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Old 11-04-2012, 08:51 PM   #1 (permalink)
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Senior Kitty with No Appetite

My almost 18 yr. old cat is in failing health - heart murmer, high blood pressure, possibly failing kidneys, blind, etc. Her last round of blood work didn't show anything getting worse (Creatanine steady, BUN slighly better), but her weight is ridiculously low.

She doesn't eat a meal anymore - a few bites or licks and then she wanders off. If I was home all day and could prompt her to eat every half hour or so, I might be able to get some weight on her. As that isn't realistic, I'm not making much progress.

Furthermore, I crush her blood pressure pill up and add it to her food. Now that she's not eating very well, I know she's not getting the proper dose. I hate to have to start pilling her every day. (I do need to try pill pockets.)

I've been leaving dry food out all day, but all I've accomplished is making my other cat fat. I'm afraid I may have to start turning my home into different "wards" to keep my pets seperate so that I can address their seperate needs - Fat cat over here, skinny cat over here, hypothryoid dog over there. . . *sigh*

Anyone have any suggestions for putting weight on her? She tends to prefer licking the gravy and leaving the actual pieces behind. My stepmother made chicken gravy for her, but she turned her nose up at it. I've been giving her bits and pieces of table scraps, but she still only eats a few bites and then leaves the rest.

Just in case anyone wonders, she had a dental a few years back, so her teeth aren't an issue.

We have another vet appt. this Saturday and I know he can give me some suggestions, but thought I'd try here as well.

Thanks!
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Old 11-04-2012, 08:56 PM   #2 (permalink)
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Does she eat any fresh/cooked meats? turkey, chicken, ham? we had a cat with a similar issue (old and failing health) who was picky and honestly it was offer whatever good things she'll eat so she eats, the clients ended up leaving out a bowl each of all the above meats, wet food and dry and the cat like yours ate a little of this or that but though out the day but having all the options kept her constantly eating. You may also be able to find one of those non cat premade foods she wants to eat eat eat.
Have you tried the vitamin pastes? we actually use a tiny amount of cat lax to get the senior thyroid cat at work to eat his pill because he loves the flavor, you could try something similar with a vitamin/nutrient paste.

Hugs to your senior and keep us updated, old pets can be quite finicky sometimes.
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Old 11-04-2012, 09:43 PM   #3 (permalink)
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Hmm, that's a toughy. Do you feed canned or kibble? Have you tried warming the food up, to make it smellier?

Are you sure about her teeth being okay? Loose teeth can cause a "lack of appetite", because it hurts to chew. Make sure your vet does as thorough an oral exam as possible.

As for her blood pressure pill, does she really object to being pilled? If you can just pill her, you know that it's down. Maybe use a pill gun? They are handy for pilling cats (ask me how I know ).

If all else fails, you can start giving her Nutrical, but getting her to actually eat would be better.
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Old 11-05-2012, 01:24 PM   #4 (permalink)
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Are you giving fluids for the kidney issues? CRF often leads to a cat who isn't interested in food. My last 2 geezer meezers both suffered from CRF and feeding them was a fulltime job. I took canned cat food and meat baby food and pureed it in a food processor and had the best results. I offered it every couple of hours when I was home- so at least 4 X per day (I work fulltime).

Also, most blood pressure pills have a BITTER taste- so do not crush into the food! Much better to use pill pockets, cheese or a soft treat to hide the pill. They are quite small, so easily hidden in treats while intact.
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Old 11-05-2012, 02:19 PM   #5 (permalink)
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There are appetite stimulants that you can give that may help. Also SQ fluids can help hydrate, and you can have Vitamin B added to the fluids which can also help stimulate appetite, or B Vit injections. I'm sorry your elderly kitty is losing steam. If she can't take in enough food to sustain her, it may be time to consider humane euthanasia, so she will not suffer.
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Old 11-06-2012, 03:18 PM   #6 (permalink)
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At this point kibble is being free fed, which is bad because I can't track what she's eating and as I said Tombstone is blimping.

I use canned/scraps for pilling, but obviously that will be changing. She used to eat the pill in her food fine, but as I said it's no longer working. I'll be trying pill pockets.

When she was younger I could pill her with my bare hands without any damage. In old age she's decided she's "not going to take it" anymore and is more than willing to bite. I do have a pill popper, but she stills struggles, so if I can avoid that I will.

No, she's not on fluids - only been advised to feed canned for moisture. She's actually VERY good at consuming water on her own in comparison to my other cats.

She's also on a renal support supplement.

The first thing I need to do is get my cats permanently seperated so I can feed each accordingly and not worry about it affecting the other.
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Old 11-09-2012, 10:24 AM   #7 (permalink)
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Fuzzy Update

Fuzzy is now setup by her lonesome in my small bedroom. I honestly don't think she misses the other cats. I also think she appreciates that this room stays pretty warm in comparison to the rest of the house.

I got my Drinkwell pet fountain set back up for her. I had stopped using it because Ivan would come drain it in one session and refilling it so often got annoying.

I did buy pill pockets for her and those are working out well so far.

I also bought a high calorie vitamin paste for her. REJECTED

I just need to monitor her food intake now that I know the other cats aren't coming in and finishing her food for her.
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Old 11-11-2012, 02:59 PM   #8 (permalink)
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Our older kitty pretty well stopped eating due to a combination of hyperthyroid and kidney failure and probably cancer metastasis (which I just didn't pursue; we'd taken a tumor from his third eyelid a year prior, and he was originally a white barn cat and had some skin cancer on his ears as well; who knows what was going on inside).

Subcutaneous fluids helped some; he'd generally eat some after getting them. Bought us some time; not a lot. OTOH, I have a friend who maintained her geriatric cats with subcu fluids 3x weekly for some years as an antidote to kidney failure. YEARS. So I'd think it worth a try.

In the end, after trying a crazy number of different foodstuffs ranging from Greek yogurt to raw meats of any kind you might name, he'd lost nearly 5 lbs. and it was time to let him go, sorry to say. Just grateful we could give him a year and a half or so of pleasant senior living.
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Old 11-11-2012, 08:00 PM   #9 (permalink)
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Fuzzy gained .4 lbs. Yeah!!
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Old 12-13-2012, 12:39 PM   #10 (permalink)
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The Pill Pockets only worked for about a month.

I am now feeding her lunch meats and tuna. She does a better job of eating them. Canned food she just licked all over the place with most of it ending up dried on the floor. She still has access to all the dry food she wants.

She'll be going back to the vet sooner rather than later. Turns out her Rabies vaccine was missed the last time she was in. Yeah! Another office visit charge. At least I'll get so see how her weight is.
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Old 12-13-2012, 12:52 PM   #11 (permalink)
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I am now feeding her lunch meats and tuna. She does a better job of eating them. Canned food she just licked all over the place with most of it ending up dried on the floor.
Did you try pureeing the canned food in the food processor?- that is what I had to do for my crew. It made it liquidy enough that they would actually eat it. I would be concerned that she isn't eating enough dry food to get the taurine she needs on just lunch meat, so it isn't a good option in the long run. And the tuna is too high in phosphorus to be safe for a kidney kitty.

My vet doesn't do rabies vacs on geriatric patients with health issues- in WV you can get it waived in those cases, if they were always kept up to date prior. I would not opt to do it if you don't have to.
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Old 12-13-2012, 01:59 PM   #12 (permalink)
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Her last round of blood work did not indicate any further deterioration of her kidney function. One value had slightly, although not significantly, improved. The blood work was done 6 months apart. At that point my vet thought something else might be in play, such as cancer.

After the last visit my biggest concern was getting weight on her, so that's what I've been concentrating on. She's probably only getting tuna once a week, so I'm not so concerned with that.

I had not thought about Taurine though. She's already blind, so I'm not so concerned about that, but it does make me worry about her heart. She does have a decent murmur. It had not changed between the last two visits, but I obviously don't want to contribute in any way to making it worse.

She actually had canned duck last night that was pretty soupy. She did not eat all of it. She is, however, finishing all of her lunch meat. I'll have to see what her blood work shows the next round.

If my vet, who is holistic and recommends titrering, thinks it's safe for my cat to be vaccinated for Rabies, then I'm okay with it. And I have no concerns that he would push for the vaccine just to make money. There have been a few occasions were I've pushed for additional testing so I knew specifically what we were dealing with when such knowledge would in no way improve the outcome.
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Old 12-13-2012, 03:15 PM   #13 (permalink)
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Hey there, all the above suggestion are great, the only thing I wanted to add..... did you ever have her thyroid levels checked? sorry if I missed it. I had topical thyroid and lasix meds for my old girl....pilling her was not an option neither was hiding it( added way to much stress for her heart condition, which our girl had because of the thyroid disease.) You can check with your vet if the medication is availabe that way and a human pharmacy can usually make it up no problems. We shaved a very small patch of fur from her neck and the meds get placed on the skin. Hope this was helpful, good luck to your elderly fur baby they are only here for such a short time.
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Old 12-13-2012, 03:22 PM   #14 (permalink)
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I would have to look at her blood work to confirm if thyroid was included.
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Old 01-18-2013, 10:07 AM   #15 (permalink)
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Just a little Fuzzy cat update. At her most recent vet visit she weighed in at 7.4 lbs. Almost a whole pound of weight gain from her low in Oct. Yeah!

Unfortunately she was having more accidents outside the litter box. I assumed it was kidney related, but when I explained it to the vet he didn't think it fit. He believes she has some sort of infection and prescribed Clavamox. He wasn't able to get a urine sample.

Her inappropriate elimination has almost stopped (only one accident), but unfortunately she's suffering pretty much every side effect of Clavamox a cat can. Loss of appetite (eating and drinking very little) and diarrhea. I don't know if the antibiotic is doing something (ridding the infection) or if it's the effects (less in less out) causing the seeming improvement in terms of accidents. She's still going - just not as often.

I was hoping I'd be able to syringe up a urine sample since I have plastic down, but as I said she only had one little peeing accident the same day as the diarrhea.
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Old 01-18-2013, 02:55 PM   #16 (permalink)
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18 is very old for any pet. She just might be going downhill from now on. You should have a talk with your family and vet to see what would be best for Fuzzy. It's better to do something now other than wait and have her suffering even longer.
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Old 01-18-2013, 02:57 PM   #17 (permalink)
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Senior kitties can be such a roller coaster, hugs to your girl and hopefully she stabilizes soon.
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Old 01-18-2013, 03:11 PM   #18 (permalink)
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I was ready to put her down if her weight had decreased, but with such an improvement I don't think she's at the end of her road yet.

I certainly wish she wasn't having the side effects from the Clavamox, but if it's actually fixing an issue that can indeed be fixed, certainly worth the effort. It's only a two week course, so it's not like she'd have to deal with its side effects from here on out.

I've read about a lot of senior cats getting grumpy and having no tolerance for other cats in the household. Fuzzy still gets along fine with Tombstone and Halle.

And if the whole "you'll know it's time" stuff is true - it's not time. Of course that leaves me in a perennial state of worrying when the time will come, but for now we have a treatable(?) condition and she's shown improvement in terms of weight.
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Old 01-18-2013, 09:58 PM   #19 (permalink)
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I would avoid Clavamox in any cat who already has issues with eating since (as you know, it causes GI upset). If she has a suspected UTI, you're better off going with a Convenia injection or course of Zeniquin, depending on the type of bacteria she has.

How high are her renal values? (BUN, creatinine, phosphorus) And what is her potassium? If her phosphorus is >5.0, we recommend putting them on a phosphorus binder (aluminum hydroxide), because a high phosphorus level caused by renal disease makes cats nauseous and less likely to eat well.

Also, all renal cats should be on famotidine (Pepcid) to help with the acid in the stomach caused by increased renal values. Controlling an acidic stomach helps them feel less nauseous and eat better.

Since pilling is a problem for most people, we have medications compounded into a transdermal cream form that you rub a small amount onto the hairless aspect of the ear flap to absorb through the skin. We often have 3 or 4 medications compounded into the same cream so you don't have to give multiple different medications at once orally. For renal kitties, we mostly use famotidine (Pepcid) as an antacid, ondansetron (Zofran) for nausea/vomiting, buprenorphine for pain (especially for older kitties who have arthritis), and cyproheptadine for appetite stimulant. We also use mirtazapine in cats as an appetite stimulant since it doesn't have to be given as often as cyproheptadine and also has anti-nausea properties.

The transdermal cream and aluminum hydroxide can be made at any compounding pharmacy. There are several in our immediate area that makes it, and its a god send for most of our clients. You should really look into it if your girl is difficult to orally medicate.

Depending on what BUN and creatinine are, you may want to consider doing SQ fluids, even if its just a few times a week. Water she gains from food is literally a drop in the bucket compared to what her kidneys need to stay happy, especially if her values are high. It's good to mix extra water into food, use pet water fountains, etc, but its no substitute for SQ fluids.

Since my clinic is feline-only and renal disease is probably the most common disease we see in cats, we've become very adept at treating it and having clients successfully treat it for many years at home. If you have any questions, feel free to PM me
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Old 01-29-2013, 05:20 PM   #20 (permalink)
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Burns - I just saw your response. I'm about to head out from work, so I'll have to type a more detailed response later.

I should be getting urinalysis results tonight and she should be done with the Clavamox. Towards the end she seemed to tolerate it better. She has actually gained another ounce. However, if it comes back indicating she still needs medication, I will definitely discuss your suggestions with my vet.

I'd have to pull her records to find out her exact values. They actually didn't get worse the last round of bloodwork, which didn't make sense to my vet. He was suspicious something else could be going on.

I'll have to ask about Pepcid as well.

She's on Enalapril at the moment. I crush it up and sprinkle it on her food. Yes, she is actually eating it - AND is back on canned food and doing well - she was on lunch meat and baby food for a while just to get her to eat. Who knows how long it'll last though.

Now the renal support supplement she's getting is proving to be a challenge. She used to eat it like a treat. Not so much anymore. If it gets to the point I actually have to pill her, I like the idea of the transdermal. Do you know offhand if Diamondback Drugs makes them? I've went through them before for liquid and have no complaints.

She is not currently on SubQ fluids. In comparison to my healthy cats, she does drink a ton of water. She did have a fountain, but either it's leaking or she's sloshing the water out/trying to pull the fountain around. I came home twice to water on my wood floor. I even had plastic down to try and protect it and it still got under it on the floor, so I've been giving her fresh bowls throughout the day and she seems to be doing okay with that.

Thanks!!
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Old 01-29-2013, 06:52 PM   #21 (permalink)
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Test Results

T4 is normal.

BUN was 28. Originally was 55.

Creatinine was 2.4. Originally was 1.8.

Phosphorous was 3.6. Originally was 4.1.

Potassium was 4.8. Originally was 4.2.

No bacteria in the urinalysis. No white blood cells. They did find red blood cells.
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Old 02-11-2013, 01:46 PM   #22 (permalink)
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Since finding the red blood cells Fuzzy has been on Cosequin for Cats. She hasn't had an accident since midway through her antibiotic treatment!
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Old 02-11-2013, 01:49 PM   #23 (permalink)
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yay Fuzzy!
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Old 02-11-2013, 04:44 PM   #24 (permalink)
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What an incredible place you work at.

Quote:
Originally Posted by Burns View Post
I would avoid Clavamox in any cat who already has issues with eating since (as you know, it causes GI upset). If she has a suspected UTI, you're better off going with a Convenia injection or course of Zeniquin, depending on the type of bacteria she has.

How high are her renal values? (BUN, creatinine, phosphorus) And what is her potassium? If her phosphorus is >5.0, we recommend putting them on a phosphorus binder (aluminum hydroxide), because a high phosphorus level caused by renal disease makes cats nauseous and less likely to eat well.

Also, all renal cats should be on famotidine (Pepcid) to help with the acid in the stomach caused by increased renal values. Controlling an acidic stomach helps them feel less nauseous and eat better.

Since pilling is a problem for most people, we have medications compounded into a transdermal cream form that you rub a small amount onto the hairless aspect of the ear flap to absorb through the skin. We often have 3 or 4 medications compounded into the same cream so you don't have to give multiple different medications at once orally. For renal kitties, we mostly use famotidine (Pepcid) as an antacid, ondansetron (Zofran) for nausea/vomiting, buprenorphine for pain (especially for older kitties who have arthritis), and cyproheptadine for appetite stimulant. We also use mirtazapine in cats as an appetite stimulant since it doesn't have to be given as often as cyproheptadine and also has anti-nausea properties.

The transdermal cream and aluminum hydroxide can be made at any compounding pharmacy. There are several in our immediate area that makes it, and its a god send for most of our clients. You should really look into it if your girl is difficult to orally medicate.

Depending on what BUN and creatinine are, you may want to consider doing SQ fluids, even if its just a few times a week. Water she gains from food is literally a drop in the bucket compared to what her kidneys need to stay happy, especially if her values are high. It's good to mix extra water into food, use pet water fountains, etc, but its no substitute for SQ fluids.

Since my clinic is feline-only and renal disease is probably the most common disease we see in cats, we've become very adept at treating it and having clients successfully treat it for many years at home. If you have any questions, feel free to PM me
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Old 06-10-2013, 10:44 PM   #25 (permalink)
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We seem to be going backwards again. About a week to two weeks ago Fuzzy lost interest in her wet food again. I'm back to feeding her lunch meat. I don't know if it's just a phase or what. In addition to always available kibble.

My purpose in posting is that when I went to feed her tonight she was walking in circles to the right. Even when I tapped her food dish on the floor she kept circling. Normally she's a "pest" about following sound and getting underfoot. I had to touch her to get her to stop. She almost started up again with it, but instead managed to find the food dish and started eating. When I checked on her later she was in her bed.

I have heard her sneeze occasionally. Ear infection?

I don't see a head tilt or anything.

She'll be going to the vet for sure. I'm just not sure how much to pursue this...
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