Freya has weird neurological/mental issues

[BeccaCat]

I’m sorry to read all of this. I hope your sweet Freya improves soon.

 

[Antonio65]

Freya was discharged from the clinic at 6:30 pm yesterday.
We're waiting for the results of urine and blood tests.
The US scan and the visit didn't find anything out of the ordinary, so the vets weren't able to determine what caused both the disorientation in the last three days and the urinary block Monday night.
I was given all the report from the visit, the neurologist and the US scan, and the prescription for the phenobarbital (Phenoleptil 25 mg) pills, at the dosage of 1.7 mg/kg, twice a day, which is lower than the one usually needed (2 x 2.5 mg/kg). The vets want to see what the reaction of Freya is to the med. In two weeks we'll have a bllod test to assess the dosage of phenobarbital in her blood, and we will adjust it if it's the case.

Freya was alert and active when she came home. We gave her a quick dry foam bath to wipe that bad smell off her. She peed herself during the trip back home as well.
The only thing is that she's still not eating... she hasn't had a complete meal since Saturday. She slowly reduced her food intake until the day she was taken to the clinic, she didn't eat anything while she was there, she didn't eat last night, she didn't eat this morning.

I'm telling you, I'm exhausted...

 

[Antonio65]

I didn't have an MRI done because the cost is about $3000 US and a 3 hour commute each way.

Just talked with the facility where the MRI will be done.
The place is 100 miles from home (1 h 30m).
The waiting list is a week long, so it's quite quick.
The cost is $715 (680 euro) for the MRI and $400 (380 euro) for the EEG and the celebrospinal fluid test.

All they need is a recent blood work (not older than 2 months) and the referral from the neurologist who visited Freya yesterday and a yaer ago.

 

[Timewarpcat]

Just talked with the facility where the MRI will be done.
The place is 100 miles from home (1 h 30m).
The waiting list is a week long, so it's quite quick.
The cost is $715 (680 euro) for the MRI and $400 (380 euro) for the EEG and the celebrospinal fluid test.

All they need is a recent blood work (not older than 2 months) and the referral from the neurologist who visited Freya yesterday and a yaer ago.

Looks like vet care is very overpriced in the United States! That's why i was careful to state the prices are for in my area and US$ but the cost difference is shocking, much more than I would have ever thought. I was very upset I couldn't get the MRI for my cat and then it turned out I didn't need it, so it was OK.

I'm very glad to hear that it's affordable for you where you live. I hope you get the information your vet needs!

 

[Antonio65]

Looks like vet care is very overpriced in the United States! That's why i was careful to state the prices are for in my area and US$ but the cost difference is shocking, much more than I would have ever thought. I was very upset I couldn't get the MRI for my cat and then it turned out I didn't need it, so it was OK.

I'm very glad to hear that it's affordable for you where you live. I hope you get the information your vet needs!

Actually it isn't the first time that we compare US vet bills with Italian vet bills, and the difference is breathtaking.
I'm glad that you didn't spend that much, considered that it was a completely different issue.

 

[ladytimedramon]

My opinion is that the trigger are the sexual hormones. Freya had her first episode when she was nearly 6 months old, the time when I had planned her spaying, and I strongly suspect that her spaying wasn't complete. Due to other health issues, she was spayed at the age of 10 months, and I believe they might have left a follicle behind and this gives cyclic hormonal storms. The fact that the last episodes are almost evenly spaced (8 to 13 days) just like they were last year, makes me think it is like the heat cycle in cats that appears every 10 to 15 days.
Freya didn't show any classic signs of heat before the surgery, so even now I couldn't tell if she's in heat or what.
What I know is that she acts like suddenly meowing out loud, or trying to dart outdoor, but not always, only for a few days every, say, 10 to 15 days.
That's the reason why I started THIS THREAD last October. I discussed this with the neurologist today and he said it makes sense and he will talk to another vet who is very expert in breeding and hormonal stuff.

I missed your previous posts on this. Have you done any follow up?

Right after I adopted Delilah, I went through a period that I didn't understand at first. She walked around yowling, would roll around, and then stick her rear up like assuming the position. She was my first cat, and my first female pet since I was about 11 (it was a puppy and we couldn't keep her so she was returned), and my first pet in 37 years. When I took videos of her doing everything and posted them here everyone said it looked like she was in heat. Since they said she'd been spayed I was confused and looked into the ovary remnant. Essentially she was going into "heat" every other week (1 week normal, 1 week "in heat"). The vet was able to confirm the hormone changes. Then they did an exploratory surgery. He couldn't find anything. I contacted my cousin (also a vet) who told me to get a referral to a veterinary internist. She said the difference between a general vet and an internist was 5 more years of college and more training. The internist did a sonogram and found a tiny bit of ovarian tissue hiding behind a kidney. He sent Delilah to a specialist surgeon who took out the piece of tissue AND some scar tissue from the spay (in case anything was left behind). Since then the signs of her acting like she was in heat disappeared.

I hope some of my story helps. If you haven't seen a veterinary internist, you might look into getting a referral.

 

[IndyJones]

Freya was discharged from the clinic at 6:30 pm yesterday.
We're waiting for the results of urine and blood tests.
The US scan and the visit didn't find anything out of the ordinary, so the vets weren't able to determine what caused both the disorientation in the last three days and the urinary block Monday night.
I was given all the report from the visit, the neurologist and the US scan, and the prescription for the phenobarbital (Phenoleptil 25 mg) pills, at the dosage of 1.7 mg/kg, twice a day, which is lower than the one usually needed (2 x 2.5 mg/kg). The vets want to see what the reaction of Freya is to the med. In two weeks we'll have a bllod test to assess the dosage of phenobarbital in her blood, and we will adjust it if it's the case.

Freya was alert and active when she came home. We gave her a quick dry foam bath to wipe that bad smell off her. She peed herself during the trip back home as well.
The only thing is that she's still not eating... she hasn't had a complete meal since Saturday. She slowly reduced her food intake until the day she was taken to the clinic, she didn't eat anything while she was there, she didn't eat last night, she didn't eat this morning.

I'm telling you, I'm exhausted...

Maybe try the recovery food? daftcat75 has used this when their cat Betty wasn't eating. I haven't tried it myself so don't know where you get it.

 

[daftcat75]

Betty White loves the Hills A/D recovery food. It is supposed to be kitty crack to get sick cats eating again. When she seems too nauseated for anything else, I can usually get her to take a few bites of the A/D.

If Freya likes the A/D, I recommend mixing it with something else as soon as you can for a couple of reasons. First, A/D isn't meant to be a forever food. But more importantly, because it has such high appeal, I wouldn't let her get used to eating the pure A/D. Conserve your nuclear option for when all else fails. Also, pure A/D, because of its high appeal, and because you're going to make it a rare offering once you can get her to eat any mix of it, the unadulterated stuff can be used for mixing supplements or burying pills. Betty's regular mix of food (until we finally see a specialist next month and get more answers) is 1 part Hills A/D to two parts Hills I/D (digestive stew.) It makes a thick pate which she seems to enjoy. But even yesterday, when she had an acid spit up (gone too long between meals) and I knew she simply needed something in her belly more than I needed to withhold food and give her gut rest, that was a perfect time to pull out a couple morsels of the A/D. Sure enough, because she never sees the pure stuff anymore, that cut right through whatever blech's she was feeling and she got a few grams of something for her stomach to chew on until she was once again ready to eat her regular food about 15-20 minutes later.

So yeah, Hills A/D is great stuff to have if your cat will eat it. Ask your vet for a can or two to try with her.

 

[daftcat75]

One other thing I found with Betty's nausea is that often when she won't eat from the plate, I can still get her to eat something if I take a morsel off the plate and set it on the carpet in front of her. I have fed her morsel by morsel a whole meal this way. On many occasions.

 

[Antonio65]

I missed your previous posts on this. Have you done any follow up?

If you mean whether I did any follow up for the hormone test, well I didn't.
My vets didn't give much credit to my theory when I first presentes it to them. Later on, all weird symptoms in Freya didn't show up anymore, and we almost forgot about them. Until a few weeks ago.
I think that the first time I saw something this year was around March? I'm not sure. Freya is a quite strange cat, and we're kind of used to weird episodes or behaviors. In the last month, though, I decided to keep trace of them, and three episodes occured so far since April 22, almost evenly spaced among them.

Late last night and this morning were the first moments when I saw her acting as usual since last Saturday morning.

The neurologist prescribed the phenobarbital, I could start it tomorrow.
But I think I will wait a couple of weeks, I want to see if she gets "weird" again in about ten days or so.

Right after I adopted Delilah, I went through a period that I didn't understand at first. She walked around yowling, would roll around, and then stick her rear up like assuming the position.

Freya never showed any clear and classic signs of heat, even before the surgery August 2021. But she often yowls or does strange things, almost cyclic.
Furthermore, there are times in the month when she tends to dart outside, when she's usually uninterested about the outdoor world in other times.
All these signals make me think she is going through heat cycles where she acts in not common ways.

Since they said she'd been spayed I was confused and looked into the ovary remnant. Essentially she was going into "heat" every other week (1 week normal, 1 week "in heat"). The vet was able to confirm the hormone changes. Then they did an exploratory surgery. He couldn't find anything. I contacted my cousin (also a vet) who told me to get a referral to a veterinary internist. She said the difference between a general vet and an internist was 5 more years of college and more training. The internist did a sonogram and found a tiny bit of ovarian tissue hiding behind a kidney. He sent Delilah to a specialist surgeon who took out the piece of tissue AND some scar tissue from the spay (in case anything was left behind). Since then the signs of her acting like she was in heat disappeared

And this is exactly what I nearly sure of, but nobody wants to listen to me. They keep saying that the vet who spayed her is experienced and that they are sure no tissue was left behind during the surgery. They ran another US scan after that, and they said they didn't see anything. But I think that if the remnant is very small, the scan can't see it.
There are even rare cases where the ovaric tissue can be hectopic, that is it's in a different position than they expect to find it.
How was the vet able to confirm the hormone changes? Is there a specific test?

 

[Antonio65]

Maybe try the recovery food? daftcat75 has used this when their cat Betty wasn't eating. I haven't tried it myself so don't know where you get it.

Yeah, I thought about these high energy foods, but my fear was that she could get used to them and didn't want to eat anything else.
This morning she ate 70 grams of wet food, that is much more than she ever ate in a single meal before.

 

[Antonio65]

Also, pure A/D, because of its high appeal, and because you're going to make it a rare offering once you can get her to eat any mix of it, the unadulterated stuff can be used for mixing supplements or burying pills.

Actually, I always found that cats don't like Hill's A/D much, at least not as much as Royal Canin Recovery, which has a couple of advantages on its side.
It's less dense, so it can given to cats with a syringe more easily.
It has higher calories, so a cat can get more energy with the same amount of recovery food.

Freya takes every pill no problem, thank God, so, at least with her, I don't need to find a trick to fool her.

So yeah, Hills A/D is great stuff to have if your cat will eat it. Ask your vet for a can or two to try with her.

This morning Freya ate on her own, 70 grams of wet food, which is a great achievement.
Over here, in Italy, vets rarely sell pet food. They can have some more classic med available, but not food.
Pet food, every kind of pet food, even for special dietary needs, can be found in any pet supply store.
I will keep in mind your advice. Thanks!

 

[ladytimedramon]

If you mean whether I did any follow up for the hormone test, well I didn't.
My vets didn't give much credit to my theory when I first presentes it to them. Later on, all weird symptoms in Freya didn't show up anymore, and we almost forgot about them. Until a few weeks ago.

The first vet I saw didn't give much credit either. That's why I saw another vet.

I think that the first time I saw something this year was around March? I'm not sure. Freya is a quite strange cat, and we're kind of used to weird episodes or behaviors. In the last month, though, I decided to keep trace of them, and three episodes occured so far since April 22, almost evenly spaced among them.

Late last night and this morning were the first moments when I saw her acting as usual since last Saturday morning.

The neurologist prescribed the phenobarbital, I could start it tomorrow.
But I think I will wait a couple of weeks, I want to see if she gets "weird" again in about ten days or so.

I had adopted Delilah in April. I didn't see anything the first two or three weeks. Because I thought it was related to allergies (I thought her rolling and licking and yowling were part of her being itchy or uncomfortable) the vet tried her on an allergy diet which she pretty much refused. I started posting video of Delilah here after she started "presenting herself" - that didn't start until about 2 months in.

Freya never showed any clear and classic signs of heat, even before the surgery August 2021. But she often yowls or does strange things, almost cyclic.
Furthermore, there are times in the month when she tends to dart outside, when she's usually uninterested about the outdoor world in other times.
All these signals make me think she is going through heat cycles where she acts in not common ways.

Remember, if she's spayed most of the hormone producing parts are gone and it's just a little teeny weeny piece that can be the size of a pin head.

Cyclic was a big part of it. I started counting and it was almost perfectly 7 days. Because I was teaching from home due to covid I was able to monitor everything pretty closely.

And this is exactly what I nearly sure of, but nobody wants to listen to me. They keep saying that the vet who spayed her is experienced and that they are sure no tissue was left behind during the surgery. They ran another US scan after that, and they said they didn't see anything. But I think that if the remnant is very small, the scan can't see it.
There are even rare cases where the ovaric tissue can be hectopic, that is it's in a different position than they expect to find it.
How was the vet able to confirm the hormone changes? Is there a specific test?

I'm sure the vets that spayed both Freya and Delilah were experienced. But I was told it only takes a couple of cells left behind to regenerate enough cells to become a problem and unless the vet was using a microscope to check after surgery anything is a possibility.

The second vet did a blood test that confirmed the elevated hormones. The paperwork is packed away and I don't remember what it was called but it showed her hormones were like those of a cat in heat. An exploratory by the vet found nothing. He was an experienced vet. But the bloodwork showed there was something there, which is why my cousin recommended the internist. The internist located the tissue behind a kidney, which is not a "usual place". The surgeon removed the scar tissue from the spay, because if cells had been caught in the healing tissue, it could also cause a problem (again, not a "usual place").

I would say for you to request the blood test first of all. You have to bring her in when she's having the symptoms (which is why tracking the time between events is really important).

If nothing else, the blood test can help eliminate the possibility.

 

[Antonio65]

I found a pdf file on the internet, and it explains in details how the tests work and which can be done and why.
I forwarded this file to the vet, and they agreed to have a hormonal test on the serum that the lab might still have after the blood work they did on Tuesday. They will start with the measure of LH levels, and this might be the starting point of a new course of investigation.
At last, they listened to me.

The pdf file I talk about is in Italian (which I am) so I think that it couldn't be useful here. Anyway, here it is:
"How, when and why dose sexual hormones"
Maybe Google Translator can be of help

 

[ladytimedramon]

That's great! I hope it works. If it turns out there is something, please try to get a specialist to do a sonogram, rather than letting a generalist do any exploratory surgery. My biggest regret is not doing that. I could have spared Delilah a needless surgery if I'd gone to an internist first (I should have spoken to my cousin the vet before anything - she's the one who told me what to do after the failed exploratory).

 

[Antonio65]

The results of blood and urine test are in.

The only levels out of range are

CPK 3496 [10-140]
LDH 345 [63-273]
AST 70 [13-49]
ALT 66 [6-62]
Total Lipase 181 [1-80]
DGGR Lipase 31 [8-30]
Serum Amyloid SAA 1.8 [0-0.7]

The vet told that everything looks fine.
In my opinion this is the sign of a pancreatitis or a triaditis. Tomorrow I will talk with them about it.

Freya didn't want to eat tonight. And she's been sleeping in the last two hours, definitely unusual for her.
She lost 110 grams (nearly 4 oz) since Monday night, and 200 grams (7 oz) since April 20.

 

[IndyJones]

I would definitely try daftcat75 s recovery food if you can find it. She needs to stop losing weight. The anorexic episodes need to stop.

If your vet can give you a prescription maybe you can order it on amazon. She needs to eat.

 

[Antonio65]

I would definitely try daftcat75 s recovery food if you can find it. She needs to stop losing weight. The anorexic episodes need to stop.

If your vet can give you a prescription maybe you can order it on amazon. She needs to eat.

She ate fine late last night and she ate three times this morning.
There's no need for prescription to buy that kind of food here. Actually, no food requires a prescription over here. They're all on the shelves at any pet food store.

I won't start with the phenobarbital until I'm totally sure she is eating correctly and gain some weight.

 

[silent meowlook]

They said the bloodwork was normal?? Did they explain the elevated CPk? That is a sign of muscle damage like with a cardiac event.

 

[Antonio65]

They said the bloodwork was normal?? Did they explain the elevated CPk? That is a sign of muscle damage like with a cardiac event.

They said everything was normal BUT the level of CPK.
They said this was the signal that Freya had a seizure without me noticing it.
I said that the level was way out of the range because of the extreme level of stress and anger during the blood draw.
I had never seen anything like that in any cat before. Freya is a sweetie, but the vet who took the blood was very rude that night. And this is why her CPK was that high.

They weren't able to explain why the pancreas levels were off too.