Encouraging Sick & Elderly Cats That Won't Eat
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Like everything to do with cat health and welfare, when it comes to getting our favourite furry companions to eat, it’s the little things that make a big difference. Coaxing your cat to eat is a bit of an art form and takes a gentle approach and lots of patience but with the right advice you are much more likely to succeed – seeing your cat tucking into their food with relish is a very satisfying feeling indeed and makes all the pandering worth the effort!
Why might a sick or elderly cat be eating less?Pain is a very important reason why cats become less keen to eat and this needs prompt assessment and treatment. The most common cause of painful or difficulty eating is by far dental and gum diseases but eye disorders, neck/spinal pain, sore throats/ulcers and oral cancers can all cause pain when eating and hence reductions in a cat's food intake. Common signs that might indicate your cat has oral pain include recently having found/lost a tooth, facial swelling, smelly breath, drooling, suddenly becoming a messy eater/dropping food outside the bowl before eating, noticing red/swollen gums, poor coat condition or stopping grooming.
One of the reasons we need to provide feeding support to cats recovering from an anaesthetic or surgery is that there is inevitably a period of discomfort after most operations and this can affect appetite until it resolves. A period of reduced appetite can also be associated with the changes in routine and the effects of the anaesthetic drugs on their gut. Some drugs and medical conditions can cause nausea (particularly diseases of the stomach and intestines). When any of us have a fever we inevitably feel less inclined to eat and this is frequently seen in cats too. It could be something as simple as a cat fight wound infection (abscess) but unless the underlying cause is addressed no amount of coaxing will resolve the problem on its own. Stress or depression can cause reduced desire to move about and use any resources such as litter trays and water bowls but it can lead to reductions in food intake too. Cats rely on their sense of smell to help taste their food. It is easy to see why they may appear "picky" when they are suffering from conditions that cause nasal congestion (eg cats infected with flu, rhinitis, nasal cancer etc). Elderly cats also have a reduced sense of smell but also tend to suffer from a variety of ailments (just as we do). Older cats are usually less physically active which reduces their need/drive to eat large meals (reduced metabolic needs) and are more stiff/less mobile (arthritic) so may choose not to get up to eat. Both of these factors make them more suited to eating smaller meals, more often. With an increased risk of dehydration older cats can become constipated which further reduces the urge to eat. Older cats are more likely to be suffering from pain (eg arthritis, dental disease) and many have chronic (long term) diseases all of which can suppress appetite. Cats suffering from terminal illnesses are often suffering from many of these factors - stress, depression, pain, nausea and the effects of drugs we've already considered. In these cats, our mutual goal is to ensure that they enjoy their last few weeks/months with you and this often comes down to providing them with good nutrition in a thoughtful way. Before you read any further it is best to read my dedicated page about offering cats food and understanding "fussy" eaters |
**WARNING**
The following information is not a substitute for proper veterinary medical attention and is designed to be used to support your cat whilst a diagnosis is being found or while treatment starts to take effect. A reduction in appetite is often a warning sign that your cat is sick or stressed and should never be overlooked. Always seek veterinary attention for your cat within 24 hours of any noticeable change in appetite. One of the most sad and frustrating things for a vet is being presented with a very sad, completely inappetant, dehydrated, very ill cat only to find out that their human has been watching the poor cat's appetite steadily deteriorate over the course of a week or more. Hopefully you wouldn't do that to yourself (or your children) so please do not wait until your cat is eating nothing at all before seeking veterinary help! Early intervention is key - starvation on top of the underlying reason your cat is off its food is a recipe for disaster and it is unnecessary not to mention the fact that it will undoubtedly be more expensive to treat. |
General advice on feeding cats
and understanding "fussy"eaters
What Should You Feed?
Prescription veterinary diets
Your vet may be able to recommend a food specific for your cats medical needs. In the short-term (few weeks), the most appropriate foods are high nutrient foods. There are many varieties available for palliative care in cats - many of them have high energy/fat levels and lots of extra vitamins and minerals required for healing. I have listed a few that I have purrsonally found useful – ask your own vet to provide you with an appropriate selection of these to try (be aware that some of these foods can be very rich and will potentially make specific conditions worse - like diarrhoea for instance. Seeking vet advice is always safest)
Hills a/d (pate)
Royal Canin Recovery (tins)
Liquivite (tins)
Purina Convalescence (tins)
Royal Canin Gastrointestinal (dry or wet)
Hills i/d (dry or wet - chicken or salmon)
Hills a/d (pate)
Royal Canin Recovery (tins)
Liquivite (tins)
Purina Convalescence (tins)
Royal Canin Gastrointestinal (dry or wet)
Hills i/d (dry or wet - chicken or salmon)
Tasty tempters
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Whilst in theory feeding unwell cats a specific food or "prescription diet" may be best, in reality they may refuse it even if introduced gradually. It is still the best thing to try and I would always persist if possible using the advice of your vet.
When it is not possible however, you can often get your cat to eat sufficient amounts of the preferred diet by adding a small quantity of what I call a "tasty topper". You choose something that you already know they can't resist and roughly mix it into the top layer of food which can really help make it more appetizing. “Tasty toppers” worth trying:
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Does your cat just like to lick the gravy?
These liquid treats are useful sparingly to initiate eating.
Don't be tempted to make up human gravy as most of these contain onion/garlic so are toxic to cats.
These liquid treats are useful sparingly to initiate eating.
Don't be tempted to make up human gravy as most of these contain onion/garlic so are toxic to cats.
- Webbox® LickELix (narrow pouch of liquid/paste)
- Other brands include: Felix Fun Sauces & Soups, Sheba Classic Soups and Purina Gourmet Soups
- Miamor Malty Paste
- Sheba Creamy Snacks
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NB: Most of these treats or tasty toppers are only designed to be fed in tiny quantities and are certainly not to be fed as a main diet. Always read the label. If a food is fully balanced with all the essential vitamins and minerals that cats need, then it will be called a "complete" food. On the other hand, if it says it does not say this or says it is "complementary" or designed to be fed with a complete and balanced diet then it is essentially nutrient deficient and will cause serious health problems if fed long term in large quantities.
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Homemade broths & purées
Always use home made broths from pure unseasoned meats. Packet gravies and stocks usually contain cat toxins - members of the onion family (including onion powder, chives, leeks, garlic). Many outdated, "self-help" internet sites suggest using jars of sandwich pastes (fish/meat) or human baby food; however, I would strongly advise against these because they will usually contain flavourings that are based on varieties of the onion family and there are far more tasty nutritional options available from your vet these days.
Variety is the spice of life
As anyone who has had a chronically inappetant cat will know your kitchen pantry can contain more varieties of cat food than a pet shop. Inevitably in times of illness you have to just pander to your cat's changing appetite and serve up a smorgasbord of foods . You may find you need to rotate the types of foods that are offered from week to week but more often than not it can be meal to meal. Having had several elderly cats with renal failure I know the frustration of opening several pouches or tins before you manage to find the one your cat fancies eating for this meal. My fridge often contains numerous half-empty tins of food that although all eaten readily one day have failed to impress the next. Luckily I have a young cat with an excellent appetite so any leftovers rarely go to waste away!
Feed little and often
Sick or stressed cats will often stop asking for food or will do so less often, so we need to bear this in mind and actively encourage them. By offering small amounts of fresh food regularly you can often support your cat's nutritional needs as well as that burning feeling that occurs when stomach acid levels build up in an empty tummy. You may have to actually take the food to your cat. Inappetant cats can find the sight of a large portion food off-putting so only offer a spoonful at a time and if that is accepted, then try a bit more.
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Automated cat feeding bowls can be useful for people who are not at home during the daytime and for those cats who prefer to eat little and often overnight (eg Pet Mate Automated Feeder).
For those of you with multiple cats there is now a cat bowl that opens when a specific cat uses it which is designed to stop other cats stealing the food - SureFlap Microchip Feeder. |
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TLC and Support
Company While Eating
Some cats like to eat in private and others seem to respond to your physical presence, so try giving them space and then taking the time to sit/lie beside them can help. Others seem to appreciate a gently stroke/rub around the cheeks every now and then and some quiet but reassuring words. It is always worthwhile doing this in moderation so that they don't develop an aversion to eating alone.
Hand Feeding
Sometimes cats need some gentle active persuasion to eat. You can use teaspoon or your finger to gently wipe some wet food on your cat's mouth or lift 1-2 biscuits out of the bowl and offer like treats. Sometimes once they have licked and tasted the food you can continue in this manner with small portions at a time at least get something into your cat while you are waiting for any treatments to start working. Many people worry that if they start hand feeding their cat will always expect this which in the majority of cases is not true provided the underlying cause of the inappetance resolves.
Some cats like to eat in private and others seem to respond to your physical presence, so try giving them space and then taking the time to sit/lie beside them can help. Others seem to appreciate a gently stroke/rub around the cheeks every now and then and some quiet but reassuring words. It is always worthwhile doing this in moderation so that they don't develop an aversion to eating alone.
Hand Feeding
Sometimes cats need some gentle active persuasion to eat. You can use teaspoon or your finger to gently wipe some wet food on your cat's mouth or lift 1-2 biscuits out of the bowl and offer like treats. Sometimes once they have licked and tasted the food you can continue in this manner with small portions at a time at least get something into your cat while you are waiting for any treatments to start working. Many people worry that if they start hand feeding their cat will always expect this which in the majority of cases is not true provided the underlying cause of the inappetance resolves.
Veterinary Assisted Feeding
Feeding Tubes
Some people believe it can help to feed your cat by syringing liquid food into their mouth but in my experience this can sometimes lead to an aversion to that food thereafter and forcing food down is unpleasant for owners and cats alike. In certain circumstances a temporary feeding tube can be placed. This allows us to reliably get food into your cat with minimal distress. It is not however appropriate in all situations.
Appetite Stimulants
In some cases it may be necessary to prescribe medication to stimulate you cat's appetite at the same time as attempting to establish the underlying cause of the problem
Cyproheptadine (Periactin) is an antihistamine that happens to have an appetite stimulating effect in cats. Unfortunately it can also have other side effects, such as agitation, howling or in some cats the opposite effect, quietness and lethargy. In a small number of cats it may decrease urination or increase heart rate, breathing rate and temperature. It may not stimulate all cats' appetites and as it is a human medication getting the dose right can be tricky. Cats on potassium supplements or those with high blood should avoid it's use.
Mirtazapine is another human medication (an anti-depressant) that in tiny doses can cause an increase in appetite and also helps with nausea. It can cause restlessness, agitation and vocalization but in some cats it will cause the opposite effect and make them sleepy. Cats on certain medications or those with liver disease, high blood pressure/heart disease and overactive thyroids may be at increased risk of developing side effects on Mirtazapine. A condition known as "serotonin syndrome" can develop in some cats and lasts until the drug wears off (2-3 days). Symptoms include dilated pupils, excessive meowing/howling, being vacant, unsteady/staggering/stumbling, pacing, agitation and increased breathing/heart rates. This reaction is not common, but is naturally a concern which is why I suggest using a very low dose every 3rd day to start with.
Diazepam (Valium®) is another drug that has been used in cats to stimulate appetite. It has been linked to liver failure in some cats so I avoid this option.
Steroids, among their many uses, can stimulate appetites in cats. They can have other undesirable effects so are not used purely for this purpose unless they have a concurrent therapeutic benefit for the cat's underlying illness.
Cyproheptadine (Periactin) is an antihistamine that happens to have an appetite stimulating effect in cats. Unfortunately it can also have other side effects, such as agitation, howling or in some cats the opposite effect, quietness and lethargy. In a small number of cats it may decrease urination or increase heart rate, breathing rate and temperature. It may not stimulate all cats' appetites and as it is a human medication getting the dose right can be tricky. Cats on potassium supplements or those with high blood should avoid it's use.
Mirtazapine is another human medication (an anti-depressant) that in tiny doses can cause an increase in appetite and also helps with nausea. It can cause restlessness, agitation and vocalization but in some cats it will cause the opposite effect and make them sleepy. Cats on certain medications or those with liver disease, high blood pressure/heart disease and overactive thyroids may be at increased risk of developing side effects on Mirtazapine. A condition known as "serotonin syndrome" can develop in some cats and lasts until the drug wears off (2-3 days). Symptoms include dilated pupils, excessive meowing/howling, being vacant, unsteady/staggering/stumbling, pacing, agitation and increased breathing/heart rates. This reaction is not common, but is naturally a concern which is why I suggest using a very low dose every 3rd day to start with.
Diazepam (Valium®) is another drug that has been used in cats to stimulate appetite. It has been linked to liver failure in some cats so I avoid this option.
Steroids, among their many uses, can stimulate appetites in cats. They can have other undesirable effects so are not used purely for this purpose unless they have a concurrent therapeutic benefit for the cat's underlying illness.
Top Tips for encouraging your cat to eat
- Ensure your cat is comfortable and feeling secure
- Avoid bullying and competition for food by feeding your cat out of direct eyesight of any other cats/dogs
- Show a little tenderness - be patient and give your cat your undivided attention. If need be encourage your cat to sniff/lick food from your finger or the back of a teaspoon. Sometimes gentle reassurance is all your cat needs.
- Cats rely on smell to enhance the taste food so warm it up to "prey" temperature and release the food's natural aromas
- Offer smelly and strong-tasting foods such as seafood and roast chicken.
- Ask your vet about which types of foods would be safe to feed and whether there are any highly palatable and nutritious foods that they can supply for supporting sick cats
- Avoid presenting elderly and unwell cats with large portions of food - they are more likely to accept food little and often and some seem to definitely prefer this approach
- If your cat does not eat, take the food away and try again a bit later.
