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Doctor Jeff
Doctor Jeff, Cat Veterinarian
Category: Cat
Satisfied Customers: 4589
Experience:  Small Animal General Practitioner and practice owner with 12+ years experience
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My Norwegian Forest Cat (mix) is 15-1/2 and always weighed

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My Norwegian Forest Cat (mix) is 15-1/2 and always weighed 16-18 lbs. Over the last year he has lost weight to range 7 lbs. or less. My vet has run FIV and feline Leukemia tests, checked urine levels, his heart, and nothing. He eats, has normal stools as always and does not vomit often. The only times I know of recently is when I have tried to supplement his eating with wet food. Even the blandest of food will cause him to vomit. His regular dry food does not seem to upset his system. I just can't get weight back on him. The vet said he can't feel anything like a tumor and his quality of life is normal. He is skin and bones, anorexic as the vet says. He has lost more than just muscle mass for his age. Do you have any other suggestions?
Hi, I am Dr. Jeff. I will try to help you. Please feel free to follow up if any more information is needed. When working with older cats that are dropping weight like this there are three common issues I look to rule in/out first. Hyperthyroidism is common older cat issue that leads to weight loss. However, these cats typically have a ravenous appetite, will vocalize more, have a poor coat, etc. What you are describing does not sound like a typical case of hyperthyroidism, plus I assume the bloodwork your vet ran probably ruled this out.
Kidney disease is also common. Cats will lose their appetite when the kidneys are not function because everything tastes toxic to them. They can also loose proteins through the urinary tract with some specific forms of kidney disease. Considering your vet ran full bloodwork and urine, I would assume this has also been ruled out.

Cancers also need to be a concern. Cancers are very tough to diagnose and are rarely 100% ruled out. You can have perfectly normal bloodwork and urine and there is still a cancer present somewhere. It often takes more advanced diagnostics to prove its presences. This may include tests like a ultrasound or MRI. While these are not cheap, they are much more likely to catch something than an xray (which does not provide much in the way of detail). So, if cancers are a concern, I do think your next step would be to have an ultrasound performed. I would recommend to make sure that the veterinarian performing the scan is competent in his/her skills as there is definitely a learning curve with this diagnostics. You want as much confidence in the test as you can get even if it means spending a little more by having it performed by a specialist.
The nice part about ultrasound is that it may also help diagnose some of the other less likely possible issues like hepatic lipidosis (fatty liver syndrome--although blood changes would likely be present), biliary disease, etc.
In the end, I would be concerned about a cancer some place. The problem is finding it. Lymphoma is the most common form of cancer in the cat, but other forms do exist. Ultrasound is probably the most practical way for you to get an answer.
Understanding that the cost of an ultrasound may prohibit you from pursuing more, if you choose not to go further, it may be worth asking your vet about different ways to stimulate the appetite. Medications such as mirtazipine, steroids (ie prednisone), etc could help. In some cases, prednisone can actually help lessen the signs associated with lymphoma. It is important to understand that you are treating without a firm diagnosis, but it is an option, if heroic diagnostics are not an option.
As for home treatments, there is not much I can offer. However, supportive care is always good. A 50/50 mix of pedialyte and water can help both hydration and nutrition. You could also try a 1/4 tablet of pepcid AC twice daily. This can reduce stomach acid production and could help with some of the vomiting. While I would not expect dramatic results, it is worth a try. I hope this helps and gives you direction.
Dr. Jeff
Customer: replied 3 years ago.
Thank you. I will try the Pedialyte suggestion. I am not sure if I want to do the ultrasound since he is older. The reason for that is because my vet and I are less likely to do anything aggressive in treating cancer, if present, due to his age. This was something that we discussed several months back. We are stumped because his behavior is normal other than the weight loss.

I do appreciate your information and suggestions.
You approach is actually very practical. I would probably advise similar to your vet in most cases. I will often ask clients if they will treat a cancer if they find it. It their answer is "no", then I will advise that spending the money to find the cancer may not be overly practical as it will not change our course of treatment. So, if your answer is no (and understand you will not work with a firm diagnosis), then it is worth discussing some of these supportive options I have mentioned. You may also see a benefit to the prednisolone option. This can help with appetite and calm down a cancer in the short term. I hope this helps.
Doctor Jeff and 4 other Cat Specialists are ready to help you
Hi Jenn,

I'm just following up on our conversation about Sigmund. How is everything going?

Doctor Jeff