Okay, this is gonna be a long thread so please bear with me. I was a member a long, long time ago and just rejoined.
In mid-November, our eight year old cat Bishop passed away quite suddenly from a heart attack. He had no symptoms anything was wrong, no murmur, was eating, drinking, and making merry literally minutes before it happened. Needless to say my wife and I were quite traumatized over it.
Only a couple of days later we noticed our cat Ripley had lost weight. Ripley is a black rescue cat, nine years old. She's always been extremely lean and tiny, and we had taken her to the vet prior to make sure she didn't have diabetes or some thyroid condition making her so small, and she was cleared. But she seemed to go from her normal, slender self to notably bony overnight.
I asked my wife if she'd noticed her eating lately (our cats, we now have four after Bishop's passing, have always been basically free graze and self-regulated eaters) and she hadn't. She had been drinking water and taking her treats, so that day (Saturday if I remember right) I made a vet appointment for Friday.
Monday she stopped eating altogether, wouldn't even take treats, so Tuesday we took her in to the emergency vet. Tests showed her liver values through the roof (ACT over 1000), and she had an ultrasound which showed quite a few gallstones, but none appeared obstructive. I'm condensing a lot down because...it's a lot of in and out of the vet and such.
She was transferred to an internal medicine specialist, more tests done, hospitalized for four days on a feeding tube, anitbiotics, various medications to thin her bile, etc. yada yada. Options discussed, etc. Eventually we had an e-tube placed and we had her home for feedings and medications and she was doing better.
Then, after a checkup, she had still lost a little weight after having her etube put in (she didn't really, she'd lost more weight in the day before the tube was placed but after her last weighing, and was gaining it back but hadn't gained enough back to be more than her last weighing, if that makes sense). So the vet increased her etube feedings by five mils. That same day I increased her food, she started drooling and growled at me when I touched her (this is the sweetest cat in the world, she's never growled at me or anyone other than her brother when he tries to play and doesn't take no for an answer). I called the vet thinking she was obstructed and the vet suggested that it was probably the increased feeding was making her feel overfull and to back down to the other level again and slowly ramp it up by a mil or so at a feeding. This seemed to do the trick, the next day no more drooling.
A day or so later (it all blurs together) she started acting uncomfortable again and vomited all over the place. Another call to the vet, she added on a second, stronger anti-nausea med, and again that seemed to do the trick. Until about a day later when I noticed she was turning yellow.
We immediately went back to the vet and she was hospitalized again (ACT now over 1200 and bilirubin up. At some point she was hypercalcemic as well but I think that was before the e-tube was put in?)
Vet did another ultrasound, gallstones didn't appear to have moved or changed much and didn't seem to be blocking, so she wanted to do a liver biopsy. We agreed and just before the biopsy the vet called back and said she'd talked to the surgeon and he suggested removing her gallbladder at the same time to stop the vector for secondary infection and keep her from obstructing. He also mentioned he'd seen cases before of cats that didn't look obstructed but actually were. So we talked again and agreed to do the gall bladder removal at the same time.
She had the surgery Christmas day. Surgeon got in there, and lo and behold she's not only obstructed, she's obstructed in more than one place and has twice as many gallstones as they could see on ultrasound.
Immediately after we got her home she was acting and doing so much better. We had to put her in a onesie because she got her cone off straight away and would not leave it alone. We were still giving her medicines and feedings four times a day and cleaning/bandaging her e-tube site etc. but she improved every single day.
On New Years she started eating kibble again, just little mouthfuls here. On the 4th, she started going to the dish and eating on her own. Again, just mouthfuls. So we started weighing her food to determine how much she was eating and on the 5th we cut out two of the four tube feedings and reduced the remaining two depending on how much kibble she ate before them.
On the 13th she was eating enough kibble I cut it down to one tube feeding, and then on the 14th I stopped the tube feedings altogether.
Now here's where things have gone wrong. She's supposed to go in on Monday and have a final checkup and have her e-tube removed.
But one of the meds she was on was Mirataz, given in her ears, to stimulate her appetite. We alternated ears each night. About the 13th, the same time we cut her down to one tube feeding, we noticed her ears were really dry and the tips were beginning to flop, and the sides to curl in. We discovered this can be a side-effect of long term Mirataz use, so we stopped it immediately, cleaned up her ears, and put some vaseline on them. We did this for a couple days and now they are no longer dry but haven't really straightened up.
When I stopped the tube feedings I also stopped her anti-nausea meds (Ondansetron and Cerenia) and just kept her on her liver meds (denemarin). The vet had said prior to go ahead and switch the cerenia to every other day until it was gone, but I stopped them both when she was eating the kibble on her own, because she had shown no sign of nausea at all since her surgery. I think this was a mistake.
She was eating well on the 15th, including overnight on her own, but yesterday morning she didn't want to touch her kibble again. Yesterday in total she ate only four grams on her own. I supplemented with 38 mils of her tube feeds, and she ate two of her treats and that's it.
She also brought up a hairball yesterday (she's been grooming a lot since her onesie came off), and has been licking and acting nauseous again last night and this morning.
I gave her the cerenia again last night, and the ondansetron this morning, and I gave her a partial tube feeding (23 mils instead of a 'full' feeding of 48) after she refused to touch the kibble again (she did sniff it this time and seem interested, then backed away). I'm going to try again with the kibble around noon and do a tube feeding again if she doesn't eat, but has anyone else been through this?
Her liver biopsies came back fine- no sign of infection, cancer, etc. Her last blood test after her surgery showed that her liver values had dropped back down into the high normal range, and we are pretty sure her entire issue was the gallbladder, but now, on the cusp of having her tube out, she's not eating again.
We're obviously going to talk to the vet again about all this on Monday, but were we wrong to stop the anti-nausea meds? She can't stay on them, or the appetite stimulants, forever, but what could be causing this nausea? After so many tests I really don't think it could be something else other than the gallbladder which is causing all this, but how can we be sure?
Is it as simple as a irritation from a hairball after grooming so much? We really want to get her tube out, but we're terrified if we take it out she's going to stop eating again even with the meds, and we have to put it back in?
I'm not expecting anyone here to have the answers. As I said, we're going to discuss all this with the vet on Monday. It's just, it's been such a roller coaster with this girl for weeks and weeks. Every time she seems to be better and on the verge of full recovery, she relapses. Has anyone else dealt with continuing nausea and anorexia after gallbladder removal due to obstruction?
Part of the problem is she's always been SUCH a picky eater (she hates wet food, and even most treats. She refuses to touch her old kibble after this so we went through about a dozen different new kibbles to get one she'll actually eat now. She refuses everything people suggest to get her weight up: churu, hates it. Nutrical, no thank you.
The only treats she'll take are greenies and a bit of plain boiled chicken. Literally everything else is a nope. Wet food, flat nope. Before the feeding tube she did take a little babyfood so long as it was mixed in with the boiled chicken, but she had to be hand-fed it and after a few times it became a 'nope' too, and she refuses to touch it.
Also, it's been a bear to find out how many kcals she should be eating (are 'normal' for her). When she was eating just the kibble and had an appetite she ate between 104 and 132 kcal, and that's including her treats (6-8 greenies). The vet had her on between 43 and 48ml for her tube feedings four times a day, so about 170-192kcals, but that was to put weight back on her. She's still not to her full weight again but she's around 7.5-7.9 lbs. Her weight before all this began was 8.9 lbs.
It's so hard because I want to hold back on the tube feedings so she's hungry and eats her kibble, but we can't afford her slipping backward on her weight again. Yesterday, even with the supplemental tube feeding, she only took in 54kcal.
So I guess, any thoughts? Advice, if you've been in this spot before? Suggestions on a good kcal intake since the internet is entirely useless for figuring this out?
She's just been through so much, and we were sooo close to being on the other side of this
In mid-November, our eight year old cat Bishop passed away quite suddenly from a heart attack. He had no symptoms anything was wrong, no murmur, was eating, drinking, and making merry literally minutes before it happened. Needless to say my wife and I were quite traumatized over it.
Only a couple of days later we noticed our cat Ripley had lost weight. Ripley is a black rescue cat, nine years old. She's always been extremely lean and tiny, and we had taken her to the vet prior to make sure she didn't have diabetes or some thyroid condition making her so small, and she was cleared. But she seemed to go from her normal, slender self to notably bony overnight.
I asked my wife if she'd noticed her eating lately (our cats, we now have four after Bishop's passing, have always been basically free graze and self-regulated eaters) and she hadn't. She had been drinking water and taking her treats, so that day (Saturday if I remember right) I made a vet appointment for Friday.
Monday she stopped eating altogether, wouldn't even take treats, so Tuesday we took her in to the emergency vet. Tests showed her liver values through the roof (ACT over 1000), and she had an ultrasound which showed quite a few gallstones, but none appeared obstructive. I'm condensing a lot down because...it's a lot of in and out of the vet and such.
She was transferred to an internal medicine specialist, more tests done, hospitalized for four days on a feeding tube, anitbiotics, various medications to thin her bile, etc. yada yada. Options discussed, etc. Eventually we had an e-tube placed and we had her home for feedings and medications and she was doing better.
Then, after a checkup, she had still lost a little weight after having her etube put in (she didn't really, she'd lost more weight in the day before the tube was placed but after her last weighing, and was gaining it back but hadn't gained enough back to be more than her last weighing, if that makes sense). So the vet increased her etube feedings by five mils. That same day I increased her food, she started drooling and growled at me when I touched her (this is the sweetest cat in the world, she's never growled at me or anyone other than her brother when he tries to play and doesn't take no for an answer). I called the vet thinking she was obstructed and the vet suggested that it was probably the increased feeding was making her feel overfull and to back down to the other level again and slowly ramp it up by a mil or so at a feeding. This seemed to do the trick, the next day no more drooling.
A day or so later (it all blurs together) she started acting uncomfortable again and vomited all over the place. Another call to the vet, she added on a second, stronger anti-nausea med, and again that seemed to do the trick. Until about a day later when I noticed she was turning yellow.
We immediately went back to the vet and she was hospitalized again (ACT now over 1200 and bilirubin up. At some point she was hypercalcemic as well but I think that was before the e-tube was put in?)
Vet did another ultrasound, gallstones didn't appear to have moved or changed much and didn't seem to be blocking, so she wanted to do a liver biopsy. We agreed and just before the biopsy the vet called back and said she'd talked to the surgeon and he suggested removing her gallbladder at the same time to stop the vector for secondary infection and keep her from obstructing. He also mentioned he'd seen cases before of cats that didn't look obstructed but actually were. So we talked again and agreed to do the gall bladder removal at the same time.
She had the surgery Christmas day. Surgeon got in there, and lo and behold she's not only obstructed, she's obstructed in more than one place and has twice as many gallstones as they could see on ultrasound.
Immediately after we got her home she was acting and doing so much better. We had to put her in a onesie because she got her cone off straight away and would not leave it alone. We were still giving her medicines and feedings four times a day and cleaning/bandaging her e-tube site etc. but she improved every single day.
On New Years she started eating kibble again, just little mouthfuls here. On the 4th, she started going to the dish and eating on her own. Again, just mouthfuls. So we started weighing her food to determine how much she was eating and on the 5th we cut out two of the four tube feedings and reduced the remaining two depending on how much kibble she ate before them.
On the 13th she was eating enough kibble I cut it down to one tube feeding, and then on the 14th I stopped the tube feedings altogether.
Now here's where things have gone wrong. She's supposed to go in on Monday and have a final checkup and have her e-tube removed.
But one of the meds she was on was Mirataz, given in her ears, to stimulate her appetite. We alternated ears each night. About the 13th, the same time we cut her down to one tube feeding, we noticed her ears were really dry and the tips were beginning to flop, and the sides to curl in. We discovered this can be a side-effect of long term Mirataz use, so we stopped it immediately, cleaned up her ears, and put some vaseline on them. We did this for a couple days and now they are no longer dry but haven't really straightened up.
When I stopped the tube feedings I also stopped her anti-nausea meds (Ondansetron and Cerenia) and just kept her on her liver meds (denemarin). The vet had said prior to go ahead and switch the cerenia to every other day until it was gone, but I stopped them both when she was eating the kibble on her own, because she had shown no sign of nausea at all since her surgery. I think this was a mistake.
She was eating well on the 15th, including overnight on her own, but yesterday morning she didn't want to touch her kibble again. Yesterday in total she ate only four grams on her own. I supplemented with 38 mils of her tube feeds, and she ate two of her treats and that's it.
She also brought up a hairball yesterday (she's been grooming a lot since her onesie came off), and has been licking and acting nauseous again last night and this morning.
I gave her the cerenia again last night, and the ondansetron this morning, and I gave her a partial tube feeding (23 mils instead of a 'full' feeding of 48) after she refused to touch the kibble again (she did sniff it this time and seem interested, then backed away). I'm going to try again with the kibble around noon and do a tube feeding again if she doesn't eat, but has anyone else been through this?
Her liver biopsies came back fine- no sign of infection, cancer, etc. Her last blood test after her surgery showed that her liver values had dropped back down into the high normal range, and we are pretty sure her entire issue was the gallbladder, but now, on the cusp of having her tube out, she's not eating again.
We're obviously going to talk to the vet again about all this on Monday, but were we wrong to stop the anti-nausea meds? She can't stay on them, or the appetite stimulants, forever, but what could be causing this nausea? After so many tests I really don't think it could be something else other than the gallbladder which is causing all this, but how can we be sure?
Is it as simple as a irritation from a hairball after grooming so much? We really want to get her tube out, but we're terrified if we take it out she's going to stop eating again even with the meds, and we have to put it back in?
I'm not expecting anyone here to have the answers. As I said, we're going to discuss all this with the vet on Monday. It's just, it's been such a roller coaster with this girl for weeks and weeks. Every time she seems to be better and on the verge of full recovery, she relapses. Has anyone else dealt with continuing nausea and anorexia after gallbladder removal due to obstruction?
Part of the problem is she's always been SUCH a picky eater (she hates wet food, and even most treats. She refuses to touch her old kibble after this so we went through about a dozen different new kibbles to get one she'll actually eat now. She refuses everything people suggest to get her weight up: churu, hates it. Nutrical, no thank you.
The only treats she'll take are greenies and a bit of plain boiled chicken. Literally everything else is a nope. Wet food, flat nope. Before the feeding tube she did take a little babyfood so long as it was mixed in with the boiled chicken, but she had to be hand-fed it and after a few times it became a 'nope' too, and she refuses to touch it.
Also, it's been a bear to find out how many kcals she should be eating (are 'normal' for her). When she was eating just the kibble and had an appetite she ate between 104 and 132 kcal, and that's including her treats (6-8 greenies). The vet had her on between 43 and 48ml for her tube feedings four times a day, so about 170-192kcals, but that was to put weight back on her. She's still not to her full weight again but she's around 7.5-7.9 lbs. Her weight before all this began was 8.9 lbs.
It's so hard because I want to hold back on the tube feedings so she's hungry and eats her kibble, but we can't afford her slipping backward on her weight again. Yesterday, even with the supplemental tube feeding, she only took in 54kcal.
So I guess, any thoughts? Advice, if you've been in this spot before? Suggestions on a good kcal intake since the internet is entirely useless for figuring this out?
She's just been through so much, and we were sooo close to being on the other side of this
