Thank you Paul.
Now Sweep will understandably be lethargic and sleeping all the time. This can arise due to not feeling well (just as we stay in bed when we are ill) and/or the weakness that comes from not eating properly.
Now the reason for my range of questions is because appetite decline in the cat is often linked to oral discomfort and/or nausea. In Sweep's cause if he is pawing at his mouth then oral pain is a concern but if he is vomiting on occasion, we have to be worried about nausea as well. And while I wish it were not the case, there is no rule to say our older kitties cannot multiple issues bombarding them and leading them to just give up and go off their food.
Since we have two issues to consider, I will start with the oral based concerns first.
Notoriously, when a cat starts showing signs of a decrease of appetite, difficulty eating, weight loss with secondary lethargy, depression, and malaise then this can be a red flag that there is an oral issue that needs to be addressed. Most commonly, we see this associated with dental disease (since the have often lived their 19 yrs without picking up a toothbrush). This could be due a fractured tooth, gingivitis (inflammed sore gums), feline resorptive lesions (example), or tooth decay. Rotten teeth can cause pain and soreness which can contribute to a cat going off their food and showing these signs. A lot of cats with dental disease will often struggle to eat, eat less, or go off their food completely. Some will initially beg for food, only to look at it longingly before giving up. Others will drool or paw at the painful site. And since this is often partly due to bacterial infection, the cats mouth's often smell and their coats can start to smell when the groom with bacteria filled saliva. Where dogs will suffer through their pain, cats aren't daft and avoid it. (though not eating isn’t a great plan for dealing with dental disease either).
In this vein, any foreign material lodged between the teeth or injuries to the tongue (via rodent bites, etc). can also cause these signs. As well, since your kitty is older, we can't rule out oral tumours. We can see cats sometimes develop aggressive tumour types on or under their tongues or in oral mucosa. These can appear as ulcers and can have a secondary infection associated with them. As well, they can also present as growths in the mouth that can displace the tongue and make it stick out. These growths can be sinister but some may be polyps (which are benign). But in either case, any lesion can make a cat’s mouth uncomfortable, cause them to go off their food.
Finally, if you think his bad smelling breath smells more like ammonia then pus, we do have to consider that in older cats we can see signs of this nature associated with kidney disease. The reason is because when kidneys struggle they are unable to filter out wastes as well as they used to. And one metabolic waste, called urea, can accumulate in the blood and cause a uremia. A side effect of uremia is the formation of oral ulcers and ammonia scented breath. And these ulcers (as well as associated nausea) can make the cats mouths sore which again will affect his appetite and thus weight. As well the toxin is know to cause nausea for kitties and that as well factors into their lack of appetite. And since this is a very common issue with cat's Sweep's age and would cause oral pain and nausea, this would be a top concern here.
Turning out attentions to his nausea/vomiting, we do again have a range of considerations for Sweep's signs. As I am sure you can appreciate vomiting can be triggered by a range of issues, and some of our top concerns would be grumbling bacterial infection, viral disease, pancreatitis, metabolic conditions (ie hyperthyroidism), cancer (lymphoma) or organ disease (ie liver or kidney troubles).
To try to rule out nausea as an anorexia differential, you can start by trying him on antacid therapy. There are a number of antacids that are available over the counter and pet friendly. I would advise only treating with one, but the two I tend to recommend are Pepcid (More Info/ Dose) or Zantac (More Info/Dose). This medication of course shouldn’t be given without consulting your vet if he does have any pre-existing conditions or is on any other medications. Ideally, it should be given about 30 minutes before food to ease his upset stomach.
To benefit him with either reason for anorexia, we'd want to see if we can tempt him to eat (as I am sure you have been). Favourite foods are allowed or you can tempt her with a light/easily digestible diet. Examples of this would be boiled chicken, boiled white fish, scrambled eggs (made with water and not milk), meat baby food (do avoid the ones with garlic powder in the ingredients) or there are also veterinary prescription diets that can be used here (ie Hill’s I/D or Royal Canin’s sensitivity.) Further to this, if tempting doesn’t work, then we do have to consider initiating syringe feeds to get food in. In that case, you may want to try Hill's A/D (LINK), Royal Canin Recovery (LINK), or Clinicare Canine/Feline Liquid Diet (LINK). All of these are critical care diets that are calorically dense, so a little goes a long way nutrition-wise. And these could just help get some more calories into him even if we can’t get a huge volume of food in.
On top off all of this, you do need to keep an eye on his water intake especially if it is on the decline. Ideally, we'd want to check his hydration at this point. To check his hydration and make sure that he isn’t becoming dehydrated, there are a few things we can test at home. One is whether the eyes appear sunken, if the gums are tacky instead of wet/moist, and whether he has a "skin tent" when you lift the skin (example). To see how to check these parameters for dehydration, you can find a wee video on this HERE. ( They use a big dog but it makes it easier to see and the principles are exactly the same) If you are seeing any signs of dehydration already, then you do want to have your kitty seen by his vet before this gets any further out of control.
Overall, these are the main things I would be considering in Sweep's case. He is an old man but his signs tell us that something is causing him to decline just now instead of this just being old age. Therefore, since he has gone off his food and we don't want this to progress to a stage where he develops secondary health issues (ie fatty liver syndrome) that cause him to suffer further, I'd advise that you do want to consider having him seen by his vet soon. I would say that consider his signs and age, it would be an urgent visit for him. Once the vet does examine him, they will be able to help determine the primary condition that is causing his anorexia. The vet can do this via an oral exam (which cats in his situation don't tend to be particularly amenable to just letting anyone look). Depending in their findings, if he is suffering from an oral issue alone than long lasting injectable antibiotics and cat safe pain relief could be helpful. And if they do find ulcers in the mouth, then you might consider having a urine or blood sample checked to determine if these signs are actually due to underlying kidney troubles for poor wee Sweep. If so, then they can advise you on treatment, his long term prognosis, and whether this is the end of the road for poor wee Sweep.
I hope this information is helpful.
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All the best,
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