PLEASE HELP

[EthanB]

Last Friday (7/2) my wife and I returned from dinner to find our cat, Jax, laying on our outdoor couch and noticed something was wrong. He is an indoor/outdoor cat, but spends the majority of his time inside. We typically let him out when we get home from work and get him back in before dark as we live on the outskirts of Lexington, KY on an acre and a half and worry about coyotes, etc. We picked him up and seemed that his front legs were mostly immobile. His back legs seemed to be working fine as he was using them to push himself around a little bit. We immediately took him to the emergency vet where they were able to run his vitals and everything looked fine. We were sent home with hope that he would regain function by the morning and we would be able to take him to our primary vet in the morning to do more testing. Our primary vet was unfortunately not open last saturday due to the holiday weekend so we took him back to the emergency vet as he was still in no better shape than the night before.

We got him to the emergency vet Saturday (7/3) morning where they began more tests: bloodwork, ultrasound, and CT scan. Bloodwork was completely normal and ultrasound was mostly normal aside from a small (7mm) mass in his abdomen that a boarded internal medicine vet said was just a calcified fat mass and most likely was not the result of what they were seeing. Saturday night into Sunday he started to get worse and was not moving at all according to the overnight emergency vet. When we came to see him Sunday afternoon he had not eaten for them but was peeing normally. He was peeing on himself as he was not able to stand to use the litter box. However, while we were there he ate quite a bit when me and my wife tried feeding him. We had asked if it would be possible to take him home and treat him with medication and fluids since he seemed more reactant to us, his owners. We were told he needed to stay and that would not be possible. The next day (Monday 7/5) we went to see him in the early morning before work and he again ate very well for us and were told it was okay for him to go home but would need to keep him comfortable with fluids and medicine. Due to the holiday weekend the CT scan did not come back until Monday (7/5) which again showed nothing out of the ordinary and gave us no answers. When we left they told us the next step would be to get him to a neurologist. So we have a consultation with a neurologist next Tuesday (7/13) where we will hopefully get more answers.

We were able to take him home Monday and I have been working from home taking care of him all week. He has showed slight improvement over the week. He is able to sit up on his own and turn over without help. He is still eating just fine. He is getting subq fluids under the skin every morning (150 ml) antibiotic every 12 hours, 1/4 tablet of blood thinner (in case of a clot) every 24 hours, and a steroid every 24 hours. I have been doing passive range of motion exercises with his front legs and he doesn't seem bothered by it as long as I am gentle. He does sleep a lot throughout the day, but has moments where he will sit up and clean himself or just sit up to see what is going on. Whenever he needs to pee he starts to move around quite a bit and meow so I take him to the litter box and he pees voluntarily. I was concerned he had not pooped since Friday (7/2) and our primary gave us an enema that I administered yesterday (7/8) and he finally pooped.

We do have one theory as of now that I will try to walk through as best as I can. When we first took him Friday night they had asked if it was possible if he could have gotten into anything. Friday night we looked around outside to see if there was anything out of the ordinary. The one thing we did find was what looked to be a decomposed mouse or mole. After finding this I did a little research and came across botulism. The more I dug into it, it seemed like it could be a possibility. From what I found botulism does cause paralysis, typically starting in the back legs and working its way up to the front legs and face. The only symptom he didn't or wasn't showing was paralysis of the back legs as his back legs have seemed to be working for the most part. We mentioned this to both the emergency vet and our primary vet. The emergency vet was quick to brush it off. Our primary vet said it was unlikely but was going to look into it more and consult with some of her colleagues. I hate to be the guy the "google doctor" but after getting no answers from any tests I was desperate to find an answer myself. The main symptoms that he was exhibiting that matched up with botulism were leg paralysis, decreased respiratory rate when he was at his worst Saturday night into sunday, constipation, and depression. I know it is rare and a bit of a stretch but trying my best to figure out what is wrong.

We also have wild berries that grow on the back tree line of our property (mulberry, wild blackberries, and wild raspberries) I'm not sure if that could have anything to do with it either.

I know that is a lot, but after getting blood work, ultrasound, and ct scan with no answer to what is wrong with him we are desperate for any advice/answers on what could possibly be wrong or if this sounds familiar to anyone. It has been an emotionally and mentally draining week with many restless nights. Any help would be so greatly appreciated!

 

[di and bob]

I would venture to say a small stroke/blood clot that was in the area of his front legs and has since dissolved. Or getting hit by a car, but you would think he would have more trauma. Maybe kicked by someone walking by. or hit with a bike? There are just too many dangers outside to narrow it down. It sounds like you are doing an excellent job with him, I pray he continues to improve. You might ask about a clot and see if he needs further blood thinners to prevent more.

 

[fionasmom]

You are being proactive by trying to find responsible medical information online for your cat, Jax. There are doctors, including human, who seem to resent that but that should not deter you.

I am very sorry that you are facing this with Jax and when I looked for information about botulism from dead animals I realized that most of the articles were focused on dogs, cattle, horses....in fact, none on cats. This may be much more rare a finding in cats which is why the doctors were not as interested in researching it. I have known vets who said outright that cats less frequently encountered poisonings because they have a more discriminate sense of something being "off." While I am not a vet, I think that your idea of botulism is at least something that should be discussed. It may not be this, but you have a right to ask questions.

You have had a lot of tests done, they are all your property, so ask that they be sent to the neurologist or carry them yourself. This does sound neurological or vascular, as you have suggested and once it is narrowed down you can zero in on treatment for whatever the underlying condition is.

Please let us know what you find out. Sending good thoughts for Jax's recovery.

 

[Meowmee]

I am so sorry about Jax, what a terrible ordeal you have been through

Nothing wrong with looking online, there is wealth of good info.

My first thought was a clot, have they ruled that out? My Syb had a saddle thrombus due to hcm which paralyzed her hind legs. Then you would think of neurological and injuries, possible toxins maybe. As well as diseases. Only a neurologist will be able to say maybe and you have done a lot of testing already with no real answers yet. Being and indoor outdoor makes it harder to dtermine the cause probably, he could have been inured but not be showing the usual signs.

The fact that it is both front legs makes me think maybe it is not a clot because this link seems to say clots from the heart affect one front leg usually. I am not sure if it can happen in both front legs at the same time.

Blood Clots and Aneurysms in Cats - Cat Owners - Merck Veterinary Manual

Learn about the veterinary topic of Blood Clots and Aneurysms in Cats. Find specific details on this topic and related topics from the Merck Vet Manual.

www.merckvetmanual.com

Leg Paralysis in Cats - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

The inability of an animal to move or feel one or more legs is referred to as leg paralysis. When motor and sensory function is only partially impaired, this is referred to as paresis. When function is completely impaired it is referred to as paralysis.

wagwalking.com

Here is a link on nerve injuries.

Leg Paralysis in Cats - Cat Owners - Merck Veterinary Manual

Learn about the veterinary topic of Leg Paralysis in Cats. Find specific details on this topic and related topics from the Merck Vet Manual.

www.merckvetmanual.com

 

[Joelle and the kittens]

I found this case report (NSFW) on forelimb paresis caused by bilateral hypertrophic neuritis of the brachial plexi. An MRI identified the swelling here. Possibly something to bring up to the neurologist.

 

[tnl]

Maybe Radial Nerve Paralysis?
PetCoach - Ask a Vet Online 24/7

 

[StanAndAlf]

E EthanB any update?

 

[silent meowlook]

Do any of your neighbors use rodenticide? Have you looked at his nails to see if they are shredded? That would indicate trauma. I have never seen botulism in a cat. It is possible although rare. Same with tetanus.

How old is your cat? Has he been recently vaccinated? What kind of food does he eat? Any weird quirks he might have? Any other health issues in the past?

If he had thrown a blood clot. I would think that they would have noticed at the ER/. I would also think his blood CPK would be elevated. A toxin wouldn't show up in the blood work unless you were testing for it. There are many tick borne diseases out there that can have neurologic symptoms, but I am sure your vet would have thought of that. I would think that the CT scan would show if there were any lesions in the neck or shoulder area. Cryptococcus can cause neurologic symptoms and in advanced stages paralysis. It is a fungal disease that cats can pick up from the soil or bird droppings. I don't know if it is your area though. I have seen tumors press on the spinal cord but also I think that would have showed up in the CT scan.

I do hope your cat feels better soon.

 

[EthanB]

Thanks everyone for checking in and offering some great advice/research. We are going to see a neurologist tomorrow and hope to find out more! We are trying to stay positive.

 

[EthanB]

Do any of your neighbors use rodenticide? Have you looked at his nails to see if they are shredded? That would indicate trauma. I have never seen botulism in a cat. It is possible although rare. Same with tetanus.

How old is your cat? Has he been recently vaccinated? What kind of food does he eat? Any weird quirks he might have? Any other health issues in the past?

If he had thrown a blood clot. I would think that they would have noticed at the ER/. I would also think his blood CPK would be elevated. A toxin wouldn't show up in the blood work unless you were testing for it. There are many tick borne diseases out there that can have neurologic symptoms, but I am sure your vet would have thought of that. I would think that the CT scan would show if there were any lesions in the neck or shoulder area. Cryptococcus can cause neurologic symptoms and in advanced stages paralysis. It is a fungal disease that cats can pick up from the soil or bird droppings. I don't know if it is your area though. I have seen tumors press on the spinal cord but also I think that would have showed up in the CT scan.

I do hope your cat feels better soon.

We have a lot of moles on our property and its very possible neighbors could have put out some kind of rodenticide, but would that have shown up in his bloodwork, or any of the other tests we have done (CT, Ultrasound)?

 

[fionasmom]

Clotting time blood tests can be run as mentioned here. I am not sure if time frame is relevant to results but I think it is.

https://lakeshorevetspecialists.com/wp-content/uploads/2018/07/Rodenticide_Toxicity_New.pdf

 

[silent meowlook]

We have a lot of moles on our property and its very possible neighbors could have put out some kind of rodenticide, but would that have shown up in his bloodwork, or any of the other tests we have done (CT, Ultrasound)?
No, unfortunately they wouldn’t.
I hope you get answers from the neurologist.

 

[EthanB]

Just wanted to update anyone who is interested. We went to a neurologist last Tuesday where they found a mass in his spinal cord in the neck. We were told that it was one of two things, either cancer (most likely lymphoma) or FCE. The neurologist was leaning more towards cancer and we were devastated. We left thinking we were in the worst possible scenario. However, the next day I received a call from the neurologist where she explained she sent the MRI results to their radiologist and he disagreed with her theory that it was cancer and said it was more likely FCE due to the location of the mass in the neck (C6-T2 vertebrae I believe is where it is located). This gave us hope again that Jax would make it through this. FCE is still a very serious condition and is rarely seen in cats. Typically it is much more common in large dogs. We were given two courses of action: 1. take a sample of his liver and the small mass in his abdomen that was found during the ultrasound to further test for cancer. or 2. Start rehab and slowly taper the steroid off and he will either continue to improve (FCE) or he will take a decline (cancer). We were initially leaning more towards the first option but after consulting with multiple vets we decided option 2 would probably be the best route because of a couple different reasons. 1. The steroid he is on would make it very hard to test for cancer elsewhere and would most likely lead to a negative reading anyway. 2. The fine needle aspirate could possibly cause further clotting and irritate him further.

With that information we decided to proceed with rehab/therapy with a local practice. Starting on Thursday night we cut his steroid dosage in half and began therapy Friday. He received 1 hour of hyperbaric oxygen chamber therapy and an acupuncture treatment to help with blood flow, reduce inflammation, and ultimately heal the area affected. He went back both Saturday and Sunday for more oxygen chamber treatments and has shown great signs of improvement. He is regaining function in his front legs a little bit each day. The vet took a video of him standing in the chamber on Saturday. I will try to post some videos at some point if anyone is interested.

With all this being said we are still not ruling out the possibility of cancer but it does seem less likely now. We just continue to hope and pray he keeps making improvement day by day. I also just want to thank everyone who commented on this post to offer support and help. This has been a very difficult time for us, but we couldn't be more happy with the progress he has made so far.

I will keep you all updated on any further improvement! Thanks!

 

[Meowmee]

Just wanted to update anyone who is interested. We went to a neurologist last Tuesday where they found a mass in his spinal cord in the neck. We were told that it was one of two things, either cancer (most likely lymphoma) or FCE. The neurologist was leaning more towards cancer and we were devastated. We left thinking we were in the worst possible scenario. However, the next day I received a call from the neurologist where she explained she sent the MRI results to their radiologist and he disagreed with her theory that it was cancer and said it was more likely FCE due to the location of the mass in the neck (C6-T2 vertebrae I believe is where it is located). This gave us hope again that Jax would make it through this. FCE is still a very serious condition and is rarely seen in cats. Typically it is much more common in large dogs. We were given two courses of action: 1. take a sample of his liver and the small mass in his abdomen that was found during the ultrasound to further test for cancer. or 2. Start rehab and slowly taper the steroid off and he will either continue to improve (FCE) or he will take a decline (cancer). We were initially leaning more towards the first option but after consulting with multiple vets we decided option 2 would probably be the best route because of a couple different reasons. 1. The steroid he is on would make it very hard to test for cancer elsewhere and would most likely lead to a negative reading anyway. 2. The fine needle aspirate could possibly cause further clotting and irritate him further.

With that information we decided to proceed with rehab/therapy with a local practice. Starting on Thursday night we cut his steroid dosage in half and began therapy Friday. He received 1 hour of hyperbaric oxygen chamber therapy and an acupuncture treatment to help with blood flow, reduce inflammation, and ultimately heal the area affected. He went back both Saturday and Sunday for more oxygen chamber treatments and has shown great signs of improvement. He is regaining function in his front legs a little bit each day. The vet took a video of him standing in the chamber on Saturday. I will try to post some videos at some point if anyone is interested.

With all this being said we are still not ruling out the possibility of cancer but it does seem less likely now. We just continue to hope and pray he keeps making improvement day by day. I also just want to thank everyone who commented on this post to offer support and help. This has been a very difficult time for us, but we couldn't be more happy with the progress he has made so far.

I will keep you all updated on any further improvement! Thanks!

Wow that is great he is getting better. FCE is very rare, I had read about that when Syb had a saddle thrombus. I hope he continues to regain his mobility and that there is no cancer involved. I am wondering why FCE was not considered as a possibility in the beginning. It seems odd that they don’t know how the spinal tissue etc gets into the vessel at least from the little I have read just now.

 

[fionasmom]

Thank you so much for posting that detailed update. I think that FCE is considered to be such a condition of large dogs that no one ever considers that a cat might have it. While this is not something that is easy to face, I certainly hope that it is treatable and that Jax continues to improve. Your choice of treatment, eliminating the other testing, makes a lot of sense especially since one result might not have been reliable and the other might have caused more issues. Here is to Jax recovering completely! Please keep us posted as to his progress.