Please Please Help! Neuro deficit in jaw and throat of cat?

gli0504

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Hi All,

I am new to The Cat Site. About three months ago, my 9 year old DSH, Nala, had to be euthanized. I found her collapsed on the floor and kidney stones had perforated her urethra, and by the time she showed symptoms, it was too late.

When Nala died, I had 2 other cats. Last weekend, I adopted a third. It took time for me to be ready to bring a third back into the house, but my path crossed with one and it felt like it was meant to be. He's about 5 months old. The other two cats I have a both males as well. One is ten, and I am writing today for and about him. His name is Gizmo, and his 10th birthday was last Tuesday.

Over the last 2.5 days, Gizmo has been to the emergency specialty clinic three times. On Thursday evening, I noticed my boy gagging on and off. He does vomit from time to time, which I always thought was his "normal". I assumed it was a hairball- he cleans the other cats a lot. I'll back up a little- after the death of Nala, I switch the cats to a wet food diet- I had tried this before, but struggled to find something that provided enough calories while being healthy and affordable that all would eat. One food that was eaten by all was causing bloody stool. Another was causing diarrhea. Others would be eaten and then refused after a few days- so it was a challenge. I did eventually get the 2 boys on Merrick's, and they were finally eating something every day. I gave them about 1/4 cup of high-quality dry food every other day to add some kcals to their intake. Both cats are overweight, so, I cut back on the the dry food unless I am traveling for work- in which case, i have to leave them something they will graze on during the second day I am gone. I am never gone for more than two nights, so it has worked pretty well. They do not vomit when they eat a wet-only diet, so I was hopeful that I was doing the right thing for them.

Fast-forward to Thursday and the gagging- when it didn't stop, I tried looking in Gizmo's mouth, and even used my finger to sweep his throat for a blockage- nothing. I went to bed and woke up 3 hours later to check him, and at that point, he felt warm. I took his temp and he had a very high fever, so I rushed him to the E.R. After three hours, a full blood workup, exam, x-ray and $500, the vet suspected that Giz had gastritis as a result of him eating the kitten food. I brought the kitten home on 10/28, so it was exactly a week later. I was told that the kitten needs to be able to graze on dry food during the day because he is young and his metabolism is extremely delicate at this age.

I returned home with Gizmo who had gotten Cerenia (an anti-nausea shot) and antibiotics in case he had an infection. I gave him about three hours to settle, and, as instructed, gave him his morning meal of wet food. He ate and vomited within 60 seconds. I tried a treat- same thing. I gave it another couple of hours, and still, he couldn't keep anything down. At this point, he was gagging frequently, swallowing and though he was calm, he was clearly uncomfortable.

I called the ER, and was told that he needed an internal medicine vet- so, I took him to an emergency specialty center where he received an ultrasound and another vet assessment. The ultrasound showed nothing significant- just like the x-ray, physical eval and bloodwork, nothing was amiss. He was given fluids under his skin and some more anti-nausea meds.

At that point, I was again told to take him home and monitor, and to bring him back if he didn't improve. Upon arriving home (I took him to my parents' house because they live 10 minutes from the specialty vet and I'm 50 minutes away) he ate 1/4 can of ID wet food and then spent his time sitting quietly under the bed or on it, but would not rest his head. About 6 hours passed, and as I monitored him, i noticed that his mouth was hanging open and he was drooling. I didn't know what to do. I must have called the vet six different times asking for advice- I had already paid $1,000 and had no answers, and the vet tech felt that the gastritis could be severe and taking time to resolve, and that he could have a swollen esophagus from the vomiting and other issues that caused him to drool because swallowing might be too painful.

I waited again, monitoring him, trying to encourage food and water intake, but nothing worked. He used his box to urinate a couple of times and had a bowel movement- which pretty much ruled out an obstruction. Come Saturday morning, I continued to keep an eye on him and try to give him food - the vet suggested baby food, so we tried that, but nothing worked. He was constantly gagging, swallowing and drooling with his mouth open- he didn't close his mouth all day.

Finally, at about 6:00 last night, I decided he needed to go back again. I applied for care credit so that i could pay to help him if there was help available. We spent another three hours at the vet, and this time, three different vets checked him and all feel that he has some kind of neuro deficit that is impinging his ability to swallow and control his tongue and mouth. The vet said the 2 causes of this are either a virus that is affecting his nerves, or a tumor in his throat. The only way to diagnose a tumor is via endoscopy- which will cost about $3,500, so the vet suggested against it because if it is a tumor, they will not be able to treat it. The vet suggested I give him steroids to control the swelling in his throat and broad spectrum antibiotics that will cover a gamut of viruses, so that if it is a virus, it's being treated. When we woke up today, he seemed mostly the same, but with his mouth closed a little more frequently and less drool.

I am terrified that he is isn't going to get better, so I decided he should come back home, even though it's far from the emergency specialty center. Upon arriving home, he attempted to eat and vomited a little, but it was the first time he showed interested in food since Friday afternoon. He ate another 2 bites and kept that all down, and even had 1 treat he kept down. He also found my glass of ice water and spent about 2 full minutes drinking- he is on Prednizone, and apparently, that can increase appetite and thirst drive. Finally, he is actually sleeping- head fully resting and sleeping on his side like he always does. But, and this is why I am pleading for help, he is twitching a bit in his sleep- his whiskers and front and back feet are just a little twitchy on and off while he is asleep.

So, I am wondering a couple of things:

1. Has anyone ever dealt with anything like this? If so, how did you handle is?

2. Is the twitching something to be worried about? I already called my vet and the emergency vet, and they said it could be normal, but without seeing him again (which would be 4 visits since early Friday morning) they can't say for sure. He is only twitching when he sleeps.

3. What next? It is my understanding that the prednisone can actually be masking symptoms of either a tumor or virus- so, he could seem to get better, but not actually improve. What do I do? Do I try to find a vet that will run diagnostics to determine if it is a virus? Given his high fever and the fact that a new animal was just introduced to his environment, it's entirely possible that it is a virus, but I am fearful of being at all hopeful.

I love this guy- truly, truly, love him. He has been my shadow for the last 9 years and 10 months and is the most gentle, smart, affectionate, wonderful and amazing pet. I never thought I would love a cat or pet as much as I love him, and I am heartbroken at the thought of life without him. He sees me out the door and greets me every morning and when I get home from work. He's my happy place. So, I guess I am looking for advice, similar stories or any suggestions out there--- ANY comments or help would mean the world.

Thank you for your kindness and reading the novel of a post I wrote (first timer),

Gizmo's Mom
 

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Originally Posted by Gli0504  
...

...

I love this guy- truly, truly, love him. He has been my shadow for the last 9 years and 10 months and is the most gentle, smart, affectionate, wonderful and amazing pet. I never thought I would love a cat or pet as much as I love him, and I am heartbroken at the thought of life without him. He sees me out the door and greets me every morning and when I get home from work. He's my happy place. So, I guess I am looking for advice, similar stories or any suggestions out there--- ANY comments or help would mean the world.
...
Gizmo's Mom, @Gli0504...the love that you have for your guy shines right through the page.

I wish I could offer you some helpful advice, but I've never had to deal with something like this.

The main thing, that I would worry about, is that Gizmo is able to eat.

If being on the Prednisone is helping him with that, then I would keep him on it. It's an anti-inflammatory steroid, so even if it's masking symptoms, it might still be beneficial if there were a tumour in trying to shrink it.

I would not even know if you could find a virus behind all this, and what type of drugs would treat that.

(It is strange that having a high fever did not show up in his bloodwork, by having a high white cell count, or any of the other differential blood cells being off.)

Do you think the twitching in his sleep can be related to the Cerenia injection?

I did read online, that muscle tremours can be a side effect.

I don't think I would worry about the twitching, if it only happens in his sleep.

(Some cats dream and twitch all the time, though I do understand that what you are seeing is something out of the ordinary, for your Gizmo.)

I'm still hoping that it is something like gastritis, and that it will go away.

And if it is a virus, then any secondary infections are being treated by the antibiotics.

ER vets are usually more expensive then regular vets.

If his esophagus is irritated from the former vomiting, then I'm not sure if a regular vet could prescribe something soothing to coat the tract, and to protect it further from ulcers or irritation.

Just sending you mega vibes that the meds he is on now, will help Gizmo return to his usual self.
 
 
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stephanietx

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We just went through this with my boy, Tumbles!  It was one of the scariest things I've ever been through with him.  He is 6 yrs old and has been on a Rx dry food since he was about 8-9 months old for gastro issues.  His main nutrition source is grain-free canned food, but he gets diarrhea and/or loose stools if he's on a completely grain-free diet. 

Here's something very interesting.  We had introduced Merrick's Purrfect Bistro Duck pate food about 3 or so days prior to the start of his issues with gastroenteritis.  I notice you mentioned that you were also feeding Merrick's.

Tumbles started throwing up everything he ate on a Friday (10/7).  He couldn't even keep water down.  He was drinking A LOT of water to calm his tummy, which is what cats do.  Let his tummy rest until Saturday morning.  Offered him food, he wanted to eat, but he only lapped up a few licks and then a few minutes later, tossed everything back up.  When he couldn't even keep the water down, I knew we needed to get him to the vet.  Found a vet to see him on Saturday, she did bloodwork and x-rays.  The x-rays showed gas in his colon and no blockages.  She gave us an antibiotic just in case it was caused by an infection, gave him a Cerenia shot, sub-q fluids, and sent us home with Science Diet i/d and a bag of fluids so we could hydrate him at home.  Brought him home and he ate a little bit. Didn't eat the rest of Sunday and refused to let us do fluids.  I took him to a different vet and they decided to keep him to make sure he didn't have pancreatitis or some other issue.  He stayed at the vet for 2 nights.  He refused to eat for them, but had one more Cerenia shot. He was urinating, but not pooping.  Thinking he wasn't eating because he was constipated, he got an enema on Tuesday afternoon.  He did finally poop, but wasn't eating still.  Wednesday morning, I spoke with the vet and told them that he doesn't do well away from home.  They gave him some a/d to get him to eat and they draped his crate with a towel to make it dark and he finally ate.  He came home overnight with a catheter in his leg.  He finally started eating again on Thursday, so he got his catheter out and he was dismissed from the vet. 

When he came home on Wednesday, we fed him a few small meals throughout the evening.  He didn't eat Thursday AM, but he ate very well for me on Thursday prior to returning to the vet to have his catheter out.  We continued to feed him small meals of i/d the rest of Thursday and only a very small feeding of his dry food. The vet didn't want us to give him too much dry food as that doesn't move through their systems as quickly as wet food.  Friday, we increased his portions of food and decreased the number of times a day we fed him.  Over the weekend, we transitioned him back to his regular feeding schedule.  Each day over the weekend, he became more like himself.  He started grooming himself. He started coming down the hallway or following us around. He started being vocal again.  That kind of stuff.

About a week after he came home from the vet, we started introducing his old food back, minus the Merrick's.  He's done very well since.  We did make the decision to add the i/d to his canned food concoction to help keep his stool solid as he's still having some issues with loose stools.  So far, so good.  We have been feeding the Duck to our other 3 kitties and don't let Tumbles clean their bowls or anything because I don't want a repeat of that experience. 

To answer your other questions, I think the twitching is normal.  This happens when they're in deep sleep.  Sometimes they'll even chirp or mew.  He's not been able to rest well, so his little body is tired.  Plus he's trying to get well and that requires rest.  I wouldn't be concerned about the twitching.

I would think the drooling and open mouth issue might be because his tummy was so upset or it might've been a reaction to the Cerenia.  If he's eating okay now, I would say that it's not a neuro issue. 

I hope this helps and I hope your guy gets better soon.
 
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gli0504

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Hi Kind Cat Friends,

Thank you @stephanietx and @cat nap so much for replying. I never thought it could be an issue with his food, but I was recently told that Merrick's was purchased by Purina, so I have friends that will no longer use it. I am seriously considering switching, but Gizmo is so picky about what he'll eat that I don't want to switch his food and take a chance that he won't eat the new stuff. I wanted to give you an update so that if this ever happens to anyone else, they are able to see what Gizzy's experience was.

After I posted on Sunday, I did notice additional twitching while Giz was sleeping, and I called the vet who wasn't particularly worried. So, since it only happened in his sleep, I hoped she was right. Sunday was day four of Giz being sick. I can't express the worry and anxiety this caused, but I had everyone I know praying and hoping and wishing for him. Sunday evening, for the first time in three days, Giz started walking around a little bit and jumped on the coffee table (he's allowed) which was the first "Giz" thing he'd done since Wednesday. He stuck his head right in my water cup and drank and drank and drank, and I let him. Later that evening, he even took two bites of food and had a treat. He gagged a bit after the treat and all the water, but seemed a little better. He's getting Prednisone every 12 hours, and I did notice that at around hour 10, his mouth was, once again, hanging open a little, though there was no tongue hanging out and he wasn't drooling. 2 hours went by, I gave him his prednisone again and after about another hour, he closed his mouth and laid down. He spent the entire night under the bed and as much as I wanted to monitor him, he wanted to be under there.

Monday (yesterday), I woke up early to give him his dose of prednisone and antibiotics. He had a really hard time with the meds. They caused him to immediately salivate and he gagged and foamed a little, but did keep the majority of it down. During the morning, I finally decided I had to leave the house because I was driving myself insane watching him. I checked in twice throughout the day and came home around 6, and he seemed again better. This time, he was actually begging for treats, actively ate when I fed the guys dinner, and, he leapt into his tree and climbed to the top- my heart literally jumped- I was that excited to see him want to move around like that. He took treats, responded to his name and was interested in the things he's always interested in. He followed me room to room and was more himself. He cleaned himself, too!

Today he's even a little better. He's eating and drinking, and, he's been much more able to tolerate the liquid meds when I give them to him.

The next step is to bring him for a vet check-in this weekend. I've scheduled an appointment with a center that has both a Neurologist and Internal Medicine Veterinarian, so that I can get an opinion from another facility and have him looked at by whichever specialist they feel should evaluate him. If he declines when I start to reduce his steroid dosage, I will have a plan based on his next check. I have a family member that has a cat that has been on steroids for four years and it's saved her life.

So that's where Gizmo is right now. The other thing going on is that my other adult cat Merlin, who's 7, has been a gagging a tiny bit and has vomited a little bit of white foam after each meal since last night. He's always been the "puker" of the group. He eat fast and too much and vomits a couple of times a week and always has. I also just had him at the vet for his checkup and they did bloodwork and a urinalysis and everything was normal.I called the vet (again), and they said to watch him closely and if he gets worse or exhibits any of the other signs that Giz did when he first got sick, to bring him in. So far, he's fever free, eating, drinking, is not swallowing frequently and his energy level is normal. I will know what to do if he does exhibit any additional symptoms, but for now, am waiting.

So, maybe this is a virus, or it's a food issue. @stephanietx do you know of any similarly priced canned foods that have the same nutritional composition as Merrick's? I've had issues finding something that hits the right balance of protien/fat/carbs. I know the rule of thumb is that 40% or more of cals should come from protien, 50% or lass of cals should come from fat and 10% or less of calories shoudl come from carbs. While I can find foods that meet this criteria, I've had one of two problems- either it's ridiculously expensive ($3 a can x 2 cans/day x 3 cats), or, it's a very lean food that is so low in calories I'd have to give each cat 3 cans a day to meet their calorie needs! So, if you know of any canned food that hits the ideal composition and has at least 175 kcals per can, please let me know!

Again, I hope this story can help someone else in the future, and I'll keep updating as things progress.

Much love to all the kind people out their that love their pets and take the time to help other pet parents!

XO,

G
 

stephanietx

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I'm so glad to hear he's feeling a little better!  The prednisone will probably also increase his appetite, at least it does in humans.  We feed mainly canned.  We give our kitties Canidae Pure chicken, turkey, and lamb and Natural Balance Wild Pursuit chicken, turkey & quail. 
 

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Hi @Gli0504, thank you for your update. I think it definitely helps others who read the thread, and find useful ideas to help their own cats.

One thing that I would ask the specialty Vets, over the weekend, is about he 'side-effects of injectable Cerenia'.

Something that 'stephanietx' mentioned about the 'drooling and open mouth issue' had me thinking about any possible side-effects.

On this Site, this thread mentioned "twitching in arms or shivering": http://www.thecatsite.com/t/288350/cerenia/30   ....Post # 32.

And having looked online....'hypersalivation' is also one of the possible side-effects.

I don't know why Vets don't give us 'print-out' sheets, like pharmacies do, about the side-effects,...perhaps they don't want to scare clients, and perhaps it depends upon the percentages, but I'd like to be informed.

It does not mean that I would not use 'injectable meds'...since I think that they are very useful...but I would ask about differences with using tablets, injections, and if there were transdermal meds, too.

How long do injectable meds last, and if using tablets would be better so that the amount given, could be adjusted up or down, depending on how sensitive our cats are to them.

Also, you can ask about using the smallest 'gel caps' made for meds, which might help if giving more than one medication, and meds with terrible tastes.

Some liquid meds might come in different flavours, or can be compounded into different flavours.

Any side effects would not explain why Gizmo was gagging and vomiting to begin with, but at least you'd know what to possibly expect.

Merlin, might benefit from having his food bowl raised, or trying to feed him from a 'muffin tin sheet', or other specialty cat bowls made to slow down fast eating:

http://healthypets.mercola.com/sites/healthypets/archive/2014/04/09/cat-eating-habit.aspx

This website might be helpful for finding a food that is suitable. It's mostly for ckd cats, but the canned food chart might help with choosing protein, sodium, fat, carbs, calories.

http://www.felinecrf.org/canned_food_usa.htm

And this one might help with calorie counts, although others have said that when it gets beyond 10 lbs, it is not accurate...so best to check with your vet.

http://petsci.co.uk/feline-calorie-calculator/

Thanks for keeping us updated, and good luck this weekend.
 
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