Reaching my wits ends - idiopathic inappetence

[OrangeTabbyDad]

Hi Everyone,
So, I've been a long time lurker here, and have reviewed so many of the posts surrounding both cat behavior and nutrition, as well as cat health. All of this, in hope that I will find some clues as to what is wrong with my 3 yr old baby girl Pixie.
First, let me introduce Pixie. She's a beautiful Canadian born shorthair orange tabby, with a spinal deformity in her neck. She weighs in at 11lbs 4oz, and is extremely lean. She's a shy one, and not much for outdoor adventures. I adopted her and her sister Lola together, when they were just little (3 months old). The original owner had no intention of keeping the girls, and as such didn't take care of them, nutritionally speaking. So, they grew up on dry food. Lola is very food motivated, and loves her snacks. Pixie on the other hand doesn't much care at all for food. I'm pretty sure, she wouldn't eat if it weren't a threat to her life. She has never had very much interest in treats, especially not human food. So, feeding her in her recent sickness has been incredibly difficult. "Finicky" or "Picky eater" are extreme understatements when it comes to describing Pixie.

So, here's the situation. She's sick with something that the Dr's can't identify. She wont eat anything except for Chicken flavored Whiskas Temptations.
The vet's have run Chest/Abdominal radiographs, Ultrasound, and a CBC panel. After these, her Dr found the spinal cord deformity but does not think anything of it. Both the vet and the ultra sound specialist are concerned by the cough, as they can hear some fluid in her lungs as she was breathing while at the clinic.
She's always had a light cough, that sounds a bit wet, but never any "wheezing" sound. She will cough every few days, sometimes once every couple of weeks. But it's common enough that her vet feels that it's a concern, and wants to start her on Flovent... I'm not excited about this, because covering any cats' face for even a couple of seconds is darn impossible and traumatizing.
Aside from the asthma, the CBC showed elevated Albumen, Cholesterol, and Calcium levels. Of course, the Albumen and cholesterol are omitted/disregarded - and the Calcium is in focus here. The Vet and the utrasound specialist believe this to be idiopathic hypercalcemia. So, they suggested transitioning Pixie onto a Hills W/D dry food diet. Pixie refuses to touch the Hills dry food. And as is typical Pixie, she wont touch it - and would rather starve to death. The Dr's want me to try soaking 11g Chia seeds in 20ml water for 20 minutes. Then try to use a syringe to get in in her. This would last for 4 weeks. This is a novel approach to treating idiopathic hypercalcemia, and I don't know what to think of it.


So, I'm feeling defeated. I have tried every trick in the book to get Pixie to eat, and she just wont have any of it. At least I have her eating Temptations

Her diet previous to her suddenly stopping eating was Orijen Original Cat, and then Stella & Chewy Cage Free Chicken Raw Coated kibble. I've tried so many times over the last couple of years to transition her to wet food... but she is more stubborn than I am, and will hold out longer than I'm comfortable with.

So, here's hoping that some of you incredible cat parents might have some tricks, thoughts, and insights that you might be willing to share with me.

-CB-

 

[Furballsmom]

Hello - I'm so sorry you're facing such a challenging situation.

In this thread I'm linking there are some unique approaches to getting food into a cat. I'll have to admit, though, that your baby sounds like she needs to be handfed regularly (I had to do that with my angel boy several times daily his last year with us), or possibly a feeding tube is necessary?
Any Good Tips To Get Your Cats To Eat? Share Them Here!

 

[fionasmom]

Chia seed articles: Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series
Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series
Bisphophonates: https://www.ndsr.co.uk/veterinary-p...t=Bisphosphonates,to less common side effects.
Low dose steroids:Idiopathic Hypercalcemia - Veterinary Specialty Center

I have never had to treat this in a cat, and certainly am not telling you what to do. The chia seed theory is clearly out there; I don't know how difficult it might be to syringe that into her mouth, but might be worth a try. Has your vet seen this work?

 

[FeebysOwner]

Hi. Are any of the vets you are seeing specialists? Maybe a group who has specialists in internal med, endocrinology, and orthopedics? I think there are likely other tests that can be done, based on the ones that have already been run, to see if there is any correlation with her spinal disorder, cough, and high calcium (although, her calcium level is not all that high, and I wonder if it has anything to do with her less than stellar diet). From what you told us, she hasn't any of the typical symptoms related to hypercalcemia, short of disinterest in most foods.

Did the testing already done include a measurement of the ionized calcium level (not the same thing as the Chemistry profile), which sometimes includes a parathyroid hormone assay. This testing is recommended when no tumors or organ dysfunction is found on a medical workup. The tests for ionized calcium, parathyroid hormone, and parathyroid hormone-related paraprotein are usually done by an endocrine research lab.

 

[OrangeTabbyDad]

Any Good Tips To Get Your Cats To Eat? Share Them Here!

Thanks for this. I've definitely gone through most of these options and scenarios. But, I admit, sometimes I can employ a lot more patience. So I'll keep trying on some of these tactics.

I am not afraid to move towards a feeding tube, since I feel this is Way less traumatic for everyone, and much easier to manage. It's on my list of things to discuss with the Dr next week, if pixie can't be coerced into eating the w/d dry.

fionasmom - no I don't think her vet has any experience at all with the chia seeds idea. He didn't present to me how to do it properly, nor did he give me a syring to use for it. I have no experience with soaked chia seeds... Do they dissolve into a gel? Or do they expand and get gelatinous like tapioca?

We (pixie and I) certainly appreciate the support.

 

[OrangeTabbyDad]

FeebysOwner thanks for the points to consider here. I strongly agree, the possible correlation has me wondering too. I will ask the vet if we can get a referral to an endocrinology specialist... Do you say "orthopedic" because of the spine?
Her symptoms are simple. She just doesn't show interest in eating, and is very particular about what she will eat. Perhaps too, I just am going about the whole food trial promotion and presentation all wrong. I admit, I don't have much experience with cats who don't have an affinity for food.
Other than the food, she doesn't poop every day, but rather every other day to every 2 days... But rarely any longer. She drinks from her fountain fairly well, and she urinated (not a heavy ammonia smell) at a "normal" flow and frequency.

"Did the testing already done include a measurement of the ionized calcium level (not the same thing as the Chemistry profile), which sometimes includes a parathyroid hormone assay." - - No. I asked about doing the ical testing, but at the time, the Dr wanted to do the ultrasound first/instead. I'll revisit this with the vet next week.

 

[OrangeTabbyDad]

Oh, I totally forgot to mention... When pixie started to lose her appetite, she was treated with a 2 week dose of prednisolone. This was to see if she would stop coughing. She did stop coughing while taking the pill, but also completely stopped eating at the same time. This is when I went bananas and just started feeding her anything she would eat (temptations). The med trial ended 3 weeks ago.

 

[FeebysOwner]

I will ask the vet if we can get a referral to an endocrinology specialist... Do you say "orthopedic" because of the spine?

Yes, because a specialty group covering multiple disciplines could confer with one another.

Other than the food, she doesn't poop every day, but rather every other day to every 2 days... But rarely any longer.

Constipation is another possible symptom of hypercalcemia. But going every other day, unless it is hard stool, is not the same thing as constipation. And, if her food has been off for a while, that will also lead to less stool movements.

 

[OrangeTabbyDad]

Agreed. The food change, and reduced volume intake explains the stool movement schedule change, more than the idea of constipation. Her stool is firm, but not dry, and feels like playdough... Same texture as its always been. It's just very long, the size of an adult finger

 

[FeebysOwner]

Her stool is firm, but not dry, and feels like playdough... Same texture as its always been. It's just very long, the size of an adult finger

Sounds perfectly normal to me!! Feeby sometimes has that, and she goes every day.

 

[lisahe]

I don't know much of anything about hypercalcemia but we do have a stubborn cat who has asthma and can be a reluctant eater.

Given that Pixie is both very young and coughing fairly frequently, I'd strongly suggest trying her on Flovent when her diet situation calms down a little. Using an AeroKat spacer helps soften the insult of putting something against a cat's nose. I can't say that Ireland likes her inhaler sessions but she tolerates them. She has relatively mild asthma (her coughing episodes were never frequent or especially long) but Flovent is a preventive medicine with very few side effects so we're glad to have her on it.

As for eating, though we switched our cats off dry food shortly after we adopted them back in late 2013, Ireland has decided she'd rather eat her topper/treat food -- Dr. Elsey's Clean Protein chicken dry food -- than her wet food. Dr. Elsey's is good stuff: the carbs are very, very low (only 2.something% dry matter) so in terms of carbs, that food is as good or better than any of the wet foods we feed. The downside is that it's dry, which isn't good for preventing kidney disease. Fortunately, Ireland seems okay with a compromise, whereby we feed her wet food with lots of extra water and a nice layer of Dr. E's food on top. She's always been a picky eater with a tendency toward constipation (those two things often go together) so I'm hoping this truce lasts! Though I do hope we can increase her wet food and decrease the dry food over time. I mention all this because maybe something there would be helpful for you, either the food itself (though watch out: Dr. E's non-chicken Clean Protein foods have chickpeas, which I'd stay far, far away from) or the feeding method. Oh, Dr. E's will send out little sample bags of dry food.

Good luck!

 

[OrangeTabbyDad]

Thanks for the kind words of encouragement, and sharing your personal experience. Is this the dry food you refer to?

 

[lisahe]

Thanks for the kind words of encouragement, and sharing your personal experience. Is this the dry food you refer to?

You're welcome! Yes, that's the food, though that price is very, very high. I buy from Chewy, where it's much cheaper.

You can write to Dr. Elsey's (here's their contact form) to ask for a sample. (I think/hope they're still sending them out!)

 

[OrangeTabbyDad]

Thanks lisahe ! I've reached out to them. Let's see if they will help out a friendly Canuck from across the puddles.

 

[lisahe]

Thanks lisahe ! I've reached out to them. Let's see if they will help out a friendly Canuck from across the puddles.

Oh, that's an interesting question... I hope they'll send to Canada! (Of course since I'm in Maine I always think everybody should ship to Canada because it's so close...) It's very good food, very calorie-dense, and we're finding that it seems (of course nothing's certain yet) that it takes less Dr. E's than expected to keep Ireland happy with her wet food.

 

[fionasmom]

Chia Seeds 101: How To Use Chia Seeds - Choosing Chia
The vet is talking about mixing them into some liquid, which will make them somewhat gelatinous.

 

[OrangeTabbyDad]

Chia Seeds 101: How To Use Chia Seeds - Choosing Chia
The vet is talking about mixing them into some liquid, which will make them somewhat gelatinous.

Hmm... this could get a little tricky to administer, since she doesn't eat wet food.

 

[OrangeTabbyDad]

Hey folks, I figured I would provide a small, unexciting update. Pixie has been showing some interest in eating the weruva Breakfast Cat, as well as the Funk in the Trunk. At first, she seems pretty into it (not THAT into it though). For the funk She'd pretty much just take the gravy, and then leave the shreds behind. If she got some shreds in her mouth, she would act as though she hated chewing the meat, and then walk away. I tried blending that one up, but she absolutely wouldnt touch it after it was pureed. So I tried "mincing" the chicken up, and that helped a bit, but not enough to keep her interested. Overall, the gravy in that one is her favorite. The breakfast cat is a pate style, and she ate a whole pouch pretty easily by herself... But after the first go, that was it. I would have to hand feed her the second pouch. But she ate it... I'm ok with hand feeding if it works! The third pouch was much harder to get her to eat. She just seemed to walk away as I tried to hand feed her... But what's strange, is that IF I could get her to taste it from my fingers, then she would show interest and eat about a Tbsp from my palm. So that took an entire day to get her to just eat the 3oz pack.
I'll keep trying different varieties of the weruva, since that seems to peak her interest. I kind of don't want to give up on that, and switch back to the temptations. As tempting as it may be, I feel like I should just pack a lot of patience and see how much she'll tolerate from the wet food...
Thoughts?

Side note, since having her eat the wet food over the past few days, her poop has recovered back to normal (it got pretty dry and small for a while there as she was only eating temptations).

Long story short she still has appetite issues, but I really want to get her off dry food... I feel I owe it to her.
So far, even though she's not eating as many calories as before, she still hasn't lost any weight (according to the Dr) since this all started back in November 2022. So, that's a good sign, right?

 

[OrangeTabbyDad]

Hi everyone, it's been a while, and I thought I should bring you a quick update. Pixie still has a very poor appetite. We have now tried nearly every brand, texture, and consistency of the foods available here in Canada. She is either one stubborn and picky eater... Or she has some mystery disease that no vet can uncover.
I'm not sure what to do at this point, since she has one or two good days where she will eat her full meal without issue, and then weeks to months will pass where I have to hand feed her to get her the calories she needs to stay alive.
I don't want to surrender her, and I don't want to euthanize her either. So if anyone has any ideas or tips on how to keep a happy life, I'm open to any and all suggestions.

 

[fionasmom]

Thank you for letting us know how things are going; I am sorry that there is not much, if any, improvement. Many times others who read threads and have similar issues do wonder how things progressed or turned out.

I apologize if you explained this and I did not get it, but were you able to get any referrals to any specialists such as internal medicine or endocrinology? If not, I think I would make an attempt to have a consultation with a specialist. All previous diagnostics are your property and should be readily given to you...at least here in the states and I assume in Canada.