Experience with nausea and low appetite

Earlier this year we dealt with nausea (turns out it was a mild case of pancreatitis), but it was good practice for what I think a lot of CKD cat caregivers run into as they manage this disease. So, I thought I'd share the story.

The symptoms we noticed were:

• Slower eating
• Acting hungry, sniffing, and turning away from food, even his favorites
• Smacking his tongue and lips around after eating a few bites
• Complete loss of interest in any food

At first, I was able to get him close to his required calories by playing "Pookey buffet", offering random foods he's never had before from like 5 or 6 different brands. Fortiflora as a topper was really helpful during this stage. This lasted about a week (and was exhausting for me, slacking at my day job). I started falling behind on his daily intake. That's when I started giving Ondansetron. 4 mg every roughly 12 hours. It was the only nausea-type med I had on hand. I think you can actually give Ondansetron more frequent than that, but getting a nauseated cat to eat a suspicious medicine was a challenge. I was wrapping the half Ondansetron tablets in the greenies pill pockets which worked pretty well.

After a day or two of the Ondansetron with no improvement, things did get a little worse before they got better. Woke up and he had had a wetter bowel movement and threw up some food and bile. Now we have zero appetite for any food or brand. Can't get him to take the greenie pill pocket with meds either. I quickly learned how to syringe the meds and gave him the Ondansetron that way. Poor guy, it must taste terrible. He was foaming at the mouth and really hated that experience. They said online chase it with water, but he was not letting me anywhere near him after the medicine syringe

That's when I got on the phone with the vet and had them come for a home visit. They took blood for the spec fPL or PLI test for pancreatitis test and it was 4.1, where I guess 3.5 is the high end of normal. The vet was cautious about prescribing more nausea and appetite stimulant meds without seeing him. But thankfully, after the visit, they left me with Cerenia (nausea/vomiting), transdermal Mirataz (appetite stimulant), and more Ondansetron.

After the visit, I boiled some plain chicken breasts and was offering him tablespoons of that every hour. He was taking that really well and I slowly reintroduced his regular food after about a day of the bland diet.

Great practice for me. And a lesson in preparedness. Having an older cat with conditions, I think having a supply of meds from your vet is wise.

- Tim

You don't want to see all the meds and supplies I have between Leroy and the rats

Leroy's appetite is iffy these days. Sometimes he'll eat everything, sometimes not so much. He even skips snacks in the feeder. Odansetron was helping but not so much now. It's hard to tell if he has pancreatitis or just not feeling well because of the kidneys.