Neurological Signs in Cats could be Cryptococcus

[silent meowlook]

Hi. I just wanted to warn anyone with a cat who has sudden neurological signs to check for cryptococcus. It is an easy, although expensive blood test.

At work last week we had a very sweet family with a very sweet cat come in as an emergency with circling and unsteady gate. Signs appeared after the cat had been out for a brief time in an enclosed yard. The cat was only 4 years old, neutered male domestic shorthair.
We ran bloodwork which was unremarkable, checked for FELV/FIV negative. We hospitalized and sent home at owners request the next day. Cat was getting worse.
The cat was first seen on a Sunday, we had to humanely euthanize on a Wed after getting the results of a positive cryptococcus. By wed he was so bad he couldn’t barely move and was crying out in pain and confusion.

This cat never showed any signs of congestion or sneezing.

I’ve seen one other cat like this when I worked specialty. That cat I kept with me for 2 weeks ( owners were out of town) and I used my vacation time to care for him. It was a 24/7 typeof care taking with him having to be tube fed etc. He got treatments of Amphotericin B three times a week. That cat was able to walk by the time he left to go back home. He still wasn’t normal by any means. Unfortunately the owner euthanized the next day as he was to much for them and they felt he was suffering. I begged to take him but they were strong in their convictions and also thought it would be unfair to me. I was devistated.

So just something to keep in mind with neurological symptoms.

 

[fionasmom]

This describes my Pangur Ban. It was all neurological; started with seizures, progressed to blindness, then onto inability to walk. He was a street rescue, so came to me with it and from the time of the first seizure to letting him go was about 6 weeks. No congestion or sneezing. It remains upsetting to me even now how it ran through his body and just destroyed him.

 

[silent meowlook]

I am so sorry!

 

[hexiesfriend]

I lost my cat this morning to this condition. Battled it for two years thought it was gone and a month ago she started falling over. It took 3 weeks before anyone mentioned the crypto caused this because they thought it was gone. My Lilly had an MRI yesterday that confirmed this and she passed away this morning in her sleep. I called the ER vets that I paid a good amount of money to during this time and told them next time a cat with a crypto history comes in falling over it’s NOT arthritis in this hips it’s likely meningitis due to crypto. I asked them to never let this happen again. I’m not sure if my Lilly could have been saved but an earlier diagnosis would have been nice.

 

[fionasmom]

I am so sorry for your loss of Lilly. When my cat first presented symptoms, a huge seizure, I got him to the ER immediately and the vet on duty told me that cats don't have seizures. It took a while for his regular vet to even figure it out and by then it was too late.

However, having been warned by you that your cat had crypto and had been treated for it, they should have known what to do.

 

[hexiesfriend]

They told me it’s unusual for cats to get meningitis and I made sure to correct them. It’s unusual for a cat without crypto to get meningitis but not one with, and they should have spotted it. I just want anyone else out there to know the regular protocols don’t work on this fungus in cats. Lilly had a clean bill of health I was told she had no crypto in her system and it was ok to stop the antifungal per protocol. That was wrong she got meningitis and died. Vets need more education about this condition.

 

[silent meowlook]

I have spent the night here at work with another suspect Cryptococcus cat with severe neurological signs and seizures. She is a Bengal. This is absolutely heart breaking. Cryptococcus is such a horrible disease. I don’t even know how I am going to work all day and keep my emotions in check.

I truly hate my job sometimes!

Just venting.

 

[hexiesfriend]

They don’t tell you the horror of this and how you need to stay vigilant with the medication. I never imagined this would get into my cat’s nervous system. 3 months post cessation of symptoms is not long enough for cats to keep on the antifungals the guidelines need to change. And blood tests are hit or miss at detecting. I wish I just kept the medications going on my Lilly she may still be here. Her blootests were negative and there was no outward signs of the problem infection. The neurologist that treated my Lilly was hopeful that back on the antifungal she’d make a recovery from the meningitis but I think she was just tired of all the doctors, she did die in her sleep on her favorite blanket. Don’t lose hope for this one! Hope the cat will recover!

 

[silent meowlook]

Thank you for your reply. This cat is suffering and there is no hope for her. I have watched her decline rapidly overnight.

I know the studies have been done and it’s been written that they can survive but honestly in 30 years, I’ve never seen it end well.

This cat can’t stand or even right herself. I have her on a ton of drugs but if I don’t, she has seizures.

The other problem is that the Crypto tiger isn’t back yet, so we can’t even start the antifungles.

 

[fionasmom]

I truly sympathize with you. Pangur's case was one rapid spiral downward which left me feeling completely helpless....which, in the end, we all were.

 

[silent meowlook]

I just euthanized her. I have to go home and give meds to my cat I haven’t seen in over 26 hours, rest an hour and go back to work.
I can’t get this little cat out of my head. I am torturing myself.
She was a little rescue cat that nobody knew anything about. Just a tingly little stray Bengal.
I hate this job.

 

[silent meowlook]

I truly sympathize with you. Pangur's case was one rapid spiral downward which left me feeling completely helpless....which, in the end, we all were.

You are so right. Completely helpless.

 

[hexiesfriend]

I just euthanized her. I have to go home and give meds to my cat I haven’t seen in over 26 hours, rest an hour and go back to work.
I can’t get this little cat out of my head. I am torturing myself.
She was a little rescue cat that nobody knew anything about. Just a tingly little stray Bengal.
I hate this job.

I’m so sorry! It’s hard work but I bet there are a hundred times as many more you help that are now happy and healthy!

 

[NadiaRey]

I just wanted to come by to say, thank you, this post brings a lot of clarity. I can relate to hexiesfriend in that I have been battling the neurological symptoms in my cat since the onset and I still remember the first vet was so dismissively stuck on the arthritis diagnosis.
And I'm so mad about a vet could say something as dumb as cats don't have strokes, fionasmom.

Specially, I want to thank you, S silent meowlook , for the warning. I'm dying over here with worry. Gremlin, my 16 year old, went from mild neurological symptoms getting progressively worse (a tick in the paws during sleep became a shake while even standing or walking, making him loose footing) to all of a sudden grave neurological hell. He has so much problems walking, falls down to one side seemly unable to stand back up, meows to ask me away when I approach or touch but needs me to stand anyways. This has been the whole week, getting even worse on Saturday, all this time developping who knows what really.

Which is the problem: we still don't know anything. Suspected ear infection, gave him drops. Suspected neck inflammation, gave him antiinflammatories. Got worse.

I want to give him a test for all neurologicalproblems-induced bacteria because I suspect all this started when I gave him some fish (he turned his nose up to salmon, but I insisted like an idiot). He never developped fever or big diarrea (vomit only twice), that's why the vets kept posponing checking those.

So, I'm sorry to ask this of you, but I beg you, could you tell me what other bacteria I should ask for when they let me do the panels? I'm now asking for cryptococcus.
Campylobacter? (Maybe coccidia?? for the intestinal-to-neurological thing)
I even heard of this thing called Ciguatera that is supposed to happen after eating pacific ocean fish (it was Chilean salmon). Have you heard of that?
Just any help or data will do.

Thanks in advance. Serious thanks.Please

 

[hexiesfriend]

Nadiarey if your kitty has crypto from a skin lesion it won’t show on a blood test a CT scan is the definitive diagnostic tool. Does your kitty have any nasal problems? Rough purring? Or and bumps on the skin?

 

[NadiaRey]

I just posted my own thread so not to clutter silent meowlook's. There I explain with more detail. But no, no particular nasal problems (well, some times, he makes sounds while sleeping. Like whislting, but he's sleeping head down or hidden too often and, seriously, I'm surprised he can even breathe like that... and other times, the sounds he makes sleeping are more like short "mh"s (dyspnea?) or randomly complains.)

Yes to rough/weird sounding vocalizations (not purring through, it's the meowing that cracks all over). And he has no skin lesions or bumps on the skin. Like I said, I suspect he ingested it. Everything happened immediately after the salmon episode... I do think there's an inflammation of the neck, I just feel it's been induced by something, that needs to be treated. (I forgot to mention: Gremlin is FIV+.)

On the other hand, you have given me very bad news about the CT scan. Gremlin doesn't tolerate anesthesia well... I don't think they give those without anesthesia.... It's the reason I got stuck with trying to test meningitis. Is there no other way about it?

 

[silent meowlook]

Hi, I don't know about doing a CT scan for Cryptococcus. I have never heard of that. It would however show if there was a lesion somewhere. But it sounds like you don't want your cat under anesthesia, and I don't blame you at all. I think, from what you have described, anesthesia would be detrimental at this point. There is no such thing as safe anesthesia. It all comes with a risk. You have to weigh that risk against what you are doing and given his current state, it wouldn't be a good idea. (I think) For the record, I am not a veterinarian.
There is a blood test titer for cryptococcus. It is expensive and requires several mls. of serum. So probably about 4 to 5 mls of blood all together. There is also a fungal panel you can send out to the lab as well. It contains tests for different fungal diseases cats can get. The important thing to realize is that you need to discuss this with your veterinarian to find out what is prevalent in your area.
Some vets are not aware of these fungi like cryptococcus and will not test because they think it isn't useful to test for it. If your vet is one of those it is best to get a referral to a specialist right away, so you stop wasting money on vet care that isn't going anywhere. If it is cryptococcus and it has caused issues in the brain, it is hard to get a good outcome. It is also expensive and not easy on the cat.
If it was my cat, I would start with a full blood panel to the lab including thyroid levels. I would get a referral to a specialist and not do anything that involved anesthesia. I would also look into what is prevalent in your area and test for that if the specialist thought it was a good idea.
Here is the rough thing though, I saw a cat once with a mass in his chest. He was tested for cryptococcus and the titer came back negative. The mass was removed and sent in for a histopathology. The mass came back as cryptococcus. So I don't know how much value I put into the test.
Cats with neurologic issues are hard to diagnose and treat. That is why a specialist is so important.

 

[hexiesfriend]

The reason crypto is so dangerous is because it attacks the brain and spinal cord hence the CT scan. Crypto lesions can be found by CT and sampled it is how my cat was diagnosed.

 

[NadiaRey]

Thank you all. I got some good news. Gremlin actually got better. Exactly one week after the symptoms first started. (All but his original neurological symptoms are gone. He seems weak, but he can walk and even jump.)

I have been giving him cuadriderm, which has miconazol (an antifungal), topically (ears), because I read it alleviated neurological pain and because I still didn't know if this was an infection in the ears. I also reasoned it also should desinflammate a bit if the problem was the neck.

But I don't know if that had anything to do with it. I just thought I would mention it because miconazol is an antifungal, safe for cats, and you can buy it at the pharmacy.

Mostly, I think it might have been an infection process...? That went away on its own....? I mean, it's weird it was exactly one week.

Anyways. I didn't immediatedly say it because I have been afraid of a relapse any second. Just in case, I'll continue giving him cuadriderm cream (+ olive oil in his diet, renal-kidney diet, and green tea and lavender tea in his water).

I do worry I should be doing more. But anyways, you have helped me a lot. Thanks for everything

 

[silent meowlook]

Can you either take a pic of the medication you have been putting on the ears or double check the spelling. I found two cuadriderma from Mexico that is like Neosporin and another Quadrireme that has a ton of different medications in it but neither one has miconazole.

One of the medications has a steroid in it which can easily be absorbed through a cats skin so it becomes systemic. This is extremely dangerous because also getting absorbed are multiple other medications that cats cannot have and that there is no way to know what the actual mg of the steroids that are being absorbed by the cat is and no way to safely reduce the dose.

if your vet gave you the meds, that is great. Glad it seems to be working, but if this is something you are doing with an over the counter or prescription medication not prescribed for your cat you need to call your vet and ask how to proceed.

Why are you putting things in his water? Cats honestly don't need plants. Essential oils are toxic to cats ads their liver is much different than other animals.


I get frustrated because at my work I see so many cats that people have (including some regular veterinarians) have tried to help using treatments for dogs and not understanding that cats are so different. I watched a young cat die of renal failure because her owner had been to the vet and found out cat had arthritis and thought she could just sprinkle some of her medications on her cats food once a day, Just a tiny bit. The cat was hospitalized a week. Still died. So, thousands and thousands of dollars later and her cat died all because she thought she could just save a buck and some time by sprinkling on some of her meds,