INAPPETENCEManaging the cat that won’t eat:
information for owners/caregivers
Loss of appetite can be a sign of an underlying
illness or pain that needs veterinary attention.
Stress and a stay in the veterinary clinic can also
result in your cat eating less. In every case, youwill need to work with your veterinarian to ensure
your cat receives the care and nutrition required
to return to good health.
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What does inappetence mean?
Inappetence is a term used to describe areduction in appetite, which is a common
sign of illness in cats. If your cat is inappetentyou will notice that they are eating less thantheir normal daily intake of food, or evennothing at all. You may, for example, describe
your cat as ‘not eating as well as normal’ or
having a ‘reduced appetite’, or being ‘fussy’or ‘picky’ or refusing food. Your cat may show
some interest in food, sniff at it but walkaway. Your veterinary surgeon may use theterm ‘anorexia’ if there is a complete loss ofappetite, or ‘hyporexia’ if your cat is eating
less than normal.
If you notice your cat eating less, or becoming
more selective (choosy) with food, or eveneating differently (dropping food, chewing on
one side), contact your veterinary clinic. It is
important to investigate the underlying cause(see page 3). Not eating enough, even fora period as short as three days, can havesignificant negative consequences for a cat,making any illness worse and causing othercomplications; hence the importance of
seeking veterinary advice.

Some illnesses and injuries can makeit difficult for cats to eat, although theirappetite is normal – for example, ajaw injury, dental disease or trouble
swallowing. In this situation, once theillness or injury is treated, the cat’s
appetite should return to normal,
although veterinary assistance, suchas the placement of a feeding tube
(see page 10), may be needed while
the cat recovers.

This Cat Carer Guide is focused on thosecats that are being managed at home
and are eating less than normal, perhaps
after recent veterinary treatment. Any
visit to the clinic, whether it is a lengthy
stay in hospital, a day as a surgicalpatient or simply a consultation, canbe a stressful experience. If the condition
being treated is associated withinappetence, then this failure to eat
normally may continue when the cat
returns home.

Learned food ‘aversion’

Pain

Effect of underlying illness(associating certain, or even(eg, osteoarthritis,(eg, kidney, liver or

all, foods with feeling unwell)pancreatitis,

intestinal diseases)

dental disease)
StressFeeling sick(eg, recent hospitalisation,(nausea, vomiting)other cats in the home)
Medications
Dehydration(bitter taste, stress(not drinking enoughof administration,or losing fluid)side effects)

Figure 1: There are many reasons why a cat might refuse food or eat less than normal, and these canact singly or in combination to reduce a cat’s appetite. (Osteoarthritis is inflammation of the joints,
and pancreatitis is inflammation of the pancreas; both are painful but common conditions in cats)2

Why is my cat not eating?
There are many reasons why your cat may not
be eating normally, including factors affecting
their physical health and/or mental wellbeing.
Generally, cats may not eat if they are feelingsick (nauseous), suffering pain or stress, or as adirect effect of their underlying illness (Figure 1).

• ‘Lip smacking’ (exaggerated lickingof the lips);• Exaggerated swallowing (repeated
and obvious);• Excessive drooling (Figure 2);• Gagging or dry retching (nonproductive vomiting), which may occur
at the sight or smell of food.

Illnesses that can reduce appetite

Illnesses can be acute (occur suddenly) or
chronic (persistent or recurring), and bothhave the potential to affect a cat’s appetite.
Examples include:• Kidney disease (acute or chronic);• Pancreatic, gastrointestinal (stomach andintestines) or liver disease;• Conditions affecting a cat’s sense of smell(eg, cat ‘flu’ or other nasal disease);• Dental disease or other oral (mouth) pain;• Abscesses (eg, caused by a bite fromanother cat);• Neoplasia (cancer);• Conditions causing pain (eg, osteoarthritis);• Neurological disease (causing nausea or
affecting the brain’s ability to control appetite);• Constipation (difficulty passing faeces).

Signs of pain in cats

Just like us, when cats are in pain they do not
feel like eating. However, cats can hide signsof pain and may just show subtle changes innormal behaviour, such as sleeping more andin unusual places, moving and standing stiffly,changes in urination/defecation, and reduced
grooming and interaction with the family.
For more information, see International Cat
Care’s Cat Carer Guide to recognising andmanaging acute pain in cats, available aticatcare.org/advice/cat-carer-guides.

NauseaFeeling sick is an unpleasant sensation and may
or may not be accompanied by vomiting (beingsick). Signs your cat may be feeling sick include:• Turning away from the food bowl (they may
initially show interest and approach the bowlof food, or even ask for food, and then refuse it);Figure 2: This cat is feeling very nauseous
and is drooling saliva. Cats may also
show more subtle signs of nausea suchas refusing food. Source: Dr Sam Taylor

Learned food aversion

If cats that are experiencing nausea,
pain or discomfort associate feelingunwell with the act of eating or seeingor smelling a particular food (or even
any food), they may develop a so-called
learned food aversion. Even when theunderlying physical condition is resolved,
the cat may show signs of feeling sickwhen presented with food, particularly
if this food was offered when the cat was
ill. Food aversion can also occur if a cat
has been ‘force’ or ‘syringe’ fed (whichis, in any case, not advisable as it causes
stress, risks the cat inhaling food into
the lungs and rarely provides enoughcalories). Food aversion may be treatedwith appetite stimulants (medications
that improve appetite), avoiding diets
fed while the cat was unwell, and by
reducing stress; occasionally a feedingtube may be required (see page 10).

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Stress

A cat that is experiencing stress may beinappetent, or may still be hungry but not
want to eat. Cats are very susceptible tobecoming stressed, and there may be
numerous factors involved, in relation toboth the physical environment (where they
live or, if they are hospitalised, the veterinary
clinic) and the people and animals within it.
What causes stress is a very individual thing,depending on the cat’s early life experiences,
its temperament or character (eg, shy or
confident) and its ability to cope withchallenges. The severity, duration andfrequency of the perceived ‘stressor’ (thesituation or thing that is causing stress)
are also important factors.
Causes of stress might include other cats in
the home (residents or entering via the catflap) or outside (in towns there may be manycats in a small area), or the return of a cat
after a period of absence (eg, after a visit to
the veterinary clinic – see box). Changes totheir home environment such as moving
house, building work, being confined indoors,a new pet or baby, excessive noise or strong
smells can also cause stress. If the cat’s‘resources’ (all the facilities that your catneeds, including somewhere to eat, drink,

Figure 3: ‘Resources’ are the things thatare important to cats. If they are positioned
incorrectly, as in this case of a food bowl
placed next to a litter tray, this may causestress. Source: Vicky Halls

go to the toilet, sleep, play, climb andhide) are not available, positioned
wrongly (Figure 3), or access is restricted,
this can likewise cause a cat stress.

Returning from the veterinary clinic to a homewith other resident cat(s)A cat returning from a visit to the veterinary clinic will inevitably smell of the clinic
environment. This novel odour can cause other cats in the household to respond aggressively
to the returning cat, which no longer smells familiar. This encounter can impact on previously
bonded animals and lead to a breakdown in the relationship in the longer term.
Here are some tips for minimising the risk of antagonistic encounters:• Bedding from home can be put into the cat carrier for the return journey to help
to reinstate a more familiar scent;• On returning home, keep cats separate initially for 12 to 24 hours;• Groom and stroke the returning cat (providing the cat experiences this as a positive
thing); this will make the smell of the clinic less evident when the cats meet;• Supervise reunions, making sure they are calm and that the needs of the returning
cat are met; for example, chasing or playing should be discouraged initially until yourcat is well again.

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Encouraging your cat
to eat at home
It can be upsetting when your cat is eating
less than normal. The first thing to remember,
however, is to stay calm and try not to worry– your own behaviour, influenced by yourconcern, may actually hinder efforts to getyour cat’s appetite back on track. Yournatural desire to tempt your cat to eat may
result in you changing your routines andbehaving unusually around food – this,in itself, may put your cat off eating.
It may be helpful to consider instead therecommendations below to tempt your cat
to eat, rather than trying to force the issue.
Every cat is an individual and this isparticularly relevant when it comes tolearning how best to encourage a cat toeat. Your veterinary clinic will be treating
the underlying illness, but there are certainly
things that you can do to encourage the firststeps back to normal eating habits.

What do I feed?

Cats often develop preferences for specificfoods at an early age, and these preferences
can become fixed and inhibit them fromtrying new foods in the future. The taste,texture and smell of food all influence a
cat’s motivation to eat, and even a slightly
different shaped dry food kibble may detera cat from eating. Therefore, the ideal foodto feed initially is the one that your cat has
previously enjoyed (providing this isappropriate for your cat’s illness). Foodshould be fresh, fed in a clean bowl andideally measured to give an idea of how
much is eaten. Your vet may have given
you a special diet for your cat’s condition,
but in most cases it is better to get yourcat’s appetite back on track again before
gradually introducing a new diet for the
long-term management of a specificcondition. If your cat is reluctant to eat a
newly prescribed diet then contact yourveterinary clinic to discuss alternatives.

You may want to consider offering ‘treat’food to kickstart their appetite – special
high-value items that your cat has
previously enjoyed, such as fish or chicken
or commercial treats. Be cautious withgiving too many treats or human food andcheck with your veterinary clinic if unsure.
Try to avoid offering a ‘buffet’ selection ofmultiple different types of food; anyone
who themselves has felt a little sick or not
like eating will recognise that plates ofdifferent types and flavours of food all
at once would not be appetising!
Always check with your veterinary
clinic what diet to feed and how much,and if treats and tempting withhuman food is appropriate.
Requirements may vary between cats
and between illnesses.

How much and how often
do I feed?

Cats that are inappetent tend to feelfull quicker, so it is helpful to feed small
quantities of food at regular intervals,
rather than give your cat large amounts
of food all at once. For example, offeringa tablespoonful of food every two hours
would be a good way to start, gradually
increasing the amount per portion as
your cat’s appetite increases. Some cats
prefer to ‘graze’, eating a little at a timeof their choosing, but try to avoid leaving
large amounts of food down as this canoverwhelm an inappetent cat.
Another important recommendation
is to feed at times other than thosespecifically scheduled for giving
medication or other treatments. If you
combine the two processes, particularly
if you intend to mix medication in food,it could result in your cat refusing meals
in case they contain medication, andmissing doses (see ‘How is it best to give
medication?, on page 8).

5How do I feed?

Whatever methods you use to try to
encourage your cat to eat, it is best to avoid
active interference with the eating processitself, such as force feeding via a spoon or
syringe or by placing food directly in yourcat’s mouth; or simply hovering close by
and watching your cat eat in a way you
would not do if your cat’s appetite wasnormal. Trying to adopt normal everyday
routines and behaviour around your cat,and not getting too involved in the actual
process of them eating, will reduce stress.
The important thing is to make mealtimes
as comfortable and relaxed as possible andthis means, for most cats, following the usual
pattern of how food has been presented in
the past. Every cat is different, and what is
helpful advice for some cats may not befor others. It is therefore useful for you to
observe your cat’s behaviour around food,when presented, to enable you to establish
how best to proceed.
Type of bowl
The type of bowl the food is offered in canmake a difference. For example, most cats
prefer ceramic or stainless steel bowls toplastic, as the plastic can taint the smell of
the food. However, if your cat has a favourite
plastic bowl then stick to this. If your cat does
not have a preferred bowl (or resists eatingfrom a particular bowl) then consider placing
food in a wider bowl or on a flat dish or plate,as some cats will spend longer at a food bowl
if the diameter (width) allows them to lower
their head and eat without their sensitive
whiskers touching against the sides of thebowl (Figure 4).
Preparing the food
As a cat’s appetite can be stimulated by thesmell of food, it may be helpful to warm foodto body temperature to enhance the aroma
and increase its palatability. This may be
counterproductive, however, if there is any
risk that your cat may have developed alearned aversion to food during the course of
their illness. In this case the opposite would

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Figure 4: A wide diameter bowl allows the cat
to lower its head and eat (or drink) without its
sensitive whiskers touching the sides of thebowl. Source: Dr Sam Taylor

apply: chilling the food or serving at room
temperature will reduce the strong odour
and taste, and may encourage your cat
to eat. This may be useful to try if your cat
appears keen to eat and approaches foodbut then walks away.
Company or not?
Some cats prefer company when theyeat, while others prefer to eat alone.
You know your cat well, so you may findthat stroking and talking softly to your cat
as you present some food encourages
them to eat. This gentle persuasion mustcome across to your cat as a positive
thing; it is easy to be anxious for themto eat and be more insistent in yourbehaviour, which will not have the desired
effect. If in doubt, it is probably best to
stay well away at the point where your cat
is considering whether to eat.
Where do I feed?
Whether or not your cat will eat is also
influenced by the environment in which
they are fed. The location where food isbe more inclined to eat if their owners
hide food, particularly dry kibble, in novel
locations. This may be sufficient tostimulate your cat to eat. For cats
recovering from surgery or with limited
mobility, food may be brought to them,and cats with osteoarthritis or spinal/
neck pain may prefer their food bowl to beraised to avoid them bending their neck.

Encouraging yourcat to drink

Figure 5: Avoid feeding in an area associated withpotential threats – for example, adjacent to a cat
flap or full length window. Source: Dr Sam Taylor

presented and what is going on around them
are important to consider. Other cats and dogs
(or even other people) being present while you
are tempting your cat to eat may be an issue.
This is particularly relevant if there hashistorically been any friction or competitive
behaviour between cats in your household,as this can influence eating habits.
If your cat is reluctant to eat in their normal
feeding location then you may get better
results by feeding in a novel setting, or evenasking another member of the family or afamiliar person to take on the role of ‘feeder’.
The chosen feeding site, if the usual feedingstation is avoided, should be in a quiet
location, away from objects or areas thatare associated with other activities (eg, litter
boxes) or that may be associated withpotential threat (Figure 5), such as:• Full-length glass windows;• Cat flaps;• Busy thoroughfares;• Noisy household appliances (eg, kitchenequipment, washing machines or televisions).
As cats are opportunistic feeders (meaning
they will potentially take advantage of foodwherever and whenever it is offered), some may

Cats obtain much of their daily waterfrom food. If your cat is inappetent, it isimportant to ensure there are sufficientand inviting sources of water toencourage them to drink and avoid therisk of them becoming dehydrated, which
may worsen their inappetence and cause
constipation. For that reason, make sure
your cat has easy access to plenty offresh water. Some cats prefer runningwater, so investing in a pet drinking
fountain (Figure 6) designed for catsmight tempt them. Cats are sensitive tothe taste of water, and some may preferbottled water over tap water, or rainwaterover boiled water, for example.

Figure 6: Encouraging your cat to drink(eg, with a pet drinking fountain if it prefers
running water) helps prevent dehydration.
Source: Vicky Halls7

If you are providing water in a bowl, then somecats will prefer a wide, relatively shallow bowl
where they can drink without their whiskers
touching the sides. In multi-cat households,
ensuring there are sufficient places to drink
water will avoid any risk of assertive cats
guarding water and preventing others fromdrinking (the same applies to the provision offood bowls). Placing the bowl away from thewall so your cat can face in any direction while
drinking can encourage some cats to staydrinking for longer as they can observe what ishappening around them. A water bowl canalso be placed outside if your cat has accessoutdoors (Figure 7). Some experts recommendthat water is provided away from foodsources, to mimic the natural behaviour of thespecies to eat and drink in separate locations.

How is it best to
give medication?
It is possible that your cat has returned
from veterinary care with medication totreat an underlying condition. However,
we all know that giving medications
to cats can be challenging, even more
so if they are not eating well. Hiding
medication in food can deter a catfrom eating, so it is never advisable togive with a main meal. Instead try witha treat (some products are specificallydesigned to help medicate cats) or ask
your vet if you can crush tablets into asmall amount of food. If this approach
fails, your vet may be able to provide
you with the same medication but ina different formulation, such as aflavoured liquid, based on your cat’s
specific needs. You could also ask yourveterinary team to demonstrate how to
put the tablet directly into the back ofyour cat’s mouth. Some bitter-tasting
medications can be improved bystoring the tablets or liquid in the fridge
beforehand, or putting them into agelatin capsule, so discuss if this isappropriate with your vet.
See icatcare.org/advice/how-to-giveyour-cat-a-tablet for more information
on medicating cats.

Figure 7: Placing a wide-brimmed water bowl
outside in an open space can encourge
drinking. Source: Dr Sam Taylor
If you are worried your cat is not drinking
enough, you can discuss with your vet
feeding a wet (tinned/sachet) diet or adding
a little water to food. Other strategies include
feeding flavoured water, such as spring waterthat comes with canned tuna or water thatchicken is boiled in (without stock), or
offering watered-down cat ‘soups’ thatare commercially available. Cat milks are
not generally recommended as they are
not a balanced food and can cause
stomach upsets.

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Monitoring your cat’s
eating and body weightIf your cat is fed ad libitum (ie, provided
with a supply of food and given the
choice regarding how much and how
often they eat), it may be difficult for you
to determine the actual amount yourcat has been eating and whether there
has been any associated weight lossor, if recovering from illness, weight gain.
Monitoring your cat’s weight at regularintervals will help you to plot your cat’stissue that is being lost, as cats can stay
fat but lose muscle mass. If you run yourhands over certain areas, such as overthe spine (Figure 8), it is easy to feel thebony prominences of the vertebrae(bones of the spine)if the muscles havewasted in that area; normally this region
would feel fairly solid and smooth.

Working with yourveterinary clinic

Figure 8: An inappetent cat can lose muscle
and this can be particularly evident on the back,resulting in the spine feeling more prominent.
In this image the cat also has a scurfy, dull
haircoat, which can indicate pain or illness.
Source: Dr Sam Taylor

progress and keep your veterinary teaminformed of any changes. Some important
points to consider are as follows:• Weigh your cat as often as your vet
recommends, likely weekly;• Weighing yourself with and without your cat
is an inaccurate method, which would misssmall weight changes. Electronic paediatricscales, designed for weighing babies andreadily available to purchase, will give youa more accurate figure;• Body and muscle condition scoring is atechnique by which you can monitor yourcat’s overall health by making certain
observations on the shape of your cat’s
body, viewed from the top and from the side(see wsava.org/global-guidelines/globalnutrition-guidelines). Muscle scoring is also
used in cats to monitor the type of body

Good communication between you andyour veterinary clinic is key to providing
the best possible care for your cat
and also helps to alleviate some of
the anxiety that you may be feelingwhen your cat is unwell. Choosing
to register with a Cat Friendly Clinic(catfriendlyclinic.org; Figure 9) gives a
caregiver confidence that the veterinary
team understand cats and work hard
to reduce the stress of a veterinary visit.

Figure 9: Veterinary practices that are
accredited Cat Friendly Clinics handle cats
quietly and carefully to avoid stress, which
can encourage cats to eat if hospitalised.
This cat, for example, has been given
a comfortable bed in which to hide.
Source: Dr Sam Taylor

9What are feeding tubes?
Various types of feeding tubes can be placedby the veterinary team to treat cats that are
not eating enough, and also to help give
medications. The tubes may run from acat’s nose to the oesophagus or stomach(naso-oesophageal or nasogastric tube,
respectively) or from the side of the neck into
the oesophagus (oesophagostomy tube).
Although these might sound unpleasant, catstolerate them very well and they can reallyhelp a patient’s recovery. Oesophagostomy
tubes (Figure 10), for example, can be used athome by caregivers to feed liquid food andslurries so the cat gets enough nutrition while
it either does not feel like eating or cannot eat(eg, fractured jaw). Your vet will discuss how
to care for the feeding tube.

Figure 10: The feeding tube in this catruns from the side of the neck into
the oesophagus (food pipe to thestomach), allowing the veterinary teamand cat carers to feed the cat and give
medications. Source: Dr Sam Taylor

For more information, see International Cat Care’s Cat Carer Guide to managing
the cat with a feeding tube (available at icatcare.org/advice/cat-carer-guides)
and accompanying video (available at youtu.be/UsLcTZ8u8Gk).
Below are a few tips regarding inappetencethat may help your vet to provide the righttreatment to suit your cat’s needs.
• Be specific – you may feel the mostimportant point to get across is that yourcat ‘is not eating’, but be specific about theamount eaten and how often, so your vet canjudge the relevance of this reduced intake.
• Keep a food diary – this will give your vet an
accurate history of how much your cat haseaten each day. Weigh the food before you
give it to your cat and then weigh any that isleft, to calculate the actual amount eaten.
• Be honest and do not be embarrassed orfeel guilty if, for example, you cannot get yourcat to eat the diet prescribed or to take their
medication. Your vet will be able to help andsupport you.
Your vet will want to treat the underlying
illness causing inappetence but may alsoprescribe appetite stimulants, as well as
medications to control nausea and pain,
to help you encourage your cat to eat
while waiting for results or for treatment

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to be effective. In some cases, it may benecessary to hospitalise a cat that is noteating; and, as we know that eating lessthan normal for even a few days canworsen a cat’s illness, your vet may
consider placing a tube to feed yourcat through (see box above).

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