UPDATES: So Jimmy wasn't eating last week; Elizabeth began not eating last 6/3 Saturday; and Katharine was a picky eater more than usual last week, also.
We discovered that all of the meds we normally would use-Cerenia, Mirtazapine, stomach meds, nausea meds-were contraindicated with his Prozac. Either the Prozac made them not work, or the other meds had a possibility of running up a heart rate/blood pressure, or can make a cat weak-depending on interaction. Jimmy saw the vet for sub q fluids Friday and Saturday and a B12 shot Saturday and began to slowly eat on his own Saturday afternoon. He spent Saturday-Sunday slowly eating a couple bites every two hours; then eating more and more often Monday and Tuesday, until he was eating a full meal on his own by Wednesday. He was slow and "out of it" and would disappear for hours until ready to eat Saturday-Tuesday; by Wednesday was hanging out upstairs again.
His CBC/chem panel blood work showed signs of inflammation and pain: neutrophils and monocytes were increased to HIGH, and the lymphocytes and eosinophils had decreased to LOW. Possible causes: anemic-he had lower red blood cells but normal reticulocytes so not likely; Bone Marrow disease-with low RBC, high others, possible but requires bone marrow testing so NO for now; kidney disease-his SDMA is increasing from 10 to 11 last time, to 12 this time. Combined with the increasing RBC it's possible. Urine test was clear, no protein, no glucose, SPG-specific gravity-was normal at 1.030. So no obvious signs but something to monitor especially as he is 14. As a cat ages, kidney disease can be a problem. His ALT, ALP, etc. were all normal-no liver issues, no dehydration, etc. Other causes with the blood results: gastro issues, pancreas issues. He had an ultrasound Thursday that showed some small intestinal thickening of the walls which indicates possible virus or possible IBD coming on. If he continues to improve-and given that Elizabeth and to some extent, Katharine, were also not eating-the vet thinks it is some sort of virus. We are to monitor, give extra lysine (herpes virus) they already take, and if further "intervention" such as sub q fluids or more B12 or other tests are warranted, we'll go from there. (Other tests-MRI? Other blood work? A steroid-although not Prednasolone because of his pre-diabetic history and Prozac.)
Elizabeth-suddenly wouldn't eat Saturday as much as usual. But given we were busy with Jimmy, we let her do her thing. Then Sunday she wouldn't eat at all. We began hand feeding her Hills AD by syringe every two hours Sunday and into Monday. Elizabeth can take Mirtazapine. She had some Sunday which took hours to kick in and let her eat very little Sunday night. She had it again Monday to no effect. We have been giving her Cerenia (anti-nausea/vomiting med) since Sunday. It might have helped but did not encourage eating. I called the vet Monday and they saw her on Tuesday. They gave sub q fluids, a B12 shot, checked CBC/chem panel, did a urine-all came out normal. Nothing like Jimmy's blood work to indicate any pain or inflammation.
We continued to hand feed her as needed until she finally began eating a couple bites every two hours Tuesday night and Wednesday. She also had an ultrasound Thursday that showed she also has a small intestine wall thickening that indicates IBD. Again, the vet said that if she's eating on her own enough, to continue to monitor her recovery. Use Forta Flora in her food-and Jimmy's-but any further "intervention"-meds, tests-will be discussed if this happens again.
Katharine-she responds well to Mirtazapine and eats well on it for a few days before needing more. She has not yet seen the vet. BUT again, the vet thinks a virus of some sort hit them. It affected Elizabeth slowly over time when she was showing signs of being a picky eater; hit Jimmy hardest because of the dental procedure and anesthesia which makes the body slower and more apt for things that are working their way through the body, to suddenly emerge. This can happen with HCM-in the form of CHF after surgery/anesthesia-for example. AND it's because they all have chronic health issues of various sorts.
Roxanne? Not sick. Secluded in the a.m. so that she eats and isn't bothered by the others; is also younger and so far healthy with no chronic issues.
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