Reaching my wits ends - idiopathic inappetence

[FeebysOwner]

I tried to go back and re-read this thread, but I am having issues with my 19+yo cat, so I think my mental absorption level is failing me. I apologize in advance if I am talking about things you have already done. You've tried appetite stimulants, such as Mirtazapine/Mirataz, Elura - and others as noted in the link below?

Since she does eat and then stops, it sounds like she correlates eating a particular food to feeling nauseous/bad. So, what all anti-nausea meds have been tried?

What is going on with her hypercalcemia?

Appetite Stimulates for Cats | PetMD
Nausea in Cats | PetMD

 

[daftcat75]

Two thoughts I have:

1. Has she had her teeth checked? I mean sedated and X-rayed. Not just pop her mouth open and have a look. My Betty had a terrible appetite when I adopted her. Steroids (prednisilone) went a long way to fixing her appetite. But it was by accident that we discovered just how badly her teeth were bothering her. She came to me with gut issues too which is why she went on pred in the first place. But once she stabilized on pred, I booked her dental appointment (the one I meant to book a week after I adopted her but her gut issues sidelined that.) The vet wanted me to give her gabapentin before the dental appointment so that she would be nice and relaxed by the time they needed to insert a catheter in her and prep her for surgery. Then literally about a minute before I was to collect her to put her in her carrier for her appointment, the doc called and said he had a family emergency and had to cancel the appointment. "Good news, Betty! I no longer have to fast you and you're not going to the vet today." I put out a plate of food for my bag of Jello (very sedated) cat and she tore into it like I never saw her eat her food. She finished that plate in one go. I mentioned that to the vet who gave me his blessing to use up the rest of the gabapentin prescription looking for a dose that allows her to eat comfortably without becoming a bag of Jello.

2. Have you tried an anti-nausea drug with her?

Three low impact drugs that you could ask your vet for a prescription are:

1. Ondansetron (brand name: Zofran) I started Betty early on this one and to be truthful, I haven't tried taking her off it yet. Every doc I've talked to says it's a fairly benign drug and she can remain on it indefinitely if she needs it. I intend to try to withdraw it sooner than later but we had other priorities first.

2. Gabapentin: We took care of Betty's two resorptive lesion teeth finally and she didn't really need the gabapentin anymore. But she also gained weight from the pred and has some arthritis. I spoke with her vet and she gave me her (same practice, new vet) blessing to keep giving the gabapentin for her arthritis or for suspected dental pain if either application gives her relief. This is another fairly benign drug that I've been told Betty can remain on as long as she needs it. Gabapentin comes in a foul tasting liquid that most cats don't like. Skip that. Ask for the capsules. If you can, I recommend splitting a capsule, eye-balling it into two piles, and repacking that into a smaller capsule (size 4 capsules from Amazon.) You can also get it compounded through a compounding pharmacy. Talk to your vet about dosage. But 50 mg per 10 lbs of cat is probably enough to produce a meaningful result without turning her into a bag of Jello. If she eats better with gabapentin, report back to your vet as there's likely some pain somewhere that the gabapentin is successfully masking. You may also be able to get a prescription for buprenorphine which may be easier to dose and administer to some cats. It is not as sustainable as gabapentin. But it would allow you to run a trial to see if pain is behind her reluctance to eat.

3. Pepcid. This is super easy and you really don't need a prescription for this. But I would ask for the vet's blessing before you try it on your own. Very few cats actually produce too much stomach acid. But you'll know in two or three meals whether this is the case. If you give her Pepcid (generic: famotidine) before meals and she eats better, then you can report that to your vet and as an avenue to explore. I would discuss dosage and trial time with your vet. If it doesn't improve her appetite in X number of days, you agree to discontinue it. Pepcid by itself is not all that useful for cats. But like ondansetron or gabapentin, it can lead your vet in the correct direction if it does produce a positive result.