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Dr.Fiona, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 6273
Experience:  Small animal medicine and surgery - 16 years experience in BC, California and Ontario
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My 19 year old cat has stopped eating. Cat it be diabetes?

Resolved Question:

My 19 year old cat has stopped eating over the last 2 weeks although he does drink lots of water. I feed him a premium all natural grain free canned food. He looks pretty weak and is urinating outside of his litter box. I think he may have diabetes. Am wondering if it is worth diagnosing and treating at his advanced age. He is terrified of car rides so I have not taken him to the vet yet, but don't want him to suffer.

Submitted: 7 years ago.
Category: Cat Veterinary
Expert:  Dr.Fiona replied 7 years ago.

Hi there,

Welcome to Just Answer! I would like to help you and your cat with this question, but need a bit more information in order to better assist you.

Has he just started drinking more water, or has this been going on for some months?

Any vomiting?
Any diarrhea, or are his stools usually small and hard?
Prior to the last 2 weeks, in the last 6 months or so, has his appetite been good or has it been picky?

Customer: replied 7 years ago.

I have really just noticed the increased water drinking the last few weeks. No vomiting or diarrhoea. He has had only 2 bowel movements in the 10 days and they were small and hard.

He did have a sensitive stomach with vomiting in the past but I changed his food to canned "wellness" brand which is grain free about a year ago and it solved the vomiting problem. He loved it, ate lots until the past few weeks.

Expert:  Dr.Fiona replied 7 years ago.

In the last 6 months or so, any change in his voice? More demanding or yowling at night?

Customer: replied 7 years ago.

Nothing new in the last little while. He has been yowling at night for years now.

Expert:  Dr.Fiona replied 7 years ago.

Thanks for your replies. They have been helpful!

So, clearly, there is *something* going on with your cat to cause him to have lost so much weight recently and to have stopped eating.

He is a senior citizen and a bit of a puzzle since he is giving us so few clues. The things that I would consider would be chronic renal insufficiency (CRI, kidney failure), hyperthyroidism (over active thyroid gland), or a combination of the two, diabetes and unfortunately we also have to consider neoplasia (cancer). These are the most common problems that I see in senior cats.

With chronic renal insufficiency cats tend to drink more, lose weight and have a diminished appetite. Some have vomiting. Many have dry hair coats and hair loss.

With hyperthyroidism, however, they tend to drink more, lose weight and have an INCREASED appetite. Some have vomiting, many have diarrhea.

With diabetes, cats also tend to eat and drink more, and have dry hair coats and hair loss as well.

With neoplasia, they may eat more or eat less, and lose weight.

As you can see, many of the symptoms overlap and with your kitty. I don't know which of these descriptions fits best. All are treatable, to different degrees.

Let me explain a bit more about each of them and the treatment options:

1. Chronic renal insufficiency.

This is what I feel is most likely for your cat!

With this disorder, the kidneys have lost the ability to concentrate urine. So, the patient just produces dilute urine all the time, regardless of what is going on. For a cat with normal kidneys, if they don't drink for a while (say, because of feeling nauseated with a hairball), the kidneys just concentrate the urine and the cat keeps normally hydrated. Same as with a human who doesn't drink all night - the first morning urine is more concentrated because the kidneys are retaining all the water they can.

Now, if your cat's kidneys can't DO that, and just keep producing large quantities of dilute urine, he is going to start getting dehydrated. One of the first things that happens is that the body tries to draw water out of the feces and the cat gets constipated because the feces are now dry and hard, so it's harder to pass them.

Also, as the patient becomes slightly dehydrated, he tends to lose his appetite. Imagine yourself being really thirsty and someone offering you a steak. No matter how delicious you might think that is, you would be unable to eat much without having a drink first.

I feel that this is the point that your cat has reached.

Kidney disease can be diagnosed by physical exam and analysis of a blood and urine sample. On a physical exam, I check the kidney size and shape. For treatment, the first step is a low-protein diet available through your vet clinic. The patient may also need supplemental potassium, and perhaps fluids given under the skin to correct any dehydration.

Here is more information:

2. Hyperthyroidism.

This is a common disorder of older cats in which the thyroid gland in the neck starts to over-produce a hormone called T4. T4 controls metabolic rate. So, the more you have of it, the faster the metabolism. Cats that are hyperthyroid tend to eat voraciously, but lose weight because they burn the calories up so fast. Their heart rates increase, and the transit time through the intestines increases. So, they may develop diarrhea and vomiting, but not always.

Hyperthyroidism can be diagnosed by physical exam and blood and urine analysis. On a physical exam, I check for enlarged thyroid glands, and a rapid heart rate, and sometimes heart murmurs. Blood and urine tests allow a vet to confirm the diagnosis.

Hyperthyroidism responds really well to treatment. The treatment options are oral medication (usually twice daily, always for the rest of kitty's life), surgery, or radioactive iodine treatment (this last is the BEST treatment because it gives you a cure, but it is expensive).

3. Diabetes mellitus is also on the list of possibilities, though it usually involves a ravenous appetite so it does not seem likely.

When a normal animal eats, the intestines absorb the calories into the bloodstream as glucose. So, now there is a lot of glucose in the blood. BUT it cannot get into the muscles or other cells that need it without insulin. You absolutely have to have insulin to get glucose from the blood into the cells. And it is the cells that need the glucose; the bloodstream is just a road that delivers it to the cells.

So, now there is a lot of glucose in the blood and it can't go anywhere. This then starts to spill into the urine - so now you have glucose in the urine. Glucose is a really large molecule, and where-ever it goes, it pulls water with it. So, all that glucose in the urine pulls a lot of water out into the urine with it, and suddenly the animal is urinating large quantities. This makes him dehydrated, so he has to drink huge amounts to try to stay hydrated.

Animals with diabetes thus drink an enormous amount of water. Also, they have ravenous appetites because their cells are starving as none of the glucose can get into them. So, they eat a lot and urinate a lot.
Diabetes can usually be managed with insulin injections and/or with prescription food plus pills depending on how far advanced it is.

I'll give you some links to further information:

4. Unfortunately, we also have to consider neoplasia (cancer) because your kitty is older and there has been weight loss.

Hyperthyroidism and CRI are FAR more common, however, so don't panic! To diagnose cancer, a vet would start with a complete physical exam to try to feel for internal masses, and would do blood work to rule out other problems. X-rays and biopsies might be needed.

If the tests for hyperthyroid disease and CRI were negative, and other blood tests were all normal, I would have to start considering cancer, unfortunately.

Some forms of cancer grow as a mass or lump and can be palpated in the belly or seen on x-rays. Some forms of cancer invade as tiny little cells all through-out an organ like the gastrointestinal tract. They are hard to detect because you can't palpate them, and you can't see them on an x-ray because they are scattered throughout the organ. In these cases, ultrasound and biopsy or exploratory surgery and biopsy can be used to make a diagnosis. Looking at a piece of the organ under a microscope is the only way to see if there are cancer cells there. Many types of cancer in cats respond really well to chemotherapy medication. There are even chemo protocols that consist of pills that the owner can give at home. Cats have minimal side effects from many chemo drugs - NOTHING like as severe as humans.

There are so many forms of cancer that it is hard for me to provide a link, but I'll give you one for a common type of cancer:

So, in summary, it sounds as though your cat may have hyperthyroidism CRI or possibly neoplasia. From what you have described, my best guess would be that hyperthyroidism is most likely. A check up and blood tests with your vet will help to make this diagnosis, and get him started on treatment to help him gain weight! I encourage you to take him in today or tomorrow as his condition sounds serious!

So, although I can't tell you what is wrong with your kitty, I hope I have given you some directions to explore with your vet.

Now, I understand you have financial limitations, so I have some suggestions for what you can do at home to help. What you can do is try to get some calories into him in liquid form - that way he is getting nutrition at the same time as fluids.

I suggest opening a can of tuna *in water* and offering him the liquid, diluted 50:50 or more with water.

Also, you can pick up Clam Juice in most grocery stores (sold in with the V8 or with the canned tuna in my grocery store) and mix that with some water.

You could try Lactose Free milk (Lactaid is the Canadian brand).

Offer him some canned cat food, and mix it with water to make a slurry if he won't eat it.

Things you can do to encourage a cat to drink are:

- offer water from a very wide flat bowl as cats don't like their whiskers to touch the edges when they drink (which is why lots of cats like the toilet bowl).

- If he likes dripping water, leave a tap dripping for him.

- Offer bottled water and see if he prefers it.

- Offer onion free chicken or beef broth, diluted 50:50.

- See if he likes water with an ice cube in it.

- See if he likes it out of a cup or martini glass.

- Offer Whiskas Kitty Milk

- Offer him canned food as the first ingredient in water

- You could try getting some human baby food in meat flavours (check that there are no onions or garlic in the ingredients) and mix that with warm water and offer that, or syringe it in little bits into your cat's mouth. Beech Nut makes a line of baby food that has nothing but meat (beef, chicken, turkey or veal) in it.

Here's a link:

If you cannot find this, you could find another meat baby food - just read the label carefully to be sure there are no onions, onion powder, garlic, or garlic powder in it.

Try to get him to drink small amounts frequently. If you can, try syringe 1 teaspoon (5 mL) or liquids per half hour into his mouth.

I will also give you some resources to explore for financial aid, in case you want to look into this.

American Animal Hospital Association
" Through the AAHA Helping Pets Fund, veterinary care is possible for sick or injured pets even if they have been abandoned or if their owner is experiencing financial hardship."
Angels 4 Animals
"Our services range from financial aid to complete treatment
to those pets and pet owners in need."
Care Credit
A credit card company for health care, including veterinary care.
"With a comprehensive range of plan options, for
treatment or procedure fees from $1 to over $25,000, we offer a plan
and a low monthly payment to fit comfortably into almost every
God's Creatures Ministry
"This fund helps pay for veterinarian bills for those who need help."
"Our efforts focus on serving the elderly, the disabled, and the
working poor."
"We are dedicated to insure that no
companion animal has to be euthanized simply because their caretaker
is financially challenged."
The Pet Fund
"The Pet Fund is a registered 501(c)3 nonprofit association that
provides financial assistance to owners of domestic animals who need
urgent veterinary care."
United Animal Nations
"The mission of LifeLine is to help homeless or recently rescued
animals suffering from life-threatening conditions that require
specific and immediate emergency veterinary care. We strive to serve
Good Samaritans and rescue groups who take in sick or injured
animals. In certain cases, LifeLine can also assist senior citizens
and low-income families pay for immediate emergency veterinary care."
They also keep a list of local and national help resources here
Feline Veterinary Emergency Assistance (FVEAP)
"Seniors, People with disabilities, People who
have lost their job, Good Samaritans who rescue a cat or kitten - any of these folks may need financial assistance to save a beloved companion."
The Feline Veterinary Emergency Assistance Program is a nonprofit 501
(c) (3) organization that provides financial assistance to cat and
kitten guardians who are unable to afford veterinary services to save
their companions when life-threatening illness or injury strikes.

Shakespeare Animal Fund
“A non-profit charity was founded after the loss of a beloved Cocker Spaniel "Shakespeare". He died after a very costly illness, and in his memory this fund was founded to help others who might face financial problems while trying to save their pet. Let Shakespeare help you!”

And this site has a very comprehensive list of financial resources:

Also, to make the car trip less of an ordeal, you may find that giving Rescue Remedy a few minutes prior to travel is helpful.

I do hope that this helps you to help your cat!

Dr.Fiona and other Cat Veterinary Specialists are ready to help you