Liz Buchanan BVSc MRCVS
Keymaster
Hello! I'm afraid that this picture isn't really complete, in that if your 23 year old cat is perfectly healthy, why aren't they eating? Cats seldom stop eating randomly - and when they do stop eating *apparently* randomly, no amount of Mirtazipine or dietary supplements are likely to over-rule the underlying problem for very long. I hear that blood tests have been done - you don't say which, but most vets would have started by running a basic panel with 12-18 general perameters on it - and if all were normal at the last check, that is one positive. However, there is no blood test for cancer and basic in-house blood tests rarely cover immediate blood glucose or pancreatitis, which is a common reason for older cats to stop earing. Nor is there a blood test for abdominal or dental pain, heart disease, arthritis or lung disease. Cats are solitary creatures and thereby expert at hiding discomfort, which is perhaps an evolutionary 'thing' in case of would-be predators.
I'm afraid that it sounds as though you need to present to the vet again and ask, 'What now?' I hear that this can be scary when your cat is 23 years old, but the sooner an anorexic cats' needs are addressed, the more likely something can be done - and the less likely they will be in discomfort. Wishing you and your loved one all the best. There are some good articles about old cats in the blog.
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