Introduction
Anorexia, or loss of appetite, is a serious condition in cats that requires prompt veterinary attention. It is defined as the absence of appetite for more than 2 meals or 24 hours. Anorexia can be an indicator of an underlying disease process such as kidney failure, cancer, or other systemic illness. It can also lead to other dangerous conditions like fatty liver disease and malnutrition. Anorexic cats can deteriorate quickly, so early intervention is key. Consulting a vet as soon as appetite loss is noticed gives the best chance at determining the cause and reversing the anorexia before it becomes life-threatening.
Diagnosing the Underlying Cause
The first step a veterinarian will take in diagnosing the cause of a cat’s anorexia is performing a complete physical exam. The vet will check the cat’s vital signs, look for any abnormalities, and palpate the abdomen. Bloodwork such as a complete blood count and chemistry panel can help identify issues like infections, liver or kidney problems, electrolyte imbalances, and more. According to VCA Hospitals, common blood tests performed include “a complete blood count, biochemical profile, total T4 (thyroid hormone), Feline Leukemia Virus and Feline Immunodeficiency Virus testing”.
Imaging tests may also be recommended to look for underlying issues. X-rays can detect obstructions, tumors, abnormalities, or foreign objects in the digestive tract that could be causing anorexia. Abdominal ultrasound allows visualization of organs like the liver, kidneys, spleen and lymph nodes to check for masses or inflammation. In some cases, additional diagnostic tests like an endoscope or biopsy may be required.
Identifying any underlying disease or condition causing the cat’s anorexia through diagnostic testing is key so it can be properly treated.
Treating Any Underlying Conditions
The veterinarian will develop a treatment plan catered to the cat’s specific diagnosis. For example, if kidney disease is the cause of the anorexia, the vet may recommend medications, intravenous fluids, or a special renal diet to support kidney function (Source 1). In cases of cancer, options like chemotherapy, radiation therapy, or pain medications may help boost appetite while treating the disease (Source 2).
Cats with hyperthyroidism will likely be prescribed methimazole or radioactive iodine therapy to regulate thyroid hormone production (Source 3). For gastrointestinal issues like IBD or pancreatitis, the vet will provide medications to control nausea, vomiting and diarrhea. In all cases, the goal is to treat any illness while also encouraging eating and minimizing catabolic effects.
Providing Appetite Stimulants
If an underlying medical issue has been ruled out or treated, veterinarians may prescribe appetite stimulant medications to help encourage a cat to eat. Some common prescription drugs used for this purpose include:
Mirtazapine – This medication was originally developed as an anti-nausea drug but has been shown to be an effective appetite stimulant in cats (https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/cat-health-news/fda-approves-appetite-stimulant-cats). It increases appetite by blocking certain serotonin receptors in the brain.
Capromorelin – This newly approved drug stimulates appetite by mimicking a hunger hormone called ghrelin. It is specifically approved for use in cats with chronic kidney disease (https://www.petmd.com/cat/nutrition/appetite-stimulants-cats).
Cyproheptadine – This antihistamine has been shown to increase appetite and weight gain in cats. However, sedation is a common side effect.
These medications are generally given for a short period of time to help kickstart the appetite. Close monitoring and follow up with a veterinarian is recommended when using appetite stimulating drugs.
Assisting Feeding
If a cat is unwilling or unable to eat on its own, a veterinarian may recommend assisted feeding methods to provide nutrition and prevent starvation. Common techniques include syringe feeding, feeding tubes, and feeding bags.
Syringe feeding involves using an oral syringe or feeding syringe to slowly administer liquid food or gruel into the cat’s mouth. Veterinarians typically recommend commercial recovery foods or blending the cat’s regular food into a smooth gruel consistency that can pass through a syringe tip. Syringe feeding requires patience as only small amounts can be given at once, but it allows control over calorie intake. This technique works best for short-term feeding assistance, as long-term use can cause oral ulcers.
Feeding tubes provide another option for assisted feeding. Tubes may be placed through the nose into the esophagus (nasoesophageal tube), into the stomach (gastrostomy tube) or intestine (jejunostomy tube). Tubes allow larger volumes of food to be given, bypass oral issues, and can be used long-term if needed. However, tube placement requires anesthesia and hospitalization. Tubes must be flushed and cleaned regularly to prevent clogging and infection [1].
Feeding bags or “baggies” allow the cat to eat voluntarily while controlling intake. The veterinarian places food into a small bag with the opening positioned in the cat’s mouth. As the cat eats, it consumes the contents while keeping the bag in place. This reduces stress compared to forced syringe feeding. However, supervision is still required.
The veterinarian will determine the best assisted feeding method based on the cat’s condition, prognosis, and duration of feeding needed. Any technique requires patience, care, and monitoring to ensure the cat receives adequate nutrition.
Providing a Palatable Diet
One way a vet can encourage a cat to eat is by providing a more palatable diet. Cats have a strong sense of smell, so enhancing the aroma and flavor of food can make it more appealing. Vets recommend warming up canned cat food or adding low-sodium chicken or vegetable broth to dry food. The moisture and smell makes the food more appetizing. Some vets suggest mixing a spoonful of tuna or bonito flakes into the food for extra palatability.
Cat owners can also try sprinkling catnip, brewer’s yeast, or freeze-dried meat powders on top of food. These additives contain compounds that are appealing to cats. A few drops of tuna or salmon oil will also enhance the taste. Offering different food textures, like adding some wet food to dry kibble, can also stimulate appetite.
According to one source, “Studies show that in older cats, feeding fresh food more frequently and adding warm water over the food can be appetizing.”1 Giving cats food at room temperature or slightly warmed up brings out the aroma and makes it more enticing to eat.
1. Cat Food – Tasteless palatability – Feline CKD Blog
Ruling Out Oral or Dental Issues
One possible cause of anorexia in cats is oral or dental disease, which can make eating painful. According to the Cornell Feline Health Center, “Oral inflammation and disease may lead to anorexia and weight loss in cats” (source). The veterinarian will perform a thorough dental exam, looking for signs of gingivitis, tooth resorption, abscesses, and fractured or loose teeth. Advanced dental disease can impede a cat’s ability and desire to eat.
If oral disease is found during the dental exam, the vet may recommend tooth extraction or other dental treatments to alleviate pain and make eating comfortable again. According to VCA Hospitals, “Dental surgery, tooth extraction, [and] removal of oral tumors” may be necessary (source). Treating dental disease can remove oral pain that is causing a cat to avoid eating. Cats often start eating again once dental issues are resolved.
Checking for Obstructions
One of the most common causes of appetite loss in cats is an intestinal obstruction or blockage. Obstructions prevent food and waste from passing normally through the digestive tract. Cats are prone to developing obstructions because they are indiscriminate eaters and may swallow string, fabric, bones, and other foreign material that can get lodged in the intestines.
A veterinarian will perform a physical exam on a cat refusing to eat, feeling for an enlarged or painful abdomen that may indicate a blockage. Imaging tests like X-rays or ultrasound can often identify intestinal obstructions and localized them to guide treatment.
Endoscopy involves inserting a small camera on a flexible tube down the throat and into the stomach and upper intestines. This allows the vet to visually inspect for blockages or other abnormalities. Endoscopy is minimally invasive and does not require surgery.
If an obstruction is found, the cat will require surgery to remove the blockage and may need intravenous fluids, pain medication, and antibiotics during recovery. Quick treatment is essential to prevent a ruptured intestine and peritonitis, which can be fatal.
Supportive Veterinary Care
The vet will likely recommend supportive care to assist with hydration, nutrition, and vitamin supplementation while treating the underlying cause of anorexia. According to the VCA Animal Hospitals, “Supportive care often includes intravenous fluid therapy and syringe/force feeding.” The fluids help prevent dangerous dehydration and electrolyte imbalances https://vcahospitals.com/know-your-pet/anorexia-in-cats. The vet may administer vitamin B injections to stimulate appetite as well https://wagwalking.com/cat/condition/anorexia. If the cat is not drinking enough, subcutaneous fluids can be given under the skin for hydration. The vet will monitor electrolytes and kidney values with blood work.
Monitoring and Follow-Up
It’s important for the vet to continue monitoring your cat after initial treatment for anorexia. They will likely want to do regular weight checks to ensure your cat is regaining lost weight. According to the Cornell Feline Health Center, “Body weight should be assessed at least weekly. Most cats require more frequent weighings initially.”
The vet may also run lab tests like bloodwork and urinalysis to check for improvement in any underlying conditions. As per VCA Hospitals, these tests can “monitor progress with treatment as well as screen for any complications of anorexia.”
You will need to continue appetite stimulation at home with techniques like warming the food, hand feeding, and providing enticing food toppings. Your vet can provide guidance on keeping your cat eating. According to Wag Walking, “Your veterinarian will show you how to force feed, but only as a last resort.”
Providing a highly palatable diet recommended by your vet is also important during recovery. The Cornell Feline Health Center notes that “Maximizing caloric intake with a highly palatable diet is essential.” Follow your vet’s specific diet recommendations for your cat.