Species: Cat Breed: Short hair tabby Age: 2-5 years
My 4 year old cat has been doing a strange behavior for the last 1.5 years. He started to lick the roof of his mouth. We thought he was grinding his teeth but he's not. I took him to the vet and got every blood test possible. And an oral exam. Everything was normal. He has a mosquito bite allergy so we thought its some kind of other allergy making his mouth itchy. I later noticed he would only do this around feeding time and he would only do it while making eye contact with me. I started to hand feed him his kibble and that would make him stop only now he will bug me every day to be hand fed. He has done this thing now every single day. So we then thought this was a mental thing. Fast forward to about a month ago he started to do it AFTER eating and the same sound would be very loud then he would vomit all his food. He was vomiting a few times a week and once he vomited water then he fainted! The vet ran all the blood tests again and all were good. I was sent to a dental specialist and his teeth were good. X-rays of chest and abdomen looked good. They said try ant acid riniditine and I did for about two weeks. While he was on the drug things only got worse. He started to burp after eating and he looked like he was tasting something in his mouth and he would swallow a lot. He would lick his lips like he was sick so they gave him antinausea meds but that just made him sleep all day. We took him off the meds but he did not stop doing the new behavior. The vet then thought he could have a stricture in his esophagus so she did a barium paste x ray series and sent it to a radiologist and they said possible inflammation of stomach, small intestine and pharynx. Maybe IBD or infection. They would give steroids if its IBS but they said if its an infection that would make things worse and they won't give him antibiotics because they don't know if its an infection. He is on a hypoallergenic diet for over 2 weeks and nothing has changed with his mouth behavior. He has vomited only once. He started to attack his tail and excessively groom since the last vet visit. It looks like he is in pain sometimes because he will sit in a ball and stare off into space. He has alway shook his head like ear problems but never an infection and he sometimes squints his left eye while he's doing the mouth behavior. I think he has been worse maybe do to stress. The vet is thinking endoscopy next, problem is its out of town about a 2 hour drive and when I took him to the dental specialist it was a 2 hour drive and we went nuts the entire way. I don't want to put him through this stress but I need to know what's wrong with him. 1. If its an infection how can he have had it for a month (that's when he got worse) and have good blood tests and no fever? 2. If it was all mental could that cause inflammation? 3. I've read that IBD cannot be seen on an X-ray so is there really any inflammation? I'm afraid it's cancer, but he's only 4. He is eating good and not lost weight. I have YouTube videos of him doing the behavior if you want to see it. Thank you.
Dr. Marie replied:
Oh wow, this is a tough case. It sounds like you and your vets have been extremely thorough. At first I was thinking this was a dental issue but you have covered that by seeing the dental specialist.
I have a few thoughts for you that you can talk to your vet about.
You could ask about the possibility of a helicobacter infection. Helicobacter is a type of bacteria that can affect the stomach and can cause some chronic issues with stomach problems and nausea. If there is nausea then this can be the cause of the licking. Helicobacter is hard to diagnose. If I'm suspecting it I usually try a course of treatment. We usually use a combo of anitbiotics and antacids all at the same time.
It's true that often we don't see IBD on an xray. However sometimes we can see signs of intestinal inflammation by seeing thickened intestines on an xray. It is not possible on an xray to tell the difference between intestines that are thickened because of IBD or thickened because of a cancer called lymphoma. Intestinal biopsies are needed to tell the difference. These can usually be done by endoscopy.
If endoscopy is a possibility for you then this is a good idea to do this. Otherwise, if this were my case I may be tempted to do a trial of steroids (prednisone or prednisolone). But, your vet is the best judge as to whether or not this will work.
The other thing that I might consider is some type of behavior modifying medication such as Reconcile in case this is what we call a stereotypical behavior. This would be something like an obsessive-compulsive disorder in people. I think this would be less likely than the other possibilities though.
I hope things improve soon!
Dr. Marie.
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Customer reply:
Thank you. Can you please take a look at these videos and let me know what you think?
http://youtu.be/Hx4zwY1UkAg
Mouth licking/ air chewing
http://youtu.be/Cso31diettM
Burping and mouth tasting
20 sec into video he starts burping
55 sec starts mouth tasting
http://youtu.be/KlFIZflfoak
Mouth tasting
Dr. Marie replied:
OK here are your videos:
Neelix is a gorgeous cat. :)
If I didn't have the history that you gave me, my first thought would be that this is a dental issue, especially if it is happening after eating.
There really is nothing specific that causes symptoms of swallowing like this but there are a few possibilities.
It's possible that there is a problem in his esophagus such as esophagitis. The endoscope would show this. Or a trial of a medication called sucralfate could help us see if things improve.
I think helicobacter is still a possibility. The licking could be nausea.
A foreign object in the stomach could do this. Not all show up on xrays. The endoscope would be helpful here.
I think a seizure or stereotypical behavior is less likely given that it happens after eating.
Customer reply:
Hello, my cat is at the vet for observation today. When Neelix went to the vet yesterday to do another follow up I mentioned to the vet that he was doing a hair ball like coughing thing. The vet said every thing sounded good in his lungs and she did a trachea pinch test. Neelix started doing the coughing. She did it again and he coughed again. She said it was strange like he had kennel cough. My vet is in the process of referring me to an internal specialist but it is in a city thats 7 hours drive. The endoscope would be in a city thats 2.5 hours away. Well last night he did the coughing again (he will wake him self up with the cough) he calmed down after a few minutes and I tried feeding him his dry food. He would chew the kibble a bit then spit it out. He then started doing that mouth tasting behavior a lot so I gave him 1/4 10mg Pepcid a/c (I've given his this before) with some water. He then started to run all over the house like he was in pain! He was pawing at his mouth and nose and shaking his head like crazy. He was twitching all the hair and skin on his back. He stopped finally after about 1/2 hour. He came to bed with me and he only stayed in a bunny position with his paws under him. I fell asleep and woke up and he was still like that. I tried pushing him over to sleep normally and he just sat right back up again. I fell asleep again and he was still in that position. It's like he can't breathe. Now what do you think this is? I'm so worried I'm sick.
Neelix at vet office coughing
http://youtu.be/cvXwepJxoGw
Dr. Marie replied:
Poor guy. I really don't know what to say. It sounds like the endoscope exam is really the next step, but there's no guarantee of an answer.
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