Most veterinarians and scientific studies say that cats are in grave danger if they go without food for more than a day or two.
I was recently stunned to discover that 2 veterinarians at a local clinic follow a unique protocol for feline critical care. These 2 vets recently saw one of my clients’ cats on day 4 of refusing to eat, and the vets told this client that it’s fine for a cat to go without food for 9 days before we need to worry about the cat developing serious health problems.
This seemed like a good opportunity for me to write a brief post about cats who are refusing to eat.
It’s also a good time for me to mention that when you’re looking for a new veterinarian, it’s fine to ask them questions that you already know the answer to. If you’re uncomfortable with their response, just continue your search for a vet.
How long can cats go without food before they’re in danger?
For decades, veterinarians, veterinary professionals, and people doing cat rescue have seen that cats who are unable or unwilling to eat for more than a day or two are at risk of developing severe, irreversible health problems. And it’s been many years since the first scientific studies have proven that these observations are spot-on.
Cats who fast for a day or longer, have their kidneys so stressed that they develop chronic renal insufficiency (aka kidney “failure” or “disease”), although the condition might not present symptoms for several months – or even years – after the bout of anorexia. (I, personally, have seen this happen quite a few times. First with my own cat, Meek, and since then with a handful of clients’ cats who’ve gone missing or have stopped eating for a while. Luckily, Meek’s vet and the other vets who treat my clients’ cats, gave us this info.)
We also know that cats who go for 48 hrs or longer without food, are at great risk of developing several potentially fatal problems: acute kidney failure, acute liver failure, and hepatic lipidosis (fatty liver disease). Because of this, most vets hospitalize cats in this situation so they can be closely watched for signs of these conditions developing.
Why are fasting cats at such high risk of developing these problems? In a nutshell, cats’ livers and kidneys are always working. Unlike many other mammals, feline livers and kidneys do not rest when there are no nutrients to process. Having these organs work without nutrients to process is sorta like driving a car without oil; it’ll keep running for a while, but will be doing increasingly more serious damage as the hours tick by.
Highlights from a few resources on cats fasting
I don’t want to overwhelm you with repetitious quotes from the oodles of scientific and layperson literature about the dangers of cats not eating. I do, however, want to give you a few quotes to illustrate just how basic these facts are.
“Although some authors state that cats should not go without eating for 48 to 72 hours, the feline practitioners on the panel recommend that clients should be informed that cats should not go without food for longer than 24 hours (less in kittens) and that clients should call if the appetite tapers over more than 48 to 72 hours.” (American Association of Feline Practitioners)
“Intravenous (IV) feeding may be required if your cat is severely anorexic, especially if it has not eaten for three to five days or longer.” (“Loss of appetite in cats”. ) Or, if you prefer to see this medial terminology from a veterinary medical journal: “Patients that consume less than resting energy requirement of longer than 3 to 5 days with no trend toward improving should receive parenteral or enteral nutrition.” (Delaney)
“Complete anorexia occurs when the animal does not consume any food for ~3 days… Anorexia sets the stage for HL [hepatic lipidosis]” . (Aiello)
“If your cat goes without food for more than 3 days there may be an excessive build up of fat within the cells of the liver. This is referred to as lipidosis. This is the body’s normal response to a spell of anorexia but the effects on the liver can be devastating. The fat that builds up in the liver cells prevents the bile produced in the liver cells from leaving the cells. This build up of bile is toxic and causes marked damage to the liver cells, resulting in liver disease and failure.” (“Hepatic lipidosis in cats & dogs”)
“The cat’s unique metabolism requires food on a daily basis. Any time a cat doesn’t eat for a few days, fat may be deposited within liver cells… Most cats with hepatic lipidosis are extremely dehydrated and require initial hospitalization and fluid therapy. The most critical aspect of treatment, however, is ensuring that the cat receives adequate nutrition. Depending on your cat’s condition, you may be able to try force-feeding your cat high-protein, high-calorie gruel through a syringe. However, most owners have little success with this approach, and it may cause the cat undue stress. In most cases, the veterinarian will recommend that a feeding tube be placed to ensure that the cat receives proper nutrition.” (Tear)
When it comes to test results related to kidney function, every minute without food and fluids counts, so “it is often necessary to initiate therapy before diagnostic evaluation can be completed”. (Hoskins)
Select sources and further reading
Veterinary textbooks include info about the risks of felines fasting. For those of us who don’t have these texts on our shelves, below are a handful of sources to get you started in your quest for more info about this topic.
- Aiello, Susan E, ed. “Anorexia”, “Disorders of the liver and gallbladder in cats”, “Feline hepatic lipidosis“. Merck veterinary manual. Whitehouse Station, NJ: Merck & Co., Inc. 4 Oct 2013.
- American Association of Feline Practitioners (AAFP). Feline behavior guidelines. 2004. Â 4 Oct 2013. http://www.catvets.com/public/PDFs/PracticeGuidelines/FelineBehaviorGLS.pdf
- Chan, DL . “The Inappetent hospitalised cat: clinical approach to maximising nutritional support”. Journal of feline medicine and surgery.American Association of Feline Practitioners (AAFP). Nov 2009. 11: 925-933. 4 Oct 2013. Accessed through PubMed.
- Delaney Sean. “Management of anorexia in dogs and cats.” Veterinary clinics of North America: Small animal practice. Nov 2006. 36(6):1243-9, vi. 4 Oct 2013. Accessed through PubMed.
- Demmer, Claire and Kathy Clayton. “”Hepatic lipidosis or fatty liver syndrome in cats”.9 Feb 2012. 5 Oct 2013. http://yourownvet.com/hepatic-lipidosis-or-fatty-liver-syndrome-in-cats/
- DiBartola, Stephen P. “Chronic renal failure” presentation in “Urinary core course” (VM602) at Ohio State University’s College of Veterinary Medicine. 4 Oct 2013.
- Ewing, Tom. “Hepatic lipidosis”. Cornell Feline Health Center. Cornell University College of Veterinary Medicine. 20 Dec 2010. 4 Oct 2013.  http://www.vet.cornell.edu/FHC/health_resources/HepaticLipidosis.cfm
- Fascetti AJ, GE Mauldin, and GN Mauldin. “Correlation between serum creatine kinase activities and anorexia in cats.” Journal of veterinary internal medicine / American College of Veterinary Internal Medicine. Jan-Feb 1997 . 11(1):9-13.  4 Oct 2013. Accessed through PubMed.
- “Hepatic lipidosis in cats & dogs”. Native remedies. 4 Oct 2013. http://web.archive.org/web/20140602063519/http://www.nativeremedies.com:80/petalive/ailment/cats-dogs-hepatic-lipidosis-remedies.html
- Hoskins, Johnny. “Results from diverse renal diseases, injuries”. Â DVM: The Newsmagazine of veterinary medicine. Dec 2004. 35.12:Â S4,S6,S8-S9. 10 Oct 2013. Accessed through ProQuest.
- “Loss of appetite in cats”. petMD. 4 Oct 2013. http://www.petmd.com/cat/conditions/digestive/c_ct_anorexia?page=show#.Uk8NF_UlqSo
- Michel, KE. “Management of anorexia in the cat”  Journal of feline medicine and surgery. American Association of Feline Practitioners (AAFP). 2001 Mar. 3: 3-8.  4 Oct 2013.
- Novák F. “Risk of malnutrition and the role of artificial nourishment”. CasopÃs lékar̆ů c̆eských. 2005. 144 Suppl 1:67-8, 70-2.  4 Oct 2013. Accessed through PubMed.
- Tear, Marianne. “Hepatic lipidosis”. Vetlearn. 4 Oct 2013. https://www.vetlearn.com/reference-desk/care-guide/hepatic-lipidosis
Here’s an excellent article written by DVM Andrew Jones about how many veterinarians remain in business despite numerous complaints and lawsuits filed against them: http://www.theinternetpetvet.com/bad-vets/ . The vet clinic mentioned in my blog post has a reputation among former clients’ whose animals deaths can be attributed to their missed diagnoses (cancers, infections, starvation, dehydration, broken bones, autoimmune disorders, etc) and lack of appropriate treatment. Yet somehow they’ve remained in business for decades. Please – for the sake of your beloved pets – choose your veterinarian carefully.
One of my readers has mentioned the following as another useful source: Chan, Daniel and Lisa Freeman. “Nutrition in critical illnessâ€. Veterinary clinics of North America: Small animal practice. 2006. 36:1225-41, 19 Oct 2013. Accessed through Elsevier Saunders.