Eddie, the forever wobbly kitten.

Hi everyone-

I'm brand new to this site, but have found myself here quite often over the past few months for advice and help.

Back in February my husband and I adopted a 2 month old Siamese (pureblood) kitten from a cattery. It's been a roller coaster ever since. The kitten, Eddie, is 7 months old now, and for the past three weeks he has had severe ataxia, trouble using both front and back legs, his third eyelid is out, but covering less than half the eye. My parents took care of him for a week before he started showing these signs, and when we got him back he was covered in fleas. They tried to help by putting Sentry on (which was originally recommended by our vet and then later we were told that it could be dangerous for kittens), the vets washed that off and put on Revolution. The fleas have gotten better, though I do still see some from time to time. He is still eating and drinking fine, but because he can't move very well or quickly, he can't use his litter box very well at all.

On top of this, he had shown similar signs to this shortly after we got him, and did about 2k worth of blood tests and other tests, all coming back normal. We treated him for an ear infection and he got better in about a week. This time, no such luck. Three weeks on antibiotics and no significant changes or improvements. We took him back in, and when they tried to get a blood sample to do some repeat tests, he got very pale and nearly passed out (and severely bruised in the two sites they tried to take the blood).

The vet has officially run out of tests that they can do, and have referred us to a cat specialist (a cat neurologist), and we start down that path this weekend. He's walking in an arched position when he does walk, but tumbles often. Just wondering if any of you have had similar experiences or suggestions or really anything. We go to the specialist on Sunday, but I'm afraid they'll just want to run more and more tests (but at a specialist it'll likely be three times the cost of a normal vet).

First, he sounds very anemic from how you describe the vet attempting to get blood the most recent time and the fact your kitten nearly passed out and had bruising.

Has anyone tested him for a vector (flea) borne disease?

There's also the possibility he has neurologic problems as a result of the Sentry flea meds.

I honestly would not use a vet that recommend any "over the counter" flea meds such as Hartz, Sentry and Seargents. This is a *huge* red flag for me.

Good that you are able to get him in to see the neurologist. Is this a specialist at a vet school? Or someone locally with a "special interest" in neurology?

I agree. When I heard that they had actually recommended Sentry, that completely blew me away.

No, we haven't had him tested for any vector born disease yet. Thank you for the suggestion.

The specialist is a VCA specialty hospital that has a department in neurology.

You said he had similar symptoms when you first got him.  Does it look like this?

As far as the wobbliness of the cat in the video, yes, but Eddie is not nearly that strong and he doesn't really have the head shaking that a lot of CH kittens have.

The confusing part is that the wobbliness went away for a while, for a couple of months or so, but then returned. Kittens that are born with CH will always have the same gate, not better nor worse, right?

This may be a shot in the dark, but it is possible that your cat is one of those rare ones who is super sensitive to MACROCYCLIC LACTONES.  These are used in many of the broad spectrum flea remedies on the market today INCLUDING REVOLUTION.  It contains SELAMECTIN, which is generally safer than most ,BUT if you have an animal whose genetic makeup allows this drug to cross the Blood-Brain Barrier, it will cause these symptoms exactly as you described.  While it is known that some dogs, particularly collies and herding breeds, do have a genetic abnormality that allows this to cross the Blood-Brain Barrier and they have all these neurological effects, there is no general study of cats that I know of.  There is a test they can do on dogs..

Long story short, I had a kitten who had the exact same problem.  He had ear mites so instead of my usual Advantage II, the vet suggested using Revolution on him because supposedly it kills ear mites too.  We did this, and within a short time he had drooling, dizziness, loss of balance,apparent blindness, somersaulting into his food dish and he was obviously miserable.  I took him back to the vet and. and the vet thought the mites had caused an inner ear infection, causing dizziness and all those effects, so he put him on an antibiotic and another drug (Antivert) for the dizziness, which helped some, but he still wasn't right for a long time (several weeks). Over time he got better and we thought that was the end of it, it must have been an inner ear infection.  When the month was up, the vet again suggested using the Revolution instead f the Advantage II (which has no macrocyclic lactones) so I put on the Revolution and went off on errands for a few hours.  When I came back he was in full fledged neurological reaction again, drooling, stumbling around, dizzy, ataxic, and at that point I KNEW it had to be related to the medication, so I washed off whatever remained on him, then packed the area with corn starch to absorb any extra oil, and by the next morning he was completely fine.

I then embarked on a study of macrocyclic lactones in general and found his symptoms perfectly described in the DOG reaction section.  I took the results fo my vet and said I'm pretty sure he has this sensitivity.  He agreed that must have been it.  His chart is no marked NO MACROCYCLIC LACTONES.  I am hoping this is what is wrong with your kitten and if so, he should recover with just supportive care and never being exposed to these kinds of drugs in the future.  Praying for him!  Do let us know.

Your cat may have something else, but the timing is related to the application of flea medicines.  I do not know which Sentry product was used by your parents, but I DO know that the Selamectin in Revolution can do this to a sensitive cat, and what I would strongly suggest is DO NOT USE ANY MORE FLEA PRODUCTS OF ANY SORT ON HIM and wait to see if the symptoms will clear up as the medication wears off.  That's what happened with my cat, until the second dose of Revolution 4 weeks after the first brought all the neurological symptoms back again within hours!  Because I was able to wash most of it off so soon after it was put on, he was then able to recover in 24 hours. 

Your cat has had these symptoms for three weeks -- exactly how long he has had the Revolution on him.  the Sentry may have been washed off but then the Revolution was put on, and now it has been three weeks.  The revolution should wear off in another week.

You said he showed similar signs after you got him and you spent a fortune on tests.  Your vet treated him for an ear infection(just as my vet treated my cat) and he got better in about a week.  It's possible that his original owners had fleas and treated him with one of the products that contain macrocyclic lactones (there are several) and they last about 4 weeks.  Your Siamese may have reacted like mine (mine was half Siamese) and then got better after the treatment for the inner ear infection (just like mine was treated) and actually he got better because the drug he was reacting to finally wore off after 4 weeks. 

Let it wear off, Do not apply any more flea medicines of any kind.  Get a flea comb and comb any fleas you find off and knock them into a dish of soapy water to drown.  Hopefully your cat has no permanent damage and will recover, just as mine did, given time. 

In addition to sensitivity, there are certain drugs it should not be used with, others that bind to the same places on the red cells of the blood.  Those include Onsior, Metacam, Convenia and ketoconazole.  If he was given any of these drugs at the same time as the Revolution, that could contribute to the problem as well.  These are all things you should mention to your vet.

Here are the signs of macrocyclic lactone toxicity.  It was after reading this that I suspected this is what my cat had, when the second dose brought these same symptoms right back when he had seemed fine.

Here re just a couple of excerpts from one site I found when trying to figure out what might be wrong with my kitten:

The major signs of macrocyclic lactone toxicity, should they occur, are neurological:

Should Selamectin or any of the other macrocyclic lactones make it into the central nervous system of vertebrates (e.g. due to BBB damage, massive overdoses or defects in the exclusionary p-glycoprotein transport molecule), then neurotoxic effects will be seen, similar to those that occur in insects. Toxic signs in mammals include: depression, drooling (hypersalivation), swallowing difficulty, tongue paralysis, incoordination of the gait (ataxia), pupil dilation (sometimes pupil constriction), apparent blindness, vocalisation (seen in cats), high heart rate, high respiratory rate and muscle tremors. In severe cases (e.g. sensitive collies given ivermectin), respiratory depression, difficulty breathing, slow heart rate, cyanosis (a blue appearance of the gums caused by a lack of oxygen in the body), seizures, recumbancy, coma and death can occur. Cattle given an overdose of ivermectin showed similar signs.

Certain animals are more sensitive to macrocyclic lactone poisoning (young animals and collies):

The BBB (blood-brain barrier) is weaker in young animals and so toxic effects are more likely to be seen in juvenile and neonatal animals, even if their p-glycoprotein transport proteins are normal. This is why there are age restrictions in place for the use of Revolution in pets. Puppies should not be given Revolution flea control if under 6 weeks of age and kittens should not be given Revolution flea control if under 8 weeks of age (see section 7 for more info on Revolution flea control in young animals).

Animals on certain medications may also be more susceptible to macrocyclic lactone toxicity. Certain medications (e.g. ketoconazole) alter the function of the p-glycoprotein transport proteins or compete with the macrocyclic lactones for them. This results in the p-glycoprotein transport proteins being less effective at clearing the macrocyclic lactones from the brain or body, resulting in a longer duration of macrocyclic lactone persistence within the body and an increased risk of neurological toxicity.

http://www.pet-informed-veterinary-advice-online.com/revolution-flea-control.html#revolution-safety

There is a genetic test that can be done on DOGS  that shows if they have this mutation.  I don't know if there is one for cats or if the same test could be used.  Here is a link to info about the test and it shows what drugs are affected.  Very important to know if you have a dog with this MDR1 gene.  It only affects SOME dogs, but if I had a dog, I would definitely get it tested before using ANY of these drugs on it since many of these drugs are used in heartworm prevention.  The discovery of the mutation of the multi-drug resistant gene (MDR1) and its effects on multidrug sensitivity in dogs was made by Washington State University. It is a patent-protected diagnostic test that has been licensed exclusively to Mars Veterinary in the United States.  The test costs $60 and a dog owner may submit blood or just a cheek swab.

https://vcpl.vetmed.wsu.edu/

"Some dogs, particularly herding breeds or mixed-breed dogs with herding breed ancestry have a mutation in the MDR1 gene that makes them defective in their ability to limit the absorption and distribution of many drugs. These dogs are also slower to eliminate drugs from the body that are transported by P-glycoprotein. As a result, dogs with the MDR1-mutation may have severe adverse reactions to some common drugs, so it is important to test your dog and share your results with your veterinarian so they can provide your dog with for the best possible care."

Drugs affected by the MDR1 mutation:

• Acepromazine (commonly used vet tranquilizer for dogs & cats)
• Butorphanol (opioid pain relief and cough relief, Torbutol)
• Doxorubicin (chemotherapy agent, many toxic side effects in NORMAL cats)
• Doramectin (treatment for mange on dogs & cats)
• Emodepside (this is used in Profender wormer for cats)
• Erythromycin (oral macrolide antibiotic)
• Ivermectin (Heartguard, heartwormpreventative; ACAREXX for ear mites) (It appears that a very small percentage of cats (less than dogs) have a sensitivity and adverse reaction to Ivermectin).
• Loperamide (for diarrhea; Immodium; OK for dogs, not recommended for cats)
• Milbemycin (this is used in Interceptor wormer & ear mite treatment for cats) (Milbemax in Canada, AU and UK)
• Moxidectin (this one is used in Advantage Multi)
• Paclitaxel (Toxol; chemotherapy for malignant tumors)
• Rifampin Iantibacterial, antifungal, fights mycobacteria, aspergillosis etc.)
• Selamectin (this is the one used in Revolution for cats)
• Vinblastine (chemotherapy)
• Vincristine (Chemotherapy)

If you can find out what was used on your cat just before you got him, it's possible that he got a wormer or ear treatment that contained one of these drugs and he had a neurological reaction back then also.  This time he has had the neurological symptoms for three weeks since getting Selamectin in the Revolution.  If he IS one of the sensitive cats, it will clear up by itself once the drug is out of his system. 

 

How is Eddie doing?