Vestibular Disease

[mstickle]

Our Chipper is a neutered male, age unknown (rescue kitty), but I'm guessing about 10 years old.  He is normally very active, very social, and very curious.  He is a treasured and beloved member of our family.  About 6 weeks ago I noticed some balance issues, very subtle at first, but within a few days becoming progressively and alarmingly more severe.  He also became very lethargic and developed a pronounced head tilt and diminished appetite.  Our local vet diagnosed the problem as a likely inner ear infection and we initiated treatment with clindamyacin.  Initially this seemed to help, and the symptoms moderated -- but never went away.  But by early this month Chipper's condition seemed to be deteriorating, and we made arrangements to see a neurologist.  The specialist confirmed the likely diagnosis and began to treat with Clavomax (62.5 mg. 2x daily).  Within a few days we saw very marked improvement, not only in the mobility/balance issues but also in the head tilt and (most importantly) in Chipper's return to his old self  -- curious, social, and playful.  But over the last few days he appears to be regressing once again.  I called the clinic yesterday and they suggested that the next step would be to do imaging as a prelude to possible surgery on the inner ear.  If this is what is required to help Chipper and if it can return him to health, we will find a way to do it.  But the cost (estimated at $4000) is a real concern for us right now, as is my concern about the stress he will endure as a result of the procedures.  I would be very happy to hear from anyone who has dealt with vestibular disease.  Any suggestions or experiences you have would be deeply appreciated.  I understand that every case is unique, but I also know that the disease is far more common than I ever realized.  Perhaps there are other steps which we might explore, short of invasive procedures, or perhaps others have experienced success with antibiotic therapy, with ups and downs along the road to an cure.

Most of all, I want to help Chipper and am reaching out to anyone who might have some advice or words of wisdom.

Thank you!

 

[red top rescue]

Probably nothing to do with your cat, but I had a similar problem with one rescue kitten and vet treated him with antibiotics for ear infection and Antivert generic for his dizziness and balance issues and he got better in a couple of weeks.  All was well until I put the flea medicine on him againm because it had been a month, and I was using Advantage Multi.  I put it on him and the other cats and went shopping for an hour or two and when I came back, he was staggering all over and dizzy like before.  Since it was so suddden, and I realized when it started before was right after applying the flea medicine, I put him in the sink and washed off all the flea medicine and then aplied corn starch to soak up any remaining oil.  By the next morning he was perfectly fine again.  Evidently, some CATS are sensitive to the "Plus" ingredient (moxidectin, a drug in the avermectin family) just as a certain group of dogs is, and it can cross the blood-brain barrier.  Unless you have recently switched to Advantage Plus, this doesn't apply to you, but I'm sharing this just on the chance you may have used that, or a related drug, that you had not used before.  Most of the drugs that prevent heartworm are in this category.

 

[mrsgreenjeens]

It's also possible that the Clavamox isn't completely taking care of the ear infection, so it's coming back.  Perhaps a different antibiotic might work better?  This is assuming Chipper was diagnosed with an ear infection in the first place.  Usually vestibular disease is brought on by ear issues, so it could be that he has a bad inner ear infection that just isn't being eradicated easily. 

 

[mstickle]

Thanks to both of you. Chip is doing much better than he was earlier in the week, although some balance issues and head tilt (minor) still remain. We are still on the Clavomax, and have three more weeks to run on the course prescribed by the neurologist. I have wondered if another antibiotic might be an alternative to more invasive things like surgery if the Clavomax was working, but not fully eradicating the infection. We'll see. The best news at the moment is that he seems to feel fine, and the lingering symptoms don't appear to be of concern to him.
I continue to appreciate any and all comments from other folks who've had experience with this condition

 

[mrsgreenjeens]

I'm glad he's doing better.  Here's hoping 30 days of Clavamox does the trick, as this is longer than a usual dose of it, I think.  None of my cats have ever been treated with it for more than 10 days. 

 

[mstickle]

Actually it will be a total of 6 weeks of Clavomax in total!! And it does seem like a very aggressive regimen. But the vet is a specialist, and appears to know what he's doing. He explained that these types of infections tend to be very persistent and emphasized the importance of making sure of finishing off the infection while closely monitoring Chip for any side effects.
I am a worrier, and I want to do everything I can for Chip. That's a big part of the reason I wanted to get input from others ... and why I appreciate the comments of others.

 

[jo singer]

Hi all,

I have a 15 year-old Oriental Shorthair neuter named Hush Puppy. We have been battling a herpes flare for a few weeks now. He is getting 

Idoxuridine for ocular herpes  Chloramphenicol as a secondary infection prevention and Buprenorphine for pain control. I have been syringe feeding him because he has a bad mouth ulcer and can't eat without hurting although he is very hungry. 

He is also on zithromax once a day, Traumeel (the old stuff) 3x a day as an anti-inflammatory, and Lysine mixed into the AD that I am using with the syringe.  He  will also be starting on Famciclovir tomorrow for systematic treatment of the virus.

Last night I began seeing him stumble a bit and get somewhat "floppy". This morning I could see that he had a definate head tilt, and he tumbles at times onto his side.  I texted my vet with a photo and she asked me to check his ears which I did- and there was very little "gunk" in them.  So without going into a book here, he will be hospitalized tomorrow for the insertion of an esophagostomy tube.

I have been doing a little research and some sites claim that there may be a connection between vestibular disease and herpes.  Has anyone heard of this connection?   I really need to know as much as possible about this condition- have been doing a lot of research and could sure use a bit of support at the moment.

Thanks ever so much,

Jo Singer

troublesniffer

 

[mrsgreenjeens]

 
Hi all,

I have a 15 year-old Oriental Shorthair neuter named Hush Puppy. We have been battling a herpes flare for a few weeks now. He is getting 

Idoxuridine for ocular herpes  Chloramphenicol as a secondary infection prevention and Buprenorphine for pain control. I have been syringe feeding him because he has a bad mouth ulcer and can't eat without hurting although he is very hungry. 

He is also on zithromax once a day, Traumeel (the old stuff) 3x a day as an anti-inflammatory, and Lysine mixed into the AD that I am using with the syringe.  He  will also be starting on Famciclovir tomorrow for systematic treatment of the virus.

Last night I began seeing him stumble a bit and get somewhat "floppy". This morning I could see that he had a definate head tilt, and he tumbles at times onto his side.  I texted my vet with a photo and she asked me to check his ears which I did- and there was very little "gunk" in them.  So without going into a book here, he will be hospitalized tomorrow for the insertion of an esophagostomy tube.

I have been doing a little research and some sites claim that there may be a connection between vestibular disease and herpes.  Has anyone heard of this connection?   I really need to know as much as possible about this condition- have been doing a lot of research and could sure use a bit of support at the moment.

Thanks ever so much,

Jo Singer

troublesniffer

Gosh, it sounds like old boy is really being put through the wringer right now

  That G-tube seems like a great idea so he can get some nutrition without having to deal with the mouth pain. 

I don't recall hearing anything about a connection between Vestibular Disease and Herpes and even though you didn't find much gunk in his ears, it's still possible he has an ear infection DEEP in his ear where you can't see anything with the naked eye.  That's usually what happens, at least what I've seen posted here.  Your Vet will be able to see it when your furbaby goes in tomorrow.  The good news is that Vestibular Disease doesn't usually stick around too long...usually.

Have you heard about using Lactoferrin along with L-Lyside for stubborn Herpes?  Here's a long thread on that topic with many folks chiming in. Maybe you'll find something helpful in here:  http://www.thecatsite.com/t/267703/stubborn-herpes-infection-add-lactoferrin-in-addition-to-lysine

Many vibes for Hush Puppy 

 

 

[mstickle]

I am certainly no expert on vestibular disease, but I thought I'd share my experience, in case it might be of some use to you.  I know it was scary for us:  Our episode began much like yours . . . very gradually, so much so that at first I thought I was imagining what I was seeing.  I convinced myself that Mr. Chips was just clumsy!  But within a few days it was undeniable -- Chip's balance was very bad, and to the extent that he could walk, he seemed only able to stumble in a circle.  Stair steps were out of the question. 

After a visit to our local vet, I quickly decided to escalate, and she was able to put us in touch with a very good neurologist.  We talked about various options, but decided to go with a mega dose of Clavomax -- 62.5 mg. 2x per day, for six weeks.  In your case, given the other issues you are dealing with and the age of your kitty, maybe that wouldn't be an option -- I know from other experiences with elderly kitties that Clavomax can sometimes be hard to handle.  But I wanted to mention it, as a possible alternative so something more invasive.  In our case it has seemed to work -- the original episode was around Christmas time last year.  The symptoms abated very gradually, but they are mostly gone now, except for a very slight head tilt and some persistent (but minor) balance issues.  Most importantly, Mr. Chips is happy and able to play normally with other members of our cat family.  Chippy was a rescue cat.  He didn't have a very bright future at all when he came here, and he has had some health issues along the way.  So we cherish every day and every week.   

By the way, you mentioned the lack of anything 'gunky' in the ears -- I noticed the same thing and pointed it out to both the local vet and the neurologist.  But they both explained (just like the posted above) that with a deep inner ear infection there wouldn't be any discharge -- and that is precisely why the needed drainage can only take place via surgery or by elimination of the offending 'bug' with a powerful antibiotic.

Best wishes to you and Hush Puppy. 

Mark

 

[jo singer]

Thanks to both of you for your replies.

Right now Dr. Hush Puppy is probably being prepared for the surgery to insert the g-tube.

The vestibular issue seems to be getting much worse.  Our vet asked us to bring him in yesterday for fluids which usually makes him feel better but this time it did not. So he is in the very competent hands of our vet right now. 

She switched him from Zithromax to Baytril as an antibiotic and he will probably begin the systemic anti-virals. But we are very concerned about his kidneys so she will be testing him today to see how they are doing. His numbers have remained consistent over the past months. He is tested about every 3-4 months now but will be tested on the anti-virals even more frequently- most likely every month or more-depending on what my vet recommends.

I am aware that the upper respiratory issues- the stuffed, almost constantly runny nose may be indicative of a more serious condition than herpes. My vet did several xrays of his skull and nasal passages and his jaw which a veterinary radiologist read. This may be nasal Lymphoma- but that is a possible diagnosis that we are putting on a back burner for now.  A CT scan has been recommended which we may persue.

My dilemma is that since he is 15- going on 16 in January, even it if turns out to be cancer is it kind for me to give him a possible 6 months more life if he is miserable? These are such hard decisions. Is the vestibular condition which also came on very slowly- like missing jumps and falling off the couch which I also attributed to just being clumsy-symptomatic of  possible cancer? 

Naturally I am hoping that the g-tube and being able to get the proper nutrition - without having to be syringe-fed- with the food going into his mouth which is very sore from a huge ulcer- make a big difference in his condition? Will his quality of life improve where HE is happy?

It is, of course premature to make any decisions but they will be based on his recovery. He is a very smart, amazing kitty- one who has stolen my heart from  our very first encounter at his breeder's home. He was a 4 month old kitten at the time and when he saw me he jumped onto my lap and then onto my head and put his paws around my neck. It was love at first sight for both of us and I adopted him immediately!!!!

So we could use some prayers right now, and sorry for the long post- but at the moment I am very concerned and this has been very helpful for me to reach out and get support.

Headbonks and purrs

Jo

>^..^<

 

[red top rescue]

If you have not yet read Dr. Kris' article about e-tubes, you would probably find it very informative.  The feeding tube will help him discover his "health potential" and you won't have to be dealing with force feeding, meds etc.

http://www.iwillhelpyourcat.com/blog/2015/3/8/feeding-cats-that-wont-eat-at-all-pina-the-e-tube

 

[mstickle]

I just want to wish you and your dear friend the very best.  I know how hard it can be --even agonizing -- to try to make the right decisions on behalf of those who are so precious to us.  Please know that others understand and care.

 

[jo singer]

Thanks so very much for all of your support. That article was SO very helpful. I sent it to my husband also since both of us are rather nervous about this whole thing.

We visited him yesterday a few hours after his surgery and he was still kind of out of it.  I spoke with a vet tech this morning so waiting to hear from the vet directly. He had a quiet night and he is acccepting the feedings and so far everything is staying down  This is good news.

I am so happy I found this support area! I am so thankful that this site exists.

So again, thanks so much for all of your help and encouragement. It means a LOT to me.

Have a great day, and will post updates from time to time!

I am just hopeful that the vestibular issue will slowly resolve. He is having some problems getting around right now.  Our vet said that since herpes can have some neurological implications that this may be part of the issue. We are just praying that he will fully recover very soon.  Our vet added clindomycin instead of zithromax right now- although she said she may decide to have both going. So hopefully this will be very helpful in resolving this issue also.

Take care and have a blessed day,

Jo

 

[2bcat]

FWIW, I had a much younger cat (about 5 years old then) last year go through a vestibular thing, and she seems fine.  She had the whole stumbling, walk in a circle, classic sort of symptoms, and she got a course of antibiotics as I recall in case of infection.  I really don't remember the treatment all that much for some reason.  It has not shown any signs of recurring and she gets around just like normal now including jumping and such but she does retain a noticeable head tilt which is apparently not uncommon.

I hope the feeding tube works out well for him and that any of these vestibular symptoms clear up without further incident.  Having also syringe fed a cat a couple years ago, I can understand what an ordeal that was.  It should be very helpful to know for sure that he is getting enough food.

 

[red top rescue]

my vet prescribed meclozine when my cat had an inner ear infection and it helped a lot with the vertigo and the nausea.  its the same as antivert for humans

 

[jo singer]

Hush Puppy is now at the AVS in Maitland Florida having extensvie testing.

He had a thorough neurological exam this morning which was essentially inconclusive so they are doing an MRI, spinal tap perhaps, xrays and blood work. 

Hopefully they find nothing- hopefully they discover a lurking infection.  

Thanks for all the help and support. This kitty mom needs a lot of it right at the moment.  I will post any updates and I am sure I will have a gazillion questions.

You guys rock!

Jo