Appetite problem

[ericbakes]

Hello, friends. It's been a few years since I've posted here about my cat, Melville. He's done really well, and has been a picture of good health with consistent glucose numbers.

Recently, however, something changed. He stopped eating about two weeks ago after a week or two of reduced appetite. He spent his days hiding under a chair, lost weight and became dehydrated. Not good.

Vet did a blood workup, gave him sub-q fluids and prescribed a week's worth of amoxicillin. He couldn't find signs of impaction or dental disease. Melville's urine was a little sugary, but no crystals or anything.

I've been force feeding him little bits of his usual paté, and he started eating a teaspoon of kibble a few times per day (not ideal, I know...). Since getting food and water back in him, he's perked up a bit, but still isn't eating much. He never begs for food. I've been giving him reduced doses of Prozinc. His blood sugar is still pretty good.

Anyway, the thing I'm most curious about is his sudden preference for gravy / fat in his food. He won't eat the solid parts of any wet food, but he loves to lick up the gravy. Any ideas about what this is all about?

I'm fairly resigned to the fact that we might lose him soon. He's been on insulin for maybe 5 years now, so his little kidneys can't be in great shape. He's only 10, but he acts more like he's 15 lately.

 

[Critter Mom]

Anyway, the thing I'm most curious about is his sudden preference for gravy / fat in his food. He won't eat the solid parts of any wet food, but he loves to lick up the gravy.

That sounds very much like a nausea problem. Here's a symptom checker:

Nausea & appetite problems - symptoms and treatments

Some causes of nausea are:

- pancreatitis

- throwing ketones (much more of a risk when appetite is poor and also when having problems administering enough insulin)

- kidney issues (did your vet check kidney markers in the blood work-up?)

- constipation (unlikely if Melville has been pooping normally but ask your vet to check.)

He spent his days hiding under a chair,

This hiding behaviour may be due to discomfort or pain. Pancreatitis is painful but impossible to know whether that's the issue without examination and testing. BTW, pancreatitis can cause cats to be lethargic but this typically resolves with appropriate treatment.

You need to check Melville for ketones. Have you got ketone test strips at home? If yes, test him for ketones ASAP. If trace result contact your vet; if higher than trace call the vet with a view to getting Melville seen as an emergency case as soon as possible today. (Ketones need to be flushed from the system ASAP to prevent diabetic ketoacidosis; this needs treatment in a hospital setting.) If you can't test ketones straight away at home, ask the vet to test for them immediately. It would help to bring a urine sample with you for the vet to test.

Realistically I think you really need to get Melville in to the vet ASAP whether or not he's throwing ketones. His inappetence could trigger hepatic lipidosis so it needs to be addressed urgently. I strongly recommend you ask the vet to check him for pancreatitis. Ask the vet for a SNAP fPL test in-house - test result plus clinical assessment should give an immediate yes/no result. Spec fPL at external lab will give picture of severity. If getting more blood work done ask for B12 and folate tests because it is common for cats with digestive system problems to be deficient.

Here is a link to the IDEXX pancreatitis treatment guidelines.

To address nausea and pain:

- B12 injection may help nutrient absorption, stimulate appetite a little and may give Melville a general boost.

- proper hydration

- Buprenorphine can help with pain relief if pancreatitis is the problem.

- For nausea, a Cerenia injection may dampen down nausea symptoms fairly quickly (but it tends to peter out a bit before the next dose is due).

- Again for nausea, in my experience ondansetron is overall a much more effective anti-nausea treatment than Cerenia but it can take a day or two to build up to where it shows full therapeutic benefit. Ondansetron and Cerenia can be given together. Here is a useful post to read on nausea meds and dosing from member 'Marje and Gracie':

http://www.felinediabetes.com/FDMB/...ast-yesterday-help.166040/page-3#post-1796242

If you think you may need to treat for nausea you may need to push for ondansetron; a lot of vets insist on trying just Cerenia at first and time can be lost in getting the nausea under control. (NB: there is a major adverse drug interaction between ondansetron and tramadol so be aware of this just in case your vet might suggest treating pain with tramadol. The combination can induce serotonin syndrome.)

A simple thing you might try at home straight away is to see whether Melville might find it easier to eat and drink a little bit in the meantime is to try raising his dishes up a few inches off the floor (though given his clinical signs I don't think it'll be much of a help at the moment).

I hope you'll be able to get Melville in to see the vet quickly and that some of the above is helpful to you. Please post an update to let us know how Melville is doing.


Mogs
.

 

[jayla-n-Drevon]

onndansetron and cypro.... sq fluids if no heart problem....
works like a miracle for my 17 year old
(we don't wait until he "needs" it--he gets it 2x a day 12/12 more ondansetron if needed)