At a glance
- About: Lethargy is defined as a lack of energy and inactivity beyond what is normal. It is a sign of an underlying disorder.
- Causes: Common causes include anemia, diabetes, viral infections, bacterial infection, abscess, urinary tract infection, liver or kidney failure and musculoskeletal injury.
- Diagnosis: Routine bloodwork such as complete blood count, urinalysis, and biochemical profile along with additional tests depending on your veterinarian’s index of suspicion.
- Treatment: Addressing the underlying cause as well as supportive care such as fluid therapy, nutritional support, medications and in some cases a blood transfusion will be necessary.
Lethargy refers to a lack of energy, inactivity, and enthusiasm. It is not a disease in itself but it is a sign that there may be something wrong with your cat. This could be something relatively minor or a sign of something more serious.
I am a big believer in knowing your cat and his usual routine. If you notice your cat sleeping more than normal and, has less energy or seems more sluggish than usual or notice other changes in behaviour it is always a good idea to have him seen by a veterinarian, no matter how subtle. Cats are exceptional at hiding sickness and pain from us, and it is the small changes such as increased sleep or loss of interest in surroundings that can alert us to a potential problem.
There are many possible reasons why your cat is behaving lethargically, many medical conditions are associated with lethargy in cats, which could be infectious or due to organ dysfunction. It can also be linked to stress and/or depression. We all know that when we feel sick, we are very often tired, this may be due to the body putting its energy into fighting an infection, or in some cases reduced oxygen supply.
Infectious causes of lethargy (viral, bacterial, parasitic or protozoal)
- Abscess – A walled off infection which is commonly caused by a cat bite.
- Ecoli – A common bacteria which lives in the gastrointestinal tract, in some cases the bacteria can move to other parts of the body such as the urinary tract.
- Feline infectious anemia – Bacterial infection resulting in the destruction of the red blood cells which supply oxygen to the organs.
- Pyometra – Infection of the uterus.
- Tularemia – A bacterial infection spread by the bite of a tick.
- Plague – A rare bacterial infection caused by y. pestis. This is the same bacteria which caused the ‘Black Death‘ in the 1300s.
- Osteomyelitis – Bone inflammation or infection.
- Feline herpesvirus – A common viral infection which is also known as cat flu.
- Feline Infectious Peritonitis (FIP) – An extremely pathogenic strain of the coronavirus which is almost always lethal.
- Feline Immunodeficiency Virus – A viral infection which is similar to HIV in humans.
- Feline Leukemia Virus -A viral infection which causes immunosuppression and cancer in cats.
- Heartworm – Parasitic worm which infects the heart and lungs.
- Severe roundworm infection which can cause anemia.
- Cryptococcosis – A fungal infection which has the potential to spread through the body causing organ dysfunction.
- Acute or chronic kidney failure – Decline in the function of the kidneys
- Addison’s Disease – Insufficient secretion of cortisone by the adrenal glands
- Congestive heart failure
- Hypertrophic cardiomyopathy
- Hepatic lipidosis – A form of liver disease caused by a build-up of fat cells in the liver as a result of anorexia
- Liver disease
- Yellow fat disease
- Ruptured bladder
Reduced oxygen levels
- Anemia – Reduced number of red blood cells
- Hypertrophic cardiomyopathy
- Pulmonary edema
- Pleural effusion
- Certain medications
- Dietary (inadequate amount of food, poor quality food)
- Heat stroke
- High blood pressure
- Hypercalcemia – High blood calcium levels
- Hypocalcemia – Low blood calcium levels
- Inflammatory bowel disease
- Nutritional disorders and or deficiency
- Pancreatitis – Inflammation of the pancreas
- Gastrointestinal disorders
- Thrombocytopenia (low blood platelets)
- Systemic lupus erythematosus
- Poisoning (zinc, ibuprofen, antifreeze, paracetamol)
- Gastrointestinal obstruction
- Urinary blockage
- Grief such as loss of a family member or companion pet
This list is by no means conclusive, there are also many other possible causes of lethargy.
Lethargy signs can be quite non-specific but may include inactivity, drowsiness, loss of interest in surroundings and activities your cat would usually enjoy (playing, spending time with you, following you around the house, chasing flies). It may or may not accompany other symptoms, depending on the cause.
- Anorexia (loss of appetite)
- Behavioural changes such as no longer greeting you at the door when you return home, not interacting with you or other pets, loss of interest in general.
- Breathing difficulty such as open-mouthed breathing, coughing, gagging, rapid breathing, panting
- Increased thirst and urination (polyuria/polydipsia)
- Weight loss or weight gain
The veterinarian will perform a complete physical examination of your cat and obtain a medical history from you, including other symptoms you may have noticed.
- Biochemical profile, complete blood count, and urinalysis to evaluate the overall health of your cat including how the organs are functioning, to check for signs of infection or anemia.
- Ultrasound to evaluate the organs and look for tumours or blockages.
- Radiographs of the heart and chest to evaluate the organs for enlargement, fluid buildup or tumours.
- ACTH stimulation test – This test is to evaluate your cat’s adrenal gland function.
- Fecal examination – To look for parasites.
- FIV and FeLV blood tests.
- Specific tests for pancreatitis.
- Heartworm tests.
Treatment depends on the underlying cause of the lethargy. Supportive care should be provided and may include:
- Fluid therapy to correct dehydration and replace electrolytes (if necessary)
- Nutritional support, if your cat is not eating at all, he may be given a feeding tube
- Cage rest (either at home or at the veterinary practice)
Additional treatment will vary depending on the underlying cause but may include:
- Bacterial infection: Antibiotics to kill the bacteria.
- Abscess: Surgery to open, drain and flush the abscess and antibiotics.
- Hepatic lipidosis: Aggressive nutritional support, fluid therapy and anti-nausea medication.
- Viral infection: Anti-viral medication and supportive care.
- Parasitic worms: Anti-worming medication to treat roundworm, supportive care for cats with heartworm.
- Stress: Determining the underlying cause of stress, grief or depression. In some cases, changes to the household dynamics and/or antidepressants may be prescribed.
- Dietary: Feeding a well-balanced diet.
- Pancreatitis: Painkillers, anti-nausea medication, nutritional support and in some cases, antibiotics.
- Poisoning: Gastric decontamination, activated charcoal to bind to the toxin and prevent further absorption, and where available, an antidote.
- Blockages: Surgery to remove the blockage.
- Heat stroke: Cool the cat down with fluids such as cool enema to treat heat stroke, along with emergency supportive care.
- Cancer: Surgery to remove the tumour if possible, in addition, chemotherapy or radiotherapy to shrink the tumour and kill any remaining cells post surgery.
- Thoracentesis to remove fluid from the pleural cavity.
- Diuretics to help the body flush out excess fluids if your cat has pulmonary edema.
- Severe anemia: Blood transfusion.