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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 15684
Experience:  Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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I have a 13 year old Maltesse that from one day to the other

Customer Question

I have a 13 year old Maltesse that from one day to the other became very lethary. She barely eats and has a hard time get up to walking. She looks ill and spends all day laying down. The Vet has done all types of test and can't figure out what's wrong. She is in medication for elevated liver enzymes and has also been on antibiotics to rule out any infection. Besides been lethargic, I also noticed her hair has thinned out a lot over the last 2 months, not sure of that is related to her condition. Any suggestions to help my baby? I believe she is in pain but we can't figure out what's wrong.
Submitted: 7 months ago.
Category: Cat Veterinary
Expert:  Dr. B. replied 7 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner, but can you tell me:

How long has she had these signs?

Do you think she is stiff, sore, or weak when she gets up and walks?

Does she have a fever, breathing changes, or joint swellings?

Any retching, gagging, lip licking or vomiting?

Is she drinking more or less? Can she keep water down?

Are her gums pink, yellow tinted or pale/white? Moist or sticky?

If you press on her belly,does she have any discomfort, tenderness, or tensing?

Did her vet just check general bloods or did they rule out hormonal diseases (ie Cushing's, Addisons, etc)?

Has she been on any anti-nausea medication, pain relief, or appetite stimulants?

Customer: replied 7 months ago.
All started about 4 weeks ago, she appears to be stiff and sore. No fever and doctor said her joints looked good, with little or no swelling - xray didn't show any joint issue. She does gag a little bu no vomiting. She drinks little water and keeps it down. No response to pressing her belly. She was on anti-nausea meds for about 10 days a month ago. Not sure if they checked for hormonal diseases. Her gums are pink.
Expert:  Dr. B. replied 7 months ago.

Thank you,

First, I must note that your lass’s situation does sound to be quite challenging, as she is giving little clue or specific sign to what is causing her current state.

Now from your history, its not totally clear what was x-rayed. Hopefully, further to her joints, her vet also has checked the spine and hips for any signs of abnormality (especially as spinal arthritis at her age could manifest this way). Otherwise, considering that we have GI signs along with stiffness/pain (but normal xrays and bloods), we’d also need also consider tick borne diseases and fungal agents for her signs. Furthermore, we can see these vague signs associated with multiple myeloma, and lymphoma in dogs her age. Of course, we do also have GI infections and pancreatitis to consider for primary gut signs and secondary discomfort. Finally, while the hair loss thinning is difficult to interpret (since we can see it associated with some hormonal diseases but can also be related to poor nutrition from self-starvation), we’d need to monitor this for changes as we work to get her eating for us.

With all those in mind, I would note that there are some additional symptomatic care options we could consider using here. First, if she is stiff, sore, and painful; then we would absolutely want her on pain relief. Especially since any discomfort could certainly cause lethargy and could even be putting her off her food. Of course, since she hasn’t been eating, we’d need to tread with care in what pain relief we use (since anti-inflammatories can cause adverse issues on an empty stomach) but your vet should be able to put her onto a gut safe option (ie Tramadol, Bupenorphine, Gabapentin, etc).

Otherwise, we need to be more aggressive with getting her eating. Now it depends what anti-nausea medication was used; but we’d want to make sure we were using a strong one (ie Zofran). If she is on that and pain relief; we’d hope to see her eat for us. If she won’t, then we’d want to add an appetite stimulant (ie Mirtazipine) to our treatment That way we can give her a “push” to eat for us. Of course, if she still refuses but she isn’t vomiting, we can even consider syringe feeding or a short term feeding tube. For both options,we’d be able to use a calorie rich diets (ie Hills A/D, Royal Canin Recovery diet, even canned puppy food) or liquid diet (ie Clinicare, Dogsure) to get some nutrition into her. And that way we’d be providing energy/nutrients for her and her immune system to help fight this ongoing issue.

Overall, your lass’s signs are non-specific and this is a complicated situation. It sounds like you are on the right track. Though if she isn’t responding to what has been tried thus far, then we need to add in the above supportive care at this point. Furthermore, as the more common causes for her signs have been ruled out, we’d need to consider those additional aforementioned concerns as we try to get to the root cause for her situation.

Please take care,

Dr. B.


If you have any other questions, please ask me – I’ll be happy to respond. **Please rate my service afterwards, as this is the only way I am credited for helping you today. Thank you! : )

Expert:  Dr. B. replied 7 months ago.
I'm just following up on our conversation about your pet. How is everything going?
Dr. B.