Third eyelid visible, tests came back good

Hi, I’ve been out of town for 4 months. I returned home and apparently my cat (10 yr old, blind, obese male) has stopped grooming himself (covered in mats), his third eyelid doesn’t retract all the way, and he seems a little more lethargic than usual. He’s just not “himself”, his face always looks like he’s groggy. However, he is still crazy about food, drinks, and uses litter box normally. We had extensive bloodwork plus urinalysis done. Everything looks good. The vet said he seems fine but knows I as the owner would notice subtle changes more than he would. Vet suggested maybe my cat is depressed by my absence.  (I disagree as my cat has a great relationship with my family members). I’ve been home for 2 weeks now and see no improvements. Not sure what to do. I don’t want to ignore an underlying condition but the vet didn’t have specific suggestions. He gave gabapentin for pain but that doesn’t cure anything. Any other opinions?

Hello!  I understand that you have a blind, obese male cat who has stopped grooming and seems very lethargic.  Nothing was found on 'extensive' bloods, but I am unsure what bloods these were or where your vet is up to in their diagnostic process (a logical method of working out what is wrong).  There are also some causes of the signs that you describe which would not show explicitly on bloods, for example certain kinds of heart disease, cancer, ascites (which would cause an enlarged stomach), hypothyroidism (incredibly rare but not unheard of), pain eg in arthritis and pancreatitis, perhaps in combination with obesity.  Usually, at this point, the vet would have a physical or mental list of problems (problem list) and possible explanations for each of them, and know what to do to try to rule certain possibilities out.  Sometimes these might need more tests, for example urine tests and imaging.  If they are at the end of their understanding,  then they would normally ask to refer the case to an expert (for example a specialist centre or vetschool). It sounds to me as though you would like to have this process explained and to understand what has been ruled out, what it could still be and what point your vet has reached with their investigations.  Obviously they know much more about your cat by now that me. Sometimes, there is no one diagnosis, but rather an individual has several smaller conditions occuring simultaneously. Best of luck taking this forward