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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 28501
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Hi Doctor, My cat has been diagnosed with FIV and has lost

Customer Question

Hi Doctor, My cat has been diagnosed with FIV and has lost allot of weight. 3 weeks ago he had diarrhea but it has not come back since. Our vet has told me only to feed him Royal Caine sensitive wet food, sensitive dry and boiled chicken or cod. However my cat is is meowing at me in the morning and getting me up but will not take any of these foods when I offer him. Is there anything else thats safe to try? Its as if hes telling me hes bored of these foods and wants something else. I don't want to risk him getting a upset stomach again but he is eating so little that I wonder if risking trying a different wet food is the way to go because eating anything would be better than nothing. Also would it contain more nutrients and be more balanced than the chicken and cod? This he eats eats a little more than the poaches which are totally refused on some days. Money or effort of cooking something not a issue just desperately want him to eat a little more and enjoy his food. Often he smells and then walks away.

Many thanks Anna
Submitted: 3 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking with Dr. Michael Salkin
Anna, it's important to understand that cats such as Spencer should eat anything that you can get down them. It's better that he eat the "wrong" food than not eat the "right" one. If Spencer will eat bad/smelly food such as Whiskers (it's really not bad but certainly can be smelly!), please feed him Whiskers. Human mackerel and tuna is fine as well as long as it's not his sole diet. If you think that Spencer would enjoy your home cooking, here are two balanced recipes for an older cat that he might enjoy:

tuna, canned, in oil, drained 3 ounces
egg, large, hard-boiled 1 each
rice, white, long-grain, cooked 1/2 cup
canola oil 1 1/2 tsp
salt substitute (potassium chloride) 1/4 tsp
bone meal powder 1/4 tsp
baking soda substitute (calcium carbonate) 1/4 tsp
salt, iodized (sodium chloride) 1/8 tsp
multivitamin & mineral tablet, kids complete 1/2 each
taurine powder, 1000mg per 1/4 tsp 1/4 tsp

whitefish, fillet, baked 4 ounces
rice, white, long-grain, cooked 1/2 cup
canola oil 2 tsp
salt substitute (potassium chloride) 1/8 tsp
bone meal powder 1/8 tsp
baking soda substitute (calcium carbonate) 1/4 tsp
salt, iodized (sodium chloride) 1/8 tsp
multivitamin & mineral tablet, kids complete 1/2 each
taurine powder, 1000mg per 1/4 tsp 1/4 tsp

Both recipes supply ~400 kilocalories - the daily requirement for a 12kg cat and so you can feed Spender as much as he'd like to eat and freeze the rest for the next meal. Please respond with further questions or concerns if you wish.
Customer: replied 3 years ago.

Aloha Dr! Thanks for your speedy reply.


 


My vet seemed to think that it was more likely the combination of mackerel and whiskers that gave him the diarrhea before. Is there more likelihood of him getting it again if we start feeding him the tuna recipe? Will have to wait till tomorrow to source a heath food shop or somewhere that will stock all those ingredients. Do you know the brand almo nature? We have a box of tuna jelly sachets of this in the house. Also Natures menu salmon and tuna. Are these better or the same as whiskers? Also do you know of any suppliments or anything else that will increase his appetite? And if my vets commonly are about to subscribe AZT? Were off on holiday for 5 days in a weeks time so are very worried about leaving him. We have friends staying over here so minimal upset to routeen but its the effort of trying to coax him with the 'safe' foods vs risking him getting diarrhea again and needing the vets/losing more weight while were away. What are your past experiences?


 


Many thanks,


Anna

Expert:  Dr. Michael Salkin replied 3 years ago.
I would think that the balanced tuna recipe would be better tolerated this time around. I regret that I'm not familiar with Almo Nature; in addition, over the counter foods often vary from batch to batch and depending upon where you live. Once again, I'm more concerned at this time in keeping him eating than fine tuning his nutrional requirements. You're welcome, then, to try anything you think might tweek his fancy.

Supplements aren't expected to stimulate appetite but Spencer's vet can prescribe mirtazapine (preferable) or cyproheptadine either of which can stimulate a cat's appetite.

Reduced viral load and improved clinical status have been observed with AZT treatment but side effects are possible including nonregenerative anemia and so Spencer would need to be monitored carefully during treatment including complete clood cell counts.

To answer your question directly, I would risk diarrhea because it's more important to get something down him at this time. The same tablets (metronidazole?) might be administered if a new food causes diarrhea. Please continue our conversation if you wish.
Customer: replied 3 years ago.

Hi again Michael,


 


Once again thank you. Are both mirtazapine and cyproheptadine steroids? I asked the vet here about giving him another steroid injection but he said it would be better to not give him too much and save it for if he took a turn for the worse. As far as I am aware so far he has had a colvasone anti infammatory inection visit April 8th (knew about gums disease only 1st trip), then Depo medrone anti-inlammatory visit 2 April 12th with take home prednicare 5mg twice daily tablets for a week (prescribed last mintue at end of session when pushed further and got the blood test) and then visit 3 he was gived the 'wonder injection' as the vet called it that was also a steroid and that lasted a week don't have the name of that one. That was the 14th May the last one as far as I'm aware. He stayed over night on a drip on the 21st May that was at the time he got the diarrhea. He was given two bags via the drip but the vet released him a day early as he managed to get him to eat a packet of the sensitive food by the am. Then he had those intestinal tablets with us at home (sorry don't know the name as it went direct to the pet insurance). The diarrhea lasted another 1/2 days after he was home and then cleared. Thats everything that has happened so far. Was thinking a new injection of some kind to increase his appetite and having the diarrhea tablets ready in the house on stand by would be the best course of action before we go away. What do you think?


 


Kind regards,


Anna

Expert:  Dr. Michael Salkin replied 3 years ago.
You're quite welcome. No, neither are steroids and unless absolutely necessary to address an inflammatory disorder such as stomatitis (inflammation of the mouth) as you mentioned, steroids should be avoided because they will immunosuppress an already immunosuppressed cat.

The mirtazapine and cyproheptadine are tablets rather than injectables and, yes, it would be prudent to have diarrhea tablets (metronidazole is preferable because it's not only an antibiotic but it has antiinflammatory and immunomodulary properties) on hand. Thank you for the additional history. FIV+ cats need to be be "overtreated" whenever anything untoward occurs. Any minor disorder can become life-threatening in these cats.

Please continue our conversation if you wish.
Customer: replied 3 years ago.

Thank you Doctor I will ask about mirtazpine tomorrow and get some safety diarrhea tablets too.


 


I'm sure it was metronidazole he must have had the last time before as the vet said something similar that it was good for both things unlike the previous pink tablets that were more specialized to only the gums.I will continue to either take him in or ring/bug the vet every time there is any kind change at all.


 


I just tried a very little of the Almo Tuna while I was boiling some chicken and he gobbled it up. But then he had a reasonable amount of the chicken too. Always easier when its hot!


 


What brand/kind of shop brought packet or canned food do you normally recommended to cats with FIV or sensitive stomachs? I'm based in the UK if that makes any difference.


 


Thank you,


Anna


 


 

Expert:  Dr. Michael Salkin replied 3 years ago.

That's the dilemma, Anna. I'm not familiar with the commerical foods in the UK. I'm just happy when my FIV patient eats. I'd be more comfortable having you cook up one of those human-grade recipes for Spencer than feeding him an over the counter food. I have to leave my computer for an hour or so but I promise to reply when I return if need be.

Customer: replied 3 years ago.
Totally understand what your saying. Just thought there might be something universal like science plan, Iams or Hills or something I could source online which might be the same?

I only have chicken, tuna and rice in the house hopefully I can source the other ingredients like taurine powder.

I won't give him any more if that almo tuna packet food today.

No worries at all if your unable to reply today.

Thank you so much for all your advice.
Anna
Expert:  Dr. Michael Salkin replied 3 years ago.
I wouldn't consider a prescription diet until I knew more about his overall health and that's done by taking a look at his blood and urine. I do have confidence in Science Diet, Iams, and Hill's because those manufacturers work closely with veterinary nutritionists and produce high quality foods. Whether a "sensitive stomach" food really addresses all the causes of a "sensitive stomach"...whatever that means, however, is debatable.
Customer: replied 3 years ago.
Ok thank you and I see where your coming from. His blood test only showed minor intestinal abnomitys and the Amenia which was more severe. Kidneys and all other major organs had good readings. Should I ask for a urine test?

Thanks,
Anna
Expert:  Dr. Michael Salkin replied 3 years ago.
I believe that a urinalysis is an important part of diagnostic testing. It helps corroborate findings in the blood. I'm pleased to hear that his major organs have checked out well.
Dr. Michael Salkin and other Vet Specialists are ready to help you
Customer: replied 3 years ago.
Thank you for all your help.

Anna
Expert:  Dr. Michael Salkin replied 3 years ago.
It's my pleasure, Anna. Thank you for your kind accept. I appreciate it.

I'm going to check back with you in a few weeks for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Please disregard the info request.