Horner's syndrome? - Do you have any knowledge about, experience with it?

[permirc]

I also asked this question on a different platform but didn't get many answers, so I am trying here also.

This is what happened;

My (previous) vet suggested to me that I could clean my cat’s ear at home weekly. (not because of an infection, just for the "benefit"). I did it on Saturday night (around 10 pm), just like many times I did before, but this time, it ended up in a disaster. My cat got extremely sick, started being dizzy, puked one time, cried out loud, and pooped herself once. This episode lasted around 30 mins - 1 hour. I was extremely scared because I did everything just like I used to before, which didn’t cause any harm at all. One of her eyes also got the “third eyelid” on, which I thought was because the solution (quite alcohol-y) got into it and irritated it. I took her to the vet on Sunday (not to the one who suggested this terrible idea but another); he gave her 2 shots (a steroid I suppose (but that's for her other, unrelated problem: she has an allergy) and antibiotics.- this one I think for this particular problem that happened) also prescribed eyedrops called Tobradex, to use it 3 times a day. (it has steroids, antibiotics in it.)

My cat, by the way, looks much better, she is calm, cleans herself, purrs, likes to be with us and being petted, walks, also ate and drank a bit, not as much as she usually does though. But she is still dizzy when shakes her head suddenly and strongly - she falls, and she still has the “third eyelid” on.

So I started to investigate on the internet, and one of them wrote that, that ear-cleaning can culminate in the so-called Horner’s Syndrome; which can be caused by trauma(!- the ear cleaning maybe?), and my cat’s eye’s symptoms are exactly like this. When I was at the wet, he didn't mention this, so I do not know for sure that she has this, but I think according to the symptoms and events it is quite likely. My vet at first thought she got an eye infection from the solution, so she is treated for that right now.

So my question, finally, is this: Has anybody heard about a similar story like mine (ear cleaning resulting in Horner’s) or has any experience with this syndrome? What do you suggest concerning treatment? I will go to a check-up on Wednesday and I will definitely mention Horner's to him, but I am also very interested in other's opinions, experience, knowledge. If you gone through it with your cat, how did it happen, what medication did the vet give, how long did it last?

I read that it is not life-threatening, not painful, and will eventually go away, but unfortunately, it can take a long time, and I am feeling extreme remorse, that I did this to my cat Also, I am a bit concerned about her decreased appetite.

My cat is like my center of life, and I am just really scared that I did something irreversible to her.
Incredibly thankful for any comments, answers!.

 

[daftcat75]

First off, it is not life threatening or irreversible. Likely what happened is that while cleaning it, you pushed some gunk against the eardrum and ruptured it. Did you clean with a swab and did you stick the swab in her ear canal? I'm sure you'll never do that again. Don't blame yourself. You got terrible advice from a vet who should have known better.

A ruptured eardrum would explain all the reactions and the continued dizziness and nausea. Depending on how much gunk is still in her ears, the vet may not be able to get a clear view to see if the tympanic membrane (eardrum) is still intact. If the status of that membrane has not been verified, I would not put anything in her ear until you get that all clear from the vet, preferably through a visual confirmation. And that may require waiting it out with the antibiotics. Unfortunately, the ear, even the inner ear, is technically outside the body as far as antibiotics are concerned. It can take a long time for antibiotics to treat an ear infection. In the meantime, on your follow-up visit on Wednesday, ask the vet to take a swab (carefully) and have it cultured to know what the infection is and whether the antibiotics she's currently getting will even be effective. For as long as she may have to take antibiotics, you want to make sure they'll do the job.

As far as the eye itself, it likely only needs to be moisturized and lubricated a couple of times a day so it doesn't dry out since she's not able to close it all the way on her own right now. With time, it will come back to normal.

For your Wednesday visit, I would have the vet confirm whether she needs eye medication or just eye drops to keep the eye moist. I think your emergency vet is just guessing there. The third eyelid up is usually a side effect of something else going on rather than a symptom that needs to be treated (aside from lubrication.) I would also ask if it it's possible for the vet to confirm whether the eardrum is intact. If she needs to be sedated for this, so be it. Better sure than guessing and better sedated than trying to do this on a squirming cat. If there's visible gunk the vet can collect, have her culture a sample so she knows whether the antibiotic prescribed is appropriate.

If you are having to give an antibiotic for a long time, it may be worth it to have it compounded into a flavored oil that she'll want to take herself rather than daily medicine wrestling matches. I highly recommend Wedgewood Pharmacy for compounding your prescriptions. If your medicine can be compounded, the vet will call/fax in the prescription and a representative will contact you about how you would like it formulated (treat, flavored liquid, flavored oil, etc.) You can often speak directly with the pharmacist if you have a question the rep can't answer.
Veterinary Pharmacy

And one more thing, antibiotics often cause diarrhea. Sacchoromyces Boulardii is a yeast-based probiotic that you can give your cat to combat antibiotic-induced diarrhea. Because it is yeast and not bacteria, it survives the antibiotic unlike other probiotics. And many cats enjoy the taste making it easy to give with their food.
My Cat Has Diarrhea - What Do I Do?

 

[fionasmom]

Welcome to The Cat Site although I am sorry that this terribly stressful situation is what brought you here. Horner's Syndrome has an underlying cause, as I am sure you read as you researched it, and IMO it sounds as if the most likely scenario is the one that you are experiencing, which is that this did occur as a result of ear cleaning. There are other causes, but obviously you are ruling out injuries, other trauma, or other medical conditions as you are taking excellent care of your cat. So, yes, I have heard of this happening during an ear cleaning. Tobradex is tobramycin and dexamethasone, which is fine, but I would ask your vet if that is what is needed as usually the eye needs a lubricant as opposed to an antibiotic.

Ask the vet to do what was suggested by daftcat75 with regards to the eyedrops and verifying that the eardrum has been ruptured so that you are sure of how to proceed. Please let us know what happens.

 

[permirc]

Thank you very much for your answer, I cannot emphasise how thankful I am!
I forgot to write that; I didn't use any cotton swab/cotton earpick or didn't put any hard object inside her ear, I simply poured the solution into her ear, because the previous vet said that this method can clean her ear as she shakes the solution out from her head. So based on this, I think that a simple liquid couldn't rupture her eardrum, right?. Also, she doesn't have any ear infections, I was just told to I can use this solution every week, (but again; not because she has any problems) as it is beneficial... And well, this happened...
On Sunday the vet used a special machine to look into her ear while we held the cat down (she is a very calm cat) and didn't say anything, so I guess he didn't find any problem.
Do you think we still need antibiotics for this or any kind of treatment, that is crucial? I am not sure how much damage a simple liquid can cause to the ear as it was just poured into it without any aggressive poking.
(I wrote in the description that she had a loss of appetite: well, I gave her some ham (human quality) which she never gets but loves its smell, and she immediately ate them, so I guess she just doesn't want to eat her regular food because she puked them out during the incident?.)

 

[daftcat75]

Thank you very much for your answer, I cannot emphasise how thankful I am!
I forgot to write that; I didn't use any cotton swab/cotton earpick or didn't put any hard object inside her ear, I simply poured the solution into her ear, because the previous vet said that this method can clean her ear as she shakes the solution out from her head. So based on this, I think that a simple liquid couldn't rupture her eardrum, right?. Also, she doesn't have any ear infections, I was just told to I can use this solution every week, (but again; not because she has any problems) as it is beneficial... And well, this happened...
On Sunday the vet used a special machine to look into her ear while we held the cat down (she is a very calm cat) and didn't say anything, so I guess he didn't find any problem.
Do you think we still need antibiotics for this or any kind of treatment, that is crucial? I am not sure how much damage a simple liquid can cause to the ear as it was just poured into it without any aggressive poking.
(I wrote in the description that she had a loss of appetite: well, I gave her some ham (human quality) which she never gets but loves its smell, and she immediately ate them, so I guess she just doesn't want to eat her regular food because she puked them out during the incident?.)

No, she still may very well be nauseated with the ham appeal being more powerful than the nausea. If you have that Wednesday vet visit, I would ask for a second opinion. If she doesn't have an ear infection or any other gunk in her ears, then I wouldn't put anything in her ears preventatively. Bring in the solution or write down its ingredients/recipe if it's homemade and run this past your Wednesday vet. It may very well be that repeated exposure to an inappropriate solution caused a damaged or ruptured eardrum. If there's no gunk or infection in the ear, then it may just be leave it alone and give it time. In the meantime, she may need anti-nausea and/or appetite stimulant to get her past the initial nausea if she doesn't return to her old food soon.

 

[permirc]

No, she still may very well be nauseated with the ham appeal being more powerful than the nausea. If you have that Wednesday vet visit, I would ask for a second opinion. If she doesn't have an ear infection or any other gunk in her ears, then I wouldn't put anything in her ears preventatively. Bring in the solution or write down its ingredients/recipe if it's homemade and run this past your Wednesday vet. It may very well be that repeated exposure to an inappropriate solution caused a damaged or ruptured eardrum. If there's no gunk or infection in the ear, then it may just be leave it alone and give it time. In the meantime, she may need anti-nausea and/or appetite stimulant to get her past the initial nausea if she doesn't return to her old food soon.

I understand now! Tomorrow I will try to buy other kinds of food for her, maybe she will eat from one of them. But until she gets anti-nausea/appetite stimulant, can I feed her like this? At least she eats this food, and something is in her tummy.
I will definitely mention everything we discussed here at the vet!
A ruptured eardrum how can be determined? As I said he looked into her ear with a special thing, which looked like as if it was a magnifying glass. Or is it have to be determined with a different method?. Also, if she, god forbid, has damaged/ruptured eardrum, what can be done with it?
I took the solution to the vet on Sunday and he said this shouldn't have caused a huge problem like this. It has 3 ingredients; isopropyl alcohol, boric acid, chlorophyll. (I am just really hoping he is competent enough to solve this situation; why did his first thought be that her eye is like this because the solution got into her eye, and not because of Horner's?)

 

[daftcat75]

Ooof! I don't like the sound of that ear solution at all. I'm not a vet. But I don't think those things should go in her ears, your ears, or any ears. If she does have a ruptured eardrum, you leave it alone and let it heal. You don't put anything in her ears. It will heal on its own with time. I'm not sure that any imaging could verify the membrane status. If there's no gunk in her ears, then probably that ear tool the other vet used should be good enough. I don't like the answers you have received so far. I'm not a vet though. But I do look forward to hearing what the Wednesday vet has to say.

You can feed her the ham for a few days (as long as it isn't cured with salt or other seasonings) until you can get her an anti-nausea and possibly appetite stimulant prescription. You can also use meat-only baby food which a lot of sick cats enjoy. I would keep trying to get her to eat her regular food though. These emergency foods can only be fed for a short period of time (maybe a week or two in an otherwise healthy cat) before potential nutritional deficiencies become a concern. You may be able to get her eating cat food again with fish flavored wet foods like Tiki Cat. I don't recommend these as regular food because fish isn't an ideal protein and cats can become addicted to fish, holding out for it, and ignoring other food offered. But exceptional times require exceptional measures. And this is the perfect time to make a fish exception. If you aren't feeding fish on the regular, then it should still hold its appeal. You just may have a hard time getting her off the fish as her appetite returns. I recommend mixing the fish food with her regular food as early as you can get her to eat them both and then slowly adjusting the ratio to get her back to her old food.

 

[permirc]

Yes, I also read somewhere after the incident that alcoholic solutions are not the best for cats.. had I known earlier I purchased it from the pet store, it is insane that they are selling things that could cause such problems as my cat has.
I saw now that she ate some from her dry food, so she is not fully ignoring that at least, only her wet food. she also ate all the sour cream I put in her bowl a few hours earlier, once a while we give some to her, it is her comfort food since being a kitty (she is 10 years now), so I am really happy she ate that too. But of course I don't want to replace her normal food with sour cream, at the moment I am just trying everything that she might eat.
I am very thankful for your suggestions, and will definitely try them out! tomorrow I can buy some baby food, and cat food from the store
I will keep this updated of course! Only thing is, I live in Hungary so the time zones can be quite different, but I will update daily!

 

[fionasmom]

I don't know if you can get this in Hungary, but most food manufacturers are now making stews or bisques that are used for treats or toppers. Hartz, Fancy Feast, and lot of others make them.

How To Get Your Cat To Start Eating Again – TheCatSite Articles

 

[GustifursMom]

The mammalian ear does a not benefit from being swabbed. The mammalian ear has a very delicate homeostasis. The inner ear was hurt causing the symptoms you described. Under no circumstances should you ever put anything in a mammal's ear.

 

[permirc]

Thank you so much! But a pleasant surprise happened this day! I gave her regular food in the morning (wet food which she ignored for 2 days), just a small amount, and by the time I got back home, her bowl was empty! So I gave her another small portion in the afternoon, and she ate all of that too, and for a 3rd time this day, I gave her some at night and ate all of it again. <3 so if we add up the 3 small amounts, she ate a full portion she used to eat! (She also ate dry food in the morning). Looks like her appetite starts to come back, after not eating much for 2 days. She is still dizzy though, sometimes you can even see her eyes moving, but not as much to affect her appetite anymore. But I will definitely tell the dizziness to the vet. Do you think she still needs ant-dizzyness medicine or appetite stimulant? I am really hoping we are moving forward with this unfortunate event.

 

[GustifursMom]

Be aware that the apetite stimulant can sometimes have the adverse effect of actually reducing apetite. The dizziness meds should continue if the cat is a bit wobbly. Otherwise, I am so happy for you! This is absolutely amazing news! Congratulations!

 

[fionasmom]

That is great news! It does sound as if she is on the mend from whatever happened to her. We do not ever tell a member to change the prescribing orders given to them by a vet, but you could call and ask if you need to continue them. Given that you have been to the vet, this should only amount to a no charge phone call.

 

[daftcat75]

Let your regular vet check her out tomorrow. Peek in the ear if she can and determine the eardrum status. As for the anti-nausea and appetite stimulants, it can be helpful to have them on hand. But if she doesn't need them, I would try without them. Because every cat is different and some cats react better to certain drugs than others. Entyce is an appetite stimulant that makes some cats nauseated and Cerenia is an anti-nausea drug that makes some cats inappetent. I prefer mirtazapine as an appetite stimulant. But it has a well-deserved nickname of "meowzapine." I would discuss with the vet whether she thinks she needs to be sent home with any prescriptions. At this point, I would expect eye drops (for moisturizing/lubricating the eye with the third eyelid raised) and not much else.

 

[permirc]

Thank you for your congratulations!

We end up going on Friday and not today to the vet, so I can update you about that tomorrow!

But today I think her appetite completely came back, to the same level it was before, she now eats so much that you have to control it or else she will gain weight Her dizziness seems to be going away too, she doesn't fall over anymore, only stumbles a bit when she shakes her head! I think we won't need the appetite stimulant, but I will mention the anti-dizziness medicine, and the moisturizing eye drops to the vet! I am still using the drops (Tobradex) she got on Sunday when the vet thought she got an eye infection/irritation, because of the solution. Her third eyelid is still there, I am hoping it will go away, and not be permanent

 

[daftcat75]

Thank you for your congratulations!

We end up going on Friday and not today to the vet, so I can update you about that tomorrow!

But today I think her appetite completely came back, to the same level it was before, she now eats so much that you have to control it or else she will gain weight Her dizziness seems to be going away too, she doesn't fall over anymore, only stumbles a bit when she shakes her head! I think we won't need the appetite stimulant, but I will mention the anti-dizziness medicine, and the moisturizing eye drops to the vet! I am still using the drops (Tobradex) she got on Sunday when the vet thought she got an eye infection/irritation, because of the solution. Her third eyelid is still there, I am hoping it will go away, and not be permanent

The third eyelid will go down. It may take a few weeks. But it’s not permanent.

January 15, 2019:
My poor Billy Idol sneer kitty with a ruptured ear drum, tooth extractions, and off the charts liver enzymes. The Horner’s is a few days old here.

February 8, 2019:
Almost a month later and you can’t see it anymore.