Recurrent neurological problems - I don't really know what to do anymore - Cat Forum : Cat Discussion Forums
 
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post #1 of 6 (permalink) Old 07-23-2018, 12:09 PM Thread Starter
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Question Recurrent neurological problems - I don't really know what to do anymore

Hey,

I have a huge problem with my cat and to be honest I do not know what to do next

Male, 4 years, breed: Scottish straight, not outgoing (no contact with other animals, no children at home). No chronic illnesses were found, but he had been struggling with a cat's flu (I don't know the right name in English) from his birth.

History:

1. In January 2018 my cat began to behave strangely - he stopped closing his left eyelid and stopped moving his left ear. That same day I took him to the vet - the neurological problem was confirmed. It turned out that he had an inflammation of the inner ear which led to paralysis of the trigeminal nerve (responsible, among others, for the eyelid and ear).
He got anti-inflammatory Loxicom and as an antibiotic Synergal. Because he did not tolerate it well- after some time he started to vomit it, he got Convenia.

2. At the end of January, he had a magnetic resonance imaging. A change was found below the eye socket, behind the throat. Description: In the area of ​​the left eardrum visible changes in the form of a small amount of secretion with a strongly hyperintensive signal in the T2-dependent sequences in its medial-pellicular compartment, as well as strong thickening of the can divider. In addition, a visible strong signal increase in both the T1 and T2-dependent sequences in the muscle range located on the medial left side of the mandible from the temporomandibular joint, around the circumaural region to the left eye socket. After a contrast was given, a moderate signal gain was demonstrated in the area of ​​the left tympanic diaphragm. Recommendation: continuation of Convenia treatment.

3. Convenia was continued in February.

4. At the beginning of March, it seemed that the cat was recovering - it became more animated, the ear began to move a bit. Unfortunately, before the end of the next dose of Convenia, there was a worsening - no ear movement, no closing of the left eyelid. This was accompanied by a flicking of the head and visual disorder (quite quickly subsided).
He got anti-inflammatory Loxicom, and as an antibiotic Aniclindan, which apparently penetrates the whole body and is quite strong.

5. At that time, a magnetic resonance imaging was performed (ie after 5 weeks from the previous one) - it showed practically no differences. Recommendation: continuation of treatment with Aniclindan.

6. In mid-March, endoscopy and intrauterine myringotomy were performed. At the end of March future results: Cytology: (...) small few bacteria (granulomas), (...) cytological picture indicates the presence of an inflammatory process. Due to the presence of bacteria, the primary or secondary background of inflammation as suggested. Aerobic and anaerobic culture.

7. In mid-April, treatment with Aniclindan was completed (after 6 weeks). The cat seemed to recover slowly, but in the second half of April - literally within an hour - neurological problems appeared again. After half an hour of going to the vet, the cat already had strong visual disorder and coordination disorder.
The middle ear seemed to be infected again. The vet decided not to give another antibiotic or anti-inflammatory drug, this time to try to "grow" the bacteria so that they could appear in the external ear and this time they were able to be taken for cytology.

8. The cat returned to its previous state after one day, i.e. without the movement of the ear and the eye, but also without major neurological problems (coordination, nystagmus). Unfortunately, this time cytology showed nothing.

9. The vet suggested that the only diagnostic method that remained was a biopsy under the control of a computer tomograph, but due to the location of the lesion it is a high-risk procedure (serious damage of arteries and/or nerves).

10. Due to the upcoming holiday I decided to refrain from the decision about the procedure. After returning (one week), the cat functioned normally. After about 2-3 weeks, he started to recover by himself - he began to regain movement functions of the ear and in a minimal degree of the eye.

11. After about 5 weeks of good form and "self-treatment", today, the cat began to feel worse again - it goes with a tilted head and does not react with the ear to the sounds/touch. History is circling.


Additional remarks:
I do not see any correlation with external factors and the recurrence of fears (stress, food, etc.). Only what appeared a few days before the current relapse is a dark discharge from the nose - a feline catarrh. Perhaps there is some correlation with the line (last days I heavily aired the flat, and earlier (in winter) I used an air purifier and the cat liked to sit nearby.

Questions:
A biopsy is very risky (cat's disability). At all costs I would like to avoid it, on the other hand I want to finally heal the cat, because the animal is feeling bad.

Have you had a similar situation or have an idea, what could be the cause of his illness?
I prefer to try everything rather than practically condemn him to a disability as a result of a biopsy.

PS. Sorry for my English, but I'm not a native speaker...
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post #2 of 6 (permalink) Old 07-31-2018, 10:44 PM
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I am sorry what you are going through and to hear about the strange problem your cat has, that even with all the diagnostics and treatments the vets have not been able to determine the cause or what should be done for your cat. It was heartening to hear that the cat did recover for a few weeks. The dark discharge from the nose.....perhaps the cat has a tumor? Only you can determine whether your cat is happy and contented, or is miserable and suffering and has no interest in eating or being responsive to you or play. Please consider the cat's quality of life and you may have to make the hard decision to have the cat euthanized if it is in pain and is suffering.

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post #3 of 6 (permalink) Old 08-03-2018, 12:52 AM
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Hi angouleme,

What is your kitty's name? I am really sorry to hear about the neurological issues, although I'm not familiar with this situation. If I'm understanding correctly, the basic issue seems to be that they cannot identify what's causing the inflammation in the inner ear. So treatments seem to work for a while, maybe bringing down the inflammation, and then the inflammation returns. You said he has had the cat flu (feline herpesvirus?) since birth. I wonder if that is connected to the inflammation.

Did the vet explain what that very technical report after the first MRI means?

I take it you are in Europe (Poland?), based on the Aniclindan and Synergal. It sounds like you've already had all of the specialized testing done, so I assume the vet you're seeing is a specialist. If not, are there any veterinary neurologists near you that you could consult? Actually, even if your vet is a specialist, there is no harm in getting a second opinion, especially if a risky procedure is being considered. In the US, it is possible to do phone consultations with some veterinary schools. Is this an option for you?

I just poked around online a bit and saw surgical drainage listed as an option in severe cases. I'm not sure what would be drained, though...

The other thing I just thought of is that some ear infections aren't caused by bacteria but by fungi. If fungus is the cause, I don't think antibiotics work. Maybe something worth considering?

(BTW, your English is excellent.)
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post #4 of 6 (permalink) Old 09-12-2018, 03:59 PM Thread Starter
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Dear All,

I apologize for a long time without an answer. In July I decided to verify the treatment with another (recommended) veterinary-neurologist. He adviced not to do any surgery (biopsy) - he recommended taking 10x Nivalin (substance improving nerve conduction) via injection (1x/day). In the absence of noticeable improvement - another 10x doses. The cat took a total of 20 doses. After that, some reaction of the ear (when touched) and the eye returned (he does not blink, but slightly closes the eye while sleeping). Of course, he gets Tears Naturalle for the eye three times a day.

MRI interpretation - doctor said that it is some atypical change, but not a tumor. Its base can be an infection.

The concept about fungal infection is interesting. The vet said that dark nasal discharge may be a symptom of fungal rather than bacterial problems (feline catarrh). Currently, the cat feels good (amuses, purrs ...). If the nasal exudation occurs, we have to examine it.

PS 1. Yes, I'm from Poland
PS 2. My cat's name is Hugo
PS 3. Thank you for your posts!

Last edited by marie73; 09-12-2018 at 05:13 PM.
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post #5 of 6 (permalink) Old 09-13-2018, 11:02 AM
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I'm happy for you that the vets seem to have found the source of your cat's problem....that it is a fungal infection and not a tumor, and especially that the cat "feels good (amuses, purrs...)". That is excellent news indeed. Hope Hugo continues to improve, and thank you for the update as it helps all of us to learn. All the best!

"There are no ordinary cats.";"Time spent with a cat is never wasted."~ Colette
"A loving cat can mend a wounded heart." ~ Unknown Author
Alkitotle aka "Alkee", "Lambie" (July 2/04 - Oct. 2/15) -- white Devon Rex
in avatar. "Always in my heart."
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post #6 of 6 (permalink) Old 09-15-2018, 03:07 PM
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Hi Angouleme,

Thanks for the update.

The important thing is that Hugo is feeling good, despite that eye that won't close. That sounds uncomfortable. I have no experience with this, but common sense would suggest that it's not a tumor because the hearing and eye issues come and go. I'd think those issues would just increase if there were a tumor. Although it may sound strange, I'm hoping that Hugo does have nasal discharge at some point so that you can have it tested and possibly get a diagnosis.

Is there no benefit to treating as if it were a fungal infection, even without evidence?
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