I'm sorry your pet is ill.

Were both a CBC and serum chemistry (also called serum profile)done?

I would do (or repeat) both of those as well as a urinalysis and probably x-ray his abdomen.

Have any of the vets shown any concern re: lipidosis?
I think an ultrasound of the abdomen is in order and I would be very concerned since he hasn't eaten or drank anything in nearly a week.
IMO, he needs hydration and nutrients until they find the problem.

Here is a link that might be useful: Lipidosis

Many thanks for your comments. I should have made clear that liver and kidney function were checked satisfactorily - no lipidosis.

Our very senior Vet (he is Cruft's Chief Veterinary Officer - yes, dogs, I know) saw Sam again today. He was not in favour of either an Xray or ultrasound - he reckons that there is no evidence that anything they might reveal is amiss.

However, he did force-feed Sam some Hills A/D by syringe, then Sam licked more off his fingers. Having got Sam home, he ate a treat stick by himself and we've syringe-fed him twice more - he wouldn't eat off our fingers (maybe after 14 years he's trying to tell us something). He is still unwilling to feed himself from a dish (you wouldn't believe all the stuff we've bought to try to tempt him - liver, chicken, haddock, beef, tuna, etc, besides a variety of cat-food) but has drunk a fair amount of water.

We're happier that he has got some food and drink inside him now but will be much happier when he's back to feeding himself. We will be even happier if we ever discover what stopped him eating/drinking in the first place.

For the benefit of anyone else who reads this with a similar problem, we had read elsewhere about putting honey on a cat's gums - some people had apparently had success with this as a starter to get their cat eating normally again. We tried it last night and syringed about 4ml of watered-down honey directly into Sam's mouth. He licked around and swallowed all of it but, sadly, I can't report that he restarted eating.

Do you knit or sew? The puking, not pooping or eating plus straining make me wonder if he didn't eat some thread or a couple of Bucky Balls or something else that's tangled in his gut. Although, admittedly, I have no idea whether that would show up on his bloodwork.

You wrote, "Our very senior Vet (he is Cruft's Chief Veterinary Officer - yes, dogs, I know) saw Sam again today. He was not in favour of either an Xray or ultrasound - he reckons that there is no evidence that anything they might reveal is amiss."

Is there a university veterinary school or private specialty practice (ie. board certified internal medicine specialist) within driving distance? Not eating is ample evidence that something might be found on an abdominal x-ray or ultrasound.

When this happened with one of mine, it turned out to be an intussuscepted bowel! This is YOUR cat, please insist on more diagnostic procedures. At this point an ultrasound or radiograph are necessary.

An awful lot of vets are specialised in canine medicine, but what works with dogs can kill cats. Insist on the ultrasound, just to rule out intussusception or obstruction.

I agree with what others have said and want to suggest you find a vet that specializes in cats.

I don't know if you have access to a university vet school clinic in the UK, but if you do, that's where I recommend you take your cat. That's where you'll find the diagnostic equipment and veterinary specialists that will be able to properly diagnose and treat your cat. I agree that an abdominal x-ray and ultrasound may be diagnostically useful, though an ultrasound should only be performed by a very experienced technician. It takes specialized training and experience to perform and interpret an ultrasound accurately.

I also urge you to acquire copies of ALL of your cat's lab reports and post them here so that we can take a look. I can't tell you the number of times vets have told me that lab results were "normal", just to have that not be at all the case when I reviewed the results myself. You should ALWAYS request copies of all lab results so that you can research them yourself and see if there are issues that need to be further addressed with a vet.

Laurie

Very many thanks to all of you who were kind enough to answer my cris de coeur. We don't have a Vet school or similar in practicable travelling distance, so sadly this was not an option for us.
After 7 visits to the Vet in 9 days, including some force feeding by the Vet & us, Sam still wasn't eating - just drinking a little water each day. We felt that it simply wasn't fair to probe and jab him with more needles, so we let him do entirely what he wanted, when he wanted for a week. This was sleeping for 99% of the time and moving very little.
After a week we concluded that his life was scarcely an existence, so with the greatest reluctance we agreed for our brave pretty Sam to be put to sleep on Thursday.
Our Vet said that he was sure that Sam had intestinal cancer of some sort but at close on 14, we didn't think it reasonable to put Sam through more investigation when the probable outcome was that it was inoperable. Cost never came into it - I would have done anything if I had thought it would give Sam a healthy life.
At 75 I regard myself as an ordinary 'stiff-upper-lip' type Englishman. Over the years I've parted from several canine and feline companions, as well as humans close to me, with just a few private tears each time but Sam's going has simply shattered me, so sorry for this literary diarrhoea and heartfelt thanks again for offering your suggestions.

Dear asturley,
I am so sorry for the loss of your beautiful boy Sam. From the picture I can see how beautiful he was, and from your posts it is very obvious how much you loved him. I hope you can find peace in your memories of your 14 years together.

So sorry asturley. It is often difficult to balance our desire to keep our pets around longer against what is best for them. It sounds like you made the right decision for your Sam, even though it was surely difficult for you. Take care.