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Our cat has stopped eating. What can we do to get her appetite to come back?

Dear Sinéad, Siouxsie and Thomas:
Our 16-year-old cat was prescribed Metacam by our vet, and was only given a low dose for three days. We stopped at that time because she was not eating well and we thought it might be from the medication. Since then she has stopped eating and drinking and has lost 1.8 pounds in two weeks. She has been rehydrated by IV and was given a shot to "jump start" her appetite yesterday. There has been no difference and the vet said all her lab tests came out perfectly. If he was just going by them and his examination of her, without knowing what is going on, he would say she was perfectly healthy. We are desperate for any help in getting her to eat and drink. She has never eaten table food (her choice). The only thing she has ever had is dry cat food (again her choice). Any help you can offer will be greatly appreciated.

Thanks,
Janice

Sinéad: Oh, my goodness! That's a big problem!

Siouxsie: We're glad you're in regular contact with your vet, and that your kitty has been having lab tests done to make sure she's healthy. As you probably know, rapid weight loss in cats can lead to serious illnesses such as hepatic lipidosis (fatty liver syndrome). We trust that your kitty's lab work has included blood tests that measure her liver enzymes, so you all know she's not developing that condition.

Thomas: A few weeks back, we answered a question from a reader about the side effects of medications (including Metacam). We wrote that appetite loss is one of the side effects of Metacam, so we're not surprised that the medication caused your kitty to lose her appetite.

Sinéad: But now your big job is to get her to start eating again. The good news is that there are some tried and true techniques for helping cats to get their appetite back.

Siouxsie: First of all, remember that a cat's appetite is stimulated primarily by the sense of smell. Therefore, any food that has a strong and tempting aroma will be more likely to arouse a dormant appetite. And warm food smells more than cool food. So we recommend that you get some high-quality canned cat food and heat it in the microwave for about 10 seconds (in a microwave-safe glass dish). Depending on the power of your microwave, you may need more or less time. The idea is to get the food to approximately body temperature (100 degrees F). This will release more of the food's aroma and make it more tempting for your persnickety puss.

Thomas: Although we generally prefer that you not microwave any food given to a cat (because microwaving destroys nutrients and vital enzymes), this is the one exception to our rule. The most important thing right now is that you get your cat eating again, and if warming the food does so, then it's fine for short-term use.

Sinéad: If you don't have a microwave oven, you can warm the food in a toaster oven, or even in a small pan on your stovetop. Just get the food warmed up enough to smell, but not so hot that it will burn her mouth.

Siouxsie: Another tried-and-true technique for stimulating the appetite is adding "tuna juice" to your kitty's kibble. By "tuna juice," we mean the water from human-grade white albacore tuna packed in water. It smells really yummy and is great for an occasional treat. We love tuna juice!

Thomas: Again, tuna is not something you should feed your cat regularly, but since it's urgent that you get your cat's appetite stimulated again, go ahead and try the tuna juice. Other tasty add-ons for your cat food include clam juice, sardines (without any extra flavor like mustard or hot sauce) minced fine, and Kitty Kaviar (a treat made of dried tuna flakes, available at pet stores).

Sinéad: You can also try human baby food. Human baby food comes in a lot of flavors, including meat flavors (this would be our recommendation), and if you buy organic baby foods, you can be sure that you're feeding your kitty a healthy snack. Get several varieties and try each one until you find one your kitty likes. Make sure the baby food you buy does NOT contain onions. Again, baby food can be heated to just about body temperature.

Siouxsie: You can also try placing a tiny dollop of baby food or warm canned cat food on the tip of your cat's nose or on her paw; she'll lick the food off, and then she might realize how hungry she is and start eating again.

Thomas: The important thing is to make sure your cat doesn't eat too much when she does start eating again. It's been so long since she's eaten that her stomach has shrunk. If she eats too much at one sitting, she will almost certainly throw up. So once your cat does start eating again, feed her small meals throughout the day, gradually increasing the amount per meal as her own appetite returns.

Sinéad: Give your kitty some canned pumpkin. Cats generally like the taste of this food, and since pumpkin has a lot of fiber, it will help to ease the constipation that almost always goes along with anorexia (lack of eating). Offer your cat a small amount on the tip of a teaspoon, and if she likes it, give her up to 2 teaspoons a day to help keep her regular and get some nutrition into her.

Siouxsie: Try some different kinds of canned cat food. Look for "stinky" flavors. Cat lovers have reported success in appetite stimulation with such products as Nutro Gourmet Classics Seafood and Tomato Bisque and Savory Hunter's Stew with Duck flavors, and Fancy Feast Seafood Filets Sardines Shrimp & Crab Gourmet Cat Food and Flaked Fish & Shrimp Feast Gourmet Cat Food.

Thomas: Keep working with your vet to make sure your cat stays as healthy as possible. And also, if he hasn't already done so, you may want to have your vet check your cat's teeth. If your cat has a tooth problem or an abscess in her mouth, this could make eating quite painful and put her off her food.

Sinéad: Consider the original condition for which the Metacam was prescribed. Does your cat have arthritis or some other condition that causes chronic pain? If so, this may be causing her to lose her appetite.

Siouxsie: You might also think about consulting with a holistic veterinarian and bringing some alternative therapies into your cat's treatment plan to help improve her quality of life. Acupuncture and homeopathy, for example, can provide pain relief without causing side effects such as loss of appetite. Nutritional therapies can help support arthritic joints, and some veterinarians even offer physical therapy programs. Many conventional veterinarians are aware of the benefits of such therapies as acupuncture, so you may wish to discuss these options with your veterinarian.

Thomas: Depending on where you live, you may be able to find several holistic vets who practice anything from chiropractic (which we wouldn't recommend for arthritic cats) to acupuncture to homeopathy to nutrition and herbalism. The American Holistic Veterinary Medical Association maintains a database of holistic practitioners in the United States and Canada, and this may be a good place to start -- presuming you don't already know of holistic vets in your area.

Sinéad: There are a number of books you can read on the subject of helping your older cat have a good quality of life until the end of her days. Our favorite is Amy Shojai's Complete Care for Your Aging Cat. This book should be available through any bookstore, and if you have a really good library in your town, it may even have a copy in its collection. Check out our recommended reading list for more good books on holistic cat care and behavior issues.

Siouxsie: We don't want to make you sad, Janice, but we feel like we need to talk about this. There may be another reason your cat isn't eating. If you try all these techniques we've told you about and your cat still won't eat, it may be that she believes she's lived long enough. Sixteen is a very respectable age for a cat, and most indoor cats live until about age 16-20. Maybe you can sit down and open your heart to your cat and ask her, does she want to stay in her body or not?

Thomas: If for whatever reason your cat doesn't want to stay in her body, the most courageous thing you can do is to honor her request and allow her to die. Sometimes all a cat needs is "permission" from her human for this to happen. Other times, you may need to assist in this process with humane euthanasia.

Sinéad: If you can't come to a clear conclusion, try consulting an animal communicator. These individuals are often quite skilled not only at communicating telepathically with your cat, but with helping you to come to terms with making this decision. Your veterinarian can also provide a more objective viewpoint that can help you with the decision of whether or not to euthanize your kitty. Starving is a very painful and miserable death, so if it's a choice between allowing her to slowly starve to death or choosing euthanasia, we would recommend euthanasia -- for your cat's sake as well as for yours.

Siouxsie: Mind you, we're not saying that you should lose all hope and just say it's time for your cat to die. But we are saying that you need to consider this possibility, particularly when your cat reaches a certain age or if she is suffering from a chronic illness that has a negative impact on her quality of life.

Thomas: We all know that saying hello to a cat ultimately means saying good-bye as well. We suspect that you've already begun your grieving process, because on some level you know this is true. We hope that you can get your kitty to eat and have a few more wonderful years with her, though, because we all know how hard it is to say good-bye.

Sinéad: Please write back and let us know how it goes, Janice. And if there's anything we can do to help you through this time, don't hesitate to ask.

Got a question? Need some advice? E-mail us at advice@paws-and-effect.com. None of the material in this column is meant to be a substitute for regular veterinary care.