meal, or not even attempt on her own to walk to her dry food bowl to eat like she did over night and such, Yes then I woudl say shes sick and her quality of life is poor. But right now she isn't at that point. Whether shes in pain or suffering? I can't tell, only because overall her attitude,behavior is just the same as it has always been. So that's what is throwing me off if there's any cancer to be considered. I just thought they get really really sick.

 

[fionasmom]

Cancer is not one disease, even in humans. If it were, there might be a cure or, at least, a more specific treatment. It is entirely possible to have cancer that does not progress rapidly, and Sassy (if there is cancer) does not have the same kind as your previous cat.

This has been a huge shock for you, and understandably. It is hard to process all of this and, for a couple of days, you should possibly try to take a step back and just observe Sassy objectively.

In your videos, she did not look like a miserable cat. Did the vet say where he thinks that, if it is cancer, it has originated? Lungs are often the place where a metastasis appears, but that does not make it lung cancer.

 

[FeebysOwner]

Feeby has lymphoma (along with all of her other health issues) but is not demonstrating any of the 'typical' signs, so not always a way to gauge anything. Not saying that for both Sassy and Feeby things won't change some time down the road, but for now, we just keep plodding along as best we can.

 

[fionasmom]

Slightly off the subject, but the 16 year old dog I mentioned had been treated for melanoma with an amputation and immunotherapy, had Cushings Disease, had an eye condition, was on thyroid medications, and simply entering the stage where comfort is of the utmost concern. When he was dxed with anal adenocarinoma (he was never blocked though), I was almost sure that I would not allow the surgery for about 5 reasons and I did not. He lived for almost a year until he just could not go further. Nothing has to be typical about Sassy or how this plays out and IMO I don't think that she has reached her time yet.

 

[miguel99nyc]

Well right, my previous cat cancer was in the colon and probable a worse one. And no I don't think shes miserable at all to be honest. Just know her intake of food at times may be a bit diminished but just due to that urge to spit the food or unable to fully swallow her food. But otherwise she just seems like her self.

As for where could the cancer has come or originated? There is no clue. He just said it could be at the point where it has spreaded into the lungs and originated elsewhere but where? don't know. We only looked that the fluid build up and the cause of her breathing heavily as her lungs appear to be confined or squeezed in a way. But even so, it's not like shes gasping for air or wheezing or panting or anything.

But that thing that gets to me as vet stated, there isn't really any meds to give her to feel any better or help the issues other than tryign to drain the fluid and allow her breathing to be easier again. Until somehow the fluid builds back up. And he made reference for that buildup to be there, it's usually from some kind of cancer or metastasis.

yes this has been a huge shock. Spent most of morning crying honestly. And I know if it is Cancer, she would get to that point where it becomes noticeable shes struggling, suffering, pain, or just outrights stops to eat like the vet said. Then I know that's when it may be time to give her up sure. But just knowing that it will get to that point is killing me.

 

[fionasmom]

I might go forward with draining the fluid from the lungs. You don't know how quickly it will return until you do it. The vet says that it will build back up in the near future, but that is based on his experience with these cases. I would also ask about furosemide and see if it would be of any use or not.

If she is not in distress, try to take this one step at a time and don't project ahead right now. You are in shock and you cannot deal with shock and acceptance at the same time, so don't push yourself there.

 

[miguel99nyc]

Well I've come to acceptance after talking to family last night. They cried as well.

Initially, I came to the decision of at least attempting to take her to the vet should her breathing get worse than it is currently since vet mentioned on call that her fluid build up is moderate and not severe yet. And then by then first see if she would allow for that drainage procedure to occur, and if not just make her to go sleep then as she would be suffering by that point. Or, if just prior to that, shows unwillingness/no desire of wanting to eat or drink, etc.

Today started off ok, seemed ok ate fine in the morning and then later on by Noonish. But since shes been wanting to sleep. Attempted to give her food twice since and just gave few licks and walked away. She has been drinking water still till this point, and just walks out to living room to just sit out there. I won't go as far as giving her an appetite stimulant to eat because I'm sure at this point she's feeling sick and id be forcing her to eat?

I think I will wait thru the night and tomorrow how she responds or still refuses to eat. If she persists, then Monday I will come to decision to just put her down. In the back of my mind, the vet's own words were - "she's a very sick cat right now, but stable". I can't tell if its from further fluid buildup but I don't know how that would still allow her to drink water and such. But the trend has been there for the past couple of days - eating less and less ever so slight. And it just pains me because of course when she don't eat, clearly mean she isn't well, and I know after yesterdays visit she isn't doing so well. I feel like I'm just dragging her life out longer than it should honestly. Even though she still wants to walk around the apartment and such, her not eating is something not of her norm unless she's ill. Unless I should try Mirataz tomorrow if she isn't eating by then? But at that point i'd feel im just forcing her to eat.

I too was at first thinking it was going to be premature to put her down soonish which is why I was willing to wait. But a cat not eating of course isn't good when her appetite has been already been diminishing of late. So i'm not 100% sure. Monday at least in the morning I will get a call about her blood work. Surely if that too comes with high or abnormal readings or anything indicative, then that too may make me go forward with her sleep.