Sassy - 17yr Old Cat - Appetite Issue (early Ckd)

[miguel99nyc]

Hello Everyone,

So once again my cat seems to have developed appetite issue where she doesn't eat as much as she was say amonth ago or so. This has happened similarly back in January 2019 and also last August 2018. It stresses me out so much because ever since she was diagnosed with early kidney disease in June 2017, I fear once she stops eating or eating less, its her disease progressing...I guess its just inevitable truthfully.

This time around, while she does eat...just less then usual. She would still come out to her bowl when its time to eat...and eats a littl ebit before she walks away to sleep. Once or twice she would just barely lick her wet food and then walk away. Other times she would eat a considerable amount (half maybe of what she used to eat) then walk away. Over the past 2 weeks or so, she been drinking water and most of the times when shes ready to stop drinking, she begins to like wanting to spit out the water or gags? And there was some time in past few weeks she would throw up the water she drank right after drinking it. Maybe just 2-3 times a week. But never she'd throw up the food.

Back in January 2019, she wasn't eating barely anything and also throwing up the water food. Back then, we did Xrays and bloodwork and kidneys were still fine per vet, and xrays show'ed nothing. So she was on cerenia, famotidine and mirtazapine. She got better as the month went on.

Now we did bloodwork again with vet to get her checked yesterday, and that still came out normal. Her urea nitrogen when up a point above normal limit and her Creatine is in higher end of normal range. BUN still well within normal. So Vet deemed this lack of appetite right now isnt being caused by her kidneys either. He recommends either monitoring her, or get her ultrasound see if she has IBD? If ultrasound comes normal then it could be just behavorial he said which... I find hard to believe? Unless age is affecting her? She is 17 yrs old and she was 12.4 pounds back in February 2019 and now went down to 11.8 since but Im sure that's the lack of her eating as much.


So all in all, I'd like to get input on what you guys think could be affecting her appetite or make her gag water at times? Also I'm posting the lab work from June 2017 thru yesterdays (2 years worth of blood) and would like to get thoughts on how you all think her CKD is progressing. Vet says he's surprised that it's going very slowly which is good news. But i still fear it nonetheless The only foods she loves (or used to love) is her Friskies fillets (lowest phosphours I can find) and fancy feast gravy lovers (low phos as well).

Thank you so much all in advance.

 

[Furballsmom]

Hello! I'm so sorry to hear this!
I apologise if you're already familiar with this website, but I wanted to mention it has a support group as well .

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Support Section

 

[shadowsrescue]

I have a kitty with recurrent urinary blockages. When his urinary function changes, he stops eating. This last time I was forced to syringe feed him so he could get something in him. A few things we tried that seemed to help.

1. We switched him from Cerenia to Zofran (ondansetron). I found that it worked better for nausea.
2. B 12 injections. He received one from the vet and within 8 hours started to eat again. You can also learn to give these at home.
3. Probiotics in his diet. I used Proviable DC (available from Chewy and Amazon) https://www.chewy.com/nutramax-proviable-dc-capsules-dog/dp/101471 and I also tried Renew LIfe Ultimate Flora The Renew Life you can usually find locally. My Kroger grocery even sells it. I just break open the capsules and sprinkle onto wet food. If she won't eat it, you can also pill her.

I also used S. boulardii from Jarrow since not only did he have inappetance, but he had diarrhea too.

The probiotics take a few days to get into the system.

Also for digestive issues slippery elm works wonders. It helps to coat the digestive tract and soothe any inflammation. I have 2 cats that take it daily. With my urinary kitty, he was getting it 3x a day, but now down to 1x a day.
You can make a syrup from the powder and it keeps in the fridge for a week. Here is the powder

and here is some info on slippery elm and making the syrup
The 'Emergency Food' Herb Every Pet Owner Needs to Have in the Medicine Cabinet

 

[miguel99nyc]

Thank you for the info!
Although not sure how I could relate my cat to the urinary blockage part...but maybe the probiotics could help and I could ask the vet?

As an update, so oddly enough, right after the vet visit Monday, my cat ate her dinner like her normal self which surprised me, and as well next morning. But now last night she didnt want to eat much again and this morning she barely licked her food again and ate just few bits of dry food...it's really stressing me out and I got just 2 weeks before I go out on vacation and fear how she will NOT eat with other relatives watching out for her while I'm gone.

Since per the vet, its not her kidneys currently affecting her appetite nor her vital organs...(vet now not in until Saturday...) Should I go ahead with the Mirtazapine he gave me? Its a 2mg pill but chopped in half so I guess 1mg. Says to give twice a week. I remember back in January, I had to give her just 1 2mg pill (not in half) and while it did work, she kept asking for food almost every hour...she was bit restless and constantly crying. It saddened me to see her like that meowing allmost thru the night barely sleeping. So I told the vet that and so he broke the pills in half to try just I guess 1mg. While I'm confident it will make her eat again...it feels as if I'm just cheating. And as the vet said, mirtzapine is not curing anything, so there is something else going on that's affecting her appetite.

Should I still proceed in starting up this mirtazapine half of 2mg? or her constantly meowing means she's not meant for it? Should I request for the same other two pills from January when she had same issue - Cerenia and Fomatdine? Or should I just go ahead with an ultrasound? Like I also feel they just trying to get money out of me...so I want to be sure if any of you think these pills would help before going the Ultrasound rout.

Thank You

 

[FeebysOwner]

I don't see why you don't go ahead and give her the smaller dose of the Mirtazapine and see how she reacts with it. Since it is less dosing, it may not have the same affect that it did before. She needs to eat, so getting her back on track with her food is essential. No it is not a cure, but it is a resolution to her eating issue if it works. And, I would think getting her to eat well is necessary with or without going down to ultrasound route. Is there a conflict in the vet's mind about using the Mirtazapine and having the ultrasound done?

As far as the other two meds which are for nausea and acid reflux - why do you think she needs those as well - unless the vet thought she should have them too? If he didn't, why go there now - especially if the Mirtazapine works by itself? And, Mirtazapine also has anti-nausea properties in addition to being an appetite stimulant.

In looking at the test results, there really hasn't been any significant change and the couple of counts that were high were by very tiny amounts.

If I am misunderstanding something, my apologies...

 

[miguel99nyc]

Hello there.

Yes I'm going to try the smaller dose when i get home work. I agree its important for her to eat then not eat. Well there isn't a conflict in vet's mind...as my cat had the same issue back in January, and he recommended Xrays and Ultrasound if xray showed nothing (which it showed nothing). So I went just giving here one 2mg mirtazapine and she was like a monster asking for food, but also made her very vocal. But that was it, just literally one pill of Mirtzapine, then cerenia and fomatidine for several days and she was fine and back to her self for the most part for the months to come after. Now vet gave me 1mg to see if it lowers the side effects.

The other two medications...the vet said it won't harm her...but he thinks shes nausea because every time she drinks water from bowl...she gags like she wants to spit out water. Maybe twice or 3 times a weeks she'll throw up the water from her bowl right after. So thats when the vet told me she may be feeling nauseous. I can try to post a video on here to show how she reacts after drinking water and this like...gagging or she like turns her head sideways suddenly and starts like licking her cheek or something as if water is dripping on her face? Hard to describe it.

And as for JUST using mirtazapine? Well I still see it as its like cheating? The vet said it isn't really curing anything as something is causing her to decrease her appetite. My worry was her kidneys disease progressing (which I guess it has somewhat?) but the vet deemed that it's not high enough for her be feeling sick from it so the vet then said either we try Mirtazapine see how she reacts, or we can try also the cerena and fomatidine as well as it won't harm her he said, or we do ultrasound. If we did ultrasound and came back normal too, then he said it could be beahvorial...then its like what, all a waste of money. He suggested in Janauary Xrays, I did that too and paid, and all came back normal. To rule out cancer or tumors he said as welll as IBD was purpose of Ultrasound.

Another thing was that as the vet was feeling her body during exam, she was growling the ENTIRE time, and was hissing as well which was crazy. She was like that back in January as well when she wasn't eating and getting examed.

The bloodwork was just to get thoughts on what were other thougths of her CKD progressing which vet says its goign very slowly which is good news considering all she would eat is her Friskies and Fancy Feast.

Thank You

I don't see why you don't go ahead and give her the smaller dose of the Mirtazapine and see how she reacts with it. Since it is less dosing, it may not have the same affect that it did before. She needs to eat, so getting her back on track with her food is essential. No it is not a cure, but it is a resolution to her eating issue if it works. And, I would think getting her to eat well is necessary with or without going down to ultrasound route. Is there a conflict in the vet's mind about using the Mirtazapine and having the ultrasound done?

As far as the other two meds which are for nausea and acid reflux - why do you think she needs those as well - unless the vet thought she should have them too? If he didn't, why go there now - especially if the Mirtazapine works by itself? And, Mirtazapine also has anti-nausea properties in addition to being an appetite stimulant.

In looking at the test results, there really hasn't been any significant change and the couple of counts that were high were by very tiny amounts.

If I am misunderstanding something, my apologies...

 

[FeebysOwner]

I may be missing the point when you say 'cheating' - I see it as cheating her out of possibly feeling better if you don't try the Mirtazapine in case it helps her to get back to eating. It isn't a situation of EITHER Mirtazapine OR ultrasound - as far as I know, you can do both if you so choose.

So, she gags on water, but not food? Maybe a video would help us to see what it is that she is doing. Did the vet check her mouth for any abnormalities? Has there been a change in the water you are giving her? Have you tried adding a little bit of water from canned tuna to her water to see if that changes her reaction? Or, perhaps bottled water as a test?

I do know from reading numerous threads on this site that an ultrasound is typically recommended to look for IBD and/or cancer/tumors. So, it doesn't seem to be an unreasonable suggestion. But, it kind of sounds like you are questioning the vet a bit, just in general. And, for the vet to suggest this might be behavioral is a valid reason to have some doubt. Have you thought about getting a copy of all her records and getting a second opinion from a vet from another practice?

The growling and hissing sounds like she was either not happy about being examined by the vet or that something hurts her. Have you tried feeling around on her like that to see if she growls at you?

 

[miguel99nyc]

Yes I will upload a video of her drinking reactions. Yeah she doesn't necessarily do it on food, just water. And I always refill her bowl with fresh cold water as sometimes since I have another cat, loose cat hairs get in there and so water looks bit dirty. So I empty and replenish it with new water.

And no, cheating I just mean like, its just making her eat again...but I'd hate for her to be on it like...forever or at least...in months to come? As if her normal appetite is gone and now she would be relying on this pill to eat from now? Am I getting that right? Or would this help her restore her appetite and be off it and her resume her normal eating habits?

SHe still does eat her dry food when we give her in afternoon after work just fine. But come dinner either she will eat little bit or half of the amount she used to eat, or just give it few licks and walk away.

And I don't know, I don't really doubt my vet as he has helped me for many years. Though at times went thru many testing just to get to a simple answer, usually with my other cats it came back all normal. Xrays and ultrasounds. So thats why I think he want's to do it just for the money and I guess I'm somewhat confident nothing will show. Plus I dont know how she woudl feel/react since I got to drop her during early morning, they make her sleep for ultrasound and pick her up end of same day especially since she doesnt like it there.

Also I've tried rubbing her feeling her body but she doesn't growl at me.

I may be missing the point when you say 'cheating' - I see it as cheating her out of possibly feeling better if you don't try the Mirtazapine in case it helps her to get back to eating. It isn't a situation of EITHER Mirtazapine OR ultrasound - as far as I know, you can do both if you so choose.

So, she gags on water, but not food? Maybe a video would help us to see what it is that she is doing. Did the vet check her mouth for any abnormalities? Has there been a change in the water you are giving her? Have you tried adding a little bit of water from canned tuna to her water to see if that changes her reaction? Or, perhaps bottled water as a test?

I do know from reading numerous threads on this site that an ultrasound is typically recommended to look for IBD and/or cancer/tumors. So, it doesn't seem to be an unreasonable suggestion. But, it kind of sounds like you are questioning the vet a bit, just in general. And, for the vet to suggest this might be behavioral is a valid reason to have some doubt. Have you thought about getting a copy of all her records and getting a second opinion from a vet from another practice?

The growling and hissing sounds like she was either not happy about being examined by the vet or that something hurts her. Have you tried feeling around on her like that to see if she growls at you?

 

[miguel99nyc]

Also for IBD, I had a cat that passed away few years ago that had IBD, but his symtpoms, although most part was completely normal, he woudl throw up food almost or water and did lose more weight and such but it was under control with medication. His appetite though was always excellent, in fact always finishing up his food, plus left over food from my other 2 cats haha. He was quite the eater, but yet never gained weight... maybe because of IBD. He had Triad disease as well, poor guy.

But with Sassy here, only symtoms her really is just decreased appetite primarily. No diarrhea or vomitting of the food she eats at all. And if it was a tumor or cancer, wouldn't she be acting up in different way or be in pain? Or if it was related to her appetite back in January...it would go away using those three medications and come back with her appetite issue? Doesn't seem likely I think which is why I'd want to hold off on the ultrasound.

I may be missing the point when you say 'cheating' - I see it as cheating her out of possibly feeling better if you don't try the Mirtazapine in case it helps her to get back to eating. It isn't a situation of EITHER Mirtazapine OR ultrasound - as far as I know, you can do both if you so choose.

So, she gags on water, but not food? Maybe a video would help us to see what it is that she is doing. Did the vet check her mouth for any abnormalities? Has there been a change in the water you are giving her? Have you tried adding a little bit of water from canned tuna to her water to see if that changes her reaction? Or, perhaps bottled water as a test?

I do know from reading numerous threads on this site that an ultrasound is typically recommended to look for IBD and/or cancer/tumors. So, it doesn't seem to be an unreasonable suggestion. But, it kind of sounds like you are questioning the vet a bit, just in general. And, for the vet to suggest this might be behavioral is a valid reason to have some doubt. Have you thought about getting a copy of all her records and getting a second opinion from a vet from another practice?

The growling and hissing sounds like she was either not happy about being examined by the vet or that something hurts her. Have you tried feeling around on her like that to see if she growls at you?

 

[miguel99nyc]

Here is the video of her drinking water and how she tilts her head suddenly towards end to lick off excess water? Not sure if its gagging. Sometimes then shortly after she sits...and either she would be fine or other times would throw up the water she just drank.

Another thing to note, she loves jumping on the bathroom sink and lick the stupid rust off the center drainage or just licks random spots of the sink. She got used to at times in past drinking water when I'd turn on the faucet (which is my fault for teaching her that) and the other day it seems like my brother washed his hands with hand soap...bubbles remained somewhat in sink, and I think Sassy drank that bubble stuff so when she threw up the water she drank after that soap remnants, she threw up that soap too I think. She also has a tendency to lick anything plastic bags around the house whcih we trying to clear of. Not sure why she likes those plastic grocery bags to lick....

Link below to download video, sorry it was too large to upload.

Download link
https://we.tl/t-TYLkrO31of

 

[FeebysOwner]

And no, cheating I just mean like, its just making her eat again...but I'd hate for her to be on it like...forever or at least...in months to come? As if her normal appetite is gone and now she would be relying on this pill to eat from now? Am I getting that right? Or would this help her restore her appetite and be off it and her resume her normal eating habits?

I don't think the vet would consider this to be a forever treatment. It is just to get her back on track with eating so that she can regain a more normal balance in her overall health stability. Additional effort still needs to be made to determine the cause of her issues while she is on the med. But, at least she doesn't lose ground with her health from not eating enough in the meantime.

SHe still does eat her dry food when we give her in afternoon after work just fine. But come dinner either she will eat little bit or half of the amount she used to eat, or just give it few licks and walk away.

So, it is just wet food that she isn't eating for the most part - for her dinner? What if you mix a bit of the wet with the dry instead of all wet at dinner? Or, if you think she would be interested, get some of those cat food toppers and mix a bit of that with the wet?

But with Sassy here, only symtoms her really is just decreased appetite primarily. No diarrhea or vomitting of the food she eats at all. And if it was a tumor or cancer, wouldn't she be acting up in different way or be in pain? Or if it was related to her appetite back in January...it would go away using those three medications and come back with her appetite issue? Doesn't seem likely I think which is why I'd want to hold off on the ultrasound.

No, I see your point. Get her past her current eating issues and think about the ultrasound later...

The other thing that comes to mind - when the vet did x-rays, did they look for/see any indication of arthritis? If she is feeling some pain from arthritis, that can reduce her desire to eat.

I still think her mouth needs another look - given the unexplained water issue, especially since she is not doing the same thing with food. And, it still wouldn't hurt to test out bottled water or something other than your tap water.

Just saw your new post - stop her from getting anywhere near the rust, that cannot be good for her to be sure. Feeby likes to chew on plastic bags as well, I just make sure they are no where near her in order to stop that.

Also, and lastly (sorry this is so long), here is an instruction about uploading a video - see if it helps any.

How To Upload And Add Videos To Your Posts

 

[miguel99nyc]

Well during her morning and evening meals I'd mix dry food into the wet food she'd then eat mix of both, but just not finish her food.

And her mouth was checked but nothing was of concern to the vet. even back in January there was nothing.

I mean it also sounds like I guess I sort of have to do an ultrasound because after that I'm not sure what other test could she go through. Vet said next step after would be maybe even opening her up for biopsies but he said that would be too extreme for this case since its just appetite being the only issue. And either way, I definitely not going to allow that to happen nor go thru with it. Would be just too much.

I just wished there was a simpler solution since its like her 3rd bout of this decreased appetite since last year. But yeah Mirtazapine will help her out I'm sure... and right now shess prescribed that 1 mg twice a week.

I don't think the vet would consider this to be a forever treatment. It is just to get her back on track with eating so that she can regain a more normal balance in her overall health stability. Additional effort still needs to be made to determine the cause of her issues while she is on the med. But, at least she doesn't lose ground with her health from not eating enough in the meantime.



So, it is just wet food that she isn't eating for the most part - for her dinner? What if you mix a bit of the wet with the dry instead of all wet at dinner? Or, if you think she would be interested, get some of those cat food toppers and mix a bit of that with the wet?



No, I see your point. Get her past her current eating issues and think about the ultrasound later...

The other thing that comes to mind - when the vet did x-rays, did they look for/see any indication of arthritis? If she is feeling some pain from arthritis, that can reduce her desire to eat.

I still think her mouth needs another look - given the unexplained water issue, especially since she is not doing the same thing with food. And, it still wouldn't hurt to test out bottled water or something other than your tap water.

Just saw your new post - stop her from getting anywhere near the rust, that cannot be good for her to be sure. Feeby likes to chew on plastic bags as well, I just make sure they are no where near her in order to stop that.

Also, and lastly (sorry this is so long), here is an instruction about uploading a video - see if it helps any.

How To Upload And Add Videos To Your Posts

 

[FeebysOwner]

How about the arthritis aspect? Did you look at the instructions for the video?

 

[miguel99nyc]

How about the arthritis aspect? Did you look at the instructions for the video?

Yeah Im trying but it can't be previewed it says. I made file as small as possible

 

[FeebysOwner]

I don't know how to help with this. I would suggest creating a thread under Site Help and giving all the specifics of what programs you are using to try to upload from, etc. and see if one of our more technically savvy (than me) members/staff can help.

Also, while you are waiting on help from that, have you checked out other foods you might try with Sassy to see if something else would be acceptable to her - and to you, in terms of catering to her CKD? The foods included in the below link are all wet foods, and list what the ingredients are in them.

Check This Out.... Chart For Cat Food Ingredients

 

[miguel99nyc]

https://thecatsite.com/media/20190701_193136_1.422570/

 

[FeebysOwner]

You got the video up!! YAY! But, tbh, I didn't see anything of particular concern especially since this video didn't include any part of her throwing up. She laps from the side of the bowl, like many cats do - but, I did notice it would seem that because of that she is rubbing her whiskers against the side and that can bother some cats like crazy.

What do you see in this video that is bothering you - in case I am somehow missing it?

P.S. She is so pretty and sweet looking!!

 

[miguel99nyc]

You got the video up!! YAY! But, tbh, I didn't see anything of particular concern especially since this video didn't include any part of her throwing up. She laps from the side of the bowl, like many cats do - but, I did notice it would seem that because of that she is rubbing her whiskers against the side and that can bother some cats like crazy.

What do you see in this video that is bothering you - in case I am somehow missing it?

P.S. She is so pretty and sweet looking!!

Thank you!!! shes my baby, had her for 17 years and now, well in the past several years she gotten so much closer to me, sleeps with me and is always with me in my bedroom. She would even get on my desk when Im doing work and stand inbetwen my keyboard and myself, she means everything to me! And when she was diagnosed with Early CKD in June 2017, it really broke my heart .

And for the video, yeah I wouldnt show the throw up lol...to graphic? But around 9 seconds when shes about done with water shes like liking her side mouth or something as if water is dripping? I may have to capture another video showing what I mean...but she does that tilting of her head and begins to lick off something kinda as if shes drooling (which she isn't). and sometimes that licking leads to her throwing up her water. Other times she does it randomly even while sitting she'll do that licking tilting head sideways thing but no throw up. Ill try to capture another video of it when I can and upload here.


Food wise, yeah she will only eat Friskies Prime Fillets and Fancy Feast Gravy lovers (well used to but now not so much because of decreased appetite). I know it's not the best option out there and healthiest but I choose the cans that are least amount of phosphorus possible. I was also tempting with the Purina Chicken Urinary Tract can...beacuse she does like that too and its much lower phosphorus? But I think my vet said those urinary foods can be too acidic? Maybe feeding her that giving her acid?

 

[FeebysOwner]

I know how you feel, my Feeby is going on 15+ and I just dread every little thing that she does out of the norm for fear of what it could mean.

Try to get another video to show us. I doubt anyone here will care about the throwing up part (you should look around at some of the other videos that have been displayed on this site!!!).

I only meant to try another food source from the perspective that maybe she would be enticed to eat more of something else since for whatever unknown reason she isn't doing well with her current foods. I thought that chart might list low phosphorus ones that you might just want to test out. And, for what it is worth, I would also try some human chicken, turkey, even maybe Gerber baby food meats (no garlic/onions/etc.). Just to see if there is anything that she goes for better than her current food.

And, for the heck of it I would try a couple of different bowls - maybe with wider mouths on them. And, don't forget about the different waters as well.

Rule out everything you possibly can, and make note of it all.

Also, have you considered asking the vet to consult with a nearby vet university to see if they might have some ideas?

 

[miguel99nyc]

Yes I will try to get different bowls too maybe and try out various foods again as well.

Also, is it possible that with just the Mirtazapine, she would get better and just regain her appetite and everything be fine? Because again, as the vet said, there can still be something underlying causing her not to eat. Could it even be an upset stomach...but last this long?

I guess the difference between January and now was that in January she was eating far less then now...and she was throwing up whatever she ate or drank. Now its just on and off just water she drinks so doesn't seem I guess as severe as back then?

I know how you feel, my Feeby is going on 15+ and I just dread every little thing that she does out of the norm for fear of what it could mean.

Try to get another video to show us. I doubt anyone here will care about the throwing up part (you should look around at some of the other videos that have been displayed on this site!!!).

I only meant to try another food source from the perspective that maybe she would be enticed to eat more of something else since for whatever unknown reason she isn't doing well with her current foods. I thought that chart might list low phosphorus ones that you might just want to test out. And, for what it is worth, I would also try some human chicken, turkey, even maybe Gerber baby food meats (no garlic/onions/etc.). Just to see if there is anything that she goes for better than her current food.

And, for the heck of it I would try a couple of different bowls - maybe with wider mouths on them. And, don't forget about the different waters as well.

Rule out everything you possibly can, and make note of it all.

Also, have you considered asking the vet to consult with a nearby vet university to see if they might have some ideas?