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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 21249
Experience:  Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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15 year old cat on thyroid meds acts hungry but can't or won't

Customer Question

15 year old cat on thyroid meds acts hungry but can't or won't eat. She was treated with frontline last week which seemed to be the approximate time of the eating disorder. Is there anything I can do for her.
Submitted: 2 years ago.
Category: Cat Veterinary
Expert:  Dr. B. replied 2 years ago.
Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.
Has Sassy asking for food, but then just turning away?
Any vomiting, retching, gagging, or lip licking?
Is she drooling, grinding/crunching her teeth, pawing at her mouth, or opening her mouth oddly?
Did you decrease her thyroid medication or did her vet?
Customer: replied 2 years ago.
She is not asking for food, no vomiting etc. no drooling etc.
Customer: replied 2 years ago.
we decreased meds. she is also on a treatment of prednisone (minimum dosage)
Expert:  Dr. B. replied 2 years ago.
Thank you,
If she isn't asking for food, what is she doing that makes you think she is hungry?
What condition is she on Prednisone for?
Are you still giving this even though she cannot eat?
Has she had any black stools?
What color are her gums (pink or pale/white)?
Customer: replied 2 years ago.
when we offer food she starts to go to it and stops.
hyper-thyroid.
she is prescribed for 5mg twice a day. we skipped a day and only gave her 5mg yesterday.
we have 5 other cats so don't know about stools except we believe they are loose.
her gums are light pink.
Expert:  Dr. B. replied 2 years ago.
Thank you again,
Can you just clarify why she is on the steroids, as this is not a treatment for her thyroid condition?
Customer: replied 2 years ago.
our best recall is that the prednisone was to help with the hyper thyroid meds (tapazole)
Expert:  Dr. B. replied 2 years ago.
Thank you again,
Now the problem in Sassy's situation is that we have an anorexic cat that has every reason to eat. She is hyperthyroid and if you lowered the dose of Tapazole dose, then this would should have an increased appetite as part of her disease not being controlled. Furthermore, while Prednisone is not routinely used as a thyroid treatment, it does tend to increase hunger as well. Therefore, while I suspect this drug is being used for another issue, it should be making her hungry and we'd not expect her to be off her food.
Since she is, we have to consider potential causes for this. First, it is possible that she is suffering from other effects of the Prednisone. Specifically, it can cause immune dampening (making her more prone to picking up infections) and can also cause GI upset (even stomach ulcers). Therefore, we have to be wary that it may be playing at least part of a role here. Otherwise, we'd have to be concerned about opportunistic infections, oral discomfort (ie dental disease, rotten teeth, or ulcers/sores/tumors causing her mouth or throat discomfort), or a possible underlying nausea.
With all this in mind and since these cats tend to have little in the way of body reserves, I do have to note that it would be best to ring her vet and update them about her decline. This is especially advisable because it would be ideal to wean her off the steroids and make sure they are not playing a role (and without really knowing why they are being used, this is something that needs to be discussed with them). As well, they will be able to determine if she has an infection or any issue with her mouth and dispense treatment (ie antibiotics, pain relief) to address those findings.
Otherwise, we can try some supportive care at home. We of course will be limited but there are some things we can do to prevent dehydration and try to keep her nutrient intake up. To start, since nausea is a common reason for refusal to eat, you can try her on antacid therapy. There are a number of antacids that are available over the counter and pet friendly. I would advise only treating with one, but the two I tend to recommend are:
*Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid)
*Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac)
This medication of course shouldn’t be given without consulting your vet if she does have any pre-existing conditions or is on any other medications you didn't mention. Ideally, it should be given about 30 minutes before food to ease her upset stomach.
As well, you will want to try and see if you can get her eating (as I am sure you have been). Favourite foods are allowed or you can tempt her with a light/easily digestible diet. Examples of this would be boiled chicken, scrambled eggs (made with water and not milk), meat baby food (do avoid the ones with garlic powder in the ingredients) or there are also veterinary prescription diets that can be used here (ie Hill’s I/D or Royal Canin’s sensitivity.)
Further to this, if tempting doesn’t work, then we do have to consider initiating syringe feeds to get food into her. To do so, we often will use Royal Canin Recovery diet or Hill's A/D. Both are available online and from your local vet. Both are critical care diets that come as a soft, palatable pate. They are calorically dense, so a little goes a long way nutrition-wise and this could just help get some calories into her even if we can’t get a huge volume of food in. As well, for syringing food, you can use the animal version of Ensure (balanced for animals dietary requirements) called Clinicare Canine/Feline Liquid Diet. Your vet should be able to order it for you but it is available without a prescription. They also make one specifically for older cats with kidney troubles, and this could be an alternative for an older cat. And in a pinch you can water down pate style kitten food to syringe feed. This way it would a means of getting food, staving off hepatic lipidosis, and buying you time to uncover the reason for her anorexia and lethargy.
On top off all of this, you do need to keep an eye on her water intake. To check her hydration status to make sure she is not becoming dehydrated there are a few things we can test at home. One is whether the eyes appear sunken, if the gums are tacky instead of wet/moist, and whether the pet has a "skin tent" when you lift the skin. To see how to check these parameters for dehydration, you can find a wee video on this HERE. (http://www.ehow.com/video_12232503_dog-dehydrated.html). They use a big dog but it makes it easier to see and the principles are exactly the same) If you are seeing any signs of dehydration already, then you do want to have your kitty seen by her vet before this gets out of control for her.
In regards ***** ***** you can do to help stave off dehydration at home (though do note that if she is already then she will likely need more the oral rehydration), encourage her to drink but offering fresh water or even low-sodium chicken broth. As well, wet foods (as mentioned above) are 35% water, so getting her to eat will help us deal with water intake as well. If she isn't amenable to drinking, you may wish to offer unflavored pedialyte via syringe feeding. While we cannot do this if they are vomiting, it may be an option for this situation. A typical maintenance rate for hydration in an animal 48mls per kilogram of her body weight a day. If you do give syringe pedialyte, this should obviously be divided up into multiple offerings through the day rather then all at once. This value will give you the total she needs for the day and is a good starting point to give you an idea of her daily requirement. If she does vomits if you give pedialyte, I would discontinue this as a therapy. (since we don’t want her vomiting because of our intervention).
Overall, we do have a few concerns for Sassy's signs if she cannot eat despite so much in her body that should push her to do so. Therefore, in this situation we would want to start the above but also touch base with her vet about the Prednisone they are using for her. If she isn't responding to the above, we would be best to have them examine her at this point. They can assess her hydration, check her signs of any sinister lumps/bumps or internal issues. They can also cover her with antibiotics, pain relief, anti-nausea/vomiting medication by injection and even appetite stimulating drugs if necessary. Depending on the findings, the vet will be able advise you on what is likely our culprit and what can be done to help get her eating again before she just fades away on us.
I hope this information is helpful.
If you need any additional information, do not hesitate to ask!
All the best,
Dr. B.