I haven’t posted here in almost 2.5 years! So let me introduce the lad who has been blessed with 29 lives instead of the normal nine. I know this is long and I apologize, so grab a low carb snack and bear with me with where we are right now. And if this should be in a different category on the forum, please let me know! tl; dr: 12 year old diabetic cat stops eating. Mom panics. Cat labs are fine. Cat decides to restart eating. Mom still panics. Bruce Stringsteen is now 12. He had his first PU surgery in 2012 and then a revised surgery in 2016 (it’s a long story). In 2019 I noticed some weight loss but reasoned it to being nine at the time. The moment he tried to steal a cheeseburger out of my hand was when I knew something wasn’t right. I took him to the vet in May 2019, and we were sent home after bloodwork. [There is a reason why I’m including this next part of the story, and you’ll understand why at the end.] The day after the vet, he was not okay. The cat who tried to steal my burger all of a sudden refused to eat. I thought it was residual from the vet (he hates the vet. Like needs chill pills hates the vet), but he wasn’t okay. He refused to eat, drink, and was hiding under the bed. That’s not Bruce. I called the vet the next day and they told me he was being diagnosed with feline diabetes (but no ketones, thankfully) and I could come in and they’d show me how to dose. I told them he needed to come in ASAP because I wasn’t sure if he was going to make it. I think they thought I was exaggerating until I brought him in and he just laid in his carrier. They syringe fed him, dosed him, and gave him SQ fluids. They gave him back to me, and we made it through a very long weekend! This forum helped save his life. I won’t get into details (you can see my posting history), but the generosity and patience of internet crazy cat humans led us to stability for almost three years. So a quick summary of how things have been since our last posting: -We moved and Bruce got three more siblings and a dad. Grumpy Old Man does not like the siblings. I am not shocked. He does like the new house, though. Lots of windows! -He was the passenger in a car accident. He got a bit rattled in his carrier and was MAD about that. He went into hiding for a few days and I wasn’t able to dose him, but we made it over that hump. -He enjoyed me working from home during the pandemic. I still do partial remote work, and he’s all about that. So for the past three years, we’ve been doing this. I’m not going to lie, I sometimes get lazy about testing (his SS is not updated), but we were doing well with his dosage for quite some time. I sometimes change things here and there depending on his diet and after a curve, but for the most part, we’ve been alright. In Spring 2021, he was acting a bit moody and was picky about food. I didn’t think much of it, as he was 11 and I figured he was just being a grump. But then the Great Food Strike of 2021 happened in the fall. His fur started looking… weird? Greasy? He seemed to have lost some weight, but nothing beyond concerning. But then one day, he stopped eating. I did the normal feeding of the squad, but he refused to come eat with everyone. I gave him food separately, but nothing. So no shot. I worried about ketoacidosis. I tried snacks. I tried smelly fishy food. I tried baby food. I tried kibble. I tried every trick in the book, but nothing. I did see him drink water and use the box, and was able to use keto strips on him. No ketones, thank goodness! But also no appetite at all. Without eating or shots, his BG consistently between 150 to 200* on the ReliOn (I’ll have to check that for sure. It’s been some time). I called our vet, who refused to see him because he didn’t have an insulin shot in two days at that point. I tried to explain that the problem was not ketoacidosis or sky high BG levels, but the same exact thing he did to us at diagnosis. The office recommended their urgent care or ER. Knowing he does so terrible at the vet, I went with my gut and decided to try the approach at home when he went through the same thing at diagnosis, which was syringe feeding until I was able to give him small insulin doses, constantly checking for ketones, keeping kibble out, opening up cans of food to see what stirred up the most interest, and repeat. I truly thought I was going to lose him, but he made it through. Last week, he decided to do the same thing again, but it didn’t seem as drastic as the Fall 2021 incident. I don’t think he ever stopped eating this time and was at least lapping up Churu/kitty gogurt/gravy toppers/baby food. And man, he thought he hit the jackpot the other night when I let him have a Temptation buffet! While we’ve been going through this, his tests have consistently been about 200 before meal time (the one exception was a 350, but I think he had grazed on kibble because my priority is him eating anything, even if it’s unhealthy). He’s been eating on his own since yesterday, so I’ve been giving him a super small .5 ProZinc dose (we were at 2.25 when he decided to stop eating). Lab work doesn’t show anything out of the ordinary. I decided to introduce him to a senior multivitamin and have been trying so many different foods (nothing higher in carbs than Friskies pate) on him I know I need to update his SS with the most recent readings, but does anybody have any experience with this? Is there something I should ask the vet to test or look for? This round, I accepted that he’s getting older and he’s had a very medically difficult life. He has slowed down, but I’d say still has more energy than his litter mate. While he is rallying, he’s still not his normal self, but he’s also much better than he was a few days ago when he was isolating and not showing much interest in food. Any thoughts? Suggestions?
When you say labs are fine, what all did they run? It's very hard to say without knowing what labs were down, but off the top of my head it sounds like chronic pancreatitis, or perhaps a GI issue. Could also be thyroid I suppose. If they haven't already run the standard CBC, metabolic panels, hematology, urinalysis, etc have those done/redone. I'd also ask for a specfPl for pancreatitis, as well as a GI panel. That might give you an idea where to start, but also possibly an ultrasound - but that's a bit pricey and requires anesthesia. Oh also - is his mouth ok? No sores, bad teeth, etc? I would also be asking for Cerenia (if vomiting), ondansetron (nausea), and mirtazapine or cyproheptadine (appetite stimulant). And I want to clarify one thing because I'm not sure if it was a typo - ketoacidosis is not enough insulin + inappetence + underlying stress/infection/inflammation. So in this situation you must keep up with the insulin as best you can, avoid skipping whenever possible. It is still ok to give insulin when they aren't eating, you just have to play with a reduced dose so they don't go hypo - unfortunately without the SS or midcycle data, I couldn't even begin to pin the tail on the donkey with that. I would also be checking urine ketones every day if you aren't already.
GI issue perhaps??! I had an issue early in the year where my girl wouldn’t eat either.she had a bit of diarrhea. She threw up only once. After 2 trips to the vet and 2 courses of antibiotics that didn’t work. I started her on a probiotic. Thankfully we have been good since. Was tough at first to get the probiotic in her as her appetite was not good but I made sure when she did eat, I mixed a dose in.
One additional thought is that manufacturers will change the formulation of a food. The food that your cat was involve with, becomes something to be avoided at all costs. As Melissa pointed out, it could also be pancreatitis. I think it's less likely dental, although it's a possibility. Dental pain doesn't spontaneously resolve.
