Possible cat stroke

Sigmacat

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Hi all, I’m wondering if my cat maybe had a stroke? I will share his symptoms and see if anyone is familiar with strokes in cats that could shed some light.

So my kitty has been treated for small cell intestinal lymphoma for a year with prednisolone and chlorambucil. Recently his appetite started to decline again and ultrasound showed some thickening again and few lymph nodes, so we started transdermal mirataz (2 days worth) and then stopped because he became very agitated at first and then was like trembling and felt warm?
Two days later, he woke up hungry but then briefly stumbled to his side when walking and got up only to start head pressing. At the vet he was slightly anemic and had slightly low potassium and was treated for both, and given pain meds and antibiotics. He’s been doing the head pressing on and off the past few days since and also stumbling still, not meowing at all, and still not eating much. Not really himself and very lethargic when not pacing.
Just curious if this is due to the mirataz, his cancer, or a stroke? If anyone can provide some info that would be great!

I’m also wondering if anyone’s kitty has has a stroke, do you remember what treatment your kitty was given after the stroke? Thanks so much!
 

FeebysOwner

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Hi. So sorry for what is going on with your kitty. And, sorry no one has responded to your post yet. I did search this site to see about other members who think their cats may have had a stroke, but most of them involved seizures, and some included temporary or permanent paralysis as a result.

I am not sure what you mean by 'head pressing', so maybe explaining that might 'ring a bell' with some of the members.

In the meantime, did you call your vet and ask their opinion of what this might be related to? I have never heard of mirataz causing this kind of reaction, although I have read that lethargy/weakness can be a side effect. The vet might have some idea if that would be possible, and they may just want you to bring him in for a brief check up. The possible reasons behind a stroke would predicate what type of treatment would be appropriate.

Hoping to see other members come along soon with their thoughts!
 

daftcat75

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When Krista woke up, stumbled off the bed, threw up, and couldn't walk right, I rushed her to the emergency hospital at 2 am. I was convinced that she was having some diabetic episode from being on daily steroids for many months. That was easily ruled out with blood and urine tests. To cut to the chase, she had a middle ear infection that was so bad, it was affecting her balance and making her nauseated. There was no way of knowing this without an MRI. And because the middle ear is technically outside the body, it was going to be very difficult to treat with antibiotics alone. Since Krista also had lymphoma, she couldn't afford to lose any more weight. Surgery was a must in her case to drain her middle ear before it ruptured her eardrum or worse.

This is what the neurologist said before the MRI about what it could have been (quoted from her thread last year):

I spoke with the neurologist and she said it could be:

a) idiopathic (”we don’t know what caused it”),
b) stroke
c) brain tumor
d) something in the middle ear
e) brain infection

Krista will be getting an MRI this morning and a spinal tap if needed based on the MRI results.
So it could be a stroke. But it could be other things too. You won't really know without an MRI.

And the bad news, the MRI is very expensive. It was $2200 here. But I live in the Bay Area in California. Everything is pricier out here.

At the very least, I would run that list past your vet and ask him if there is anything that can be treated or ruled out without an MRI. If you have insurance for the guy or you can afford it, definitely get him an MRI.

BTW, Krista recovered from the surgery nicely. If it weren't for the lymphoma, she'd probably have made a full recovery. She would have another two months after that before the daily steroids and a bladder infection proved too much for her. I don't regret getting her that surgery for a second, though.
 
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Sigmacat

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Hi. So sorry for what is going on with your kitty. And, sorry no one has responded to your post yet. I did search this site to see about other members who think their cats may have had a stroke, but most of them involved seizures, and some included temporary or permanent paralysis as a result.

I am not sure what you mean by 'head pressing', so maybe explaining that might 'ring a bell' with some of the members.

In the meantime, did you call your vet and ask their opinion of what this might be related to? I have never heard of mirataz causing this kind of reaction, although I have read that lethargy/weakness can be a side effect. The vet might have some idea if that would be possible, and they may just want you to bring him in for a brief check up. The possible reasons behind a stroke would predicate what type of treatment would be appropriate.

Hoping to see other members come along soon with their thoughts!
Thank you for responding, and thank you for your suggestions and concern. The head pressing he is doing is like stopping and pressing his head into the floor and another time into the wall and holding it there? My doctor doesn’t believe it is the mirataz either, and suggests his ultrasound shows his cancer is worsening but not sure if that is what is causing these neurological issues or if it is instead from a stroke or the mirataz. Thank you for your input!
 
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Sigmacat

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When Krista woke up, stumbled off the bed, threw up, and couldn't walk right, I rushed her to the emergency hospital at 2 am. I was convinced that she was having some diabetic episode from being on daily steroids for many months. That was easily ruled out with blood and urine tests. To cut to the chase, she had a middle ear infection that was so bad, it was affecting her balance and making her nauseated. There was no way of knowing this without an MRI. And because the middle ear is technically outside the body, it was going to be very difficult to treat with antibiotics alone. Since Krista also had lymphoma, she couldn't afford to lose any more weight. Surgery was a must in her case to drain her middle ear before it ruptured her eardrum or worse.

This is what the neurologist said before the MRI about what it could have been (quoted from her thread last year):



So it could be a stroke. But it could be other things too. You won't really know without an MRI.

And the bad news, the MRI is very expensive. It was $2200 here. But I live in the Bay Area in California. Everything is pricier out here.

At the very least, I would run that list past your vet and ask him if there is anything that can be treated or ruled out without an MRI. If you have insurance for the guy or you can afford it, definitely get him an MRI.

BTW, Krista recovered from the surgery nicely. If it weren't for the lymphoma, she'd probably have made a full recovery. She would have another two months after that before the daily steroids and a bladder infection proved too much for her. I don't regret getting her that surgery for a second, though.
Thank you so much for responding and sharing your story, I am sorry for your loss it sounds like you are a very good cat parent and krista was lucky to have you.
I did suspect a middle ear infection as well, but ironically enough my other kitty passed away a few months ago from a suspected ear infection that at the end they believed was a brain tumor all along as it didn’t respond to antibiotics and the bacterial strain test came back and it was not an antibiotic resistant bacteria. With that kitty she truly couldn’t walk at all during her downfall, she couldn’t hold her head up either we had to hand feed her and she had squinty eyes and her third eyelid protruded we also had to give eye drops because her eye was drying out on the right side and eventually she became super rigid and couldn’t open her mouth to eat and chew so we sadly had to say goodbye as the doctor believed it was a brain tumor and didnt recommend an mri at that point.
So with my current kittys situation it is different, he can walk just is very stumbly and the head pressing is odd. His ultrasound did show more thickening and lymph nodes than 2 weeks ago (I had taken him in then because I was concerned his appetite was declining and he was more lethargic than usual) but my internist that has been treating him for his lymphoma didn’t seem too concerned then. However today he said his ultrasound looked worse, no masses but more lymph nodes present.
He suspects toxo so he is on clindamycin currently and his bloodwork doesn’t show elevated wbc so he doesn’t think it’s an infection either. I’m not sure what to think, if it is a stroke or his cancer spread (which he said is odd with small cell lymphoma), or if it truly is a reaction to the mirataz.
He did suggest an mri but it is an hour and a half away and my kitty hates car rides and the vet but maybe that is the route we will take, but he has been in the er and no improvement on fluids pain meds and his prednisolone. I am hoping he makes a recovery. Thank you so much for your advice.
 
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Sigmacat

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When Krista woke up, stumbled off the bed, threw up, and couldn't walk right, I rushed her to the emergency hospital at 2 am. I was convinced that she was having some diabetic episode from being on daily steroids for many months. That was easily ruled out with blood and urine tests. To cut to the chase, she had a middle ear infection that was so bad, it was affecting her balance and making her nauseated. There was no way of knowing this without an MRI. And because the middle ear is technically outside the body, it was going to be very difficult to treat with antibiotics alone. Since Krista also had lymphoma, she couldn't afford to lose any more weight. Surgery was a must in her case to drain her middle ear before it ruptured her eardrum or worse.

This is what the neurologist said before the MRI about what it could have been (quoted from her thread last year):



So it could be a stroke. But it could be other things too. You won't really know without an MRI.

And the bad news, the MRI is very expensive. It was $2200 here. But I live in the Bay Area in California. Everything is pricier out here.

At the very least, I would run that list past your vet and ask him if there is anything that can be treated or ruled out without an MRI. If you have insurance for the guy or you can afford it, definitely get him an MRI.

BTW, Krista recovered from the surgery nicely. If it weren't for the lymphoma, she'd probably have made a full recovery. She would have another two months after that before the daily steroids and a bladder infection proved too much for her. I don't regret getting her that surgery for a second, though.
Also, with my other kitty I was talking about in my previous response we truly don’t know if it was a middle ear infection that did get too bad and ruptured as they feared for krista or if it was really a brain tumor all along as we didn’t have the chance to get an mri it happened so quickly over the span of a week or so and we were initially treating for an ear infection as they found puss in her ears. So again, my current baby may have an ear infection but since the symptoms seem different I have no clue what to think :(
 

daftcat75

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The middle ear is technically outside of the body. A middle ear infection is very difficult to treat with antibiotics alone because you're essentially treating it as a skin infection at that point. Any infectious material that does not come in contact with the skin in the middle ear is not going to be affected by the antibiotics. That's why a surgery was absolutely needed in Krista's case. They had to make an incision beneath her jaw to drain her middle ear. The only other way to get there would have been to intentionally rupture the eardrum--not an option any of us was willing to consider.

You can ask your vet for gabapentin to calm him down for the car ride. I really do think an MRI is your best bet right now.
 
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Sigmacat

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Okay thank you so much for your advice, I really hope it is something we can treat as he is my soul kitty I call him and has been with me for 13 years! And you may be correct I worried about that with my other kitty too that they just didn’t treat her aggressively enough but sadly we will never know and i know witb cats it is super hard to diagnose them as a lot of conditions mimic one another and they can’t speak to us to tell us what’s wrong! Thank you again for all your help so far I really do appreciate it.
 

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Okay thank you so much for your advice, I really hope it is something we can treat as he is my soul kitty I call him and has been with me for 13 years! And you may be correct I worried about that with my other kitty too that they just didn’t treat her aggressively enough but sadly we will never know and i know witb cats it is super hard to diagnose them as a lot of conditions mimic one another and they can’t speak to us to tell us what’s wrong! Thank you again for all your help so far I really do appreciate it.
Thanks daftcat75 daftcat75 for the link in. Our beloved angel Moti had a stroke. She seemed fine and then she was in a sort of frozen position, on her side, in one of the cat beds, with her head and neck held at a bizarre angle. She recovered very quickly from these effects. But her doctor diagnosed her as being in kidney failure and I learned how to give sub-Q, which got us 7 good months together. There were no other medical problems during this time. This is not very helpful, as each case is unique, but I will say that for us, learning to give sub-Q made all the difference, and if I ever have to do this in future, I have the knowledge and the confidence. *PRAYERS* from the heart for your sweet little man!
 

kittenmittens84

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Mirtazapine can cause stumbling, dizziness, tremors, and trouble walking in cats, but I was under the impression that the transdermal version is supposed to mitigate a lot of the risk of those type of side effects because the dose is lower and it’s absorbed more slowly. Pacing and meowing a lot are common side effects of the transdermal version though. Has it been getting any better? Or worse?
 
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Sigmacat

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Mirtazapine can cause stumbling, dizziness, tremors, and trouble walking in cats, but I was under the impression that the transdermal version is supposed to mitigate a lot of the risk of those type of side effects because the dose is lower and it’s absorbed more slowly. Pacing and meowing a lot are common side effects of the transdermal version though. Has it been getting any better? Or worse?
Thank you for your response, that does make me feel a little better about the transdermal dose. I was nervous as he had never had it before and I stopped after two days since he became agitated and then acting odd shaking and was warm to the touch to me. He didn’t actually start the pacing behaviors until 2 days after we had stopped giving the mirataz and the pacing has remained pretty consistent still. That is also when he began pressing his head into the floor and wall as well was 2 days after stopping the mirataz. Which is why I think the er vet and my internist don’t believe it’s the mirataz, but they are also not sure what is causing him to act this way. He did get very vocal and agitated at the er when they gave him his cerenia injection and subq fluids because I told them he hadn’t been eating much and they thought maybe he was nauseous or dehydrated. But now I am nervous the stress of giving him these things also may have caused something? Although he did over and was head pressing before that initial er visit, he just wasn’t doing the pacing and was still “himself” (ie alert, meowing, walking normally).

He did have one random spike in blood pressure the first night in the er, but since then it stabilized on its own and hasnt spiked again in 2 days either.
Sorry for the info overload, just trying to give the whole picture if anyone has a similar experience as both the er doctor and my internist don’t know what is causing this. Thank you so much for your response and insight!
 

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Thank you for your response, that does make me feel a little better about the transdermal dose. I was nervous as he had never had it before and I stopped after two days since he became agitated and then acting odd shaking and was warm to the touch to me. He didn’t actually start the pacing behaviors until 2 days after we had stopped giving the mirataz and the pacing has remained pretty consistent still. That is also when he began pressing his head into the floor and wall as well was 2 days after stopping the mirataz. Which is why I think the er vet and my internist don’t believe it’s the mirataz, but they are also not sure what is causing him to act this way. He did get very vocal and agitated at the er when they gave him his cerenia injection and subq fluids because I told them he hadn’t been eating much and they thought maybe he was nauseous or dehydrated. But now I am nervous the stress of giving him these things also may have caused something? Although he did over and was head pressing before that initial er visit, he just wasn’t doing the pacing and was still “himself” (ie alert, meowing, walking normally).

He did have one random spike in blood pressure the first night in the er, but since then it stabilized on its own and hasnt spiked again in 2 days either.
Sorry for the info overload, just trying to give the whole picture if anyone has a similar experience as both the er doctor and my internist don’t know what is causing this. Thank you so much for your response and insight!
Vets need to realize and acknowledge that each of their patients is an individual and that their reactions to medications may be different from the norm. This is why I am very wary of allopathic (western, symptom-focused) medicine for humans or members of other species. Of course we must give our loved ones, presumably including ourselves, the best care possible based on the best information we have. But we also need to know that sometimes there are not answers to our questions. I hope your guy continues to be stable and to benefit from his care.
 

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Sending good thoughts & prayers for your baby boy. I KNOW how close a feeling you have w/ him. Threads like these always wake me to reality & the seriousness on ANY illness let alone ones this serious.

PS -- Tarasgirl, Excellent post & very well said. It is NOT always in our hands nor our call. WE can only do our very best but love our kitties as often & much as we can.
 
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