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Thread: My cav is refusing to eat. What can I do to get his appetite back?

  1. #1
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    Default My cav is refusing to eat. What can I do to get his appetite back?

    Hi,

    My cav Da Vinci is refusing to eat this morning. His appetite has been gradually getting worse over the last two weeks, but I have cajoled and enticed him to eat with some success, but this morning he flat out refused.
    I am at a loss as to what to do.

    He has been taking a cocktail of meds for 5 and 1/2 months due to MVD. He was at the "moderate" stage of MVD only in May, 2011 according to his cardiologist. Da Vinci is at the "severe" stage of MVD now. He will be 8 years old in several months. We have a vet, but we work with a cardiologist 100% on this. There has been a lot of water under the bridge since May this year. He had a CHF in September (couldn't breath and gasping for oxygen) and had to go to ER. A couple of labor breathing alarmed us to go to see his cardiologist several times since then.

    To make a long story short, his latest med protocol is:

    Furosemide 40MG 3x a day
    Spironolactone 12.5mg 2x a day
    Enalipril 5mg 2x a day
    Vetmedin 2.5mg 2x a day

    I have no doubt that this regiment has been saving his life, but it is also robbing him of his appetite. Da Vinci had been a voracious eater. He loved treats and loved food. He was a full of life for so many years. Not anymore. He is subdued and doing very little activities. I DID expect less activities, but refusing to eat is tormenting me. The loss of appetite has been so sudden I don't even know how to cope with it. Because of his refusal, giving him meds is becoming more difficult and almost impossible. I had to fight hard this morning to finish off his meds. By the way, we've been cooking for him ever since he started taking meds. We used to mix kibbles (salmon) and various cooked meat. Lately on salmon, beef and chicken, carrots and rice, etc. Up until just two weeks ago, he's been eating rather well. For the last two weeks, it has been going down the hill precipitously.

    I read plenty on this forum that many cavs at this stage would refuse to eat and end up with losing weight and eventual loss of life.

    I am turning to you folks who have gone through this med regiment to see if I can do anything to have his appetite back. Is one of the meds he is taking more culprit than others perhaps? Have you changed the cocktail to get his appetite back?

    I appreciate any help you can give.

    Thank you.

  2. #2
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    A few thoughts:

    When is the last time that you ran blood chemistry/CBC and urinalysis? Loss of appetite is a classic signal of kidney disease, so I'd want to run blood chem asap to rule that out along with looking at other major organ values (liver, pancreas, etc.) to rule out liver disease, pancreatitis, etc. In advanced heart failure, the poor perfusion to the major organs along with the meds can cause other organ failure.

    Since he has been on the meds for 5 1/2 months but appetite remained good until the last two weeks, I'd be less likely to think that the anorexia is related to his medications. I personally have had quite a few Cavaliers and other dogs on heart meds, and they have kept a good appetite up until they died.

    Could ascites be a factor? When you consult the vet to run blood chemistry, the vet can examine his abdomen to see if there is new ascites.

    I think that a consult with GP vet and/or cardiologist should be done asap.

    Pat
    Pat B
    Atlanta, GA

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    Can't give any advice, but I am sending positive thoughts to Da Vinci. Hope he starts eating soon.x
    Kathleen
    Thomas (tri-colour) & Jade (blenheim) waiting at the Bridge

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    hi
    sorry to read about da vinci hope he starts eating asap
    give him a kiss and a cuddle from me and louie

  5. #5
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    Thank you for all your thoughts.

    Pat, Da Vinci got his blood chemistry test done at the end of September. So, it has been about three months. As a matter of fact, we were planning to do it soon. I just contacted Da Vinci's cardiologist. He recommended the same thing. We didn't see anything noticeable from the last blood test. However, as I recall, his vet (GP) told me that his kidney function was slightly elevated, but not to the point we need to be concerned about.

    I am going to get the test done tomorrow and go from there.

    Thank you.

  6. #6
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    Acute kidney disease can come on very suddenly, and chronic kidney disease can go undetected for a long time and then there is a sudden "crash." This is a particular area of interest to me. What most pet owners don't know and what most vets don't explain is that by the time you see elevated creatinine and BUN, the kidneys are only functioning at about 25-30%. An earlier "warning" system is urine specific gravity (SG) in a urinalysis, which is why I always test urine whenever I run blood chemistry (and why I also own a digital refractometer so that I can test urine at home). Kidney disease shows up first with a low USG (shows an inability to concentrate urine) long before there are rises in blood kidney values. To accurately test USG, a first morning urine sample should be used, preferably after the dog has gone 6-8 hours without drinking or urinating. This is hard to do with a dog on high furosemide as your boy, and dogs taking furosemide will normally run a lower USG because they drink and pee more often.

    Another problem with dogs on heart meds is that the furosemide will cause an elevated BUN simply because of dehydration, so that is to be expected. Creatinine is a much more specific measure of kidney function. If a senior dog is running a high normal creatinine and a low USG, I know that there is already chronic kidney disease and then I will adjust the diet to be more kidney friendly and I'll monitor more closely. When creatinine and phosphorus become elevated, the first outward symptom is usually anorexia.

    Two situations in my past:

    14 year old Cavalier with mild heart disease, on enalapril only for years, stable with no symptoms of any illness. Early November ran blood chem along with echocardiogram and complete workup with internist. Blood chem showed high normal creatinine, slightly high BUN, but USG was very good. Third week in November stopped eating. Ran blood chem the second day - Major acute kidney disease with very high creatinine, BUN and phosphorus. Despite hospitalization with state of the art treatment, kidneys shut down, and he was gone within a few days. In retrospect, he probably had chronic kidney disease for some time and I should have adjusted his diet. So now I pay attention even to high normal values.

    15 year old Cavalier in end stage heart failure on many meds. Stopped eating. Blood chem showed elevated kidney values and urinalysis showed low USG. Hospitalized with state of the art treatment. In this case, we were able to bring his kidney values down to high normal and he came home. Lived another year and a half with daily subq fluids, adjusted diet and some kidney friendly supplements including phosphorus binder. Put to sleep at 16 1/2 for reasons other than heart or kidney disease (blind/deaf/extreme senile anxiety/quality of life decision).

    I became very well educated about kidney disease, and I am very watchful for symptoms and test quickly so that I have time to respond. As you can see above, sometimes you win and sometimes you lose, but I always try.

    Another seemingly healthy teenager who stopped eating had acute IMHA (immune mediated hemolytic anemia), and I lost her.

    So yes, whenever I have a dog that becomes a picky eater, I immediately test so that I can quickly rule out (hopefully) some of these problems or quickly deal with them.

    Pat
    Last edited by Pat; 1st January 2012 at 11:11 PM.
    Pat B
    Atlanta, GA

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    Pat,

    Thank you again. Your knowledge definitely helps me equipped to deal with this situation better. In the back of my mind, I always knew there would be a kidney issue I might have to deal with down the road considering the amount of meds he's been taking. My heat aches thinking about what Da Vinci is going through, me being not proactive about this sooner.

    I will get the blood-chem test and urinalysis done tomorrow. Thank you.

  8. #8
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    Remember that kidney disease is just one possibility; it's not a foregone conclusion. Blood chemistry is an easy way to rule things in or out, and hopefully that will be ruled out tomorrow. Maybe he is too dehydrated now, or maybe his blood pressure has gotten too low, both of which can affect the appetite. Your vet can narrow down the possibilities.

    Next, don't be hard on yourself. The only way we know about these things is after we've gone through them. I've had 22 dogs in my adult life and 18 are gone so I've just had more experience with geriatric dogs with various illnesses than many pet owners. I've lost more dogs to kidney disease than to heart disease and even more dogs to cancer, so I've done a lot of reading and studying about these diseases. You are way ahead of many Cavalier owners already because you are working with a cardiologist, so you are doing a great job.

    Hang in there - one day at a time. I've walked in your shoes, and I know that it's a hard road.

    Pat
    Pat B
    Atlanta, GA

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    Just catching up on this thread - with a very simple question: do you raise Da Vinci's food/water dishes? With severe heart disease, dogs can find it very uncomfortable, if not impossible, to put their heads down to eat or drink, or even lower them slightly. When my Cavalier started on CHF, I hand fed her when she was sitting down, and lifted her water dish so that she could drink sitting down. Also gave her her favourite food - which for her was a freshly-cooked chicken thigh!

    Kate, Oliver and Aled

  10. #10
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    Kate,

    Thank your for your suggestion.

    I have not raised his water/food dish. So far, he manages to drink water from the water dish on the floor. I just tried your method of having him sit down. He appears to be a little more comfortable taking food from me. Because of his total loss of appetite, I have been hand-feeding him in the last few days whatever he is willing to eat. Chicken thigh has been his staple for many months, but I have not given him in the last week or so. I will try it again both steamed and grilled.

    So far, the only thing he manages to eat is low-sodium deli-sliced hams. Even then, he takes very little.

    Thank you for your thought.
    Last edited by summerwalk; 2nd January 2012 at 04:12 PM.

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