Update on Sylvester - any help?

Hi Guys

So I posted on here about my cat 15 year old male cat Sylvester a few weeks ago and got some great advice about his condition.

So he still has very weak hind legs, getting weaker and weaker. Slightly dragging them when he walks and when he goes for a poo he collapses after it as if its made his legs very weak. He is also still twitching and tremoring too when he tries to relax. Usually when trying to fall asleep he begins twitching a lot, enough to stop him from having a proper sleep and also when he drinks water, he has very big twitches form his shoulders/front legs.

- His feet is still always warm so I think this is enough to rule out any form of blood clot

- His temperature is checked often and its normal so this also partly rules out infections.

- His urine was tested a few times and again, was fine.

- Hyperthyroidism and Diabetes has also been ruled out and we have been informed that cats only really tend to get one form of diabetes so they don’t think its diabetic neuropathy either.

- Only a very small reading of an enzyme appearing in his liver was found but not enough to be any sort of problem apparently.

He has been allowed outdoors all his life, however now because he is slow we don’t let him unless on a leash. When he goes to the toilet he takes a while to pee. He goes in and out his litter tray as if hes trying to do it but cant, although he has always hated the litter tray and will hold in the toilet as much as he can until he is allowed outside. When hes deserpate he goes.

Medication:

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  Lactulose 1-3 times daily to make it easier for him to poo, not that hes constipated, but just so he doesn’t have to strain so much.
• 
  He is off Loxiciom now and back on steroids (prednisolone).
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  I give him a glucosamine supplement with his food incase its arthritis too.
• 
  He is also on other medication to help with nerve function,.
• 
  He is fed a half wet/half dry diet of J/D hills food and given cat milk as a treat mainly to keep his weight up as he has lost a lot of weight and muscle and also drinks lots of water in his own time.
• 
  He is had 1 anti-biotic shot around a month ago incase of any infection

We have narrowed it down to the fact he may have a problem with his right hind hip which often gives way and he falls over. He has had a growth under the skin on the same hip for a few years now which isn’t serious. Could this have anything to do with it?

Again his blood tests are all perfect and he will be getting up to date blood tests at a later date however we have to get blood from his neck whilst still awake so this is very stressful for him. We don’t want to do this a lot.

Does anyone else have any advice or been through something similar?

I know this screams X-Ray/MRI/CT Scan, HOWEVER… he has very bad reactions to anaesthetic – the vets here (I live in the North East of Scotland) will not give him an X-Ray. I have tried literally begging around 6 veterinary practices here which takes u to 1.5 hours to drive to and all have declined to give him an X-Ray without anaesthetic – the equipment is not up to date enough to do it without aneasthetic they tell me unfortunately.

I just don’t know what else to do? The vet said she would be able to get him through a very light sedative which would be a very light anaesthetic for the X-Ray/Mri scan, however it will take a LOT out of him and he will take a long time to recover just from that – but if this is the best chance I can give him.. should I do it or not.

Could anyone help?

Thanks a lot

My vet here in small town Nebraska just x-rayed my 14 year old with out anesthesia, I could maybe see it for the CT scan or the MRI though. But maybe just get an X-ray first to see if it points to anything? I would be REAL suspicious of that 'growth' on his hip, it could have invaded nearby nerves or muscles and causing problems. I'm sorry I can't be of help, I know how heartbreaking it is to feel so helpless, my heart goes out to you. I pray you find an answer!

Without progressive cardiac disease, he has many options for sedation. Acepromazine is helpful for Xrays, with or without masking down some/completely with inhalant gas. Educational institutions refuse to do fully awake radiography also... they sedate, place patient, exit the room, and monitor patient/capture Xrays outside the room.

It's more a preference for higher safety standards, not so much their lack of technological equipment. Sometimes hospitals don't have the adequately trained staff to wear protective lead, professionally restrain and expose the anatomy needed in the image, while limiting their own Xray exposure, thus the administration elects for sedation and remote capturing of Xray images.

Perhaps the safety regs of Scotland don't allow a human to be in the Xray room, even with protective lead covering all organs/glands. I don't have the luxury of sedating for Xray as my patients are already unwell, having trouble breathing, or may need general anesthesia for emergency surgery, so sedation just for Xray isn't an option.

Full anesthesia is absolutely needed for CT scan/MRI, as we can't tell a cat to hold absolutely still for many minutes while the machine scans them, and we need the option of injecting dye and connecting monitoring equipment is vital when dye is used. Anesthesia is a must for these.

There have to be options as so many severely ill or traumatized/injured patients get imaging done. Propofol is the best anesthetic option for such patients, and your cat may have had a bad reaction to one of the other commonly used sedatives, such as DexDomitor and/or Ketamine, as these are poor choices for geriatric, ill, or traumatized patients, but still popularly used in combination anesthesia for cats.

Ask for details about precautions, monitoring, and their selection of the type of anesthesia that is best for your aging, less than best health boy. Arm yourself with information and get them to understand you want to be the best advocate for your cat you can, and imaging is important to you but not at the expense of his well-being, so consideration of his history with anesthesia is important in their selection of sedation this time around, or you are not going to allow them to Xray/scan him.

Good luck with Sylvester and I hope they can definitively diagnose and help him!

Thanks so much for all of your help!

I will use all of this information tomorrow when I call the vets. I had asked about the different types of sedation but I wasnt given a straight answer. I was uust told that the equipment wasnt modern to be able to adequately perform an X-Ray without sedation.

This time i will come armed!

Thanks so much for all your advice. I greatly appreciate it.