Urgent: Cat won't eat, seems nauseated

Wirtz Family

Wirtz Family

Member Since 2026
We are at shot time. Skippy is not interested in eating and is salivating a bit. We got her to eat a teaspoon on higher carb wet food mixed with Sheba pate. But what if she doesn't eat the rest of the night?

She is also on methimazole for hyperthyroid. We increased the dose a couple weeks ago, and we saw positive changes in regulating her insulin, or we think we do. Her massive amts of urine decreased and seem normal amounts now.

She has been really great this morning, happy, like her old self. And we noticed this the last few days on the reduced dose of insulin (1.25u to 1.0u). Even this morning she was fine.

Should we shoot her as usual (1.0u)? She is definitely not feeling great, lethargic, too.

What do we do?

PS We will get a vet appt asap and get labs done, hopefully tomorrow if they have an opening.

UPDATE: We gave her the full 1.0u dose as she was >200 BG. Now we have to figure out what to do about her methimazole dose... I think that is what may be making her nauseated. It's been 2 weeks since we increased the dose from 0.5 tab to 0.75 tab twice per day. It might just be getting to be full force now. Wish us luck tonight and tomorrow morning. I don't know what to do about her methimazole dose.
 
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What a beautiful cycle she had yesterday. Absolutely beautiful. It would have been a great opportunity to shoot a blue number (which will need to happen sooner or later) BUT with Skippy not eating and acting nauseated I understand your hesitation. Did you get any tests last night?

I just saw your post over on the thyroid group. Hopefully Ro will answer about the methimazole this morning. She knows a lot. I am on that group, although my cat had the I-131 treatment and isn’t on any meds anymore. I hope you can get that sorted out.
 
No tests last night. She was nauseated most of the night. But we shot her with the full 1.0u and gave her 1/2 tab (instead of 3/4 tab) meth. She was over 300 BG this morning, so I wonder if she dropped too low last night (from not eating) or the low dose of meth had an effect. We did 3/4 meth this morning, so I will see how she does today. She already looks uncomfortable :( Calling the vet soon for an appt. (She usually looks uncomfortable for about a 1/2 hour after eating a meal, like in the sphinx position with her ears a little flattened. So **something** always made her a little nauseated, maybe. We really noticed it with the wet food and onset of diabetes though.)

Yea, that I-131 treatment seems like a no-brainer, except for Skippy I don't think it'll be an option - she doesn't eat or drink because she is so stressed out at the vet.

Just cleaned the cat boxes. Only 3 pees yesterday and no poops.
 
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@Suzanne & Darcy Vet thinks it might be pancreatitis, which 3 months ago wasn't mentioned to me even though the labs indicated it (but I had my suspicions). That makes sense to me because Skippy gets into the sphinx pose after she eats usually, then about 30 minutes later she relaxes, like her tummy hurt for a bit. The vet also said to go back to 0.5 tab methimazole 2x per day without even waiting to see the new labwork. *sigh* Since the meth seems to help the diabetes and glucose numbers, I am going to wait to make a change to the meth dose. I am going to focus on finding a lower fat cat food. Maybe I can do half what we have, and half new low fat stuff... She stopped eating the Tiki Quail pate a week or so ago, just turned her nose to it... I wonder if it's a high fat food and it made her tummy hurt more. Though I don't know what triggered this last event if it was, in fact, pancreatitis.

Edit: From what I am reading, fat doesn't trigger pancreatitis in cats... Is that in line with what you know to be true?

The Sheba pate is 25% fat (DMB) and the Tiki Quail is 30% (DMB). I don't think that's a huge difference, do you? (Maybe Skippy thinks quail lives matter more than chicken or cows?? haha) Any suggestions for wet food, I am all ears.
 
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From everything I have read, it is old thinking that fat is a problem for pancreatitis. That is also what they say on the groups.io pancreatitis group.
 
I do understand the thing about the meatloaf position after eating (sphynx). My cat who had pancreatitis did this too. He ended up having liver disease also though. I will be interested in seeing her bloodwork.

Did you get feedback about the methimazole dose from the thyroid group?
 
Suzanne & Darcy said:
You did get bloodwork done today, right? Did they do the pancreatic specific lipase test?
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They are doing the full blood panel. The vet wasnt even going to do the panel. He just said, reduce the meth back to a 1/2 tab. I said, "well, let's test the thyroid and anything else; what if it's pancreatitis, then the labs will show that." I also said, let's get data to figure this out. And when he walked out I heard him say full blood panel, but I am sure he didn't add anything else on, so I suspect it's the same as the last couple panels Skippy had. Did I have to ask for anything extra (lipase test)? He should be calling today at some point.

The thyroid group didn't really say one way or another. One said I could reduce the dose or eliminate it and then build back up, but most said to get the anti-nausea meds. I am thinking it's not the thyroid med that made her sick, it was a bout of pancreatitis. Every single time she eats, she gets into the sphinx position for 30 min, then relaxes after that. Last night she went under the bed after I tested her and then put her in front of her food and she at a little. Then under the bed, then she comes out about 30 minutes later and sleeps on the recliner.

Our dog had pancreatitis and it was a disaster. Long story short, I did a little online reading and it *seems* that cats may not be sensitive to fats like dogs are? Some vets think it might be a "residue" issue and a low residue diet may help? I dunno. I think they just don't have any real answers for cats with pancreatitis. The Sheba we feed her doesn't seems super high fat... 25%. I hate giving her more drugs, but that anti-nausea med might be the only answer that is sure to work.
 
@Suzanne & Darcy Welp, we got the lab report back (or I should say the vet did, I havent seen it yet but gonna call and ask for it now), and her WBC count is near zero. The vet prescribed Clavamox and I had to ask for Cerenia. We just gave her the Cerenia, so we are hoping she will eat soon so we can give her the Clavamox (pill). (I am pretty sure it's not an infection though.) She has been nibbling a few times today, but nothing substantial. Every time she eats, she hurts or gets nauseated (unsure which, or both). She also has been lethargic and not moving much.

As soon as I get the report, I will enter the numbers in the sugar sheet.
 
Wirtz Family said:
@Suzanne & Darcy Welp, we got the lab report back (or I should say the vet did, I havent seen it yet but gonna call and ask for it now), and her WBC count is near zero. The vet prescribed Clavamox and I had to ask for Cerenia. We just gave her the Cerenia, so we are hoping she will eat soon so we can give her the Clavamox (pill). (I am pretty sure it's not an infection though.) She has been nibbling a few times today, but nothing substantial. Every time she eats, she hurts or gets nauseated (unsure which, or both). She also has been lethargic and not moving much.

As soon as I get the report, I will enter the numbers in the sugar sheet.
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What about pain control. Pancreatitis can be painful. I would ask for Buprenorphine which is a liquid that is squirted in the cheek pouch and up onto the gums.

This is very upsetting. What does the vet think is the cause of the low WBC? Are all the various types of white cells low (neutrophils, lymphocytes, monocytes, eosinophils, and basophils?)

The reason for the antibiotics is to prevent an infection which she is very vulnerable to due to not having white cells to fight anything off. I am so upset. She is not FIV+ is she? What is the plan to bring up the wbc?
 
I would write on the thyroid group and tell them this if I were you. Perhaps Ro may know if there’s a link between the methimazole and the low wbc. I have seen cats become very anemic on methimazole before, but I don’t know about low WBC — I recall having read that it usually occurs within the initial months of starting treatment with methimazole. Skippy has been on it a long time. Did the vet say to stop the methimazole for the time being?
 
thanks for the replies - to answer your questions: The vet said to give the Cerinia a chance to kick in and if she's still not eating, they would consider pain meds. The vet didn't know why the white blood cell count is so low -there are a few possibilities, including cancer. As for the different cell types, platelets were 96, neutrophils 136, lymphocytes 867, monocytes 680, eosinophils 17, and basophils 0. The vet gave us a broad-spectrum antibiotic in case there's an infection we don't know about. Skippy's not FIV+ The vet did not say to stop the methimazole.

she's been sleeping since we gave her the Cerinia - we've put her in front of food twice, and she's walked away from it. she has eaten a pea-sized dollop of Churu though, but she still did the sphynx thing, like she was in pain or nauseous. The question at this point is what to do in an hour and a half when it's time for her insulin shot if she's still not eating. We also need to give her the antibiotic with food, so getting her to eat is going to be critical.... We'll try to feed her with a syringe, but if you have any other ideas, please let us know - not sure how much food we'll get down her w the syringe.
 
she just ate about a tablespoon of food on her own. We tried several kinds, and all she wanted to eat was Fancy Feast. we were able to give her the shot and her methimazole dose. Now we wait and see..... she was in pain for about a half hour after she ate...
 
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Ondansetron can be much more effective for nausea (if she is nauseated) than Cerenia. Cerenia is good at preventing vomiting and can help some cats with nausea. The two drugs can be used together as they work in different ways. It’s done all the time.

Has she ever had an ultrasound? Did they do the pancreatic specific lipase test or the catalyst pancreatitis test?
 
she was def in pain after she ate - did the sphinx thing for about a half hour. we gave the antibiotic immediately after she ate. the more we watch her, the more we think it's pain and not nausea - she was trembling/shivering while laying on my wife after she ate. Never had an ultrasound, although we discussed it w the vet today. Not sure re the pancreas test - will need to look. We're getting the feeling that her pancreas is pretty worn out - from what we've been reading, it's most likely pretty scarred from years of bouts of pancreatitis (she would puke a lot for a few days, then it would clear up, be OK for a while, and then the cycle would repeat - for years. Not feeling super-optimistic this evening, but we'll see what tomorrow brings....
 
Oh no! I am so sad to hear this news. My heart really goes out to you. I lost a wonderful, funny, inquisitive cat last October who also had almost no white blood cells. He didn’t last two days after we found that out. We had been told after biopsies that he had an autoimmune condition, and that was being treated and he had improved but then he took a severe turn for the worse. I honestly don’t think they even knew what caused that or why he died. So when you told me about Skippy’s bloodwork yesterday I was really scared. It was too familiar.

I am really really sorry. I actually have lost 3 cats in the last six months under very unusual circumstances where the vets didn’t have a full grasp of the conditions. It’s a great loss for your family to have lost Skippy so young. 11 years is not long enough. I am so very sorry.
 
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