15yo female cat just dxd w/asthma, now having seizures?
Hi to all,
I was hoping to get some input from some folks here. I'll try to explain to the best of my ability what's going on, and if anyone has had any similar experiences I would be very grateful for your posts. Apologies for the length of this post, but there is a lot of information that needs explaining; please bear with me.
Background: My kitty, Beade, turned 15 in September. She's been with me since 8 months of age; she is spayed and not declawed. For the entirety of her life, she hasn't had a single episode of illness or poor health; she will occasionally get a bit of conjunctivitis in her left eye maybe twice or three times a year, where it gets itchy and watery, and that disappears within three days. She is totally indoor now for the past three years, though she was a partially outdoor cat for several years (she could go outside in the yard as long as it was light out and I was home, but she would come inside if I weren't at home or when I went to bed).
On December 6, my husband and I were sitting in the living room having breakfast, when Beade jumped up onto his desk to try to get to his toast. I didn't witness it directly, but my husband described the event to me later; apparently she "lost her footing" (his words) and started to fall off the desk. He picked her up off the desk before she fell, but when he picked her up she meowled (meow + howl, a sound I have only heard once before when she was frightened or hurt by something). He sat her down on the floor, and she seemed very freaked out, her limbs were stretched out in front of her in a very unnatural way, and she sat very still for about a minute and a half, we assumed to collect herself after being scared by the event, and then she walked away, shaken but otherwise unharmed, we thought. About an hour later, at around 11 AM, she meowed from the hallway, and when I went to her she was just sitting there, seeming to be fine, but her breathing seemed more rapid than usual. I called the vet and told the receptionist what was going on, and they recommended I bring her in when I could, so I made an appointment for 5:30 that evening, the earliest appointment we could get for an emergent visit.
By the time we brought her in, her breathing was very rapid and shallow and she was very clearly in distress. The vet, who was very dismissive and seemed impatient with us, told us that she was in complete heart failure and was going to die that night. She advised we leave her there at the vet so she could be given pure oxygen and they could run tests, which we did. When I asked the vet what course of action we should take, the woman indicated that Beade was in very poor health and would not make it through the night, and that her 25 years of experience told her that this cat was in complete heart failure and at her end. This after appearing perfectly well less than 12 hours earlier.
The vet took some blood, did an xray, put her in an oxygen tent, and gave her some breathing treatments, and then called us later that evening. She told us that she had deteriorated over that period and that we should come and get her because, and I quote, "there will be no one here tonight and I don't want to come to work in the morning to find a dead cat." On the phone with me, the vet indicated that we were basically going over to say our goodbyes, and that they had done all they could. We rushed to the vet, determined that she was going to come home with us one way or another, as I no longer trusted this woman's opinion.
By the time we arrived, something in this woman's demeanor had changed, and she no longer seemed convinced of her original diagnosis. I don't know what, but I suspect she spoke to another vet; suddenly she was telling me that Beade was, in fact, NOT in complete heart failure, that it might be something more akin to asthma. The xray was almost completely white, indicating that she was getting almost no air, and the blood work they did ruled out liver or kidney failure. She was given a shot of steroidal antiinflammatories, and we took Beade home not knowing what would happen.
She improved over the course of the day but then deteriorated again that night, and when we brought her in the next day I insisted on seeing another vet. The man that we saw was much kinder, more patient, certainly more tactful, and definitely a lot more interested in Beade's welfare than the first one had been. He thought that we should treat her with long-term steroidal antiinflammatories (Depo Medrol), since the Solu-Medrol had worked well but had worn off so quickly. He gave her that injection, and by the next day her breathing had improved dramatically. By the end of the week she seemed to have recovered almost completely, and we took her in on Christmas Eve for a booster shot about three weeks after the first one. It seemed we had dodged a bullet, and this vet told us that her symptoms all indicated feline asthma, but it seemed more like a diagnosis of last resort to me. Nonetheless, the fact that the steroids were working, combined with her breathing pattern, we accepted the tentative diagnosis, and pursued treatment on that recommendation.
On Friday we took her in for a checkup, and she was given a big thumbs up by the vet. Her breathing difficulties had resolved, there was no evidence of wheezing or rales on expiration, and everything else seemed normal. The vet gave me a course of prednisolone to give her orally. He told me to give her a whole pill (5 mg) mixed in with her food every day for two weeks, then wean her down to a half a pill (2.5 mg) for two weeks, then stop. I was concerned about giving her the pills, knowing she wouldn't take well to them, but he told me that as long as I could get at least half a pill in her a day, even if I couldn't get the whole pill in her, that would be enough to sustain the steroid dose. (For some reason I was uneasy with this, but I'm not a vet.)
I started the course Saturday morning and managed to get a half a pill into her on Saturday, and again on Sunday. Then on Monday morning, everything changed. And this is where things get confusing.
I awoke Monday morning to a sound that I thought was a distressed meow, but being half asleep I wasn't sure. When I found Beade she was under the bed just sitting there, so I coaxed her out for some food. I gave her the food with the pill in it, and she ate a few mouthfuls. She seemed a little uneasy to me somehow, like she was worried or something. Then she walked through the living room, and fell over. The exact sequence of events was this: Her back legs seemed to fold under her, she rolled over onto her back with her legs curled up at her belly; her body stretched out, neck back, and she seemed to cough or make a kind of gurgling/strangling sound with her mouth open; she was still and quite stiff for a moment, and then she rolled back over onto her stomach, looking around as if confused. The whole thing took mabye eight seconds. I ran to the phone and called the vet, and while I was describing the symptoms to the receptionist, she had another episode, exactly the same sequence of events. I took her to the vet's office immediately.
She didn't have an episode while she was in the office, so the vet was unable to see exactly what happened. I had only witnessed two of them, so at this point I don't think I understood that they unfolded the same way each time, all I knew was that she was collapsing. He suspected that she might be fainting, and mentioned clots in her legs that might be caused by a cardiac condition. He did an EKG, which showed no abnormalities but for a possibly widened QRS, but that could have been the result of the resolution on the EKG machine being really lousy, so he wasn't willing to commit to that, and he said that when he listened to her heart it sounded fine, no murmurs and no skipped beats. So the skipped beats on the strip might have been the result of bad printing or bad resolution on the monitor, he wasn't sure. He tested her gait, which was fine; her hindlegs were warm without lumps. He scheduled a scan of her heart to be done Friday morning, and gave her another injection of the Depo so I wouldn't have to worry about giving her the pills.
Now, I have to admit, the timing of these events was weird. It didn't seem like it could be a coincidence that she was having them as soon as the dose of steroids was low in her system. I thought she was having them because of the steroids, and once the Depo caught back up she would stop having them. She continued to have episodes, all alike as described above, on Monday until about 11:30 PM. Then on Tuesday morning, she had none at all. None Tuesday afternoon either. I had assumed that the steroids had kicked in and were curbing the episodes (although admittedly she had been quite still all day, preferring to sleep in her little bed or in the closet on top of a pile of clothes, only getting up to eat and use the litter box, so her activity was definitely less, which may account for the fewer episodes).
But then Tuesday night, she had another one--only this time it wasn't a full-on event, just a sort of half one. This time it was just that her legs seemed to go out and she'd roll over, but she didn't seem to have the stretching and shuddering that she had had on Monday. It was difficult to tell, but it appeared that the events were less severe than they had been, although they were still scaring her. She meows in distress when they happen unless either my husband or I are here to comfort her, and then she seems more calm. But they resolve quickly, within ten seconds or so, at which point she gets up and walks away with no sequelae. This includes the fact that her legs seem fine, she doesn't seem to have trouble walking (which is what I would expect if there were clots), and other than confusion and some obvious distress, she acts normally afterward.
When I described the events to the vet on Monday, I didn't have all the information I do now, so his interim diagnosis of them being fainting spells, possibly brought on by clots, makes sense in that context. But now, after seeing several more of these events, I am convinced that these are seizures. The event is just too scripted for it to be a fainting spell. A true syncopal episode (fainting spell), I would think, would be at least a little different every time dependent upon where she was, whether she was in motion, standing/sitting, gravity, etc. But the fact that they happen exactly the same way every time, the shudder at the end, plus the confusion, leads me to believe that they are seizures. I will be sure to tell him this on Friday when they are scheduled to do a scan of her heart, but I don't know how much support I'm getting from this practice at this point.
This is my first experience with a sick cat, believe it or not, after 15 years. I have been very lucky, and so has Beade. I know it's difficult to diagnose animals, especially cats as they are so good at hiding their distress and pain. But I admit I'm a little concerned that I might not be being heard. I asked him about the possibility that the steroids might have something to do with this, and he didn't think so; I asked him whether she might have too much in her system, and he didn't think so; I asked him whether she might have too little, and he didn't think so. He says cats are very resistant to the side effects of steroids, but after a month's worth of Depo in her system, is it possible she's having a reaction? or could it be that this a reaction due to withdrawal? It just seems strange that she had one episode way back at the beginning of this whole thing, then nothing until Monday, when the steroid level was starting to drop off. I just don't know if I'm getting decent medical help here, and considering my experience with the first vet I'm not sure how much trust I'm willing to put into this practice.
I'm wondering whether anyone else here has had similar experiences, either with steroids/Depo or asthma or seizures, or if anything here sounds familiar. I'm also hoping someone can give me an idea of what could be going on here; I'm wondering whether these are two separate diagnoses--asthma and seizures (or something else which is causing the events)--or if it wasn't asthma to begin with and there is something cardiac going on that might be causing the events to occur. Basically, any help, guidance, ideas, brainstorming or thoughts would be appreciated.
I admit I am frightened. Beade has been with me for 15 years, and she is my family. I am not one of these people who sees cats as disposable; I know her like I know myself, if not better, and although I know she is 15, I still feel that she has a lot of life in her to live. I want it to be good life, though, and I will do anything I can to get her well and healthy again. It's hard to believe it's only been a little over a month when all this started...it seems like a lifetime. I spend my day just watching her, hoping today the events will cease and she will be all right...though I don't know if that would be a good thing or not, because if the steroids do in fact curtail the events, that might mean there is something very severe underlying this, something less treatable...there's just so much to consider, and I'm so sorry for the length of this so I'll just shut up now.
I thank you very much.
Last edited by wissywig; January 19th, 2012 at 10:18 AM.
|asthma, cat, seizures, steroid injections, vet advice|