Idiopathic Vestibular Disease vs. Brain Tumor

ermentrude

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Below is a small novel about the sweet 11 year old ragdoll in my profile pic. I'm looking for comments / experience with cats that had idiopathic vestibular disease (IVD) or a brain tumor. The things I find online about IVD seem to say that most everything is good in 3 days and in a week to 2 weeks it can be completely back to normal. Was that your experience? If experience with a brain tumor (I'm so sorry), was it a quick decline? How bad was it for the cat?


Small novel...

About a week and a half ago my 11 year old ragdoll started suddenly turning in circles and had trouble 'sticking the landing' when he jumped. He also had a noticeable head tilt and wasn't terribly interested in eating or grooming. I got him to the vet and they said it was either idiopathic vestibular disease or a brain tumor. They walked me through the options - referral to a specialist, an MRI / CAT scan, and then brain surgery to remove a tumor if that was what it was, or to try Prednisolone and see if that resolved it. They did say if I went with the Prednisolone, it would make later scans difficult. But they also stressed most often this is idiopathic vestibular disease. I went with the Prednisolone.

I didn't make the Pred decision lightly. Although I could find a way to afford anything for my cats, this beautiful, loving cat will not have brain surgery, that would be for me, not him. I had a cat previously that I put through surgery and recovery which involved a feeding tube for weeks after, it was awful for him, he was in pain and confused. It was my mistake that got him in that situation and my youthful stubbornness that had to 'make it right' and have surgery. Only a few short years later he had cancer in his mouth and I let him go although they said there was a surgery for that too. I tortured my previous sweet boy, and I promised him I would learn from that and never do it again.

Back to my ragdoll. The first few days after the vet were bad, but then it seemed like a miracle. He was jumping up on beds, going to the top of the cat tree, bathing and eating like a mad man. The head is still tilted but that seems from reading like the last thing to go or may never go. The vet tech called twice for updates, one of which was early this morning and they were glowing. The tech did say that if anything is going backward I might start to notice it as tonight was his last every-other-day tapering off of the pills.

So of course today I've noticed a few balance issues and weird behavior. I don't know if it is confirmation bias because the vet tech said I may start seeing things, or if it is real. He tried to scratch his neck and couldn't seem to get the back leg to do what he wanted, he looked frustrated. He tripped up a little when he shook his head (head shaking / tripping happened much more severely early on). But he had good signs too. He jumped on a rather high antique bed, and jumped 6 feet from a chair to an ottoman and stuck the landing. He also ate like crazy and had some cookies too.

But looking back I'm also trying to think if I can find irregularities in his behavior since lock down. Just before lock down in March, he had an upset stomach and didn't eat, but he got a shot of Cerenia and was fine. A week before he got sick this time he went to the vet also because his eyes were quite goopy. He has allergies and that happens every few years. Vet said I could give him some antihistamine and that seemed to clear things up for about a week before his circle episode.

I'm just not sure if I should be hopeful that the circling is over and he is doing much better in many ways or if the fact that he has any symptoms at all almost 2 weeks later basically means it must be a tumor and I should be steeling myself for the end of life decision. The vet had said if it was a tumor they could treat with the Prednisolone for a while, so basically it would be the same as what we've already done.
 

white shadow

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Hi ermentrude. Wow, this must be hard for you.

I've absolutely no personal experience with anything like this.

Do you know what sort of diagnostic process was done to reach this conclusion? How many Vets were involved (you said "they")? Do you know what they did/looked at or looked for? How long did it take to come up with the diagnosis (of either/or)?

I'm asking after doing a little 'looking around'. There's a lot involved in being able to even suggest an "ideopathic vestibular" issue. Did you know that symptoms "seem to occur more frequently when the seasons change from warmer to cooler and vice versa" ?

I can give you the reference for that if you want and another.

But, I'm wondering about the diagnostic process itself and then, whether another evaluation/opinion should be considered. If I wanted a 'second opinion', I think I'd be looking for a long-practicing, consummate feline Vet, perhaps someone with a special interest in nurology, perhaps even a neurology referral. There's a lot to look for before turning on those scanning machines, apparently (including 'ordinary' xray).
.
 

di and bob

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Even with the Prednisolone, he may have slight symptoms reoccur if he has allergies. The antihistamines may have even affected his balance, along with persistent allergies. Cerenia can have the side effects of ataxia and uncoordinated walking too, but that may be a stretch, especially this much later. I have given small doses of Prednisolone for tumors and cancers in cats, often for over a year. Their quality of life was so much better it was well worth it. If he is eating, drinking, and not having any major issues, I would continue monitoring and see how it goes. it may take a long time for his nervous system/brain to heal from this. Just get him in if things get worse, no matter what it si it is better to catch it early.
I don't blame you at all for not wanting surgery. I have brought cats in for abscesses and other conditions, and the surgery that was performed was MUCH worse than the condition itself. It took them twice as long to heal. I treat abscess now with antibiotics and cleaning when the cat will let me. (some are feral). I guess it takes experience to learn theses things. The treatment can increase the suffering so much it is not worth it. I'll pray for your little boy, miracles still happen you know!
 
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ermentrude

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I called the vet today and am waiting for a call back on next steps. One of the signs of an issue is that I've read about is rapid eye movement, especially when their head is upside down. My sweet boy loves to have his belly rubbed and goes fully on his back, head upside down to achieve this. Twice now, yesterday and today, when he's curled over for a belly rub he has had a panic moment and flip flopped around like a fish out of water. Today I specifically looked at his eyes while this was happening and they were darting all around. So I think I'm not making this up, as the medication is tapering off he's sliding backward.

I didn't mention but the other cats in the house have been acting quite oddly for several weeks. My standoffish female has been actively seeking me out, sitting on me and purring loudly which in 4 years she has never done, as the medication has worked, she has backed off a bit. The large boy who formerly would cuddle with the ragdoll has started trying to intimidate him and steal his food (everyone ate in peace before a few weeks ago). I think animals are much more intuitive than we know, they sense weakness and illness. Humans are the last to know.
 

daftcat75

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Below is a small novel about the sweet 11 year old ragdoll in my profile pic. I'm looking for comments / experience with cats that had idiopathic vestibular disease (IVD) or a brain tumor. The things I find online about IVD seem to say that most everything is good in 3 days and in a week to 2 weeks it can be completely back to normal. Was that your experience? If experience with a brain tumor (I'm so sorry), was it a quick decline? How bad was it for the cat?


Small novel...

About a week and a half ago my 11 year old ragdoll started suddenly turning in circles and had trouble 'sticking the landing' when he jumped. He also had a noticeable head tilt and wasn't terribly interested in eating or grooming. I got him to the vet and they said it was either idiopathic vestibular disease or a brain tumor. They walked me through the options - referral to a specialist, an MRI / CAT scan, and then brain surgery to remove a tumor if that was what it was, or to try Prednisolone and see if that resolved it. They did say if I went with the Prednisolone, it would make later scans difficult. But they also stressed most often this is idiopathic vestibular disease. I went with the Prednisolone.

I didn't make the Pred decision lightly. Although I could find a way to afford anything for my cats, this beautiful, loving cat will not have brain surgery, that would be for me, not him. I had a cat previously that I put through surgery and recovery which involved a feeding tube for weeks after, it was awful for him, he was in pain and confused. It was my mistake that got him in that situation and my youthful stubbornness that had to 'make it right' and have surgery. Only a few short years later he had cancer in his mouth and I let him go although they said there was a surgery for that too. I tortured my previous sweet boy, and I promised him I would learn from that and never do it again.

Back to my ragdoll. The first few days after the vet were bad, but then it seemed like a miracle. He was jumping up on beds, going to the top of the cat tree, bathing and eating like a mad man. The head is still tilted but that seems from reading like the last thing to go or may never go. The vet tech called twice for updates, one of which was early this morning and they were glowing. The tech did say that if anything is going backward I might start to notice it as tonight was his last every-other-day tapering off of the pills.

So of course today I've noticed a few balance issues and weird behavior. I don't know if it is confirmation bias because the vet tech said I may start seeing things, or if it is real. He tried to scratch his neck and couldn't seem to get the back leg to do what he wanted, he looked frustrated. He tripped up a little when he shook his head (head shaking / tripping happened much more severely early on). But he had good signs too. He jumped on a rather high antique bed, and jumped 6 feet from a chair to an ottoman and stuck the landing. He also ate like crazy and had some cookies too.

But looking back I'm also trying to think if I can find irregularities in his behavior since lock down. Just before lock down in March, he had an upset stomach and didn't eat, but he got a shot of Cerenia and was fine. A week before he got sick this time he went to the vet also because his eyes were quite goopy. He has allergies and that happens every few years. Vet said I could give him some antihistamine and that seemed to clear things up for about a week before his circle episode.

I'm just not sure if I should be hopeful that the circling is over and he is doing much better in many ways or if the fact that he has any symptoms at all almost 2 weeks later basically means it must be a tumor and I should be steeling myself for the end of life decision. The vet had said if it was a tumor they could treat with the Prednisolone for a while, so basically it would be the same as what we've already done.
My Krista had similar symptoms. I got her the MRI and it came back inner ear infection. Better than a brain tumor. But it still required surgery. I wasn't going to refuse her surgery. The other option was pill and pray with antibiotics with possible complications of the infection ruptures her eardrum or on the other end, it enters her brain. She got on the surgeon's schedule for the next day and she came out of the surgery, "like a rock star" (surgeon's words.) I believe she stayed over one night and I picked her up the next day.

These are the before videos:
https://thecatsite.com/media/miss-weeble-wobble.423507/
https://thecatsite.com/media/neurologic-nystagmus.423508/

This is a few days after:
https://thecatsite.com/media/off-her-hocks.423512/

And a month after:
https://thecatsite.com/media/nascar-krista.423667/

Unfortunately, unrelated to all of this, she contracted a bladder infection that proved too much for her. Her senior years were not easy but she was always a fighter. She had her nine lives and then some. So when she ran out of fight, I know now there was nothing left to be done for her.

I'm glad you're working with someone who has you using steroids responsibly. I think Krista's vets' willingness to just keep her on steroids indefinitely was a contributing factor to her decline and inability to recover even after her lymphoma remission was achieved.

But yeah, long story short, did you have inner ear infection ruled out? If not, you might want to pay for that MRI after all. The surgery is non-trivial. It's expensive. There is some recovery period. But there's no reason to believe Krista would not have continued to recover if she didn't have other health complications.
 
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ermentrude

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The doctor said he ruled out ear infection, said his ears looked very clean.

It isn't about the cost, I'd give anything for my cats, but that look, after surgery when they're in pain and don't know why, but they love and trust you implicitly. I don't know how to justify his suffering for me to have more time with him.
 

daftcat75

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If it’s not about cost, then I’d get the MRI so you’re not forever questioning or doubting whether you chose the right path for him.
 

daftcat75

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Ask your vet again about an inner ear infection. Seems to me if the doc could have seen past the eardrum, we wouldn't have needed an MRI.

You may also want to see if there is a neurologist you can consult with if you're not already.
 

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fionasmom

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I have experienced both IVD and brain tumors in dogs and that is all I am going to say about them. You have had a couple of big terms thrown at you and I would definitely do the MRI so that you at least know what is going on. This is not the same issue as going ahead with brain surgery for your baby. I, too, after several experiences when I was younger, woke up to the fact that it is completely possible to put animals through a hell that they don't understand because you think that you are saving them when you should have created some kind of hospice care for them and let them live out whatever good days they had in peace.

Certainly it is your money and your decision, but you are going to wonder about this for a long time if you don't get some sort of diagnosis. I recommend a referral to a neurologist, not even just a cat specialist, as either of these conditions is well into the field of neurology and not just cat care.
 
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