Horner’s syndrome in 11 year old cat

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lynne8832

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Going to neurology tomorrow. I’ve heard great things about the neurologist that we are seeing. We will do a CT scan or MRI depending on what the vet thinks will be best and go from there. I am trying not to get ahead of myself yet by thinking about the options and deciding what we would do given an aggressive cancer diagnosis.
 
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lynne8832

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Hey everyone, I wanted to give an update on Shyla this morning. We took her to the neurologist and they were amazing. Her doctors and nurses were so incredible and I definitely feel that she is in the best hands. The doctor said that it could definitely be a middle or inner ear problem or a tumor somewhere, but she honestly did not seem too “doom and gloom” about it. She said that many times, tumors can actually be very effectively removed, which was reassuring. She will be staying there for the day to get an MRI, CT, and a spinal tap and I will pick her up later tonight. I would greatly appreciate some positive thoughts for Shyla :)
 
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lynne8832

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Hi everyone, I have a wonderful update. Thank you all so much for your kind wishes for Shyla. The neurologist just called and did not see any evidence of a tumor on her MRI or CT. She said that she does have lots of fluid in her middle ears, which is why she’s having all of these alarming symptoms. They also sent out a spinal tap to make sure that it hasn’t caused meningitis. She said that we should have those results back on Tuesday, does anybody know if meningitis is treatable if she does have that? We are going to start her on antibiotics and will see how she does. Worst-case scenario she will need surgery, but I am so happy!
 
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Hi everyone, I have a wonderful update. Thank you all so much for your kind wishes for Shyla. The neurologist just called and did not see any evidence of a tumor on her MRI or CT. She said that she does have lots of fluid in her middle ears, which is why she’s having all of these alarming symptoms. They also sent out a spinal tap to make sure that it hasn’t caused meningitis. She said that we should have those results back on Tuesday, does anybody know if meningitis is treatable if she does have that? We are going to start her on antibiotics and will see how she does. Worst-case scenario she will need surgery, but I am so happy!
It could be a very long road to recovery without surgery. Inner ear is technically outside the body. That makes it very hard to reach with antibiotics. And with the eardrum intact, you can’t just pour something into her ear. You may want to discuss a timeline with the neurologist e.g. how long to try antibiotics before resorting to surgery?
 
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lynne8832

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It could be a very long road to recovery without surgery. Inner ear is technically outside the body. That makes it very hard to reach with antibiotics. And with the eardrum intact, you can’t just pour something into her ear. You may want to discuss a timeline with the neurologist e.g. how long to try antibiotics before resorting to surgery?
That is a great idea. The neurologist is supposed to call me back soon to determine if she can come home tonight or needs to stay overnight due to her just now being woken up from anesthesia. I will ask her about how long we should try the antibiotics before deciding on surgery.
 
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Okay, so I just spoke with the neurologist and she said that we will do the antibiotics for 2 weeks. I will call to schedule a surgical consult on Monday and if she improves, I can always cancel it. If she does not improve after 2 weeks on the antibiotics, we will plan to go to the surgeon to discuss her surgery. She seemed very optimistic about her prognosis and recovery. She also said that even if the spinal tap comes back saying that she has meningitis, that it is very treatable and usually cats with meningitis arising from ear infections have a very good prognosis for recovery.
 
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Does it seem reasonable to wait a few weeks to see how she responds to the antibiotics? It didn’t sound like the neurologist thought that surgical intervention was necessary right now. She said that most surgeons like to have the cat on antibiotics for 2-4 weeks to see how they respond. I’m just worried that it will get worse or spread to her brain. I am also worried that the spinal tap results will show that she has meningitis.
 

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Does it seem reasonable to wait a few weeks to see how she responds to the antibiotics? It didn’t sound like the neurologist thought that surgical intervention was necessary right now. She said that most surgeons like to have the cat on antibiotics for 2-4 weeks to see how they respond. I’m just worried that it will get worse or spread to her brain. I am also worried that the spinal tap results will show that she has meningitis.
Those are fine questions for the neurologist. It does seem like they are trying to walk the conservative line of non-invasive vs waiting too long. After Krista had the surgery, the surgeon wanted her to stay on antibiotics for up to a month. We made it 20 days before it was affecting her appetite too much to continue.

Sometimes the difference antibiotics makes is dramatic. Betty was lethargic and barely eating for a week after her endoscopy. In a Hail Mary, since labs and imaging didn’t turn up anything, she was put on antibiotics and the turnaround was literally overnight.

Recognizing the inner ear is still outside the body, I think two weeks is a reasonable balance between “give it time” and “let’s not be too stubborn here.”

The surgery is likely a ventral bulla osteotomy. The surgeon would cut a hole in her jaw and drain her inner ear like an oil drip pan in a car rather than puncturing her eardrum. It’s something of a worrisome surgery when you read about it. But it’s got a good success rate. If you think she can wait, you might want to try the antibiotics first. But if she’s already having a hard time, then bring that up with the neurologist and see what can be done to get her to surgery sooner.
 
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Those are fine questions for the neurologist. It does seem like they are trying to walk the conservative line of non-invasive vs waiting too long. After Krista had the surgery, the surgeon wanted her to stay on antibiotics for up to a month. We made it 20 days before it was affecting her appetite too much to continue.

Sometimes the difference antibiotics makes is dramatic. Betty was lethargic and barely eating for a week after her endoscopy. In a Hail Mary, since labs and imaging didn’t turn up anything, she was put on antibiotics and the turnaround was literally overnight.

Recognizing the inner ear is still outside the body, I think two weeks is a reasonable balance between “give it time” and “let’s not be too stubborn here.”

The surgery is likely a ventral bulla osteotomy. The surgeon would cut a hole in her jaw and drain her inner ear like an oil drip pan in a car rather than puncturing her eardrum. It’s something of a worrisome surgery when you read about it. But it’s got a good success rate. If you think she can wait, you might want to try the antibiotics first. But if she’s already having a hard time, then bring that up with the neurologist and see what can be done to get her to surgery sooner.
Thank you so much. I will definitely speak to the neurologist tomorrow when I pick her up. And yes, she did say that the surgery would be a ventral bulla osteotomy. If the antibiotics were n out making a difference, we would absolutely get her scheduled for surgery, I would just hate to prematurely put her through that surgery if the antibiotics may make a difference. I assume the neurologist would have immediately scheduled her for surgery if she thought that it was immediately necessary. She has a wonderful team and I trust their recommendations. I am definitely anxious waiting for the results of the spinal tap, but it sounds like meningitis from an ear infection is typically very unlikely and the neurologist suggested that it is usually very treatable if caught early. Tomorrow will only be 1 week since Shyla began to exhibit symptoms, so I feel like we got things moving quite fast. Also, did Krista end up recovering from her infection? Do you know if the recovery rate from these types of infections is usually good?
 
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daftcat75

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Thank you so much. I will definitely speak to the neurologist tomorrow when I pick her up. And yes, she did say that the surgery would be a ventral bulla osteotomy. If the antibiotics were n out making a difference, we would absolutely get her scheduled for surgery, I would just hate to prematurely put her through that surgery if the antibiotics may make a difference. I assume the neurologist would have immediately scheduled her for surgery if she thought that it was immediately necessary. She has a wonderful team and I trust their recommendations. I am definitely anxious waiting for the results of the spinal tap, but it sounds like meningitis from an ear infection is typically very unlikely and the neurologist suggested that it is usually very treatable if caught early. Tomorrow will only be 1 week since Shyla began to exhibit symptoms, so I feel like we got things moving quite fast. Also, did Krista end up recovering from her infection? Do you know if the recovery rate from these types of infections is usually good?
I would say Krista was well on her way to recovery. Sadly, that wasn’t the only thing she was dealing with. She had GI lymphoma. About two months after her surgery, she got a bladder infection that proved too much for her already immune-suppressed and cancer-wasted body. 😿🌈

This was her a couple days after she woke up in the middle of the night, fell off the bed, threw up, and staggered on her hocks. In her case, I took her to the ER in the middle of the night and elected to let them keep her the remainder of the night so that she could see the neurologist in the morning. It would have been about a two week wait if I had taken her home and booked a neurologist appointment through the front door.
View media item 423508And:
View media item 423507
This was her just a few days after the surgery. She’s moving much better.
View media item 423512
This is one month out.
View media item 423667
Sadly, she was gone just a few weeks after that. I mean you can already see just how skinny she was. I’m so impressed that she recovered even that well from the surgery given how tiny she had become. She was 11 lbs most of her life. 9 was a good weight for her. She was about 4 lbs in that last video. 😿

I would say that even in Krista’s condition (incomplete cancer remission), she still pulled through that surgery with flying colors.
 
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lynne8832

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I would say Krista was well on her way to recovery. Sadly, that wasn’t the only thing she was dealing with. She had GI lymphoma. About two months after her surgery, she got a bladder infection that proved too much for her already immune-suppressed and cancer-wasted body. 😿🌈

This was her a couple days after she woke up in the middle of the night, fell off the bed, threw up, and staggered on her hocks. In her case, I took her to the ER in the middle of the night and elected to let them keep her the remainder of the night so that she could see the neurologist in the morning. It would have been about a two week wait if I had taken her home and booked a neurologist appointment through the front door.
View media item 423508And:
View media item 423507
This was her just a few days after the surgery. She’s moving much better.
View media item 423512
This is one month out.
View media item 423667
Sadly, she was gone just a few weeks after that. I mean you can already see just how skinny she was. I’m so impressed that she recovered even that well from the surgery given how tiny she had become. She was 11 lbs most of her life. 9 was a good weight for her. She was about 4 lbs in that last video. 😿

I would say that even in Krista’s condition (incomplete cancer remission), she still pulled through that surgery with flying colors.
Sweet Krista! I’m so sorry for your lost, she was so adorable.
I am picking Shyla up right now and the neurologist said that she did well overnight! We are starting her on both antibiotics and two medications for nausea to help with her appetite. She suspects that Shyla is not eating much because of her nausea. I spoke to her about the VBO surgery and she said that while she does suspect that she will ultimately need the surgery, she said that most surgeons want them to have been on antibiotics for at least a few weeks as it makes the procedure much safer. She said that it was not emergent and we did not have to get it done now and it was fine to wait for 2 weeks on the antibiotics prior to seeing the surgeon for a consult. She said that she will call me next week with the results of the spinal tap, but even if she does have meningitis, it will be treated with the same antibiotics and they usually respond well, so her prognosis is excellent at this point!
 
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lynne8832

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Shyla is home and doing amazing! She is definitely very uncoordinated and dizzy, but she is doing awesome otherwise. She is eating, drinking, and using the litter box! We are just going to keep her confined in a bedroom to prevent her from potentially injuring herself by trying to jump up onto things. She has two medications for nausea and dizziness and two antibiotics! She is still her super sweet self and I am so happy to see her feeling a bit better and having a better appetite!
 
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