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My sweet kitty, Tilly, is having her second bout (in four months) of serious digestive distress due to Pica. (the vet diagnosed her with colitis this time and we're treating with antibiotics, antidiarrheals, probiotics and sub cu fluids as needed) She compulsively eats soft plastic. We no longer keep plastic grocery bags in the house, and the only trash cans with liners in them are in closed door cabinets, but she finds everything! She got her head stuck in my husband's pants pocket in order to dig out a candy wrapper. Now that we're in a mixed generation household, we encounter family members who don't remember to be as careful as we have been. Our vet has "never seen a positive outcome" with a pica cat past five years. We're at loose ends. No matter how careful we are, she always seems to find something and we just can't afford to spend a thousand dollars every few months.
We suspect that the problem is behavioral/stress/anxiety related vs nutritional, as she's had this compulsion through several food changes, and seems to act out worse in times of upheaval.
Because I know someone will ask:
We have so far been unsuccessful getting her transitioned to wet food, the dry food she eats is of the highest quality (and highest protein content) we can find, Orijen Cat and Kitten.
I plugged in a Feliway diffuser today. I know its not specifically intended to treat this sort of anxiety, but the vet and I figured it couldn't hurt.
In addition, he has prescribed her amitryptaline to begin once her infection has cleared up (she currently takes four meds for the colitis, including a really hard to deliver pill, and we want her to still love us when this is over :p)

Have any of you dealt with this? Do you have any suggestions that we're not trying to implement? I feel like we're running out of options, and its breaking my heart.
 

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Mia has pica too. You cant leave grocery bag or baggies lying around, I have been lucky that it has all come out "in the end". However , I started her on Nutro Max Cat Salmon Flavor (renamed, it use to be called the hairball formula) a few weeks ago and now you can see it coming out in her poo. I'm sure it must have been before too as I have never had the problems you have with your cat. Maybe a hairball formula would help it come out easier if she does get ahold of plastic. Hope you find a solution and quick.
 

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After her infection clears, talk to your vet about using a Probiotic with her food. My holistic vet recommended it when I had trouble with one of my cats and she started eating inappropriate items. The probiotic is designed to deliver small amounts of trace minerals and elements and is supposed to eliminate the pica. It worked on Abby really well. I could tell when I ran out or forgot to give her her daily serving with her food, because Abby would start chewing on wool clothing, plastic bags and paper. As long as she got her probiotic, she was fine.
 
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