Hind limb weakness in otherwise healthy 9 month old cat.

Rax

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Hi,

Just looking for thoughts or idea for a recent problem that's cropped up in our small cat, Ernie.

She's a female domestic Medium hair cat. 9 months old. Spayed. She was the runt of her litter and has always been small - now at 9 months she weighs 6.3 lbs (her brother's almost 10lbs at the same age). She's playful, very affectionate, has a good appetite for food and water, and no problems using the litter box. No obvious signs of pain or discomfort. No other medications or health issues. Bright, alert, and responsive.

But about two weeks ago, we began to notice she wasn't jumping much, and instead would claw her way up onto the bed, chairs, the couch, etc... And it seems to have gotten worse. She can walk and run and play mostly fine, but can't seem to jump up onto things, or stand on her hind legs almost at all now. She flops over often now instead of sitting.

Since we couldn't get a regular vet appointment immediately, we took her to an urgent care center, where they examined her and did x-rays - finding the following:

Mild muscle wasting pelvic limbs. Moderate muscle wasting around the gluteal region. Mild generalized hindlimb lameness. 1-2/5. Left pelvic limb seems slightly more affected than right. Patient will walk several steps and then sit. Able to sit in normal position but will occasionally slump to hips it. No significant pain on spinal palpation.

We recommended radiographs of her back legs and pelvis to look for evidence of skeletal trauma, abnormal bone development, or bone loss from vascular diseases (legg-calv-perthes disease). Initial radiology review showed a couple areas of bone within the femur which appeared to be abnormal. We recommended an STAT radiology review for further interpretation.

Initial radiology review showed a couple areas of bone within the femur which appeared to be abnormal. We recommended an STAT radiology review for further interpretation. The radiology Review showed strong suspicion for decreased bone integrity (osteopenia), and an area in the lower back (lumbosacral intervertebral foramina) which is suspicious for a space-occupying lesion leading to the muscle loss and subsequent bone loss.


X-Rays are here with the possibly abnormal area circled in the second image:
The clinic referred us to another urgent care center that had a neurologist and an MRI machine.

The neurologist there was concerned that her symptoms could be caused by an infection such as Feline Infectious Peritonitis (FIP - likely dry form) , Toxoplasma, or Cryptococcus.

We agreed to a blood panel (Antech Feline Serology 2) and are waiting for the results currently - which we should have tomorrow hopefully. They also did a urinalysis (idexx), FeLV/FIV lab test, a PCV/TS lab, and a CBC chem 17 w. lytes.

If the blood panel comes back negative, the next step they're suggesting in an MRI - which is a big step because of the cost (approx. $3K - $3.5K). Everything above has already cost around $1.6k.

I guess while we're waiting for the blood test results, I'm looking for advice about three things:

  1. Ideas for what else this could be?
  2. Has anyone had a good experience getting a feline MRI? Has it been worth it?
  3. Next steps?
We don't want to torture her with endless medical treatments if the chance of success is low, but she's also so young that we don't want to give up prematurely.

Thanks.
 

kittenmittens84

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FIP is the #1 cause of neurological issues in cats under 2, and FIP with neuro involvement often presents as back leg weakness and trouble jumping because it attacks the nerves in the spinal cord that control the hind legs. I don’t think bone loss is commonly seen with FIP but I’m not sure. Are they also doing a blood chemistry panel?
 

cat nap

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The radiology Review showed strong suspicion for decreased bone integrity (osteopenia), and an area in the lower back (lumbosacral intervertebral foramina) which is suspicious for a space-occupying lesion leading to the muscle loss and subsequent bone loss.
Hello R Rax ...
did the Vets offer you any treatment for the suspected osteopenia?
...or the 'space occupying lesions'?
such as anti-inflammatory meds, pain meds, even antibiotics?
X-Rays are here with the possibly abnormal area circled in the second image:
The clinic referred us to another urgent care center that had a neurologist and an MRI machine.

The neurologist there was concerned that her symptoms could be caused by an infection such as Feline Infectious Peritonitis (FIP - likely dry form) , Toxoplasma, or Cryptococcus.
I suppose since you are awaiting on the results of the blood panels...then perhaps they would not be giving antibiotics...but I find it a little strange that the neurologist would be thinking about the above concerns...unless there were other symptoms as well.

Are there any other symptoms, besides the ones you have already mentioned that would lead them to believe in these types of infections?
Any fever?
Loss of appetite?
(previous cat I had while a teenager, (late 1980's), had the wet form fip, with loss of appetite and fever...so that is why I ask.)
We agreed to a blood panel (Antech Feline Serology 2) and are waiting for the results currently - which we should have tomorrow hopefully. They also did a urinalysis (idexx), FeLV/FIV lab test, a PCV/TS lab, and a CBC chem 17 w. lytes.

If the blood panel comes back negative, the next step they're suggesting in an MRI - which is a big step because of the cost (approx. $3K - $3.5K). Everything above has already cost around $1.6k.

I guess while we're waiting for the blood test results, I'm looking for advice about three things:
  1. Ideas for what else this could be?
  2. Has anyone had a good experience getting a feline MRI? Has it been worth it?
  3. Next steps?
I have not had to get an MRI for my animals, (knock on wood), so cannot help with any advice here.

But has your Ernie, been playing with your other cat at all...and if so...could the other cat have accidentally given a bite on Ernie's back, and then it may have healed over?

(the only reason I mention this, is because another previous cat we had, in the early 1990's, showed no signs of illness, but suddenly stopped and layed down on the stairs, right in front of my sister and me. He meowed, too. And seemed to be in pain when touched. We rushed him to the Vet, and there, the Vet discovered that he had a bite on his back...(sort of where you show in your x-ray...but further towards the head)...on the spine area. The Vet had shaved his fur, and showed us the puncture marks...though they were healed over, and no abscess. She gave him antibiotics and pain meds...and at the follow up appointment ...he was okay.)

I'm really hoping that your cat has something that is easily treated like this...or else something else easily treated.
Thank you so much for posting your detailed post, and X-rays, since they really educate the rest of us, on what is going on.
 
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Rax

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Hello R Rax R Rax ...
did the Vets offer you any treatment for the suspected osteopenia?
...or the 'space occupying lesions'?
such as anti-inflammatory meds, pain meds, even antibiotics?
Not yet. They didn't want to give her anything yet because of the possible upcoming MRI.

I suppose since you are awaiting on the results of the blood panels...then perhaps they would not be giving antibiotics...but I find it a little strange that the neurologist would be thinking about the above concerns...unless there were other symptoms as well.

Are there any other symptoms, besides the ones you have already mentioned that would lead them to believe in these types of infections?
Any fever?
Loss of appetite?
(previous cat I had while a teenager, (late 1980's), had the wet form fip, with loss of appetite and fever...so that is why I ask.)
No, she has no other symptoms we can see. She's eating well, using the litterbox, still walking around and even running and playing. Still affectionate and no obvious pain, even when being picked up and handled. The only symptom that we're aware of is her hind leg weakness and inability to jump or stand up (for treats, etc...).

But has your Ernie, been playing with your other cat at all...and if so...could the other cat have accidentally given a bite on Ernie's back, and then it may have healed over?
Hmmm. It's possible, so thanks for the suggestion. I just went over her back in that location but couldn't feel anything there. I'll take a look with a light and see if I can see anything through her fur.


Thanks for all the great replies so far everyone. Hopefully we'll hear about the blood test later today.
 

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Hello R Rax ...
did the Vets offer you any treatment for the suspected osteopenia?
...or the 'space occupying lesions'?
such as anti-inflammatory meds, pain meds, even antibiotics?

I suppose since you are awaiting on the results of the blood panels...then perhaps they would not be giving antibiotics...but I find it a little strange that the neurologist would be thinking about the above concerns...unless there were other symptoms as well.

Are there any other symptoms, besides the ones you have already mentioned that would lead them to believe in these types of infections?
Any fever?
Loss of appetite?
(previous cat I had while a teenager, (late 1980's), had the wet form fip, with loss of appetite and fever...so that is why I ask.)

I have not had to get an MRI for my animals, (knock on wood), so cannot help with any advice here.

But has your Ernie, been playing with your other cat at all...and if so...could the other cat have accidentally given a bite on Ernie's back, and then it may have healed over?

(the only reason I mention this, is because another previous cat we had, in the early 1990's, showed no signs of illness, but suddenly stopped and layed down on the stairs, right in front of my sister and me. He meowed, too. And seemed to be in pain when touched. We rushed him to the Vet, and there, the Vet discovered that he had a bite on his back...(sort of where you show in your x-ray...but further towards the head)...on the spine area. The Vet had shaved his fur, and showed us the puncture marks...though they were healed over, and no abscess. She gave him antibiotics and pain meds...and at the follow up appointment ...he was okay.)

I'm really hoping that your cat has something that is easily treated like this...or else something else easily treated.
Thank you so much for posting your detailed post, and X-rays, since they really educate the rest of us, on what is going on.
My first guess too. Still wondering about this. My beloved Sun was diagnosed with dry-form FIP *years ago before any treatment was available* at age 2 and lived almost to 16 with regular Immunoregulin injections, plus steroids when needed and B-12. There was never any limb weakness.
 
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Rax

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Thanks for that information - it's good to know that about FIP.

But yes, it's a very strange and disheartening problem - she seems fine in every single way (happy, eating, litter box, playing) EXCEPT that her hind legs are wasting away, getting weaker and weaker.
 

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I had a cat, Pangur Ban, with Cryptococcus. Not a good thing but I am not sure that your cat fits that description. It is often exposure related from a fungus in the soil although there are other causes. Pangur had been starving on the streets when I found him and I never had one clue what his past was. It sounds to me as if you know where this little girl is from and what her kittenhood was like. She also is not exhibiting many of the symptoms of cryptococcus which might first be seen. Ultimately, there can be CNS disorders from it, seizures, paralysis, blindness but this is as it plays out. I could be wrong, but I am just not thinking it is this.

As for MRIs, they can give valuable information; however, as the vet if there is a chance that nothing will turn up once they do it. Does he have a strong enough suspicion that it will give you something to go on or is it being used only as a rule out test?
 

tarasgirl06

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Thanks for that information - it's good to know that about FIP.

But yes, it's a very strange and disheartening problem - she seems fine in every single way (happy, eating, litter box, playing) EXCEPT that her hind legs are wasting away, getting weaker and weaker.
This is not approved in the US and it is very expensive. But it is promising:
Cure for FIP | GS441 is available | FIP Treatments
 

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Hi!
My kitty, Potato is currently undergoing FIP treatment (Thriving! Fingers crossed.) with GS 441524 so I’ve become unnecessarily well versed in that cursed illness and what to look for.
Did your vet do a CBC?
With FIP the most common indicators are high total protein and low (<0.6) albumin/globulin ratios.
Honestly, I doubt you kitty has neuro FIP especially if she seems to be in perfect health otherwise but it’s a nasty disease that sometimes manifests in the weirdest ways.
 
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Rax

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Hi all,

We just got all her blood tests back, and they're all clear. So no evidence of FIP, Feline leukemia, or anything else - though they did explain there's a small possibility that the tests can miss certain things.

Her condition doesn't seem to be getting any worse, and she seems happy, content, and not in any pain. Honestly, unless you made a point of noticing that she doesn't jump and has a little trouble getting up on furniture, etc... you wouldn't know anything is wrong.

We're thinking about delaying the MRI and seeing how she does over the next few weeks - just keeping a close eye on her, watching to see if she gets worse.
 

tarasgirl06

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Hi all,

We just got all her blood tests back, and they're all clear. So no evidence of FIP, Feline leukemia, or anything else - though they did explain there's a small possibility that the tests can miss certain things.

Her condition doesn't seem to be getting any worse, and she seems happy, content, and not in any pain. Honestly, unless you made a point of noticing that she doesn't jump and has a little trouble getting up on furniture, etc... you wouldn't know anything is wrong.

We're thinking about delaying the MRI and seeing how she does over the next few weeks - just keeping a close eye on her, watching to see if she gets worse.
Although I am NOT a vet and NOT an expert and would never want to advise anyone as to health concerns, I have to say my intuition based upon the results of these tests and your description of her current behavior would lead me to agree with you. *PRAYERS* for her to improve on her own! Please do keep us informed.
 

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I really don’t want to cause you unnecessary panic but if his ataxia hasn’t gotten better on it’s own (caused by trauma that the body is taking care of itself etc) and the progress has been gradual and gotten worse in time I urge you to do more tests.

It’ll be traumatic for your kitty but many illnesses have a great chance of recovery when caught in the early stages. Maybe something will come up if further looked into.

Did they do an SAA count to check for inflammation and it’s severity?
If you have them, could you post photos of his test results to have a look at?
Many tests including FCoV antibody and even PCR tests sometimes come back negative if the illness is isolated to the CNS so they’re not 100% reliable.
WBC, TP and A/G numbers can still be telling even though they’re all in range and seem alright on paper.

I took my kitty to the vet in February because he was simply acting a little different. No fever, no tangible loss of appetite etc. He just changed his usual sleeping place and position, seemed to suddenly be picky about what foods he ate and had the occasional lumbar rippling similar to hyperesthesia.
All his bloodwork came out clean, only an SAA test indicated that he had an inflammation going on somewhere in his body.
Before the SAA results came in the vet deemed that there was nothing wrong with him and he was simply depressed, gave us zylkene and sent us on our way.
Later on an ultrasound was performed and they found that his pancreas was inflamed. He was diagnosed with acute pancreatitis.
Still, bloodwork was all in range. Absolutely nothing seemed wrong on paper.
No matter the treatment (prednisolone, convenia, subQ fluids etc) he didn’t show any improvement for more than a month and that’s when I started to suspect an underlying cause.
The vets were still adamant that it was severe acute pancreatitis turning into chronic, even though the severity was getting worse by the day and prednisolone was just slowing the decline instead of stopping it as it would if it was an autoimmune problem.

I still wasn’t 100% sure it was FIP before starting GS. Unless there’s thoracic or abdominal fluids to directly test, the diagnostic process is more of a “nothing else works, PCR and antibody are positive for FCoV, there’s a chance it’s FIP” instead of being absolutely sure it is.

Just to be on the safe side and nip future regrets in the bud please make them look into your kitty’s condition more thoroughly.
 

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Hi all,

We just got all her blood tests back, and they're all clear. So no evidence of FIP, Feline leukemia, or anything else
- though they did explain there's a small possibility that the tests can miss certain things.

Her condition doesn't seem to be getting any worse, and she seems happy, content, and not in any pain. Honestly, unless you made a point of noticing that she doesn't jump and has a little trouble getting up on furniture, etc... you wouldn't know anything is wrong.

We're thinking about delaying the MRI and seeing how she does over the next few weeks
- just keeping a close eye on her, watching to see if she gets worse.
Thanks so much for the update, R Rax . :)
(I wanted to ask yesterday, but then I remembered that you'd need extra time to relax, and take some time to absorb the results for yourself...not too mention different time zones and all.) :blush:

I think it's great that the Blood Labs and urinalysis came back clear. :biggrin:
Even if they do 'miss certain things'...at least you know that nothing major of an infectious nature is happening.

**In the future, you can always follow up with your regular Vet, and ask them to do another blood panel...with thyroid or diabetes test...added on. (I'm not sure if this was already part of your initial blood tests. And I only mention it because some of the online readings that I quickly did, did mention hyperparathyroidism and diabetes, as well,...though these were in older cats...so may not have any value for you.)

**Some members, here, have even mentioned that they ask their regular Vet, ...to sometimes reach out to major University Vets...for a consultation. I don't know how much this costs...and how it's actually done...but it's something to keep in mind...if regular Vets have not seen many cases like this one.)
(Who knows, if your regular Vet...in the area...has seen similar cases...then it might even be something 'inherited' depending on where your cat was born, and who the parents were.)

Because you mentioned that her condition does not seem to be getting any worse, and she is definitely not in any pain...then I would also do what you are doing and take a 'wait and see' approach.:)
That sounds very wise to do.

(What I'm hoping is that Ernie, may have just injured or sprained that area of her back muscles, spine,...from doing some of those fantastic kitten/young cat jumps, leaps or falls, twists or turns,...but perhaps not enough to cause any outward pain...so that with time...her body can adjust and heal on its own.)
No, she has no other symptoms we can see. She's eating well, using the litterbox, still walking around and even running and playing. Still affectionate and no obvious pain, even when being picked up and handled. The only symptom that we're aware of is her hind leg weakness and inability to jump or stand up (for treats, etc...).
...But yes, it's a very strange and disheartening problem - she seems fine in every single way (happy, eating, litter box, playing) EXCEPT that her hind legs are wasting away, getting weaker and weaker.
Since Ernie was the runt of the litter...then I'm also wondering if this is something that she was born with (congenital)... or an inherited trait.
And only now showing some signs...as she develops and grows longer or larger.
Hopefully something that she can grow out of...or adapt to...since she is only 9 months old.

Hoping that whatever that "space occupying lesion is"...is that it will go away...or diminish.
(The radiology Review showed strong suspicion for decreased bone integrity (osteopenia), and an area in the lower back (lumbosacral intervertebral foramina) which is suspicious for a space-occupying lesion leading to the muscle loss and subsequent bone loss.)

The good thing is that you noticed, ..and at least took her in...had the x-rays and initial assessment done...where they actually graded the lameness. (I suppose it is only done by a visual and physical exam...so will vary from vet to vet...but still it's excellent to have this initial score.)
(Mild muscle wasting pelvic limbs. Moderate muscle wasting around the gluteal region. Mild generalized hindlimb lameness. 1-2/5. Left pelvic limb seems slightly more affected than right. Patient will walk several steps and then sit. Able to sit in normal position but will occasionally slump to hips it. No significant pain on spinal palpation.)

Maybe there are also some 'muscle strengthening exercises' that can be done with Ernie, in the future.
I would honestly wait in asking or doing any of these...until you know for sure...from your Vet...if any further wasting is happening.
Plus you don't want to cause further wasting or pain...if a nerve is involved.

I'm thinking pinched nerve, here,...since that area is full of nerves...going in all sorts of places.
(Though, I would think that would be painful...or numb...if a nerve was involved.)
As for MRIs, they can give valuable information; however, as(k) the vet if there is a chance that nothing will turn up once they do it. Does he have a strong enough suspicion that it will give you something to go on or is it being used only as a rule out test?
I definitely agree with Fionasmom, here, ...in that I would ask your Vet or Neurologist...what can be done... if nothing remarkable shows up...on an MRI...and how they would treat that.
Is it primarily used to rule out time-sensitive issues, uncontrolled growths,... or progressive ones where specific treatments are then given.

Would love to see a photo of your Ernie, but only if you want to,...and have the time to post one.
Sending Strong Health Vibes...that your Ernie does well in the coming weeks. :vibes::vibes: :tabbycat::goodluck:
 
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An update:

After some bargaining on price, we agreed to the MRI and (if that showed nothing out of the ordinary) a spinal tap and analysis.

Preliminary results on the MRI showed nothing abnormal - no tumors or masses, and no pinched or squeezed nerves either. We're waiting for a more in-depth review of it. As a result, they also took a spinal fluid sample and that's off to be analyzed now - looking for signs of infection or inflammation. We should get results on both in the next few days.

So after all that, we don't know anything. It's so strange - she's super playful and happy and eating well, but her hind legs are just so weak they can barely keep up with her. She's still walking, but can barely jump, dragging herself up on even the lowest obstacle.
 

tarasgirl06

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An update:

After some bargaining on price, we agreed to the MRI and (if that showed nothing out of the ordinary) a spinal tap and analysis.

Preliminary results on the MRI showed nothing abnormal - no tumors or masses, and no pinched or squeezed nerves either. We're waiting for a more in-depth review of it. As a result, they also took a spinal fluid sample and that's off to be analyzed now - looking for signs of infection or inflammation. We should get results on both in the next few days.

So after all that, we don't know anything. It's so strange - she's super playful and happy and eating well, but her hind legs are just so weak they can barely keep up with her. She's still walking, but can barely jump, dragging herself up on even the lowest obstacle.
*PRAYERS* continuing for her! Good on you for finding agreement on having these tests done.
 

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Hopefully the tests show something.

At this point, you might want to gather up all the test results and see if a vet university is willing to review them. Otherwise, you might be dealing with one of those mysterious things where the best you can do is manage the symptoms.
 
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