You have raised several good points for me to address and I will try to hit them all.
1. (My cat is about 16 years old, and over the last several months, has just been hungry all the time. She weighs about 6.5 lbs, and the most she ever weighed was just over 7.) Weight loss in the face of a voracious appetite in a senior cat is highly suggestive for hyperthyroidism. Blood tests can reveal this possibility.
2. (She gets Fancy Feast canned (she won't eat any other kind - I've tried them all) and Iams Senior dry.) Cats that are repeatedly offered choices of food when ypoung because they delay or avoid eating anything in particular, learn to walk away to see what comes next. In an older, possibly sick cat eating whatever, unless there is a medical need (which in this case there may be) there is little reason to change and cause the cat emotional stress. However, in younger cats, pet owners should not play this game. "Finickiness" is most often trained into a cats psyche by owner anxiety at cats who do not horry to eat. Many cats are grazers, unlike dogs, but can and should be trained as kittens to eat meals. Doing so has advantages: it is immediately apparent whether eating is adequate, or occurring at all AND when a pet is ill, there are still fallback foods as yet untried with which to tempt an older sick cat that may not be eating. (Hold your fire with food changes, young cat owners!)
3. (She is not eating her dry food at all.) May be "finickiness" as described in #2 above or painful dental disease. Get it checked out.
4. (Last summer, she was vomiting then fainting, and the vet put her on Enalapril for blood pressure, which was a bit elevated. We took her off that just before I moved, and she hasn't had any more fainting episodes at all, and rarely vomits now.)
Hypertension (high blood pressure) may be a primary problem or secondary to another condition like hyperthyroidism, kidnesy disease or heart disease. Hyperthyroidism may cause vomiting, Hypertension from any cause rarely spontaneously resolves. You either need to treat primary hypertension or treat an underlying condition. Have that re-evaluated.
5. (The only other medication she is on is phenobarb PRN for a twitching skin condition that no vet has been able to diagnose in 10+ years (not epilepsy, maybe FHS, maybe allergies but she didn't respond to allergy tx, etc). She hasn't needed the it in about 2 months.) Paraesthesia or hyperesthesia syndromes are thought to be phantom nerve sensations or even a psychological problem. Phenobarbital can be helpful, however it can cause increased appetite, weight gain as well as liver problems and sedation. There are other medications available to address hyperesthesia. If its not constant and the cat is not pulling fur or damaging skin, then perhaps this problem is a lower priority right now and can be temporarily ignored.
6. (She is 16, and I don't want to keep putting her through medical stuff if it's not needed. She's become a cranky old lady and isn't fond of the vet.) These points are no doubt true, however, I would ask"Is it better to "put her through" untreated disease.
"Medical stuff" as you say may be the answer to her problems and may well prolong her good quality of life.
See a new doctor where you are. Get the following done: physical examination with attention to palpating neck for thyroid enlargement, CBC, biochemical analysis, urinalysis, thyroid test (T4), blood pressure, abdominal xrays (may reveal mineralization or other kidney abdnormalities). Once that information is assembled, a rationale decision can be made as to what if anything needs to be done.
Good luck and let us know how it turns out please.
Arnold L. Goldman DVM, MS
MedHelp & PDOC
My 15 year old cat is always hungry, as well. Strange thing is she was 11 or 12 lbs a couple of years ago, 9.4 lbs in the fall and now 7.2 lbs in the spring. She keeps eating, but is losing weight and also vomiting more. We had all bloodwork done in the fall and she has great vitals - all levels fine - in fact, that of a younger cat. I recently went back in to have more bloodwork done on her as she shows all signs of hyperthyroidism, but her levels were normal. No diabetes or other ailments. Vet now suggests abdominal x-rays, etc. I wonder if it is something abdominal. Could be bad...cancer? Not sure what to do as the tests keep getting more expensive and the cat does not like to go to the vet - gets very stressed.
There are numerous other conditions which may lead to weight loss. Blood work and urinalysis alone may not detect all of these. Weight loss and vomiting may be due to any of these and may not affect the appetite. Repeats of tests allow changes to be monitored over time and those changes may be instructive. Blood work is fairly inexpensive and as the testing becomes more involved and complex costs are greater. Repeating lab work is the least expensive, and most likely way to possibly detect an identifiable problem before going further with diagnostics.
X-rays may be helpful. If they are not then ultrasound or endoscopy with intestinal biopsies may come next. Medicine is a process of ordinary exclusion of known possibilities, rather than the product of someone wise "looking the pet over" and surmising the correct answer. Adherence to the process most often leads to a correct diagnosis. Often simple and common things are figured out easily and that is what people have come to expect. However, inflammatory bowel disease in all its forms, pancreatic disease, gall bladder and bile duct disease, various liver ailments, endocrine disorders and others can all show as your cat has, with nonspecific signs.
Follow up with your doctor and if you are not satisfied, see a Board Certified Internist (credential is DACVIM) for a second opinion. Always seek second opinions from specialists rather than other generalists. Otherwise you may find yourself trying to parse the best of 2 out of 3 equal opinions for the most likely correct answer.
Good luck and let us know how things turn out.
My 12 year old cat is hungry all the time, she has even been eating food out of the garbage! She has not lost any weight but according to the vet has normal high thyroid. She is also on insulin fir diabetes and on a diabetic diet. She won't stop crying for food, she is peeing and pooping everywhere and her poop is very stinky! I don't know what else to do! Ive asked the vet for thyroid pills that didn't work. She is costing me a fortune and I'm pregnant and am nervous of cleaning all the cat poop and pee that's hidden all over the place! Any ideas?