Hi! My cat is a 9 year old female. She never had any particular health issues, with the exception of a seasonal skin allergy that has appeared the last 2 years. This year it was a bit rougher and she got some cortisone injection once to help her. That seemed to work and she stopped eating her hair.
However, she's recently behaving weird regarding her food. She hasn't lost her appetite, so if I present treats she'll run for them but it feels like she's having trouble chewing, she drops food bits around her plate and looks like she hurts when she eats. You can see her behaviour in the videos here:
She doesn't eat much of her own food and she's losing weight. She eats maybe a few grams per day (a few kibbles). She's not interested in wet food either.
The doctor said that her mouth looks fine, does not look like it could be a problem. Her blood tests are also ok.
What do you think she's going through? This has been going on for more than 2-3 weeks now and I don't know what else to try. What are your thoughts?
Hi Dimitris,
I can see what you're describing well with the videos. I can also tell that your kitty is losing weight based on the appearance of her back/spine. Just based on the videos and seeing her dropping food (and not knowing much else other than what you've relayed), I suspect she still has an issue with her mouth/oral cavity. while you mentioned your vet looked at her mouth, a basic oral exam can sometimes be difficult to do completely and our patients may not allow us to see things very well in the 1-2 seconds we have to take a peek.
To cause enough oral discomfort to cause dropping of food and lack of interest in food, there are a couple of possibilities. One is something called a resorptive lesion. These are ulcerative lesions on the teeth themselves that will continue to progress until the entire tooth basically dissolves and disappears. But when early, they can hide just beneath the gumline. They are not associated only with tartar build up or bad teeth. We believe they are immune-mediated and that the body starts to attack one or more teeth. Thus we can see them in cats with otherwise good looking teeth. I have even missed small ones with oral exams because it can be hard to isolate all 30 some teeth and be sure there's no issue, especially back teeth. Sometimes they cannot be seen on oral exams at all but when we take dental x-rays during a dental procedure, we can see the x-ray evidence of their presence. We know that these can be painful for cats, especially if they have a couple at the same time.
A second possibility is ulcerative lesions on the soft tissues like the gums or cheeks or soft palate. These can be caused by viruses like calicivirus and by allergy or sensitivities (and then they can be called eosinophilic plaques or ulcerations). These may reside all the way in the back of the mouth and can be easy to miss unless a really good look all the way back was had. This isn't always easy to do on a basic exam either.
A third possibility, which I hope isn't the case, is that an oral mass or tumor is present. These can start out very small and be easily missed, especially if they start under the tongue. Squamous cell carcinoma is the most common in my experience.
Here are some methods to try with your vet. First, you can try empirically treating for mouth pain with a medication like buprenorphine. If when given pain medication, your cat's appetite and ability to eat improves noticeably, this at least helps support that something in the mouth is painful and needs to be investigated more. That's the least invasive option.
A sedated oral exam is a close second. If your cat had normal bloodwork and has no heart condition, there is low risk to sedating her for a few minutes to get a more accurate look in the mouth, including all the way in the back and under the tongue. The teeth could also be better inspected.
The third option is to do a dental procedure under anesthesia. Again, with normal bloodwork and if there is no heart condition, risk could be considered lower. This would allow for dental x-rays that can be used to look for tooth resorption and any abnormalities with tooth roots or the jaw bone. You might even stumble on an infected or abscessed tooth, which may not show above the gumline. A dental procedure would also allow for more to be done at that time, like addressing resorping or infected teeth, or taking a biopsy of any concerning tissue.
I hope that's helpful.
@chris-vanderhoof she’s usually resting like this recently. Could this indicate an issue with her stomach?
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@chris-vanderhoof thank you very much for your thorough response. This is really helpful. I have booked an appointment with a vet dentist to examine her more deeply. Meanwhile, it seems I found a wet food that she wants to eat which is a good sign. She's still picky with eating but at least she eats more than before. In 2 days we'll also run ultrasound checks in her belly and heart to check if there's anything else bothering her. Thank you again!