? Jasper won't eat, is it time for a feeding tube?

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LunaArt

LunaArt

Member Since 2017
TL;DR: Jasper has only eaten approx. 140 calories in the past 7+ days and is still refusing to eat except for licking/eating a tiny bit of plain tuna. Is it time to have a feeding tube installed?

My FD kitty, Jasper (and I), have been through the ringer this past week. I'll try to keep this short as I can. Jasper was diagnosed with FD and put on Prozinc in early Nov 2017. I was able to get him into remission with no carb food by mid Dec. In early Feb, he was diagnosed with hypertrophic cardiomyopathy, which is at an early stage so he needs no meds yet.

His currently problems all started a week ago Wednesday. Following a bath for allergies (he usually tolerates these reasonably well for a cat), I noticed him breathing really hard and wheezing harshly. I rushed him into the emergency vet clinic and they diagnosed him pulmonary edema. He was immediately put in an oxygen cage and on lasix to get the fluid out of his lungs. Two days later, I took him up to a university small animal teaching hospital for a follow-up on his heart condition.

Well, they inform me that he was misdiagnosed due to the xrays done at the emergency clinic being underexposed. :banghead: They said he had a severe asthma attack, did not have fluid in the lungs and that I should immediately take him off of the lasix. Jasper has had asthma for many years, but I have never seen him any sort of attack like this so I didn't recognize it as related to his asthma.:oops:

I was able to take him home that night, which was Friday night. He would not eat while at the hospital and wasn't interested when he got home. After a while I have him 1/8 tab of mirtazapine I had left over and I was happy when he ate a little wet food later that night. The next day, Saturday, he ate some more wet food and I thought he was doing okay, but later that night he refused to eat again and he did not look/act very well at all. I ended up trying to syringe feed him a little bit, but it didn't go well and he eventually vomited some of it back up.

So Sunday, we took him back up to the emergency clinic at the university. They held him overnight and ran a bunch of tests on him including blood work, urinalysis, repeat xrays and an abdominal ultrasound but they didn't show much wrong with him other than they think he has a little bit of pneumonia in one of his lungs and they put him on antibiotics. He was also very dehydrated and had low potassium due to the lasix he was erroneously put on, so they addressed those issues as well. I took him back home on Monday.

Jasper still wouldn't eat at the hospital and now he won't eat at home either. I have tried many things to get him to eat: heating up his food, offering a variety of foods including his dry food, all his favorite wet foods, new wet foods and plain tuna with juice. He doesn't like treats. I gave him another mirtazapine pill, which did nothing. The only thing he would respond to was the plain tuna. He licked it a couple of times, ate a flake or two and then abruptly walked away and hid under the bed. I thought that perhaps he was nauseous so I quick took him over to my regular vet. It was after hours, but she gave him a quick check and gave him a shot of Cerenia.

We are back home now and the only thing that interested him tonight was the plain tuna again. He perhaps ate 1/2 tsp of it before refusing any more. I tried sprinkling some of it on his wet food, but he is getting irritated with me trying to get him to eat. Also, I have tried fortaflora and parmesan cheese sprinkled on top in the past and he does not care for either.

I have been monitoring him for ketones throughout this ordeal and also had them run a Spec fPL test to try to rule out pancreatitis, but we don't have the results back on that test yet (vet thinks it will be negative based on ultrasound). His blood glucose has stayed fairly normal for his situation. It was in the 180's on my meter when he was the most stressed out and was at 107 this morning.

Jasper has only eaten approximately 140 calories in the past 7+ days and of course the very big concern is that he may develop hepatic lipidosis soon. I have been in contact with the vets at the university animal clinic and they have advised that if he hasn't started eating by tomorrow, to bring him in to get a esophageal feeding tube put in. Jasper has been acting very ill and hiding a lot, but I have noticed that he may be feeling just a little bit better today with the tuna licking and he has been moving around/snuggling with me a tad bit more.

Do you think it is time for a feeding tube to be installed, even though he licked/ate a tiny bit of tuna today? I am leaning towards yes. I would hate for him to go through all that and to then start eating right away, but every day, I fear his liver will become damaged.

Very sorry for the extremely long post.

TL;DR: Jasper has only eaten approx. 140 calories in the past 7+ days and is still refusing to eat except for licking/eating a tiny bit of plain tuna. Is it time to have a feeding tube installed?
 
How is he this AM? I agree with your vet, if he’s not eating this AM a feeding tube would be a wise choice.
 
I agree that a feeding tube is probably what he needs at this point. It seems worse than it is. Many years ago I had a cat that needed one and she (and I) tolerated it very well.
 
Thank you @Sharon14 and @Kris & Teasel for your help!

Jasper seems to be feeling a bit better again this morning, although mornings are typically Jasper's most affectionate and happiest times. When I was mixing a new concoction of plain tuna/tuna juice on one side and his favorite ocean fish wet food on the other with a little mixed together in the middle, he actually came over to me. I think he was enticed by the tuna smell.

When I gave him the food, he sniffed the wet food for a while (slight progress) but then only ate a little of the tuna (maybe a teaspoon or less?) and then walked away. I tried to gently encourage him to eat more a couple of times, but he was not having it.

The senior student at the university clinic that has been seeing Jasper told me to just bring him over today if he wasn't eating yet. I don't know if eat tiny bits of tuna a couple times a day counts or not?? I'll be giving her a call in a little bit to double check before I drive all the way over there.

I am not opposed to the feeding tube at all, I just didn't want to put him through it when he seems on the verge of eating again. But since it has been over a week since he's had hardly any real substantial nutrients, it's still probably the best call, don't you think?
 
LunaArt said:
Thank you @Sharon14 and @Kris & Teasel for your help!

Jasper seems to be feeling a bit better again this morning, although mornings are typically Jasper's most affectionate and happiest times. When I was mixing a new concoction of plain tuna/tuna juice on one side and his favorite ocean fish wet food on the other with a little mixed together in the middle, he actually came over to me. I think he was enticed by the tuna smell.

When I gave him the food, he sniffed the wet food for a while (slight progress) but then only ate a little of the tuna (maybe a teaspoon or less?) and then walked away. I tried to gently encourage him to eat more a couple of times, but he was not having it.

The senior student at the university clinic that has been seeing Jasper told me to just bring him over today if he wasn't eating yet. I don't know if eat tiny bits of tuna a couple times a day counts or not?? I'll be giving her a call in a little bit to double check before I drive all the way over there.

I am not opposed to the feeding tube at all, I just didn't want to put him through it when he seems on the verge of eating again. But since it has been over a week since he's had hardly any real substantial nutrients, it's still probably the best call, don't you think?
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I doubt that a tiny bit of tuna is enough. Given the danger of hepatic lipidosis I'd seriously consider the feeding tube if the vets are recommending it.

Have you tried syringe feeding?
 
The teaching vet at the university clinic told me not to because it can lead to food aversion and add stress to an already very stressed out kitty. I syringe fed him a couple of times late Saturday night and it did stress out Jasper considerably, so much so I was worried that he may just collapse. Plus he threw up all of the second feeding, so I agreed with the vet and haven't done it since.
 
LunaArt said:
The teaching vet at the university clinic told me not to because it can lead to food aversion and add stress to an already very stressed out kitty. I syringe fed him a couple of times late Saturday night and it did stress out Jasper considerably, so much so I was worried that he may just collapse. Plus he threw up all of the second feeding, so I agreed with the vet and haven't done it since.
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No need to stress him further. It seems that the feeding tube is your best option. So many things can go wrong if he doesn't get enough food in him soon. There are quite a few people here who have experience with an esophageal feeding tube. You could post a new thread asking for their input. My cat's was done long ago and was called a PEG tube (surgically installed). It went right through her side into her stomach and the tubing was wrapped around her under a bandage with the feeding valve end exposed on her back. I had to mix wet food with enough water to be able to syringe it slowly into her via the valve. The valve was then rinsed by syringing water into it. She tolerated it really well for three weeks, gradually started eating on her own more and more and the tube was removed when she was eating all her food on her own. Occasionally the valve would get blocked with food and I had to take it off to clean it out but that was a minor issue. I fed her every few hours multiple times a day and she'd hunker down and purr through it all. When the tube was no longer needed, the vet just pulled it out - no sutures required.
 
Thank you for the information @Kris & Teasel !

I just called the student vet and she is thinking that I should give Jasper another mirtazapine pill today to see if that helps him to start eating more and then if not, bring him in for the feeding tube. She is going to talk with her teaching professor to see if he agrees and then she will call me back with recommendations. I stressed to her that I was getting concerned that we may be waiting too long and that even if he does start eating now, I worry he won't be eating very much at first. She pushed back a little and said they start out slow when feeding through the tube also, so it wouldn't be much different. Her professor might disagree with her, so I'll just have to wait to see what he says. Ugh! This is so frustrating!
 
LunaArt said:
Thank you for the information @Kris & Teasel !

I just called the student vet and she is thinking that I should give Jasper another mirtazapine pill today to see if that helps him to start eating more and then if not, bring him in for the feeding tube. She is going to talk with her teaching professor to see if he agrees and then she will call me back with recommendations. I stressed to her that I was getting concerned that we may be waiting too long and that even if he does start eating now, I worry he won't be eating very much at first. She pushed back a little and said they start out slow when feeding through the tube also, so it wouldn't be much different. Her professor might disagree with her, so I'll just have to wait to see what he says. Ugh! This is so frustrating!
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You do have to feed many small meals slowly through a feeding tube. Too much too quickly can make them vomit. I suppose you could try the appetite stimulant. Is he showing any signs of nausea liking lip licking, sniffing food then walking away? People here with experience say it's best to address the nausea first with something like ondansetron before giving a stimulant. Some people find that cyproheptadine works better as a stimulant.
 
LunaArt said:
Thank you for the information @Kris & Teasel !

I just called the student vet and she is thinking that I should give Jasper another mirtazapine pill today to see if that helps him to start eating more and then if not, bring him in for the feeding tube. She is going to talk with her teaching professor to see if he agrees and then she will call me back with recommendations. I stressed to her that I was getting concerned that we may be waiting too long and that even if he does start eating now, I worry he won't be eating very much at first. She pushed back a little and said they start out slow when feeding through the tube also, so it wouldn't be much different. Her professor might disagree with her, so I'll just have to wait to see what he says. Ugh! This is so frustrating!
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Sorry to hear he's not well, but since he is actually looking at least a little bit interested in the tuna, while you wait for an answer you could try to assist feed him (syringe feeding him) just a little bit of food at a time (about 1 - 1/2 ml), I've done it giving them food every two hours, and alternating with a little bit of water (about 1-1/2 ml) also every two hours and it has worked well, after a while who knows he may even start eating again on his own
 
Kris & Teasel said:
You do have to feed many small meals slowly through a feeding tube. Too much too quickly can make them vomit. I suppose you could try the appetite stimulant. Is he showing any signs of nausea liking lip licking, sniffing food then walking away? People here with experience say it's best to address the nausea first with something like ondansetron before giving a stimulant. Some people find that cyproheptadine works better as a stimulant.
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He isn't doing the lip licking, but he is sniffing his food and walking away (except for the tuna, sometimes). My regular vet gave him an injection of cerenia last night at about 6:30pm in case he was nauseous. She gave me some cerenia tablets to give him, so I'll give him one of those tonight.

Jasper ate a little more tuna for me a little while ago. The student vet just called me back after talking with her professor and said to go ahead with the mirtazapine pill. I'll see if that helps and if it doesn't work well, I will talk to her about the cyproheptadine tomorrow. I am supposed give her a call tomorrow to update her and determine what to do if he is still only eating tuna. She told me that cats with hepatic lipidosis don't usually want to eat anything at all so it was a good sign that he is willing to eat tuna.

He does seem to be feeling a bit better today. Purring a lot and wanting to snuggle with me and have me pet him more. I'm being cautiously optimistic that he is headed in the right direction finally. I keep waiting to hear him crunching on some of his dry food. It is a very nutrient/calorie dense food and I would be so relieved.
 
Veronica & Babu-chiri said:
Sorry to hear he's not well, but since he is actually looking at least a little bit interested in the tuna, while you wait for an answer you could try to assist feed him (syringe feeding him) just a little bit of food at a time (about 1 - 1/2 ml), I've done it giving them food every two hours, and alternating with a little bit of water (about 1-1/2 ml) also every two hours and it has worked well, after a while who knows he may even start eating again on his own
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Thank you @Veronica & Babu-chiri for the suggestion. I have been very tempted to do this, but the teaching vet's advice was not to because it could stress him out more and become food adverse. I tried to syringe feed him a little Saturday night and based on his reaction to that, I reluctantly had to agree with the vet.

The student vet just called me back and I asked her again if I should try to assist feed him a little bit and she again said no. Especially since he has started eating a tiny bit again, she thought there would be a high possibility of him becoming food adverse and backtrack on what little progress he is making.
 
Have you tried giving him some plain meat in broth human baby food (no seasonings, garlic, onion)? That tempts some cats to eat. Right now try anything he might eat - sardines, canned fish, plain roasted chicken, etc.
 
Kris & Teasel said:
Have you tried giving him some plain meat in broth human baby food (no seasonings, garlic, onion)? That tempts some cats to eat. Right now try anything he might eat - sardines, canned fish, plain roasted chicken, etc.
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No, I haven't. I'll pick some up and try that. I think I will also try some Fancy Feast to see if he will eat that. He's never had it before, but it is worth a try. On the plain roasted chicken, do you mean make it myself or can I get like a rotisserie chicken and cut out some of the middle part of the breast/thigh to feed him?
 
LunaArt said:
No, I haven't. I'll pick some up and try that. I think I will also try some Fancy Feast to see if he will eat that. He's never had it before, but it is worth a try. On the plain roasted chicken, do you mean make it myself or can I get like a rotisserie chicken and cut out some of the middle part of the breast/thigh to feed him?
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Try Fancy Feast or Friskies. You can either cook the chicken yourself or give some meat from a rotisserie chicken - not the seasoned skin though.
 
Thank you so much for your suggestions, @Kris & Teasel. I tried some chicken baby food, but it was refused. Jasper did take a liking to one of the fish Fancy Feast classics. He has eaten maybe a little more than 1/3 of the can so far over several short visits to the plate. I tried to get him interested in a little more tuna, but he didn't go for it. I would estimate that he has had 40-45 calories today, tops. And, that was with giving him the mirtazapine and cerenia. He doesn't like me to hand feed him anything like on my finger or from a spoon and he gets irritated with me when I keep trying to shove food in front of him or set him gently in front of the food dish.

Also while I was away at the store, he pooped out a bunch of black looking mucus in and around the litter box. It was a pudding-like consistency. I dipped a bit of tissue in it in several places and it was really a yellowish green color. I texted my regular vet right away to ask if she thought it was because he is currently on antibiotics. She said that antibiotics typically produce a more watery diarrhea. She had me add some Purina fortaflora to his food and to have the stool checked if it persisted.

To top it all off, my other cat (Alfie) who is closely related to Jasper (same father, mothers were sisters) suddenly came down sick last night. Like really sick and in great pain by this morning. I had to run him to the vet today. He was very nauseous and a bit dehydrated. While they were putting some subq fluids in him, he pooped out bloody diarrhea. Which is so odd, because he had a perfectly normal poop at 8pm last night. The poop had lots of bacteria in it, so he is on antibiotics and cerenia as well. He still acts very ill. He has stage 2 CKD, but only one of his kidney values was slightly elevated (probably due to be dehydrated), so they don't suspect a problem with his kidneys. They think that pancreatitis is a possibility and I have him fasting for a test tomorrow. :( I will admit I cried a few tears today.
 
I’m so sorry you’re going through this. To have two sick at the same time is so hard:bighug:
I would get that stool checked. Black could be blood and the green/yellow could indicate liver problems, perhaps from not eating.
 
Thank you @Sharon14 and @Kris & Teasel. I will be talking with both my regular vet and the student vet today, so I will check with them. I still have the "sample" in a sack. I'll see if they can still use it for testing/checking.

He ate a little more over the night and had a total of 3/4 of one FF can plus some tuna, so approx. 75 cals total yesterday.
 
LunaArt said:
Thank you @Sharon14 and @Kris & Teasel. I will be talking with both my regular vet and the student vet today, so I will check with them. I still have the "sample" in a sack. I'll see if they can still use it for testing/checking.

He ate a little more over the night and had a total of 3/4 of one FF can plus some tuna, so approx. 75 cals total yesterday.
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That's some improvement in food intake but he needs more. I hope your vets can give you some good direction.
 
I've tried to feed Jasper 3 different foods this morning and he wasn't interested in any of them - sniffed and then walk away. I heated up a little tuna for him and he ate a tiny bit again (8-10 calories). I'm going to go get some more of the FF food he ate yesterday and see if he will eat that.

I called the university student and she was no help. She was encouraged by his eating 75 calories and when I asked if it continues that he only eats 50-75 calories a day, how long can we go on like that. She didn't really have an answer for me - she just sort of trailed off "Well, as long as he is eating . . ." So aggravating. She wasn't concerned about his dark green pudding poop either. Said it probably was the antibiotics and wouldn't be consistent with liver issues.

I asked her if cyproheptadine would be worth a try as an appetite stimulant and she had never heard of it. She was going to ask around and see if anyone else knew about and give me a call back. :rolleyes: I had to ask her about the Spec fPL test results and she told me it was slightly elevated; not significant enough to indicate pancreatitis.

I am going to try to get both cats in to see my regular vet today, if possible. I also will try to get my vet to examine a sample of Jasper's poop.
 
LunaArt said:
I've tried to feed Jasper 3 different foods this morning and he wasn't interested in any of them - sniffed and then walk away. I heated up a little tuna for him and he ate a tiny bit again (8-10 calories). I'm going to go get some more of the FF food he ate yesterday and see if he will eat that.

I called the university student and she was no help. She was encouraged by his eating 75 calories and when I asked if it continues that he only eats 50-75 calories a day, how long can we go on like that. She didn't really have an answer for me - she just sort of trailed off "Well, as long as he is eating . . ." So aggravating. She wasn't concerned about his dark green pudding poop either. Said it probably was the antibiotics and wouldn't be consistent with liver issues.

I asked her if cyproheptadine would be worth a try as an appetite stimulant and she had never heard of it. She was going to ask around and see if anyone else knew about and give me a call back. :rolleyes: I had to ask her about the Spec fPL test results and she told me it was slightly elevated; not significant enough to indicate pancreatitis.

I am going to try to get both cats in to see my regular vet today, if possible. I also will try to get my vet to examine a sample of Jasper's poop.
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Cyproheptadine is a human antihistamine med. It might need a prescription from your vet for a human pharmacy. You could call a human pharmacy to ask. In my opinion he's not getting enough calories. He's still in FD remission so I'm not sure whether ketones are a threat. Hepatic lipidosis is though. Did you try mirtazapine? Ask about antinausea meds?
 
I just wanted to give an update on Jasper and Alfie. There is some great news and some not so good news. Jasper seems to have fully recovered. He slowly started eating more and more. The Fancy Feast seafood feast food really helped him turn a corner. I did finally get some cyproheptadine from my regular vet, but it didn't seem to help his appetite much, so I stuck with the mirtazapine. I gave his last dose of the mirt 2 days ago and he is doing so well, I am going to discontinue it. He finished his course of antibiotics last Monday and since I last posted, his stool slowly turned back to a normal color and for the past 2 days, he has had pretty normally formed stool again. So, I think this crisis is over for Jasper. :joyful:

Alfie on the other hand, is still struggling. Imagine my surprise when a day or two after Alfie started feeling ill, he started to poop green stool! So now our theory is that while Jasper was in one of the emergency clinics, he picked up some sort of bug that he then passed onto Alfie once we got him back home.

Alfie's symptoms were pretty much the same as Jasper's, except that it seems to be affecting Alfie much more. He stopped all eating and drinking for several days and was in tremendous pain. My vet gave me some buprenorphine to help with his pain and that really helped make the poor little guy more comfortable. The good thing is that he tolerates syringe feeding much better. So I was able to syringe feed him Hill's A/D food for several days to get enough calories into him. I had to give subq fluids to him at home since he was not drinking.

After several days, Alfie slowly started drinking and then finally eating a little on his own. I have been giving him mirtazapine, so that helped a little. His stool is not green anymore, but he is having several bouts of smelly diarrhea every day. He is currently on Flagyl which is supposed to help firm up the stool. I took him back to the vet today and she had me increase his dose of Flagyl to 2 times per day and she gave him a shot of short acting (24 hr) prednisone . It hasn't really helped. In fact it seems like his appetite is getting worse. I'm wondering if the Flagyl is causing that. I'm still having to give him fluids every day also due to the excessive diarrhea. I hope he turns the corner soon, like Jasper.

Anyway, I just wanted to post an update and also give everyone who replied to my posts a huge Thank You! Y'all have been a great source of information and help when I was feeling very overwhelmed. :bighug:
 
Thank you for the update. I’m glad Jasper is doing well and fingers crossed Allie recovers quickly. Maybe google side effects of Flagyl in cats?
 
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