8 year old neutered male Maine Coon, Tubes. 9.4 kg at his heaviest, 8.4 in July, 7.6 last week. The picture is of him just a few months ago, now he looks so tired and skinny it's heartbreaking. 

He had a food allergy episode in June, but we figured out he was allergic to fish protein and put him on food without it. Sadly, he stopped eating around Aug 21. Since then:

* Blood test came back normal except for borderline low red blood cell count
* They initially gave him a steroid shot, which definitely worked well (made him more active and he ate on his own) but due to the heart finding below they are hesitant to keep on giving him steroid shots.
* He's on transdermal cyproheptadine for appetite and it isn't doing much anymore. It seem have worked for a few days but now he doesn't seem to respond to it much. We also have Mirtazapine, so we will try that but don't have much hope given how little response he has to cyproheptadine now.
* As a result have been syringe feeding him prescribed urgent care food (which he obviously does not like)
* X-rays: enlarged heart, some spine disc issue that maybe just related to age.
* Cardiologist echo: HCM phenotype, ACVIM stage B2, moderate left atrial enlargement with "smoke" in it. Will be starting on 1/4 of a 75mg clopidogrel daily.
* proBNP came back 200, so not in heart failure
* Thyroid numbers came back normal
* FIV and FeLV both negative
* This week we noticed his gums and inner ears look pale
* We will be putting him on Rapamycin, the vet will prescribe 2.4mg/week.

 Questions for anyone who's been through this:

1. For people with HCM cats who went off food, what actually got them eating again?
2. Did anyone have success with any other medication or treatment?

Thanks in advance!

Mike

Advice for 8yo Maine Coon: not eating, lost weight, HCM 2b diagnosis