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

[FeebysOwner]

All you can do is what feels right to you.

 

[miguel99nyc]

Don't get me wrong. I'd still love her to be around. But she's 21 years old and she isn't going to get younger. Apparently 21 is I believe 100 in human years. She's had a very long life. Outlasted two younger cats. I bonded with her even more after my last cat passed away about 3 years ago because she'd stick with me so much, go on my bed sleep with me and all. So it felt like a whole new experience/revival of bonding with Sassy as I had been associated with all 3 cats I had along with her. So these past 3 years have felt like it was like a new cat around sort of speak. From sleeping with me, waking up with me, waiting for me to feed her and all in my room. And that's another thing. She got so close to me and primarily resided in my room because I began feeding her in my room once my past cat Charlie had to fast for his imagery and such when he had that colon tumor, so many at times in the mornings since he wanted to attempt to eat(but couldnt from being sick) id lock myself in my room and fed Sassy in my room those mornings. Since she got accustomed and so she would eat in my room from there on. She must have felt comfortable doing so and safe in my room. So since, every time I'd get home from work, she'd follow me right away to my room to eat and all. I love her with everything. But ever since she became blind, she sort of became independent. I'd just be around for to guide her from hitting walls, feeding her as well or guiding to her bowl, and guiding her to her bed. I'm sure its been depressing for her, not being able to see us and all. Though us family here ensured we gave her affection and rubs and all to make her know we are there and around. She has enjoyed it.

There's part of me that wonders - should I really pursue have the vet send off the xrays to a radiologist. He said he can not a problem however he's certain of what he say himself in the xrays. He mentioned if something was questionable in his eyes, he would have recommended to send it off to a radiologist for interpretation. He can send it off Monday morning and I think we'd get a response sometime in afternoon. Im hesitant on the mirtazapine. If she was really ill say right now, wouldn't she also avoid water?

 

[FeebysOwner]

It is just me personally speaking, but if the vet is willing to send the x-rays for a second opinion, is there a reason you are hesitant to do so? Even if the radiologist agrees, all that has done is give you another opinion with which to base your decisions on. Did you ask your vet if there is a chance that the radiologist would consult with an in-staff cardiologist/pulmonologist?

I am not sure I understand the doubt about trying mirtazapine. Doesn't Sassy have anti-nausea meds as well to take?

On a more 'objective' perspective, a cat will 'shut down' as their particular bodies 'choose' to do. Drinking water may be the last of those.

 

[miguel99nyc]

Well, the reason I was a bit hesitant was because the vet himself yesterday evening after returning my call, when i asked him on it, he mentioned that while he said it was no problem, he mentioned how usually just upon looking at Sassy's xrays himself, he was able to determine she wasn't doing well for one and there isn't any doubts. Plus he mentioned about saving money if I didn't send it out to radiologist (it's an additional cost to have it sent out). I also felt a little bad because it seemed as if I doubted him and his expertise. But I will proceed with him having it sent out first thing Monday morning when he's back in the office. I can ask if he can have it sent off to cardiologist/pulmonolgist as well.

Sassy does not have any anti-nausea specifically. The only thing she been giving since her appetite issues over past 2 years was mirtazapine. And usually that sort of boosts her appetite and gets her going to eat. The thing is, if she is suffering from some disease, and if i gave her mirtazapine say tomorrow morning so she can eat something, wouldn't that just be tricking her/forcing her to eat? That's my hesitancy. Before, I'd give it to her in similar situations when all she would do is lick her food only and not eat it. It is odd how she had attempted to eat this morning just fine, its just in the afternoon thru now shes been just giving these similar licks and walking away. So that was my question, should I try mirtazapine tomorrow morning if she still doesn't show interest in eating by then?

And to the last part, if she's just drinking water, that could be a sign of her body shutting down?

 

[FeebysOwner]

IMO, she should have an anti-nausea med as back-up. There is an anti-emetic value to mirtazapine, to some degree. If you have reached the point of not wanting to try to get her to eat because you fear you are forcing/tricking her to do so with mirtazapine, then - again - that is your call.

I know you have a lot of issues to deal with, but her eating fairly OK this morning, but not later in the day seems drastic to me for you to assume that mirtazapine couldn't make a difference as it has in the past.

Cats shut down, as I said, in many differing ways. So, there is no definitive process; and from what I can tell, you have not seen a trend in her long enough to make that kind of assessment.

Why not at least treat her as you have in the past until you get another opinion on her x-rays? If she doesn't respond to the mirtazapine, it is just one more thing to add to your decision-making list.

 

[miguel99nyc]

Well, that was my thinking thru this afternoon. I had hoped this afternoon or even just now as she woke up on her own from bed, went to drink water again solely and now just sitting outside in living room, this behavior does remind me ALOT like those times she had appetite issues in the past. And usually got resolved with a bout of mirtazapine. I'm not assuming mirtazapine won't work at all. To your point, if she doesnt respond to mirtazapine, yes, it is one more thing to guide in my decision, and monday surely would wrap that up. If she responds which I hope, great. At least until I get feedback on blood work and xrays consultation.

I will try the mirtazapine tomorrow morning. just tried feeding her now yet again but just gives licks and walks away. If a cat is sick/nauseous, would they still attempt to drink water? Just wondering.

And no I don't think i seen her decline...I've seen videos of cats near deaths and they look at lot worse, a lot lethargic and all. I just don't see her there just yet either.

 

[iPappy]

Personally, I'd give the mirtazapine a try. I have used these appetite stimulants before, transdermally. One of my cats was at the end of his life, and it did very little to help him eat and that did help with my decision making, but deep down I am so glad I tried it, just in case.

 

[fionasmom]

You are being very logical about all this, as hard as it is. However, take this one day at a time and investigate the options that you have listed. Personally, I might try the Mirataz, but that is your decision.

Please remember that we are here for you.

 

[miguel99nyc]

I really appreciate that.

Today I thought at first Sassy was going to pull through eating on her own. Somewhat did earlier on and even late last night too, but now in this afternoon she just continues to give few licks and walk away.

I just administered the Mirataz into her ear, to see if that will get her to eat soonish. If it doesn't, as mentioned before then at that point nothing will get her to eat. And she can't go days with barely eating anyway.

Still going to await blood work and further consultation tomorrow on xrays but if Mirataz doesn't respond then I will have to make that choice. I guess the vet was right how fast this might act. Because Friday she seemed ok eating wise. But suddenly Saturday and today her appetite had diminished. I don't think its coincidence to vet visit either. She still makes effort to be drinking quite a bit of water and use her litter box and all. But eating just not happening.

 

[miguel99nyc]

Ok so I guess the mirataz worked quick...even though i used half a strip(dose) onto her ear to prevent her from getting vocal or hyper, and an hour had gone by and made her come into my room easier than the past 2 days and she ate really well. Of course I know its from the Mirataz, didn't know would work that quickly. And considering how much she had, no gagging or anything. I just omitted any dryfood as earlier today she spit that out with saliva at end of her meal.

So if Mirataz worked, I guess she isn't in a full decline yet.

 

[FeebysOwner]

So if Mirataz worked, I guess she isn't in a full decline yet.

Good. I am glad it helped. There is something to be said in consistency with meds too. I don't know how long you stretch in between doses of Mirataz, but maybe finding a pattern to giving it to her routinely - be that every 2 or 3, or even 4 days, rather than sporadically might help. It could help to reduce the ups and downs you see. I mostly give Feeby one-half dose every other day, and I think it might help her avoid having as big of highs and lows in her eating.

 

[miguel99nyc]

Well before with her appetite issues, id just give it once and that would be it and gets her going from there on.

I do recall in previous posts I think even about your Feeby, giving her rountely every other day or so yes. I only tried avoiding it because it would get her hyper and vocal. I would lessen the dosage for sure, but even then, I would see her on her way of eating well after that one dosage.

Now I wonder though, as I was kind of certain Mirataz wouldn't work just based off how she looked and given her potential diagonsis, how did Mirataz work? Say for example, if the fluid in her chest was preventing her from eating which is what vet said, only way to alleviate that is thru drainage. Then that would possibly allow her to eat on her own possibly is what I was assuming. Or, if it didnt help, and if it was cancer just making her appetite diminish in the past few days, how could the Mirataz, especially at half dosage allow her to eat? Is that how Mirataz works? Like it just bypasses whatever underlying issues there may be and enables the pet to eat regardless?

To iPappy point, he mentioned it got to the point where Mirataz helped just very little and helped his decision making. I just thought honestly Sassy was getting to that point rather quick, and thought this time Mirataz wasn't going to work.

It could also mean maybe she may require it more often than before or every other day or so similar to your Feeby because of her condition. And I wouldn't mind that, but is that a safe approach to take? It isn't forcing her upon to eat?

 

[FeebysOwner]

I can't answer most of any of your questions. All I can say is this: If Sassy was so full of fluid, I personally think Mirataz would not get her to eat.

I have never looked at giving Mirataz to Feeby as forcing her to eat. But to help whatever it is that is blocking her desire to eat. This drug is somewhat of an anti-depressant, but also affects serotonin levels that are tied to appetite as well as nausea and vomiting. If she is experiencing any of the issues associated with her serotonin levels - for whatever the reason may be - then it seems reasonable to think that Mirataz might help from that aspect.

The body works in mysterious ways (to quote an old, old anecdote), and I cannot imagine that Mirataz is going to overcome other factors that would be so pressing as to preclude Sassy from being able to eat.

Have you ever read any articles about Mirtazapine/Mirataz?
Mirtazapine For Cats: Overview, Dosage & Side Effects - Cats.com

 

[FeebysOwner]

I do want to add one thing - there are times that I have given Feeby Mirataz without the results I was hoping for. So, I wait and give it to her again - primarily on her 'schedule' - only for her to respond. What was going on - I have no idea. But I was glad I tried again.

 

[miguel99nyc]

Right. After all, after call with vet on Friday evening, he said Sassy's fluid build up was moderate and not severe at that moment of xrays.

Yes I did look at that site along with other ones too. Just wasn't sure it was going to fully work. Sassy just ate another big meal just fine and now is just walking around the apartment. However now it's deemed, as I just by chance tried once again dry food and althought she will eat it at first, some point along the way it gets her to gag and spit out. Meanwhile her meal prior to this one, just gave her solely wet food and ate it with no problem. I guess she just can't have dry food anymore. Vet did say I could try to add water to it. But I know wet food better than dry food for her kidneys?

And as for the times mirataz didn't work on feeby, what happened then? Didn't Feeby not eat if it didnt work for that day or so?

 

[FeebysOwner]

If Sassy likes the taste of the dry food, no harm in adding some water to moisten it and see what she does.

Feeby just didn't eat so much on the days the Mirataz didn't do the trick. It is not a true science about when/how the Mirataz will work for her. Sometimes, even 24 hours later she is still not keen on eating. She has plenty of weight on her at this point, so I don't worry about it. Plus, she always gets some baby food meat (with supplements) and knock-on-wood, she rarely turns that down.

 

[miguel99nyc]

Right. I'm now in some trial phase to see how long this Mirataz will last. At least the half dose has helped her eat substantially - quite near her normal amount, and without making her vocal or hyper thankfully. How long this lasts will determine how often I give Sassy mirataz. I do give it transdermally along with her Amlodipine, so I'm just going about cleaning her ears almost daily before applying new set of meds onto it.

I too want to think that I ain't forcing Sassy to eat with Mirataz. I asked the vet about it last night and he said that he believes she will need Mirataz because she's most likely not feeling well with everything going on around her chest area so that gave me the impression now she will be on this rather routinely. A little scary because again, in the past would just take one bout of it to get her going but with what potentially may be ailing her and the severity, seems like she will be needing it every so often just to get her to eat similar to your Feeby.

Vet will be if hasn't just yet sending out the X-Rays to radiologist. Seems like their location is with cardiologists on board as I just checked Sassy's Xray report from last year. But in that report, they write down their findings and conclusions and specify if there's any masses throughout the body, around the heart or lungs as example. Then also findings on her spine/bones, digestive tract, etc. So they do somewhat of a detailed break down of Xrays. Of course in last years Xrays, there were nothing abnormal about her Xrays or masses or metastatic disease other than arthritis essentially. While I hope something similar will return, I know they will at least provide some insight as to what may have caused the Pleural effusion.

 

[FeebysOwner]

Feeby has been on Mirataz since 11/2021, and most likely for the rest of her life. Maybe that is why I don't look at it as forcing her to eat, since it mostly works and has helped her for a long time now. It is what helped her gain some weight back and now aids in her being able to maintain it.

Good about the group who will likely be taking another look at this most recent x-ray! I hope they do as thorough job this time as last.

 

[fionasmom]

I absolutely agree that any appetite stimulant that increases appetite comfortably is not forcing an animal to eat. Sassy is voluntarily enjoying her wet food; you are not syringing it or forcing it into her mouth. If it needs to be used on a regular basis for the duration, just determine with your vet what that duration might be and follow it. FeebysOwner described how it works, and that is the same way that a huge number of medications in that class help with appetite and depression in humans as well. I have used it before, have a current prescription for it now for Graycie (who is young and recovered) and don't have any qualms about it.

Sassy may feel more comfortable if she does eat, so regardless of anything else that is going on, this may be adding to her quality of life that she eats a good meal.

 

[miguel99nyc]

So I just got off a call with the vet about an hour ago. I don't know why he hadn't sent out yet the Xrays...but he's going to and should hear back from him within an hour or so from now.

Bloodwork is what he called me on and surprisingly most of it is normal. But I guess that isn't indicative of anything I suppose... in relative to her potential cancer diagnosis.

He did specify however her kidney values haven't increased as much to say she's sick from that which seems amazing for her values remaining lower end after nearly 7 years from her diagnosis, yet eating just regular commercial foods. Her pancreas levels were bit high (currently working on obtaining bloodwork PDF) so he mentioned of putting her on steroids for it. Wonder if that's tied into her fluid buildup or her not wanting to eat on her own. But ultimately that will be determined with the detailed report of the Xrays by radiologist.

We also spoke brielfy of attempting the drainage once, and to see how it goes after. He mentioned how he had a cat drained as such, was put on steroids and held up for a good 2-3 weeks? Maybe once a month procedure? Then he also mentioned another example another cat was drained and it built back up in 2-3 days and so at that point it isn't practical to bring her in so often of course and in that case, I'd definitely consider her going to sleep - that would be too much suffering on Sassy's end.

The vet initially upon last visit was hesitant to give her any steroids as it would make her thirsty and pee more which may affect her kidneys he said. Is that true? If that is the offset of her kidneys getting worse, I mean at that point would be to just extend her life a bit more. But I just don't really see her suffering aside from the breathing and such.