Joe not eating

[jbweeks722]

Hi,
My 12 year old Siamese is not eating. (He may be nibbling some when I'm not home - I am leaving food out. We have a 2nd cat so it is hard to tell.) He has always had a huge appetite and weighed about 22 pounds. He acts like he wants to eat but has begun turning his nose up at everything - even wet food. He loves lettuce but won't even eat that now. His weight last Monday was just under 18 pounds.

Took him to our vet and he had x-rays and blood work. Nothing showed up in xrays except stool. He has been constipated. They gave him enema and I gave him laxatone and he pooped Monday night but not since. (He is refusing laxatone now) Blood work only showed his WBC was slightly elevated. Not diabetic, thyroid ok.

Mouth checked out ok too. It took him a couple of days to recover from sedation and he has acted like himself for the most part except for eating. He does come out and sit with me and purrs but he does have times he doesn't want to be bothered or doesn't purr at all. This is not his usual behavior. He is a lover and wants to be all over me and purrs quite loudly usually. It just seems he has suddenly changed and the weight loss concerns me. I don't know how to get him to eat and I am aware of the consequences if he doesn't.

I have a call into the vet because she said the next step is antibiotics. Any thoughts, suggestions? Thank you very much for any assistance you can offer.

[Traci]

What is the brand and type of cat food you're feeding him?

Have you given any treats, human foods, etc?

Has he vomited?

Was a urinalysis done?

Did the vet bother to test the stool sample for bacteria?

In what time frame exactly has he lost weight? When was his last vet checkup before the recent vet visit?

[jbweeks722]

Hi Tracy,

Thank you for your quick reply - to answer your questions:

He has been Hill's R/D with a little Science Diet Indoor Cat kibble mixed in. (He would wolf down the small kibble and vomit it back up) I've been doing this for a couple of years.

I don't give my cats human food - though this week I did try a little tuna in water. They don't get treats either. I tried to give Joe cat treats when I first got him but he didn't want them.

He vomited after pooping Monday night. He has occassionally vomited in the past when over eating.

I asked if they checked his kidney function and they said they did. I will ask about the urinalysis and stool analysis.

He was last in to the vet in March. His weight was just under 22 pounds then.

He is at the vet now getting fluids and antibiotics.

[Traci]

If the 4 or so pound weight loss was gradual since March, then it's not entirely drastic, but it is not ideal. If you and vet feel Joe has lost the 4 lbs rather rapidly within the last couple months, then yes, it is concerning.

I suspected he may be dehydrated, so it's good he's getting fluids at the vet. The absence of vomiting may be a good sign, but when Joe is released and at home, you should keep him well hydrated. If you're feeding dry food, offer canned food once or twice a day, so he can get a bit added moisture. Try putting another water dish somewhere in the home for easy access. Allow him to drink from the tap if you're inclined, some cats love drinking out of the tap, and it encourages them to drink more. Try giving bottled or filtered water.

It's strange nothing was indicated on the xrays. I would suspect something indicating inflammation, gassy bowel loops, etc (the WBC elevation could indicate inflammation or infection or both). Was this mentioned at all? Do you know if a large or small volume of feces was eliminated after the enema?

Do you know what type of blood profile was done, in that, did it include something like a complete "senior" or "geriatric" profile?

Do you know if the amylase and lipase were normal? These are enzymes which, if abnormally high, may indicate pancreatitis - although the fPLI (sent to an outside lab) is the best choice for accuracy and diagnosis for pancreatitis.

What sedation was used, was it gas anesthesia or injectable anesthesia? In gas anesthesia, for prolonged periods, depending on the procedure, intubation with an esophageal tube can cause irritation in the esophagus (sometimes inflammation, and sometimes even a mild infection) - if an esophageal tube was used, ask the vet to rule that out. It could be one reason he isn't eating, due to some irritation. A simple course of Carafate (Sucralfate) and possibly Famotidine (Pepcid), might help if that's the case.

Do you know if Joe had a fever before, during or after the constipation issue and during treatment?

I think the next step would have been a fecal exam, to rule out parasites or bacteria (if suspecting bacteria, one usually wants to do this before antibiotics are given, to ensure the correct antibiotic is chosen for the particular pathogen)

It could also be something as simple as Joe developing some type of intolerance to his food or certain ingredient (which any cat can develop at any age), in which you could choose an equivalent type in a different veterinary brand (like Purina veterinary or Royal Canin veterinary) - maybe even a hypoallergenic diet on a trial basis.

If the vet can't get him to eat today or tomorrow, I would suggest, pending the fecal exam, a potential ultrasound. Sometimes these can pick up what xrays may not.

Conservatively, you could continue the antibiotics, and consider a different food at this point, it doesn't have to necessarily be an equivalent veterinary brand or hypoallergenic at this point in time, I would suggest rather, a more bland diet like Hill's Rx I/D, and in canned form if you think he'll eat the canned (dry is fine too, but in light of the recent constipation episode, canned would be better at least for now). If his GI tract is aggravated, the I/D could help, and it wouldn't be an insult on a tender tummy - he might just take to it. I'd try this for about a week, to at least see if you can get him eating. If the vet feels it's warranted, due to his prolonged anorexia, he can prescribe an oral solution of vitamins, which might be a good idea right now, ask him about that.

If it comes to forced-feeding, then pursue an ultrasound. Rule-outs: pancreatitis, IBD, bacterial infection, immunological problem or neoplasia - the latter I don't wish to scare you with, it's just a rule-out. I'm assuming his heart health was checked?

Hopefully, Joe will start eating on his own, but as you know, it's imperative he is eating something rather than nothing, ask the vet about the I/D, oral vitamin suspension, the fecal exam to rule out bacteria, potential fPLI and/or ultrasound.

Please keep us posted, and hang in there....hopefully it is just a case of GI tract upset following a constipation episode, but bacteria should be ruled out ASAP -

[jbweeks722]

Tracy, The weight loss has not been gradual over 4 months. I do offer him canned food now but he walks away. He wants to eat, he is in the kitchen acting hungry but walks away from everything lately. I don't know what kind of blood profile was done. It may be listed on the bill so I'll check it when I get home. The vet indicated some stool was eliminated after the enema but not all. He did pass some that night but not a huge amount. And he vomited after. I believe the sedation was by injection.

Thank you so much for your feedback. I will certainly follow up on your questions with Joe's vet. I have been thinking an ultrasound may be called for. And I will keep you posted. I am just beside myself because this has come out of nowhere. I rescued Joe 7 years ago this month after losing another cat to cancer around Thanksgiving that year. I am a wreck.

[Traci]

Talk to the vet about what we've discussed here and take it from there.

Another option, a bit less invasive, would be a barium xray series, to rule out an impaction (although the xray should have shown this, but it not always will, especially if it is in a hidden stomach area rather than intestines) - this is when barium is given orally, then a series of xrays are taken at intervals of 15 minutes, half an hour, and so on,...if the barium stops or pools at a certain area on the xray and doesn't pass through the intestines or colon to be eliminated, this could point to an obstruction or fecal impaction in which the xray will show the location. Ask your vet if this might be feasible at this point before an ultrasound....and again, talk about the I/D or whatever food he feels might get Joe eating on his own again. It's crucial he starts eating sufficiently, without vomiting and stays well hydrated.

Hang in there, and please keep us posted.

[jbweeks722]

I will do that Tracy. The good news is that he did eat some wet food tonight. Not alot but it was something. He has been more his old self tonight-all lovey and purring. Now if he would poop...

I will let you know how the weekend goes.

[Traci]

The fact he ate a little is a good sign! It could be he eliminated most of what was in the colon, and that could be why he hasn't had a stool, not eating will not produce stool. But, do talk to your vet about the potential for a partial obstruction, and I'd give the vet a call first thing in the morning to discuss that.

There are two flavors of Laxatone, one is tuna, one is regular flavor, whichever one he refused, ask the vet if he has the other flavor. It can be mixed with a bit of warm water, drawn up in a syringe or eyedropper and given orally, it might help smooth things along if there is residual feces in the colon. This isn't to undermine what we talked about earlier of course, but do mention that to the vet in the morning as well.

Please keep us posted, give your little guy a hug for me, and hang in there!

[jbweeks722]

Just had to tell you that he ate again today! Wet and dry! He has urinated but I am not sure that he pooped. I have 2 litter boxes and both cats used both boxes. His stool is larger than the other cat's. There was one stool that was slightly larger than the other. So it could be his.

I haven't tried laxatone today. He is refusing the tuna flavor which he has liked in the past. I will try the other flavor. Giving it by eyedropper is a wonderful suggestion and I will do that if he won't take it on his own. I feel so much better seeing him eat. But I know we are not home free yet. He is quite social and clawing the furniture so he is a bit more fiesty! I had to let you know.

[Traci]

Thank you so much for the update, I'm so glad to hear he is eating on his own!!

Remember, he hasn't eaten hardly anything in several days, so he won't produce until he has something in his stomach to digest.