Would appreciate feedback re: my cat starving himself

[cataan]

Monday, May 15 I noticed my 17 year old cat didn't eat his wet food (I only provide wet food) and he is a ravenous eater, loves to eat, though he is not overweight, in fact slightly underweight, as I never overfeed my cats. He didn't show any behavior changes other than this. I thought that was odd and on Tuesday, May 16 I was very busy and didn't notice until I went to bed that he again did not eat. On Wednesday, May 17 he ignored his food so on Thursday, May 18 I took him to the vet.

Blood work showed a very slightly elevated BUN (but lower than the last time he had blood work a few months ago) and a creatinine of 4, so slightly elevated. He had an ultrasound, urinalysis, and was given sub-Q fluids and an appetite stimulant. The stimulant didn't do anything and the next day, Friday, May 19, he received more fluids and a different stimulant. The stimulant encouraged him to eat a few bites but otherwise was ineffective. Over the weekend I gave him sub-Q fluids and famotidine.

Monday, May 22 (today) the ultrasound results show a small nodule on his pancreas and on his liver, but the radiologist didn't think they were cancerous. His intestines showed slight thickening, but nothing that would be so significant that he'd stop eating. Basically, nothing unusual for a 17 year old cat. I could get biopsies done but the nodules are small, 6 mm, and at his age he really can't have major surgery so what would be the point? His renal values decreased and the creatinine is barely above the normal range, so while he probably has mild kidney disease, it wouldn't cause him to stop eating.

He has not really eaten in a week, and that itself will kill him if not addressed. He is now on prednisone, cerenia, two appetite stimulants (alternating each every 12 hours), famotidine, sub-Q fluids every other day. He did not eat this morning and still, as of this evening, shows absolutely no interest in food, like it isn't there. While he looks tired (as expected since he hasn't eaten in a week), he also came up on my bed to cuddle with me, and he purrs when I brush his fur. If you didn't know that he is on a hunger strike or feel how bony he is you wouldn't know how ill he has become.

I'm hoping the medications help by tomorrow, and I ordered some Churu treats to see if he will eat, but if not then I have to decide Wednesday about next steps, which could include a feeding tube, or the decision to let him go.

I am posting this message in case anyone has seen something like this - my cat is on a hunger strike for no apparent reason and at some point, if he isn't there yet, he's going to cross a line where cannot recover and his physiological systems will begin shutting down. I need to help him!

 

[FeebysOwner]

I don't know what the range is for your vet's lab, but creatinine of 4 is pretty high from what my vet's lab is. If you have the actual test results, they should have included a range. What about his phosphorus level? Another helpful indicator of kidney disease.

What are these appetite stimulants? How much sub-Q fluids are you giving him? Cerenia usually is best used for cats that are vomiting, ondansetron usually works better for cats who are nauseous. But every cat varies, so it is a bit of an experiment to see what works best for each cat.

Baby food meats can be a very helpful way to get a cat to eat again. Gerber Stage 2 or Beechnut. I would try those. I have an 18+yo cat who is hyperthyroidic, with kidney disease, arthritis, and suspected lymphoma. She is on numerous meds, and half of her diet is baby food meat, which can be supplemented - as I do - to make them nutritionally complete.

 

[cataan]

Thank you, FeebysOwner!

The creatinine is now down to 3 after the fluids and I don't know the phosphorus level - I was given a can of Hill's renal diet cat food but my cat ignored it.

For many years my cat vomited fairly frequently after eating, usually with a very small bolus of fur - not really a hair ball, just a small, marble-sized bolus. He once took Cerenia and it stopped the vomiting, so if he does eat hopefully he'll keep it all down. He is taking Mirtazapine and Elura, alternating them every 12 hours since they had little effect using only one every 24 hours. The hope is that the increased stimulant affecting two different pathways will boost his desire for food.

I was giving him 100 ml of sub-Q per day, which will be decreased to 100 ml every other day for the time being (or 50 ml each day).

The strange thing is he doesn't taste the food and walk away, he just isn't interested, he ignores it, or if I put it in front of him he almost looks annoyed. It's like he just doesn't care and after a week he has got to be (literally) starving. I just gave him some canned tuna and he showed no interest at all other than a very brief sniff, after which he climbed up onto my bed to chill. I'll try the baby food.

 

[Robyn5678]

Is he vomitting ? My 18 year old stopped eating but would vomit a lot. Several days after she last ate, she vomited undigested food. Is he drinking water at all?

 

[cataan]

Hi Robyn - he is not vomiting; he only vomits (undigested food) when he eats and has some fur in his stomach, but he hasn't eaten enough to have any "ammo" to vomit. Also has not pooped in a week - nothing to excrete.

 

[FeebysOwner]

Good on the drop in creatinine! I can't explain the mirtazapine, normally that is an oral med that isn't even given daily, usually every 2-3 days, depending on the dose. I know next to nothing about Elura. What I do know is a cat that is made hungry with these products is still not going to want to eat if they feel nauseous. So, maybe cerenia isn't the answer for him.

Renal foods are often not accepted by many cats. And his other foods that he usually eats, he may be connecting to making him feel bad, even if that is not what the problem is. Try the baby food meats and see what happens. You can also try some things in this article (see below link) if you feel amenable to doing so.
How To Get Your Cat To Start Eating Again - TheCatSite

Keep us posted, please.

 

[cataan]

I got some baby food and a syringe. When I got home and went to his room (he lives in my bedroom), he was hanging out, walking around (slowly). I rubbed some of the baby food on his chin and around his mouth and NOTHING - he didn't lick it, he didn't care at all. I've never seen a cat completely ignore food puree rubbed on his face. WTH? So I decided he is going to get syringe-fed. I fed him two or three teaspoons of food (need to be careful and give him small, frequent amounts, rather than a lot at one time) and he was not happy about it, though he did eat it. When I was done he was not happy and is now curled up in my closet, trying to stay away from me. It really seems like he wants to kill himself through starvation, I do not understand this.

 

[daftcat75]

I have heard and seen in at least one of my cats how Cerenia can suppress appetite. It's listed as an uncommon side effect on the insert. But that was studies in dogs. Since it's only off-label use in cats, I don't know that there have been enough studies. But my guess from anecdotes here and personal experience is that Cerenia causes inappetence in cats in greater frequency than dogs.

A few ideas I have:

a. Ask for ondansetron to try instead of Cerenia. They work in different ways. You can even try them together if you think he needs the Cerenia.
b. Ask for gabapentin. There may be an undiagnosed source of pain (dental pain? how's his teeth?) that is preventing him from eating. I thought for the longest time that my cat had nausea. But after I dosed her with gabapentin before a vet appointment that was canceled at the last minute, I discovered by accident that pain was holding back her eating. When she finally had her dental appointment, her eating got so much better. Since she also has arthritis, I have continued to give her gabapentin and she doesn't leave remainders anymore.
c. Ask for Hills A/D recovery food. I call this Betty's "cake frosting" because she cannot resist anything--including her meds--that is topped with the stuff. When she had a fever of unknown origin last summer and wouldn't eat anything else, she kept nibbling at the A/D--enough to keep her going until the antibiotics took over and she started feeling better again.
d. I think antibiotics get overprescribed. But if you're at the end of your other options, maybe a short course of antibiotics might clear up something that has yet to be diagnosed. I put Betty through $3000 worth of tests with her fever of unknown origin and ultimately, a single dose of Veraflox turned her around the next day. We finished the course as prescribed. She got a little extra A/D mixed in with her food for those few days since the 'flox tasted awful.
e. I don't know what could have brought it on. But has he been tested for pancreatitis? That could account for his unwillingness to even consider food. It is not a standard blood test and thus it can get overlooked if you or your vet aren't specifically asking for the test.


Good on you for syringe feeding. I would try it with the A/D. He'll probably like the taste better and it's going to be better for him. This is really what A/D is for: getting sick cats and dogs back to eating. If there are no dietary reasons why he can't have the A/D, that's what I would try to get into him right now. If he likes the stuff, and most cats and dogs do, you can slowly start mixing his regular food back into the A/D to see if you can get him back to his regular food again. At this point, you're fighting inertia. Bodies at rest tend to stay at rest, and cats who are fasting tend to keep fasting. Here's hoping A/D whether by choice or by syringe will help break him out of that funk.

 

[Alldara]

Hey! Just chiming in on some tips.

- elevating the food a bit if you haven't already (I see you're syringe feeding right now). If a cat isn't eating they get too nauseous to eat and then it's cycle. So syringe feeding can break that a bit but elevating the food can help if it's acid buildup or arthritis.

- warming up the food. Smell is a big part of eating and it can be difficult for an older cat. Warming it up helps, also using kitten food instead as it can be more smelly.

- using a blender to blend it up. This works well for sick cats of all ages.


Hope your cat feels better soon.

 

[furrypurry]

Cerenia makes my cat stop eating. We never use it anymore.

 

[cataan]

I'm starting to give up hope. He just doesn't want to eat, doesn't groom himself, is so frail, and though he can walk, it's clearly not with any strength. I gave him gabapentin some days ago and while it initially made him want to eat, it later knocked him on his ass and he was really out of it, sedated. I gave him a dose less than half the prescribed amount today and, while not in a stupor like last time, was clearly out of it. Regardless of gaba, he flops rather than sits, and when I feed him much of the food (like the consistency of a shake - I blend up Hills kitten food or renal food though sometimes give the baby food - ends up on his face and under his chin and he does not care to clean himself so I have to wipe him down with a wet paper towel. He gets roughly 4-6 teaspoons (20-30 ml) of food at a time, so figure three times a day that's 12-18 tsp which I don't think is enough calories. I'm hydrating him with sub-Q fluids daily and also syringe-fed water but I feel this is not a battle I'm going to win. The vets wanted me to kill him Thursday but I couldn't do it. Came close Friday but I'm just hoping he will start eating again. I'll get the A/D if he makes it to Monday. He is taking prednisolone and I started back on cerenia today, but maybe it's interfering with his appetite? The vets really want him to take it, with the most important drug being prednisolone. I just don't want to give up on him though I get the feeling he has given up.

 

[cataan]

FWIW his diagnosis is kidney disease and pancreatitis.

 

[Alldara]

Unfortunately, when the body begins to die, it stops wanting/needing food. That is one of the signs of death coming soon. Yes, it can happen with just illness too and sometimes it doesn't happen. Usually, with hyperthyroid cats they get more hungry. Not eating was a big sign with Lily that she was ready to go and I ignored that and regret it.

There are quality of life charts to help you decide what to do: Quality of Life Scale for Pets online calculator

 

[furrypurry]

I am going through something very similar. My Purrcy has CKD and we have been dealing with acute Pancreatitis for almost two weeks now. I am syringe feeding and also feel sometimes that it’s just not enough. We have had three feedings today of 20ml each and will do one more tonight. We just started pred and I am worried about that because he is prone to herpes breakouts and we certainly don’t need that right now. I have only given him one dose and may chicken out and stop it. I think he is a little better - maybe - just a little. I also worry about having to take him to the vet clinic while on pred since it lowers their immune system. What a ride. He has lost almost a pound that he didn’t have to lose. I feel defeated because I tried so hard to keep some weight on him and boom. His CKD numbers were really good about a month ago but that excitement was short-lived as he was clobbered by this so soon after.

BUT, now to what I really came here to say. Cerenia is a horror for Purrcy. It STOPS his appetite and makes him like a zombie. We have used it a few times per the vet’s recommendation, but I don’t plan to ever get it again for this cat. We have been using Zofran twice a day injected subcutaneously and it has worked. He has eaten a few treats at least and does seem mildly interested in food. With Cerenia he won’t even sniff food. It’s like he doesn’t know what it is.

i know how you feel. This is an awful thing to have to deal with. I am exhausted and stressed to the max. I love this cat dearly, as I know you do yours. Yes, this being the end has crossed my mind several times. But, I just can’t give up until I am convinced he is ready. Something tells me that he’s just a sick boy and wants to get better.

I truly hope things turn around for you.

 

[cataan]

Thank you, Alldara, and yes, he is breaking down. For what it's worth, a little while ago I laid down on my bed and my cat was in a corner on a pillow I set out for him, resting. He looked over at me and slowly walked to the bed, started eyeing an attempt to jump up onto the bed, at which time I patted the stairs I had set up for him, and he hobbled up the make-shift stairs and laid down on my chest. As I was petting him I came up with the idea of sprinkling decent amounts of catnip around the perimeter of my room on various dressers etc. - he cannot get to it but the scent should be all over. I then syringe-fed him with the open container next to the syringe and he seemed much more tolerant of it, didn't fuss. Maybe that was just luck and won't happen again, or maybe it actually helped. I'm going to fed him again soon using this protocol. Fingers crossed.

 

[cataan]

Furrypurry - I will tell you my vets said the most important medication to provide is prednisolone over everything else. It's really important to control inflammation. I think I might have to stop the cerenia if it really does suppress the appetite but it's supposed to increase appetite. Weird. I also think it's good to syringe-feed water during the day and provide the sub-Q at night since the cat cannot drink while it's asleep and you cannot provide water while asleep either.

 

[FeebysOwner]

The big thing with pancreatitis is to keep your cat eating - anything. As mentioned above, some cats do better with ondansetron (Zofran) as opposed to Cerenia. It is usually more effective for nausea, whereas Cerenia often works better to reduce vomiting.

Make sure you don't overload him with oral water syringing to the point that it fills up his belly making him less inclined to be receptive to food.

 

[maggie101]

FWIW his diagnosis is kidney disease and pancreatitis.

My old cat had triiditis. She survived another 5 years. I wish Elura was around back then. She was on a high dose of fruity flavored medacine. It made her starving! Can you compound his prednisolone?

 

[daftcat75]

Pancreatitis is awful and painful. If gabapentin allows him to eat, I’d rather take the sedation with the eating than having a cat that is uncomfortable and starving. FeebysOwner is right. You need to feed your way through pancreatitis. If you are giving sub-Q fluids, then skip water syringes and add more feedings. Pick up the A/D. This is exactly what it is meant for. You’ll water it down as much as you need to to get a good flow out the syringe. But I’ve seen straight A/D squished out a syringe. Whatever works to make it manageable for both you and your cat. All wet food is 75% moisture or higher. As long as he’s getting enough feedings, he is getting enough moisture. And the sub-Q fluids will help make up any difference his kidneys might need. You should ask your vet to be certain. But I would aim to get 1 can of A/D into him a day in as many feedings as it takes to get him there without making him pop. Maybe six or maybe eight. Whatever it takes, right? If and when he wants to eat the A/D on his own (and always give him this option), try mixing it into regular food because A/D is rich and he probably won’t want to eat a can on his own. But if it helps him eat and if the gabapentin helps him eat, then you can adjust the A/D to regular food ratio to help him back to eating on his own. And in the meantime, I wouldn’t be so conservative with the gabapentin if it helps him. I’d rather he eat and sleep very well than do neither particularly well. Extraordinary times call for extraordinary measures.

 

[cataan]

Hi daftcat - the problem I am having with the gaba is that it clocks him out and all he can do is lay in a stupor. The first time I gave it to him he ate, but hours later was out. Now he is just out even with a half dose - I suppose it's possible that the syringe feedings are filling him enough that he won't eat before the gaba clocks him but I don't know. I might try reducing the dose again to get the pain relief without the sedation but I'm going to wait until later so I can see if the mirtazipan will work. I'm going to get his blood values checked tomorrow and use that as a guide for next steps. He's been getting consistent sub-Q and wet food so his creatinine and bun, assuming they are high, need to be consistent with prior checks which showed they were only slightly outside of the normal range (still above the range, just not a huge amount). I can't imagine not having pets and saving an animal's life, but I hate this part so much.