Hello Elly, I'm Dr. Deb.
I recently came online and see that your question about Taz hasn't been answered. I'm so sorry that you've had to wait for a response,but if you still need assistance, I'd like to help if I can.
I do have a few questions to ask first, if you don't mind: 1. Is he lethargic?2. Any vomiting?3. Has any blood work been done recently?
4. Have you offered boiled chicken or human baby food?
There may be a delay after I receive your answers since I have to type up a response to you and I may be offline at the time you respond. But I'll get back to you as soon as I can since I'm on the computer some part of every day.
Thanks for your patience. Deb
Elly: I'm sorry that I was off my computer when you responded back but am appreciative of the the additional information.I do know how difficult it can be when dealing with a senior citizen especially one who's starting to become a fussy eater. In my experience, there can be several explanations for his waxing and waning appetite...he appears to really like one thing for a few days and then doesn't. And, this symptom is rarely related to the fact that you just haven't found the "one" right food which he'll like. Usually in these cases, there is some underlying medical problem which is causing him to have less interest in eating. 1. Nausea.Even though he might still be in the early stages of renal failure (as opposed to the latter stages of it), this may be enough to throw his appetite off. As I'm certain you know, these older cats don't have many reserves; if he's feeling just a little bit nauseous because his kidneys aren't filtering toxins from his bloodstream (even though he may not be actively vomiting), then this may be enough for him to have less interest in food. This pattern of an intermittent appetite is a commonly seen one in older cats with kidney issues. It can be particularly frustrating since you think you've found what they "like" but then they only eat it for a few days. a) If he's not too difficult to pill and it won't stress him out, then you could give him over the counter Famotine (Pepcid AC) which may help with his nausea. The dose would be 1/4th of a 10 mg tablet twice a day.Since this drug may be difficult to find in the UK., an alternative would be Omeprazole (Prilosec) at a dose of 1/4th of a 10 mg tablet once a day.b) There is a stronger drug called Cerenia which would have to be dispensed by your vet but it does have anti-vomiting as well as appetite stimulant properties. It comes as an injection which lasts 24 hours as well as pills. c) Many of these cats will benefit from an appetite stimulant such as Mirtazapine or Cyproheptadine although they would have to be dispensed by your vet.d) And, if he would tolerate it, fluids under the skin can be enormously helpful for these cats. I've had many clients through the years who have given fluids to their cats at home but I do realize that some cats simply won't tolerate it and that some owners are uncomfortable with the procedure. But, if this is something you think is feasible, then a conversation with your vet might be a good idea.2. When presented with a case where the blood work doesn't necessarily support an end stage disease (such as renal failure or liver issues) and yet I have a cat who's appetite is diminishing, I always worry about cancer somewhere in the body, unfortuantely. I may not be able to pinpoint where it might be located (although an ultrasound may be helpful in that regard), but I always worry that this may be the issue.In these cases, quality of life issues are my priority. If my patient will cooperate, I often make the same suggestions as I mentioned in #1. 3. The sense of smell can be reduced in these older cats and may contribute to the problem but I seldom attribute the problem solely to this issue.4. Issues such as bad teeth or infections in the mouth can cause an intermittent appetite. If you didn't see significant improvement while he was taking the antibiotics, then this may not be the sole issue either (although it may contribute in some small way to a reduced appetite).However, if you did see improvement while he was taking them but then his appetite was off again when they were discontinued, then it may be worthwhile to restart him on a long term course of low dose (once a day or every other day) antibiotics such as Amoxicillin. I've frequently prescribed such a drug and dosing schedule for my older patients who are not good anesthetic risks. I don't particularly worry about drug resistance either since I'm more concerned about quality of life issues. 5. Cats with pancreatitis often demonstrate issues with their appetites. There is a test called spec fPL which can be run although I've come to question its reliability in some cases.An ultrasound may also be quite helpful in diagnosing this problem. Treatment options will be limited but many cats benefit from pain medication and the aforementioned fluids under the skin. Since he appears to eat table food, then I do think the chicken and baby food (avoid those with onion and garlic in them) are reasonable choices. They obviously won't be balanced but at this point, it's important to try and get him eating again.I hope this helps and provides additional options to consider. I know how frustrating this problem can be since I've dealt with it both personally and professionally more times than I can count. Deb
Elly: I absolutely understand your position since I share it; this is how I view health issues involving my 20 year old cat. I know his time is limited since he's starting to drink a lot of water and continues to lose weight. I fear he has kidney issues but am reluctant to put him through the trauma of a car ride to my hospital so that bloodwork can be done.I, too have no interest in prolonging his quantity of life if the quality is gone (he would be a bear to treat for any condition!!!).It's obviously difficult to know how much more quality time Taz has but the suggestions I made are not terribly stressful nor invasive. He wouldn't need to be sedated for an ultrasound but in all honesty, if something very serious was found, it sounds like you wouldn't go to extremes...nor would I. So, it becomes moot in a way: why bother to pursue additional diagnostics if further treatment wouldn't be pursued. There is obviously value in knowing what may be going on with him but it wouldn't necessarily change the outcome in other words. I've seen a number of cats in my career respond in the most surprising ways to fairly simple treatments so it's possible that his quality and quantity of time can be extended.But, if he's one of those cats that you simply cannot medicate, then, for me, the stress wouldn't be worth it.I don't think he's suffering but clearly starving is not a good way to end your life. You might try the Omeprazole and/or fluids and/or an appetite stimulant and gauge his response. If he doesn't respond in a positive fashion, then it may be time to make that most difficult and painful decision about him. Deb