Sorry that this is long, but I want to give ALL details in case it helps.
I adopted Plushy about a year and a half ago from a shelter. The shelter had said he was about 3.5, so my estimate was that he was about 5 years old now. He was never a very active cat, but would run around with our other cat at least once every couple days. In late October, he started having some cold symptoms (sneezing a lot, especially while eating) and was hiding under the bed more. Thinking he was a young cat, I chocked it up to being a cold and waited it out. After a few weeks, his cold symptoms were much better, but I noticed that he had lost some weight and was still lazier than usual.
I took him to the vet and was told he may be more like 9-10 years (the vet admitted it is very hard to tell, but by looking at his teeth and eyes, he thinks he is older than 5 but we cannot be certain of his age). In August when we took him in for his routine shots, he was weighed in at 10 pounds and the vet (same vet both times) didn't seem to notice the discrepancy in age, but did comment that a dental may be something to think about but he didn't think it was urgent (this will be more relevant later).
When he went in in October, he was 8.25 pounds. The vet figured he was hyperthyroid so we did a CBC, T4, Kidney, Liver and Chem Panel. The vet called and said his results came back "quite good" (I can post the numbers if you think that is helpful) and ruled out any serious problems as far as what the blood tests reveal. We put him on antibiotics to see if maybe the weight loss was from a URI or something, but that didn't help. We did fecal tests for parasites and also checked for giardia and cholitis... all negative. BTW: his stool is consistently a light goldish brown and runny, but the vet keeps brushing this off.
The vet decided the next step was to try separating his food in a different room since our other cat is much larger and seems to dominate the food (although this never seemed to bother plushy for the first year and a half we had him). While Plushy has been more cuddly again lately, he is still very thin (I can still feel his back and hip bones very easily). The vet said if he doesn't improve, we could test him for FeLV/FIV or do some x-rays. The paperwork I received from the shelter says that he was tested (negative) for FELV/FIV about 6 months before we adopted him and was current on all shots. He wasn't vaccinated for FELV and the vet seems to think this might be the answer but I have my doubts since both of our cats are indoor ONLY.
Plushy has been eating and drinking the entire time, although it may be a smaller quantity-- it's hard for me to remember because I only really paid attention when this all started. I have noticed that he seems to chew very deliberately (kind of like he is trying to chew with his back teeth... his mouth opens and closes very wide) and constantly drop pieces of food out of his mouth on the floor. It takes him a long time to eat compared to our other cat. Very recently (last week or so), I also notice that Plushy hasn't been eating as much of his hard food, but eats his soft food and still begs for people food so I feel his appetite is normal. I am starting to think this may be a dental problem, but the vet hasn't even suggested this.
Please let me know what you think this could be and what course of action for testing may be appropriate.
Dr. Marie replied:
Thanks for giving me detailed information about Plushy's situation. It is often frustrating when an older gets sick and we can't figure out why.
While I won't be able to say a whole lot without actually examining Plushy I can give you my thoughts on his situation.
It sounds like your vet is doing all of the same things I would. Logically, when we have a cat who is losing weight and everything else is normal on their tests, it is a good idea to test for feline leukemia and FIV. It does sound quite unlikely though that either of these is the culprit as he has been an indoor cat. In theory though it's possible that if he picked up feline leukemia just before being tested at the shelter he could have tested negative and then harbored the virus for a while. But, the chances of this happening are small.
When I see an older cat who has weight loss and runny stools then there are two things that I get really concerned about. The first would be inflammatory bowel disease. IBD is hard to diagnose without doing biopsies of the intestines. Many cats with IBD do really well on small doses of steroids, so you can ask your vet about trying this.
The next possibility that I get worried about is an intestinal cancer such as intestinal lymphoma. Often cats with lymphoma will have no changes in their bloodwork and will simply have diarrhea and weight loss. It is really hard to tell the difference between IBD and lymphoma.
One of the best things that you could do is talk to your vet about taking intestinal biopsies. However, this is usually quite expensive and it involves an abdominal surgery.
Another thing you could do is have an ultrasound done of his abdomen. This sometimes can pick up cancer in the abdomen but not always.
If extra tests like this are not in your budget then you can talk to your vet about trying him on a small dose of steroids to see if that helps.
I hope things look up soon!
Dr. Marie.
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Customer reply:
Thank you for your time and thoughtful answer. So should I rule out a dental issue at this point?
Dr. Marie replied:
Ah, sorry that I forgot to address that issue! From what you have described I think a dental issue is not likely, but still possible.
Has your vet had a good look at his mouth? They should be able to tell if there is a dental problem. But this really shouldn't cause the soft stools.
I have often found that cats will do what you have described with Plushy's mouth because they are nauseous. The nausea could be because of intestinal pain.
Sometimes if I am not sure if a cat has a dental issue I will prescribe a few days of some pain medication and see if that makes a difference. It's worthwhile to ask your vet about this, but I'm thinking the culprit is something else.
Dr. Marie.
Customer reply:
Thank you Dr. Marie! I am taking our other cat to the vet tomorrow to get his shots. I will ask about the possibility of trying steroids with Plushy for a short time to see if that helps. I have been doing some reading about use of steroids in cats and it says that it should not be used for prolonged periods. How does this work with a chronic disease like IBD? Is this something that he would have to be on for the rest of his life and if so, what is the prognosis for cats with IBD? Is it typical for a veterinarian to prescribe a trial dose of steroids without actually doing the biopsy?
Thanks again for all of your help!
Dr. Marie replied:
You're very welcome.
I will quite often do the trial dose of steroids if I think a cat has IBD but the owners do not want to do surgery to biopsy. It all depends on how likely your vet thinks this could be IBD though.
The prognosis is great for cats that we can control well with medication.
He would likely need meds for the rest of his life. We usually try to get cats down to a very low level of steroids given every other day. At this dose it is generally very safe.
Customer reply:
Hi Dr. Marie,
Thank you again for all of your advice. He was tested negative for FeLV, FIV and Heartworm :) The vet did agree to put him on prednisolone for a trial and he was put on Hills I/D food. This is the fourth day he has been on the medication. How long does it typically take to see some changes if this is working?
Dr. Marie replied:
It really varies from cat to cat. Some cats will improve within a few days. I think if there is no improvement within a week then I would be concerned that this is not IBD.
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