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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 33254
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My cat is sick every few days but is always ravenously hungry

Customer Question

My cat is sick every few days but is always ravenously hungry (demented) even after just being sick. I have had her at the vets on many occasions and they have done an endoscopy and found nothing. We have tried her on/off various foods - hills sensitive biscuits - I have changed the food (felix) to hills wet food but she won't eat it and is still sick - help - I am running out of options. We have kept her indoors so she can't eat grass because we thought that was the problem but it isn't. She has lost quite a bit of weight but is still very perky even when she is sick. We have stopped all treats so the only thing she now has is 1 tablespoon of felix cat food 3 times a day and a few royal canin maine coone kibbles (my daughters 2 maine coone boys for are living with us at the moment). Could she be allergic to something?????
Submitted: 4 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 4 years ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry to hear of this with Honey. I have a few considerations...

Hyperthyroidism - a relatively common cause of polyphagia but weight loss - is often underdiagnosed in our cats. Please check Honey's T4 (total thyroid) value. Anything over 2.0ug/dL suggests hyperthyroidism even though the normal range for a 7 year old cat is cited to be up to 4ug/dL.

Maldigestion and malabsorption are important tentative diagnoses as well. We should be able to rule out malabsorption (poor absorbtion of digested food) because an endoscopy revealed a normal GI tract. Maldigestion, however, is due to an exocrine pancreatic insufficiency (EPI) which defines a lack of digestive enzyme production by the pancreas. This isn't a common disorder in cats but an important one in a cat such as Honey. EPI is identified by a PLI blood test.

A food intolerance can certainly exist. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Honey's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra. A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.

Please respond with further questions or concerns if you wish.