Sudden onset of seizures, pacing and blindness in my cat

Hi - I'm new here but have a very strange problem with my cat and am desperate for any help or advice you can give.

I am based in the UK.  My partner and I have a 10-year-old neutered domestic short-haired male cat.  He is diabetic and his blood glucose is well controlled with long-acting Lantus insulin.  We check it frequently.

Twice in the past six months, my partner has found him outside, dazed, confused and wailing.  My partner brought the cat inside and he spent the next 4-5 hours pacing around and not sitting still.  He appeared to be temporarily blind and confused. Eventually he sat down and seemed to recover quickly after that, walking and eating as normal.

Three days ago (Sunday), he was at the cattery early in the morning.  The cattery attendant walked past his pen and he was fine.  Ten minutes later, she said that she saw him passed out on the floor.  She did not give him food, but instead she gave him his full dose of insulin (she claimed she panicked but never rang me to ask advice) and brought him to the emergency vet.  Unsurprisingly, this induced a critical hypoglycaemic state.  He spent the next 24 hours being stabilised by the emergency vet, including critical care, fluids and and a glucose curve.  Eventually his blood glucose returned to the teens. I returned to the area to be with him. The emergency vet checked his BUN (8), his creatinine (32) and simple bloods (all normal).  He also did VBGs, which showed slight respiratory acidosis (due to the hypoglycaemic shock) and slightly elevated lactate (same reason) but nothing too alarming.

After his 24-hour assessment by the emergency vet, I brought him to his regular vet on Monday morning and this regular vet confirmed he could go back to the cattery with a reduced insulin injection. He was clinically fine.  He was alert, recognised me, and could see just fine.

Yesterday morning (Tuesday), I got a call from the cattery saying that he was "not acting like himself". He had knocked over his bed and his water dish sometime in the night. The cattery attendant had injected him in the morning with the reduced level of insulin but he hadn't eaten anything. Cue the second cattery-induced hypoglycaemic state in 48 hours. I immediately brought him to his regular vet. He was very confused and disorientated on the table. Whilst being admitted for observation for the day at about 9:00, he had a seizure and was administered rectal diazepam.  He stayed there all day to have his glucose monitored. It was very low until late afternoon (usually below 4). Whilst in the kennel, he was confused, pacing around and feverish (temp 39.4).  The vet ran kidney tests (all normal), full blood count (all normal) and feline lipase (slightly abnormal).  She drew some urine and did a gram stain. Under the microscope she saw what appeared to be a high level of bacterial population. She said she suspected a UTI, possibly of staph origin. She sent the urine off for culture and sensitivity and we hope to have results at the end of the week. She gave him two different antibiotics (both penicillin derived, cannot remember the names). When he left for the day, he was still feverish.

At the vet's, my cat's glucose levels stabilised at the end of Tuesday in the high teens. I brought him home with me last night to monitor him myself and run my own glucose curve.  Throughout the evening, he was barely walking, just shuffling around or sitting in an odd, half-raised position.  He wasn't eating anything unless it was held up to his lips. I checked his blood glucose periodically throughout the night and it was still elevated (high teens, low twenties) but I followed the vet's instructions and did not give him any insulin. I locked him with me in my room overnight with his food, water and litter tray.  He spent the entire night pacing around the room's perimeter; he must have walked 100 laps, just around and around.  He ate a little bit of food, which I mixed with water to hydrate him, but only when I held it to his lips.

He had a very short seizure at about 5:00 this morning, a classic tonic/clonic jerking which was over very quickly.  It was terrifying to watch.

I brought him back to the vet this morning (Wednesday). She did simple neurological tests and said that he was blind, but it was central as his optic-nerve reflexes were consensual and working just fine.  Whether this blindness is permanent or temporary, she did not know.  

The vet's theory is that he has either FIV (feline immunodeficiency virus), FeLV (feline leukaemia) or FiP (feline peritonitis (dry form)).  An exacerbation of any of these can apparently have neurological manifestations, which would explain the pacing, blindness and seizures, as well as fever. This leads to anorexia, which leads to hypoglycaemia, which leads to amplified effect of insulin, which causes neurological signs in a vicious cycle. The vet has taken blood samples to be lab-tested for FIV, FeLV and FiP and we should have answers next week.

Meanwhile I'm traumatised that my cat is blind, psychotic, having seizures and feverish, seems to have an infection which is not shifting and will not drink nor hardly eat.

I should note that he is very funny about weeing.  He can hold it in for days, which is terrible for him.  The vet induced urination this morning and she was gobsmacked at the amount that came out. He hadn't weed in at least three days.

Any advice you can give about his situation is most welcome.  Do you think the vet's theory about FIV/FeLV/FiP is correct?  Does anything else cause blindness or seizures in cats? Any observations or other ideas?

We're at our wit's end here.  He is such a lovely little cat but it seems he is really suffering here.

Many thanks for all advice.

I'm so sorry you're going through such a medical crisis.  

We recently had an incident where our diabetic cat also had hypoglycaemic state. Apparently, he had gone into remission (which is sort of common, especially in cats diagnosed diabetic when older) and we didn't know. We gave him his regular evening injection and by 10pm he was acting similar to what you describe, including being temporarily blinded.  

Is it possible the vet has not made a correct diagnosis and your kitty is in remission?  Can you bring him for a second opinion somewhere else?

I hope others who are more experienced and knowledgeable about what you describe will see this thread and comment.

Hi sivyaleah, thank you so much for your reply.  We love our little bundle of joy so much.

Well when he's been at the vets they've done a glucose curve, and I've checked him quite frequently at home over the past few days as well, and his little body is sadly not producing insulin.  We ruled out remission rather early on.  I checked him a minute ago and he's on the hyperglycaemic side.

The vet fears it might be FiP, as it's common.  We are waiting for test results.

He actually seems to be doing slightly better; he is now slept on the sofa behind me.  This is the first time I've seen him sleep in several days.

This is very strange: he fails the blindness test, meaning that he doesn't react when I move my finger from far away to very close to his eye.  Since his pupillary reflex is intact, however, his cranial nerves are working fine and this makes me think it is a central-brain problem.  But he can still see things.  He jumped down from the sofa a little while ago, walked around my feet and table, and got his own food and water from the other side of the room.  Then when he got tired, he walked back round and hopped back up onto the sofa.

I don't understand how he can see if he's not responding to that finger test.  Very odd!

I am so grateful for your attention in any event.

branchlake said:

 
Hi sivyaleah, thank you so much for your reply.  We love our little bundle of joy so much.

Well when he's been at the vets they've done a glucose curve, and I've checked him quite frequently at home over the past few days as well, and his little body is sadly not producing insulin.  We ruled out remission rather early on.  I checked him a minute ago and he's on the hyperglycaemic side.

The vet fears it might be FiP, as it's common.  We are waiting for test results.

He actually seems to be doing slightly better; he is now slept on the sofa behind me.  This is the first time I've seen him sleep in several days.

This is very strange: he fails the blindness test, meaning that he doesn't react when I move my finger from far away to very close to his eye.  Since his pupillary reflex is intact, however, his cranial nerves are working fine and this makes me think it is a central-brain problem.  But he can still see things.  He jumped down from the sofa a little while ago, walked around my feet and table, and got his own food and water from the other side of the room.  Then when he got tired, he walked back round and hopped back up onto the sofa.

I don't understand how he can see if he's not responding to that finger test.  Very odd!

I am so grateful for your attention in any event.

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Gosh, this is so difficult for all of you.

I would suggest seeking out info from the following website devoted to diabetic cats.  They were extremely helpful to me. The community reminds me of the one here at The Cat Site.  They also have a Facebook page. I think you'll get better attention there since it is so specific to that disease. There are a few people here that belong to that group.

I hope I'm allowed to put the link here, I sometimes forget if it's ok or not so if Mods see this feel free to remind me!

http://www.felinediabetes.com/FDMB/

or at Facebook

https://www.facebook.com/groups/felinediabetes/

Good luck, I know how rough this can be.

Thank you once again sivyaleah for your kind advice.  I'll check out the diabetes links above.

My little cat is doing much better now; I think the UTI antibiotic treatment has probably done the lion's share of the work.  His neurological symptoms seem to have largely abated and he is rapidly approaching recovery.

Thank you again, all the best to you.