At the beginning of Feb 2011, Darwin's appetite started to decline a bit. At first I wasn't worried, since he'd recently had a bath and occasionally, if he was working on a hairball, his appetite would be down a little until the hairball passed or he coughed it up. At this point, he was still eating a good amount, just in several extremely small meals. I offered him some of his favorite wet foods which he eagerly took so I didn't think there was much cause for concern, since he continued to beg for food and show interest...
until I came home one night and he wouldn't touch anything. Please keep in mind, Darwin is a TRASH. CAN. We've struggled with weight his entire life, and he always eagerly ate anything that was put in front of him. So this was a huge and alarming change. I had every intention of calling the vet first thing the next morning, up until he went into the litter and tried to pass a stool, which amounted to nothing more than a lot of straining and yowling.
I took him to the emergency vet that night. X-rays, bloodwork, and an enema later, they declared him healthy but extremely constipated. They sent him home with a clean bill of health and some laxatives and we thought that was that - after all, he's getting a little older, and as we age, things don't work as well as they should.
His appetite did improve some, thought it wasn't what it had been. Once again I wasn't too concerned, after all, he'd just been through a lot.
Over the next couple weeks, though, his appetite never rebounded. Throughout what I thought was his "recovery period", I had been bringing food to him, and thought he was eating sufficient amounts and had just gotten used to the special treatment.
I was leaving for a vacation on Feb 18, and when I'm gone for just a few days, I always have a neighbor come in a couple times a day to feed and spend time with Darwin. He has separation anxiety, and does NOT do well in a kennel at all, but seems to be OK for short periods at home with company here and there. However, this time I decided to drive him 100 miles north to my old room mate's house so that he wouldn't be alone. He still wasn't eating that well and I had a gut feeling something was wrong, although I didn't know what, since he was still affectionate, alert, and playful. I half thought he was getting spoiled and I was just neurotic, but I decided on better safe than sorry.
Well, good thing I did. The day after I left, Darwin stopped eating entirely. Long story short(er), my friend took Darwin to our old hometown vet, who did more extensive blood work, urine cultures, another set of x-rays, did another enema (the problem was that Darwin wasn't eating enough volume to move stool through his digestive tract, so what was in there would just sit and get hard and backed up), and pronounced him healthy except not. He confirmed what I suspected: that the constipation was the symptom, not the disease.
The good news was it likely wasn't cancer unless there was a tumor no one could see on an x-ray, he is in the VERY beginning stages of kidney failure so that probably wasn't the problem (B.U.N. normal and creatinine only 2 points high), all blood work was normal. The vet in our hometown did see that the walls of his bowels were thickened, and thought it could be either fat around his bowels, or inflammatory bowel disease and/or pancreatitis, since they can travel together, and recommended I take him in for an ultrasound. By this time, he had lost almost a pound in 3 weeks.
I returned from my vacation and scheduled the ultrasound. My regular vet also ran an fPLI, a test for pancreatitis.
His ultrasound was normal, but the one thing we wanted to see, his pancreas, was the one thing we COULDN'T see because there was a loop of bowel in the way. When his fPLI came back, he was RIGHT on the cutoff line for pancreatitis. His was 5.3, the limit is 5.3, so there was clearly some inflammation.
Thing is, one cat can be at 5.0 and be sick, and another can be sky high and acting fine. It just depends on the individual.
He was given mirtrazipine for an appetite stimulant and anti-nausea, and he had a HORRID reaction to it. I thought the stuff was going to kill him. I called my vet and explained his symptoms, and she said if he was no worse 12 hours after the dose (which he wasn't), he'd clear the drug with no problems, which he did.
He was also given buprenorphine for pain, which stopped cold what little eating he was doing, which is where assist feeding came in. We did that for a week, and when he showed no improvement or inclination to eat on his own, he was started on prednisolone and began to improve dramatically.
As of this writing, he's on his second-to-last pill and doing fine. He's back to his old hungry, playful, purry self and barring anything else unforseen, we will have many more happy years together.
It took a lot of detective work and money to save my guy, but it was all worth it and I'd do it all over again in a heartbeat. He's my world, and I'd do anything to make him feel better.