Heart breaking effects of vestibuar syndrome

As short a story as I can make it:

Cat was fine at 8:00pm, let him outside for the evening

Came in at 6:00am, severe drooling, stumbling, can't walk.

Spent 2 days in the ICU but took him home because he wasn't eating there, and felt he'd be more comfortable at home.

Also spend 2 days on the internet trying to understand this.

Blood tests are fie, pending toxoplasmosis results

He's on Doxycyclene and Meclizine for ataxia, still drooling badly and can't walk.

I'm a guy and guys aren't supposed to love cats but I can't even begin to explain how devastated I am to see my cat this way. His name is Alec and he's the only one who's got me past the most difficult time of my life a few years back.

He doesn't eat and I have to figure out how to feed him but worried he will vomit and make things worse but I'll see how it goes today.

He likes confined spaces which probably helps his ataxia so I let him sleep in his cardboard box under my desk.

He's safe and comfortable and responds to his name by wagging his tail so his mental state is fine.

Just looking for help or advice to make him recover and interested in hearing from others who were in a similar situation, what you did, did your cat recover, how long, etc...

Thank you so much

It sounds like poisoning with a macrocyclic lactone type insecticide.

I had one this happened to.  He had received Advantage Multi flea medicine because he had ear mites.  In the past he took Advantage II.  Nobody suspected.  Long story short, it turned out he was one of these  cats who have a genetic defect which allows macrocyclic lactones (like ivermectin, selamectin, moxidectin etc. which are in almost all flea control products that also either killl worms or prevent heartworms) to cross the blood-brain barrier and so they are poisoned just like the insects are.  It CAN be treated agressively using charcoal drenches, or if it isnt a serious overdose, he will recover in about a month very slowly.  Mine had recovered, also had meclizine etc. and seemed fine (vet thought it was inner ear infection from the mites) but after a month there were still mites so he got another dose of the advantage multi, and within an hour he was back in the old neurological state just like before.  Tht's how we knew.  I bathed him immediately (it had only been on for an hour or so) and packed the area with corn starch to absorb any extra oil (it's a fat based i.e. lipid medicine).

If your cat has been exposed to ANY of the flea medicines that have these, wash him, pack the area with cornstarch and get him to the vet.  Charcoal helps inactivate the stuff -- otherwise it recucles through the liver and the bile produced goes back into the intestine and gets reabsorbed and continues to make them sick.  I hope this is what is wrong with your cat.  If it is, he will be fine in awhile.

Somw  Dogs have this problem but cats have not be3en studied for it but they do have it.  Vets know about it in dogs but not in cats, but we are seeing it more often now that more of these products are being used in the new flea medicines.    It is called the MDR1 gene

ASK YOUR VET TO CONSIDER THIS DIAGNOSIS.

Here is the vet info on these sorts of drugs

http://c.ymcdn.com/sites/www.aavpt.org/resource/resmgr/imported/macrocyclicLactones.pdf

If you have not put any flea/worm preventatives on your cat, then perhaps someone used one in the vegetation outside and he got into it.  Spinosad is often used for insects on trees etc. 

Vertebrates do not have glutamate-gated chloride channels and therefore macrocyclic lactones do not have these to act upon (i.e. no receptors for the insecticide means no toxic effect from the insecticide). Vertebrates do have GABA-gated chloride channels in the central nervous system (and some in the peripheral nervous system and gut), however, in most normal animals, the macrocyclic lactones are prevented from making contact with these channels because of the strong, exclusionary blood-brain barrier (BBB) and because of the p-glycoprotein transport molecule, which swiftly removes any macrocyclic lactone compound that makes it through the BBB and into the brain.

"Should Selamectin (which is the active drug in Revolution) or any of the other macrocyclic lactones make it into the central nervous system of vertebrates (e.g. due to BBB damage, massive doses or defects in the p-glycoprotein transport molecule), then neurotoxic effects will be seen, similar to those that occur in insects. Toxic signs in mammals include: depression, drooling, swallowing difficulty, tongue paralysis, incoordination of the gait (ataxia), apparent blindness, tremors, seizures, coma and death. Though at first it seems odd for "excitation" signs like fits and tremors to occur with GABA-gated chloride channel activation, be aware that nerves cross-link in weird and wonderful ways and should a macrocyclic lactone cause the inhibition of a nerve that is, itself, an inhibitor, the overall result on the central nervous system might turn out to be one of excitation.

The Archives of Insect Biochemistry and Physiology in December, 2003 explains the "excitation" (tremors, fits, excitement) side effects seen in mammals poisoned with macrocyclic lactones another way in its article on chloride channels and selective insecticides. According to the article, the mammalian toxicity effect is dose-related. At lower doses, the macrocyclic lactone drugs bind to the GABA-gated chloride channels of mammals, but do not actually activate them (i.e. do not cause the influx of chloride ions that suppresses the nerves). They just block the GABA from getting access to them. This results in the nerve being easily and excessively activated (there is no GABA down-regulation of the nerve) and thus, an opposite, excitatory effect is noted - often a 'coarse tremor' or convulsions. With increased concentrations (doses) and longer-term exposure to the drug, the GABA channels do get activated, similar to the effect seen in insects, with resultant suppression of target nerve activation and signs of ataxia (wobbliness), flaccid paralysis and even death."

Hi Phil and welcome!  I'm sorry about your kitty and hope what Red Top has said helps!  There is a thread on this site about the dangers of Cheristin (formerly Assurity) flea treatment as well.  Go up to the search bar up top on this page (or any page for that matter) and enter Cheristin for more info.  If indeed this is the cause of your kitty's vestibular syndrome.  Knowing the cause is the first step.  Did he eat anything poisonous?  If so, how does a vet test for this?  

Thank you for the response and so glad you figured out what was going on with your cat.  I once put Frontline for dogs on another one of our cats and panicked about reading how bad it was, also read of cats dying even when using as required. For Alec, I haven't given him anything this year because I haven't found a single tic on him this year yet. I immediately suspected poisoning of some sort, accidentally or intentional, and brought this up with the emergency care vet. They didn't think it was related, although didn't take any tests for it, and focused on the vestibular "disease" which he had all the classic symptoms, but still I wonder if he got into something.

My local vet just called and I explained he wasn't eating and I just got done dropping him off.  The vet tech also asked about possible poisoning, so again this possibility comes to mind. They will keep him there for the day but I might have to bring him home every evening if he needs to stay there. I just hate to see him being traumatized and so confused and uncomfortable.

My wife passed away 6 years ago and Alec was the only thing that kept me from severe depression. As silly as it sounds, he gave me a reason to live and I would do anything to make him better even selling everything I have to help him. 

Thanks again

It happened so fast that I think some kind of insecticide poisoning is likely.  Maybe you could check with your neighbors and see if anyone has sprayed their gardens for bugs recently.

Here are the symptoms of macrocyclic lactone insecticide poisoning in cats, and my cat had all of these except for the hypothermia, coma and death.

Cats: Ataxia, vocalization, disorientation, dementia, whole body tremors, dilated pupils, apparent blindness, circling, head pressing, slowed heart rate, hypothermia, coma, and death.

Immediate Action
Seek veterinary attention.

Veterinary Care
General treatment: For oral exposures, the induction of vomiting may be continued, gastric lavage is performed, and activated charcoal is administered.

Supportive treatment: IV fluids and parenteral nutrition (feeding tube or IV nutrition) are given to maintain hydration and meet caloric needs. To prevent decubital ulcers (bed sores), soft bedding (mattress) is provided, the pet is turned every few hours, and any sores that form are treated. If anaphylaxis occurs, appropriate treatment is given. Seizures and hyperthermia are controlled as necessary.

Specific treatment: Physostigmine may be administered in severe poisoning cases.

There have been good results using a feeding solution that contains lipids, as the lipids seem to draw the poison.  I doubt it is vestibular syndrome, it came on too hard and too fast, just like it did with my cat.

Thank you so much for your help and advice.  He's back at our local vet here in Flanders NJ, admitted for tests so hope they will find something. I truly could not believe how fast this came on.

As I look back on this crazy weekend, the emergency hospital only mentioned vestibular syndrome but no diagnosis shows up on my bill, only meds and charges for the related stay. I've been worrying myself sick with reading the internet and watching You Tube videos.  I'm going to check if our town sprayed any insecticides or pesticides last week, thanks to your suggestions.I didn't want to post this pic because I knew it would upset me seeing it but here it is

Doctor just called and says his blood work is fine. He has a good baseline because Alec had a slight upper respiratory infection 2 months ago and they did blood work which matches the most recent tests.  He ruled out vestibular syndrome because of the level of drool he has and other severe conditions like ataxia and Nystagma (pardon the spelling). He's on an IV now and getting hydrated and getting steroids along with other meds through the IV.  Still not able to force feed him because of the heavy mucus.

He mentioned central nervous issues possibly caused by a tumor or stroke but would need a specialist. God help me because I'm fearing the worst, actually God help him and don't bother with me.

This is the 2nd saddest day of my life

What a very beautiful boy. 

I'm sending prayers and hugs that your Alec will be fine .

Omg he's so gorgeous!  He looks like a sweetie!  Get well Alec, soon!

Wow, so sorry to hear about this! 

It sounds EXACTLY what I just went though! 

I as told it was perhaps vestibular disease as well!

More about it here (have you seen this already?):

http://www.cathealth.com/neurological/vestibular-disease

My cat died in June and the symptoms sound exactly like what you are witnessing.  In the end it turned out to be poisoning from what is being suggested here. 

Feel free to message me re: this please and I can fill you in on this. 

So very sad for you.  I am in the same boat.  Was extremely attached to my late cat ... was with her through a lot of very difficult times too and still devastated 2 mos.+ later since her passing!   

This post might be the most helpful thing I've found. I keep taking my cat to the vet to find out what's wrong and they keep saying it's probably neurological. These symptoms match what's going on so now I can take her and ask the vet about it. She has the ataxia, drooling, trouble swallowing, dilated pupils, and they said they think she's going blind.

I found fleas on her for the first time and tried over the counter products that didn't help so I took her to the vet and got frontline. I never thought it could be a reaction to that, but now I have something I can ask about.

@ForLoveOfMonkActually Frontline doesn't contain any macrocyclic lactones.  There are three levels of frontline now. 

Frontline - fipronil only

Frontline Plus - fipronil plus S-methoprene

Frontline Gold - fipronil plus S-methoprene plus pyriproxyfen

However, you didn't say what over the counter product you tried first, and whether these symptoms are related timewise to the first product or the second.  As mentioned above, Cheristin is an over the counter product and it DOES contain a macrocyclic lactone, spinetoram.  Trifexis is also an over the counter product and it contains TWO macrocyclic lactones, spinosad + milbemycin oxime.  All those could cause the symptoms your cat has if your cat, like mine, lacks the ability to keep these lipid insecticides from crossing the blood-brain barrier. 

Mine was blind during the early part of it but he got better over time as the drug left his system.  When he got the second dose a month later, he was drooling, staggering and ataxic within an hour (which is as long as I was gone -- could have been even faster).  The macrocyclic lactones are recycled in the liver.  It detoxes the blood and puts the poisons into the bile, which then goes into the intestine and gets reabsorbed, so these drugs can be cumulative,  The best way to get them out of the system is through charcoal drenches and/or intravenous treatment with feeding fluids that contain lipids, because the lipids absorb them.  I know this just from reading, not experience.  With my cat, once he reacted to the second dose, I knew what it was and got it off him in an hour and he was OK again in 24 hours.  It didnt stay on long enough to be absorbed completely, fortunately, or he might have died.

I received a few private messages but didn't get an email notification so sorry for not responding.  Alec has now been to 3 different hospitals in 4 days but things are looking better for him.

The last 5 days are a blur and it hard to remember all the details but basically we took him to our local vet to be admitted after we took him home from the "emergency" hospital. He wouldn't allow me to force feed him and give him meds and I was worried he would worsen from not eating in 3 days. The local vet tube fed him and ran more blood work....all was good.  Did a full X-Ray and didn't see anything.  He was under IV with Cerenia for dizzyness, Famotidine and the used steroids (Dexamethasone) to help him recover.  His Nystagma did go away but they were still concerned with his Ataxia and not being able to eat so referred us to a neurologist. The local vet was 100% sure it wasn't poisoning because his blood test/liver/x-ray was fine.

When I went to pick him up and take him to the "next" hospital,  I was amazed on how good he looked.  He was meowing and purring for the first time in days and no longer drooling. First time my hopes were raised with this little baby. He was very happy and responsive sitting under the seat of the car during the 1.5 hour drive to Red Bank hospital in Tinton Falls NJ. I cracked open a can of his favorite food and he perked up and sniffed it but still didn't eat or couldn't eat.

DR. Glass at Red Bank was looked at him and noticed he was weaker on the right side along with his falling over but did mention he was improving.  He took interest when I told him Alec had a respiratory infection a month early and brought up the possibility of a parasite.  He basically gave me 2 options, take him home and see how he responds to meds or stay there and do an MRI to rule out any chance of a tumor, cancer, trauma to his head, etc... My jaw hit the floor when he said $3500. I'm by no means rich but had to know what was going on and feared a relapse or him worsening when I could have found out what's going by doing the MRI so he's getting one done this morning.

So I sit here waiting for the phone call....Is he OK or will the MRI show something?

I'm so hesitant to get my hopes up.  My wife had a heart attack in 2009 and almost died, spent 10 days in the ICU. She got better, talked to her at 8:00a the day of her release and she was so happy to come home. Me and the kids went to pick her up, her door was locked and the doctor rushed us in a private room to tell us she died.  So we got that news while holding her flowers and "welcome home" balloons. Like I said in my original post.  Alec helped me recover from that and I owe him big time.

I'm so glad to hear some good news about Alec! I hope he gets a clean bill of health today. That was a heartbreaking story about your wife. I'm so sorry.

Thank you to everyone. Just writing and reading has helped  me a lot.

He is home now.  The MRI showed some distortion in his left occular lobe, the first part of the brain after the sinus canal. He didn't have a stroke, has no tumors or lesions. The doctor believes this was parasitic and caused by a parasite entering his sinus, maybe more through his ear. Not sure what the sinus has to do with the "balance" part of the brain but he explained how certain flies lay eggs which become larve that stick to blades of grass. Alec spends time outside and the theory is a larvae went through his nose and into his sinus which coincides to his sneezing about a month ago. The larvae the continued into the front part of his brain where it had no oxygen to live and died thankfully because it would have killed him had it grown.  I'm a little unclear if other larvae may have gotten in his ears or another one made it to the back of his brain since that area doesn't affect balance but was too nervous to think straight and ask questions. He showed me other MRIs of cats with similar but more severe parasites and the same basic areas were affected along with strange looking "stuff" on the side of the brain, which thankfully Alec has none of that.

He was so happy to see me and my daughter and enjoyed the ride home.  My worries about him not eating are gone because he polished off a whole container of his favorite food along with a handful of his treats. His eyes are steady and no mucus or drooling but he's very clumsy and falls over. From what I understand this will improve over time (forgot to ask about that too) and cats can sometimes re-route their nerves from damaged areas. Right now he thinks he's "normal" because he tried to jump over a low gate we have in the living room and face planted himself on the carpet so now I have to baby proof the place so he doesn't fall or try to jump on something.

Meds are steroids, Clindamycin, and Phenobarbital. Poor cat had IVs in every leg by now and looks like a poodle and needs to just sleep and realize he's home for good now. I'm fortunate enough to somehow get the money to pay his medical bills, or at least pay off his medical bills, and feel so very sorry for people that cant do this.

As for me, I'm just going to sleep next to him tonight and thank God I didn't lose him. I'll probably check back in a few days and update his status for the nice people wishing us well