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Cat Forum / Health and Behavior / November 2005Cat Starving Himself After Urinary Tract Blockage
Hi Folks, Our nine year old male domestic shorthair had a urinary tract blockage back in July. He had a large, walnut-sized stone in his bladder. It was touch and go for a couple of weeks, but he was strong and healthy and seemed to recover fully. After six weeks, there were no signs left of the bladder stone according to our veterinarians. One of the things our veterinarians requested was that we change his food. He had been on a mix of premium dry foods, but they said that wet food would be better for keeping crystals from forming in his bladder. They also gave us a prescription of Cosequin, which is supposed to strengthen his bladder after all of the inflamation. We tried a number of better grade and premium canned foods that are low in ash and/or claimed to be for urinary tract health. We noticed that he was enthusiastic about the new foods initially. Shortly after his recovery from the blockage, he began to have periodic episodes of "dry" vomiting. He would appear to be straining to get rid of something, but all that would come out was a small amount of liquid or foam. Afterwards, he would not eat anything for a day or two, and then regain his appetite. This started to happen every week or two, and gradually became more frequent. He does not go outdoors, and rarely eats anything besides what we feed him. He has gradually eaten less and less in the months since his blockage. He started out weighing 8.5 lbs and is down to 5.5 lbs. He looks like fur over bones! I'm afraid he's not going to last much longer. He has had blood tests, and has no infection or diabetes. His blood levels are all "normal" according to his doctors. They cannot find any lumps after substantial searching. They are testing him for pancreatitis now, another blood test. They also suspect inflammatory bowel disease, but that takes invasive surgery to detect. While this is going on, he continues to eat tiny amounts of food and waste away. We were wondering at first if it could be related to the Cosequin, because he began sniffing and refusing the wet food first. We stopped giving him the Cosequin about a week ago, but he still continues to refuse most wet food and only eats a little of the dry. We have tried several new wet and dry foods with poor results. We're about to try canned tuna and sardines to see if that gets him to eat more than a spoonful. He has been a great friend and entertainer for the lucky years we've had him. If anyone knows of something that might preserve our cat, I'd be very grateful! -dreq > He has been a great friend and entertainer for the lucky years we've had > him. If anyone knows of something that might preserve our cat, I'd be > very grateful! > > -dreq Very sorry this is happening. After reading your post my first thought is get x-rays of the surgery (if some are already available) have a different vet look at the x-rays. everything has been considered except for a blotched surgery? Very sorry again Best to ya's > Very sorry this is happening. > After reading your post [quoted text clipped - 7 lines] > Very sorry again > Best to ya's He did not have surgery. He was catheterized for the blockage, and got better on s/d chow. Thanks, -dreq > He did not have surgery. He was catheterized for the blockage, and got > better on s/d chow. > > Thanks, > > -dreq I see... wow! Well this is a caring bunch of folks, I know many will say a prayer, a prayer that the vet will find the real problem. See Ya > Hi Folks, > [quoted text clipped - 46 lines] > > -dreq First, it's important that you get him to eat. Cats can develop hepatic lipidosis very quickly if they don't eat. It' better to give a cat a food he'll eat rather than have him refuse to eat a food that's good for him. Try different foods. Most cats love Fancy Feast and for some of their flavors they're really improved their formula and ingredients. But you can also try diced chicken or even baby food (get the flavors *without* onions). Once you get him to eat and he gets a little more weight on him you can try again to *slowly* introduce the foods he's supposed to have. Since he is having renal problems, it's also important to get him to drink. Some of the things I've done to accomplish this with my 15-year-old is to keep water bowls in all the places she likes to occupy to make it convenient for her. But also I keep changing the location of some extra water bowls (cats are curious and will wander over to the new location to take a sniff and will usually take a drink while they're there). Also, I've got a Drinkwell fountain that gives them oxygenated, filtered water and provides running water for those cats who like to drink from faucets (and since cats have a hard time seeing the surface of still water they like these because the surface of the water is always in motion making it easier for them to drink). If all else fails, give him the water from cans of tuna in spring water or things like chicken broth. Other than all that I would get another vet's opinion on what's going on. Just ask your current vet for all their records and test results and take them to the second vet for more options. Hugs, CatNipped See another vet. Bring his records. Your vet is missing something important. Gail > Hi Folks, > [quoted text clipped - 45 lines] > > -dreq > See another vet. Bring his records. Your vet is missing something important. Particularly if he has allowed this cat to waste to 5.5 lbs and has not addressed the problem or at least hydrated him. I agree with the poster that said to try to get him to eat anything he can. Fancy feast is a great suggestion, also, if you have a Trader Joe's near you, they make a canned cat food that no cat can resist - it is Tongal (sp?) Tuna. Mine went nuts for it. HTH Beth > Hi Folks, > [quoted text clipped - 46 lines] > > -dreq Has his thyroid levels been checked? A small percentage of hyperthyroid cats develop a form of the disease known as "apathetic hyperthyroidism". The symptoms are completely opposite of the classic symptoms of hyperthyroidism. These cats have a decreased appetite, lethargy or anorexia and significant weight loss. So, if his T4 levels haven't been check, that should be a must. Also, you might want to speak to your vet about cyproheptadine (Periactin). Its an antihistamine for humans but works as an appetite stimulant for cats. Cypro might help jump start his appetite. Since your present vet can't seem to find the problem, I think its time for a second opinion. Your loyalty belongs to your cat not your vet. Be sure to get a copy of all of your cat's medical records. Best of luck. Phil > Has his thyroid levels been checked? A small percentage of hyperthyroid > cats develop a form of the disease known as "apathetic hyperthyroidism". [quoted text clipped - 14 lines] > > Phil Hi Phil and everyone, Thanks for the pointers. We did receive cyproheptadine when we brought our cat in for weighing late last week. His thyroid levels were tested and they are normal. We have had to pill him before and he's highly resistant, to the point of foaming at the mouth after a few days. We started out by trying to give it to him ground up in food, but one whiff and he refuses to eat. He's gotten very experienced at noticing doctored food. We're going to use the piller again and hope for the best. We have two veterinarians at our animal hospital, the second one started seeing him this week. Her opinions mostly track the first one's, but not exactly. We're waiting on the test for pancreatitis now. She offered us to install a feeding tube in our cat today, but we are waiting two days to see if the appetite stimulant works. He has about 1 lb left of buffer weight before forced feeding is unavoidable, according to his new doctor. We also have a large plastic syringe (along the lines of a turkey baster) and have been recommended to give him some a/d food with it as many as six times a day if he's not eating enough. I'm hoping he'll still be willing to eat voluntarily someday, after what he (and us) are going through! Thanks again, -dreq > Hi Phil and everyone, > > Thanks for the pointers. > > We did receive cyproheptadine when we brought our cat in for weighing > late last week. His thyroid levels were tested and they are normal. You might want to speak to your vet about re-testing your cat's thyroid function with the free T4 by equilibrium dialysis (fT4ED) assay (~$20). Your cat might have an underlying disease that's falsely depressing his T4 levels. FT4ED isn't affected by other diseases because the blood sample is dialysed before its assayed. > We have had to pill him before and he's highly resistant, to the point > of foaming at the mouth after a few days. We started out by trying to > give it to him ground up in food, but one whiff and he refuses to eat. > He's gotten very experienced at noticing doctored food. We're going to > use the piller again and hope for the best. Good idea. But next time you pill him, put the cypro in a #3 or #4 gelcap so your cat doesn't taste the medication. I assume he gets 1/2 of a 4 mg pill 2x a day. Half a pill fits in a #4 gelcap perfectly. If he gets a whole pill (which I doubt), cut it in half on the line and put both halves in a #3 gelcap. If you use the gelcap, you might not have to use the pill-popper. Just drop the pill into the back of his throat (laryngopharynx) as far as you can and as quickly as you can. http://www.maxshouse.com/Medicating_Your_Cat.htm > We have two veterinarians at our animal hospital, the second one started > seeing him this week. Her opinions mostly track the first one's, but [quoted text clipped - 3 lines] > lb left of buffer weight before forced feeding is unavoidable, according > to his new doctor. Texas A&M GI lab offers the new feline PLI test- which is probably the most accurate test for diagnosing pancreatitis in cats. Its more accurate than the TLI and serum amylase and lipase levels. You might want to speak to your vet about it. At the very least, it should rule out pancreatitis. To my mind, a rule-out is almost as good as a rule-in. > We also have a large plastic syringe (along the lines of a turkey > baster) and have been recommended to give him some a/d food with it as > many as six times a day if he's not eating enough. I'm hoping he'll > still be willing to eat voluntarily someday, after what he (and us) are > going through! Try heating up the a/d or even better, canned kitten food (more protein) to about body temperature- warmed food is more aromatic and might stimulate his appetite. Cats are attracted to food more by smell than taste. This might also help if he has an olfactory problem. Best of luck, Phil > We have had to pill him before and he's highly resistant, to the point > of foaming at the mouth after a few days. We started out by trying to > give it to him ground up in food, but one whiff and he refuses to eat. > He's gotten very experienced at noticing doctored food. We're going to > use the piller again and hope for the best. I know that one! We recently had big trouble with our newest cat and pills. Our vet suggested a compounding pharmacy. It was a life-saver. We used a liquid medicine compounded into chicken-gravy flavor, and mixed it with a small amount of chicken-flavored wet food. Worked perfectly. Good luck with your cat. Pancreatitus can be tough to diagnose, our internist vet used ultrasound to be sure for our cat a few years ago. He ended up going being put on IVD wet food, which is a food for cat with suspected food allergies. It has one novel protein (like duck) and one starch. It worked very well for him. Rhonda Hi Folks, I've been watching my cat eat every meal lately, trying to gauge whether it's enough to sustain him. Our veterinarians are preparing to install a stomach tube on him to give him more food today. They say that this is in order to protect his liver and kidneys from damage. Yesterday as I watched him eat a small amount of dinner, i noticed that he was rotating his head to the left as he chewed. It occurred to me that I've seen him do this from time to time recently, especially when he's eating dry food. It was more pronounced last night. At one point, his head was turned far enough that it was nearly upside down for a moment. I thought: Toothache! I pointed this out to my wife, and she said "That's right. I just remembered, the doctor told me that he had a bad tooth when I first took him in two weeks ago." The doctor did not consider it to be a serious problem, at least compared to the weight loss. Could the pain of an untreated toothache cause a cat to come close to starving to death? It seems possible to me. I've had toothaches before. So far his blood tests have not shown any high white cell counts. If he has a localized infection in his mouth, I don't know whether it would show up. Does anyone have more insight into this possibility? Thanks again everyone. -dreq > Hi Folks, > [quoted text clipped - 30 lines] > > -dreq It certainly does not help!! Poor baby. I hope that he gets to feeling better soon. (I don't think that a sore tooth (or even infected- would necessarily show up in blood work. I tell you what, Blood tests are great but they can be wierd too and not show up things the way one would think). >Our veterinarians are preparing to install >a stomach tube on him to give him more >food today. I can't believe your vet was so careless as to ignore the bad tooth. Not only can it be very painful and cause what is happening to your cat, it can also cause issues with other organs if infection gets into the bloodsteam. If this were my cat I would allow them to put him under, but not to put in a feeding tube. I'd have them do a dental instead and get the bad tooth out IMMEDIATELY. My guess is that once the pain is gone from the tooth he'll start eating with gusto and the stomach tube will be unnecessary. Megan  Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray > I can't believe your vet was so careless as to ignore the bad tooth. Not > only can it be very painful and cause what is happening to your cat, it [quoted text clipped - 6 lines] > > Megan Thanks Megan & everyone, We discussed the matter with his second veterinarian this morning. Apparently the distinction here is what qualifies as a bad tooth. She explained that he has surface decay on two of the teeth on his left side, so that the enamel has worn away and is exposing the dentin. There is, however, no evidence of infection. She said that this would cause some sensitivity, possibly even pain. She does not think he would give up eating - and throw up - as a result however. He'll be coming home this afternoon with a feeding tube installed. He's having more blood tests to see if his organ functions are still good. We're back in the dark on what's going on, at least until the pancreatitis test comes back. This is hard. -dreq > We discussed the matter with his second veterinarian this morning. > [quoted text clipped - 12 lines] > > This is hard. Poor baby, poor you. I hope for you both. > Thanks Megan & everyone, > [quoted text clipped - 15 lines] > We're back in the dark on what's going on, at least until the > pancreatitis test comes back. I'm sorry it turned out it wasn't his teeth. That would have been a quick fix, but I'm glad he's getting a feeding tube. If he hasn't eaten enough for a while, it's possible that his liver is already damaged. I had a cat who developed hepatic lipidosis from not eating, but blood tests never showed any changes until he'd had an ultrasound that determined it was hepatic lipidosis. I'm not sure why it works that way. From there, blood tests were needed to make sure he was making progress. The feeding tube makes it easy, but please be sure to take it slow. It's so tempting to quickly dump the contents of the syringe into him, but that will surely induce vomiting. What type of feeding tube is it? PEG (inserted directly through the stomach wall) or does it go down the nose or into the throat? My cat had a PEG tube, which required some upkeep and wrapping to keep him from trying to pull it out, but he did amazingly well with it. I hope it won't take long to get him eating again. Let us know what the results of the test are, please? SignatureCheryl > Apparently the distinction here is what qualifies as a bad tooth. She > explained that he has surface decay on two of the teeth on his left > side, so that the enamel has worn away and is exposing the dentin. > There is, however, no evidence of infection. Dentistry isn't my strong suit, but if the enamel has eroded to the dentin and there's no evidence of infection, sounds like it might be a stage 2 feline odontoclastic resorptive lesion (FORL) a/k/a 'neck lesion" a/k/a "cervical neck lesion". Is the affected tooth one of the mandibular third premolars? If you look at this picture of a cat's mandible, the third premolar is the first tooth after the gap (diastema) behind the lower canine tooth. http://www.maxshouse.com/anatomy/mandible__right__medial_view.jpg I don't know why the lower premolars are called "3rd" & "4th" premolars- since cats don't have 1st or 2nd lower premolars or 1st upper premolars. But the lower 3rd premolar is the tooth that's most commonly affected with FORL- although any tooth can be affected. She said that this would > cause some sensitivity, possibly even pain. If the dentin is exposed- you can be assured he's in pain. Usually, its impossible to tell the extent of the lesion without x-rays. If one tooth is affected with FORL, its a safe bet that others will be detected with x-rays- even if they can't be seen by visual examination. Many times hyperplastic gum tissue (gingiva) or even pulp covers the lesion. She does not think he would > give up eating - and throw up - as a result however. Is she kidding? I've seen cats with FORL *hiss* at food because they associate the pain with the food! > He'll be coming home this afternoon with a feeding tube installed. Oh no. I have a horrible feeling that he stopped eating because it was painful, and a PEG tube might not have been necessary. Although at this point, a PEG tube might be necessary to avert malnutrition and hepatic lipidosis until he's stable enough to treat his dental problem and get him eating on his own again. I can't believe the vet didn't take x-rays of his teeth before doing anything else- especially in a cat with a visual tooth problem. He's > having more blood tests to see if his organ functions are still good. > > We're back in the dark on what's going on, at least until the > pancreatitis test comes back. > > This is hard. I feel like an idiot because I didn't think to ask you if your vet checked her teeth- I just automatically assumed she did because that's part of a routine examination- *especially* in a cat that stopped eating for no apparent reason. I sure won't take anything for granted again- that's for sure. I'm almost afraid to ask if she took your cat's temperature. Please keep me posted on the diagnosis and his progress. Best of luck. Phil. > She does not think he would > >>give up eating - and throw up - as a result however. > > Is she kidding? I've seen cats with FORL *hiss* at food because they > associate the pain with the food! Hi Phil, Thanks for another very informative reply! I would love for this to be a tooth problem, because it would be so easy for us deal with compared to inflammatory bowel syndrome. Our veterinarian consulted a visiting specialist, who examined our cat and then decided to perform ultrasound on his abdomen. They found no tumors, but his intestinal wall appears to be inflamed. It measured slightly over 5 millimeters thick. She says that this is conclusive evidence of IBS. Another data point: the one food that he is willing to eat consistently is a dry cat food with relatively large kibble. It's the one he's most familiar with, as we have fed it to him for years: Science Diet Light Hairball. Everything else we've given him - even foods that he would have turned backflips for last Spring - he has eaten eagerly one or two times and then refused. The list of no longer acceptable foods includes canned tuna, sardines, sliced turkey and ham, several varieties of Fancy Feast, and tender vittles. If it's a dental problem, wouldn't he be eating the softer foods and refusing one that requires chewing? I still want to hope it's something more treatable. If we can get him past all the pain and indignities he's suffered in the last few weeks that quickly, he certainly deserves it. I'll be taking him to get a second opinion from an unrelated doctor as soon as we can arrange it. I've gotten some recommendations for good diagnosticians in our area. Thanks again. -dreq Hi Derek, I agree with Megan. Our cat has such a bad infection, that his face and sinuses swelled -- he had all of the symptoms of a very bad cold. With being diabetic and him decided not to eat, we had an emergency on our hands. The vet knew he had a bad tooth but was waiting for his diabetes to be controlled before doing something about it. By the looks of it, she did not think it would cause his not eating. She called in a specialist (dentist) and he removed the tooth and planed a few others to the gum line, but said he did not see the normal infection-paths that you would see from a tooth causing this many problems. Both vets, the internist and the dentist, did not think they had found the bigger reason for his problems after the dental. (By the way, our cat also had pancreatitus, and everything was going out of control.) Guess what, 24 hours after the tooth was removed he was obviously feeling better, and started eating on his own again. He recovered very quickly after that. Now at any sign of a tooth problem I get the cats in and have it taken out or cleaned. Good luck to your cat, Rhonda >> I can't believe your vet was so careless as to ignore the bad tooth. Not >> only can it be very painful and cause what is happening to your cat, it [quoted text clipped - 27 lines] > > -dreq > Could the pain of an untreated toothache cause a cat to come close to starving to death? It seems possible to me. I've had toothaches before. Yes! Why hasn't your vet figured this out, especially if he pointed it out to your wife? He should have extracted it before your cat got into this state, Derek. If I were in your place I might think about going to another vet. |
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