What chance does our cat have of recovery after seizures and coma?

July 23, 2009 12:37 PM

Cat in recovery from suspected poisoning. Came out of post-seizure coma, now has suspected blindness, partial paralysis. What do we do next?

We found our otherwise healthy 7-year-old cat unconscious on our (5th floor) back deck yesterday at 6.30am. Got her to the emergency room within a half hour. She was limp, unresponsive, pupils constricted almost to vanishing. Tests & X-rays showed no trauma, but hypothermia (low body temp) & hypoglycemia (low blood sugar) as well as shock. She had seizures, both before and after we found her.

After ~24 hours on a glucose drip, in an incubator, with supplemental oxygen, antibiotics (in case of undiagnosed infection), atropine (I think - some kind of antidote for an unknown poison), stomach pumping & ingestion of activated charcoal, she woke up and started eating, responding, moving.

HOWEVER, as of 3 hours post-coma, she still could not support herself on her back legs, and the vet suspected some neurological problems. We've taken her to a neurologist where she is awaiting a consult (while still on an IV). The intern who did see her thinks she may be blind, but i guess we'll know more when she's had a full workup.

This cat's recovery so far is just miraculous. We thought that she was a goner for sure, and I'm pretty certain so did the emergency vet practice, as there was a real sense of surprise & jubilation when we came to get her this morning.

I wonder if anybody else out there has had a cat go through seizures/unconsciousness and then had residual problems. Were they temporary, or permanent?

From the internet research I've done, it looks to me like neurological symptoms such as temporary blindness and paralysis are not uncommon post seizure. What I'd like to know is how soon we should be expecting a change.

We've been warned that the neurologist may want to do an MRI (at a cost of ~3K). We don't want to put our cat through anything unnecessary but we do want to give her the best chance. On the one hand, if, via the MRI, they found swelling putting pressure on nerves, spine or brain, that they could fairly simply surgically relieve, and therefore 'repair' - it might just be worth it. And I imagine we'd want to get this diagnosed & treated ASAP.

On the other hand, she was very, very, very ill and she's been making progress since waking up that you can literally measure by the hour, we strongly suspect is still in with a good chance of recovering on her own (or maybe with some anti inflammatories, steroids etc.). In the ~2 hours between leaving the first emergency vet office and being seen by the neurologist's intern, she had gone from being unable to use her back legs at all to being able to crawl a bit using them.

Anyone seen anything like this - an unidentified poison causing seizures and coma? What about recovery after seizures anyway - could we still be seeing "spontaneous" recovery days rather than minutes after the incident?

We don't want to put our cat through unnecessary pain & distress if it turns out she's unlikely to be able to be treated, or if treatment may not give her any quality of life. But we don't want to give up on her too early.

Any advice?

thanks!!

posted by geekgirl397 to pets & animals (20 comments total)

My cat who is now 12 was poisoned when he was 4 with dog flea treatment. Basically, we mixed up the OneSpot for our 180lbs Saint Bernard with OneSpot for the cats. He never went into a coma, but he did have seizures. The vet wasn't sure if he would make it, and said there could be lasting liver damage and neurological damage. He was hospitalized for two days and made a great recovery.

That said he has had some mild lasting issues. He's stayed sort of "jittery" for lack of a better word. His eye constantly do this weird "tracking" thing where they shift back and forth when he's looking at something. He's also had very mild seizures, where he loses his balance, gets rigid for a moment, and sometimes shakes. They last for about 10 seconds, and he recovers within a minute or two. These have gotten more frequent (going from one or two a year to one a month) over the last several years. However, in December, he had one major scary seizure (about a minute, frothing at the mouth, pooping). Since then, he hasn't had even a mild seizure. The vet doesn't know what to make of it. I joke that it reset his brain.

Other than that he's a healthy happy cat.
posted by kimdog at 1:11 PM on July 23

I'm so sorry this happened to your cat. Do you have any idea what she could have gotten at? Do you have any plants on that deck that are poisonous to cats? You can check poisonous plants here. If you can figure out what Kitteh got into, all the better, as that might inform whatever the vet has to say about her prognosis, and might inform your decision.

Otherwise, I think it's kind of a case by case basis, as to whether she is doing better in a reasonable amount of time. Obviously it is very hard to decide what to do, but I always try to think about whether I am affording an animal the same respect I would afford a human being in a critical situation. If there's not going to be any real quality of life, and it's not something that I'd feel like in a comparable situation I'd feel okay about my mom living that way, then I say it's time to let Kitteh go.

Good luck. I hope your cat gets better.
posted by Medieval Maven at 1:30 PM on July 23

We have no idea what she got into. She's *supposed* to be an indoor cat, but has been exceptionally feisty and determined from kittenhood: she's such an accomplished escape artist, that eventually we gave up trying to confine her so she pretty much has free rein (I don't like it, and I always knew that we were risking shortening her life ... don't want to get into arguments over indoor/outdoor here - trust me, I've agonized over it constantly).

It could've been anything outside. We live in the city. She's a ratter. Sometimes the city puts rat poison down (although there are no warning signs announcing such at the moment, and they usually do post them). It might have been a pesticide. We're pretty sure it's not antifreeze. The vets tried to identify what it might have been from her symptoms, bloodwork and stomach contents and still don't know. Based on her symptoms and my research I suspect it could be a rodenticide called Alpha-Chloralose (AC) or possibly the pesticide Permethrin. But that's just my amateur internet sleuthing. (The emergency vet also suggested Broma-something or other)

Her kidney, liver function etc. are all fine - all her internal organs are working just great. the only residual problems appear to be neurological. Could be caused by having had the low glucose levels (not enough fuel to the brain) or could be associated with the seizures. We just don't know.
posted by geekgirl397 at 1:40 PM on July 23

My family had a cat who experienced something similar. One day he came in (inside/outside farm cat) and was wobbling all about, having seizures. I can't recall what happened with our initial vet visit. This eventually passed though, and he made a good recovery over the next few weeks. He had a bit of a balance problem afterward but not enough to really throw off his hunting skills. He was the same old cat otherwise and lived something like 5 good years after this episode. I believe he eventually had another bout of seizure problems and had to be put down.

We never figured out what happened to him. Unfortunately, we didn't have the monetary resources to pursue investigation/treatment, but as far as we could tell he felt fine so we let it go.
posted by Ultra Laser at 2:16 PM on July 23 [1 favorite has favorites]

If it were me, I would do the tests. I might wait a day or two, just to see if she's really progressing quickly, but I'd probably do it.

Our cat Woody almost died from the Iams food contamination fiasco. He was fine one night, the next day he was almost dead. It was that fast. Once we got him to the emergency vet and they basically flushed his system, he started recovering nicely. We didn't know at the time that it was the food (the recall hadn't happened yet) so we had him seen by various specialists because he was only 4, for crying out loud. A perfectly healthy 4-year-old cat does not just almost die for no reason. Well, of course, the vets couldn't find a reason, but by day 3 or 4 he was almost back to normal. Once we found out that it was the food (about 2 weeks later) we went ahead with some treatments our regular vet recommended and he has his blood drawn every six months now to check his kidney levels. He's at more risk for early kidney failure and if we know early we can treat him sooner. So far so good.

So, I'm one who believes in testing young animals. Your girl could have at least a dozen years left to live a very happy life, and if the MRI shows something fixable...I'd do it.
posted by cooker girl at 2:18 PM on July 23

This must be so scary - to see your beloved pet so terribly sick! I've been there, and it's a helpless feeling.

I haven't had the same issue, but it seems very good that her organs are not damaged. If her spirit is strong that's also a great sign. You'll have to listen and ask lots and lots of questions. Not just of the vet, but also of the techs who can sometimes be a wealth of good info.

Not the same, but I can give one example of a brain injury in our horse: Not from a seizure, but from rearing up and falling over backwards and hitting her head. She did have damage and was very, very unstable on her legs. We supported her with hay bales for one day till she was stable enough to take to the vet school which was very close by. They didn't MRI (horse is too large), but pumped her full of DMSO. She became eventually stable enough to move around, clumsily, so we brought her home. I slept in the barn for over a month keeping a look-out for her falling or worsening. She gradually recovered enough stability to be able to lie down and eat grass, etc. But, we never even thought of riding her again. She wasn't ever as steady on her feet. Not the same, but there is some hope for recovery, depending on the injury.

All this goes to say that you're on a day-by-day basis. It's good to see steady improvements. You'll need to consider how much support time you'll need to devote to her recovery if there's a good prognosis. It can take a whole lot out of you, and you'll be making decisions in an emotionally exhausted state. That's when it's hardest. If you have any friends or family who can help you, now's the time to ask for their help.
posted by mightshould at 2:19 PM on July 23

It's ultimately a call only you can make. If I were in your situation, as long as she's still making progress I'd hold off on the OMG expensive MRI. (And this is coming from someone who's taking her dog in for surgery tomorrow that will cost up to $2k. So I feel ya.)

I've told the story before about the kitten my husband and I found dying on our street last year. To save the re-telling and show off her cuteness, her story can be found here. What that story doesn't tell is that there was a chance of poisoning in her case too - her face was covered in black dirt and the vet suspected she may have tried to eat something just because she was so starving. While she didn't have any seizures, she did recover completely from her temporary blindness and other neurological signs.

I'm so sorry this happened to you, and wish the best for you and your cat.
posted by misskaz at 2:32 PM on July 23 [1 favorite has favorites]

Heh, correcting myself, I just remembered that Maddie was seizing when we found her. I completely forgot that her weird movements were probably seizures. She has never had another one.
posted by misskaz at 2:33 PM on July 23

My cat almost died from flea and tick medication (I suspect she licked it off another cat, as I used the appropriate dose for her). She went to the emergency vet as soon as I found the problem, and she had a few seizures in the car en route. When she got home, she was weird, neurologically -- eyes funny, twitching, personality just off, etc -- after a few days, she was back to her normal level of weird, though she never went in the living room again (I moved 8 months later, and she hasn't had paranoia about any other room since).

I'd probably wait out the weekend considering it, unless they suggest there's a real need for timeliness. But I'd most likely test her. An MRI is pretty much non-invasive, though they'd have to knock her out so she wouldn't move. At 7 your cat is still quite young. Also, she might be more willing to stay inside now that something really bad happened to her outside.
posted by jeather at 2:36 PM on July 23

This is the only similar reference i have been able to find on the web following finding my cat in a similar state on Monday. I came home to find my one year old cat practically frozen and unresponsive. I got him to the emergency vet ASAP and he had no temperature at all but his heart and breathing were ok. Although he was blind, temporarily i hope. He is a house cat, who ventures out of the window but not down to the street, and i still have no clue what it could be, i have searched my flat for anything that could be poisonus and searched the web to see if anything i find is, and still have no clue. It is a mistery so far. We warmed him up and he was put on a drip and placed on a heat mat. I just had to go home and hope for the best. The vet phoned me in the morning and said when he woke he was fitting. They put him under anesthetic, when he woke he was still fitting, i have been to see him several times and am heart broken. Just feel so bad for him. They are going to wake him tonight when it is quiet and hope that the fitting has stoppped so they can see whether he is responding. I can only hope for the best and hope he recovers to a good quality of llife, but am so scared he will have permanent brain damage. Time will tell. I really hope your cat gets better too.
posted by mayfly83 at 2:52 PM on July 23

Hmm. I am doubtful about the mechanism by which poison could cause swelling that needs immediate surgical intervention to prevent permanent damage to the spinal cord etc. Google's chief suggestions of connections between poisoning and surgery seem to be where the poisoning object is still lodged in the intestines -- presumably not true for your recovering cat.

Given how many people make great recoveries from strokes which caused paralysis originally, I would be hopeful for some good recovery.

I think you are lucky to have such an enterprising companion, and do not think you should beat yourself up or vow to keep her imprisoned because of an unfortunate incident. As Medieval Maven said, she could have been poisoned by house plants.
posted by Idcoytco at 3:15 PM on July 23 [1 favorite has favorites]

I would echo the notion that if the cat is making progress, and if the price of the MRI is not trivial to you, hold off.

Slightly disturbing anecdote ahoy: in 1990, my SO and I had just moved into an early 20th century house and were painting the bathroom. We left the window open to help air out the room and dry it out and one day when we were both at work, our young cat was sitting in the window when the heavy window frame fell on her like a guillotine, pinning her by the neck for who-knows-how-many hours until I got home late that night. I took her to the animal hospital and tests revealed that she was blind and partly paralyzed on one side. The vet recommended putting her down and said the chances of recovery were slim. My SO would not hear of it and insisted on bringing her home after a weekend in the hospital.

Within a week the cat was showing signs that she could see, and a month later, it was as if nothing had ever happened. The cat lived another fourteen years with no ill effects.
posted by ricochet biscuit at 3:29 PM on July 23 [2 favorites has favorites]

I think the idea is that any swelling may have been caused by trauma that we don't know about: xrays are clear but she has a small abrasion under one eye, and presumably could've been thrashing around during her seizures. Definitely not houseplants: I only buy plants I've thoroughly researched as being non-toxic to cats and if people send me flowers I don't bring them into the house if they have anything remotely risky in them.

But - she wanders the neighborhood freely so could've nibbled on any plant she found. More likely she drank something; she's fascinated by fluids and will drink from the dirty water in the sink instead of from fresh water from her bowl.
posted by geekgirl397 at 3:30 PM on July 23

Has your kitty been tested for toxoplasmosis? One of our cats had seizures once in a while, not frequent and he came out of them ok. The first time we took him to the vet they could not find anything. This year, he had a seizure and after could not stand up, and his pupils were different sizes. He was very distressed and stayed under the couch where he normally never goes.

I thought it was all over for him. The vet did a blood test for toxoplasmosis which came back positive. The next step would have been expensive neurological testing. He was on a strong antibiotic for two weeks, and very slowly got better, his eyes returned to normal and he was able to walk normally. He is now fine, half a year later, no symptoms. Cats get this disease from eating contaminated wildlife, so if your kitty is a hunter it is worth looking at as one more possibility.

I hate to hear about sick kitties and hope yours will be ok.

Hexatron's Wife
posted by hexatron at 3:38 PM on July 23

What is the treatment if she does have brain swelling? Perhaps if the treatment isn't too invasive you should forgo the 3000.00 MRI and just treat her? If that is the problem then it could fix the problem if not and the treatment won't do worse damage you save 3000.00 dollars and your situation stays the same.

In the meantime I believe pets and humans always heal better in a positive loving environment. Keep your spirits up. I hope everything works out for you all.
posted by gypseefire at 3:56 PM on July 23

we're bringing her home from the vet today. Vision still not normal: we think maybe she does have light/dark discrimination, but can't focus. Walking a bit better, apparently. Vet doesn't think there's any need for an MRI or further tests. All her vitals etc. are normal & healthy.

Thank everyone so much for all your advice and sympathy. We're far from out of the woods, but now we know she's still in with a shot for further recovery.

I know everyone thinks their cat is special, but our little Amber (only 7lbs and still looks like a kitten) really is one of a kind. Her most salient characteristic has always been her determination: she has always known exactly what she wants at any given moment and will not stop until she gets it. She's a real tough character, but is also extremely good at giving and receiving love (no cat has ever been able to withstand more petting than she demands) - so I think she must have as good a chance as any cat of bouncing back from this.

mayfly83, I hope your cat is on the mend. It's incredible how far our cat has come in 2 days and I hope your little one makes it too.
posted by geekgirl397 at 7:32 AM on July 24 [1 favorite has favorites]

She came home!

Home care sheet from the vet indicated she still had vision problems.

However, on the way home, in the car she followed my gaze and grabbed my finger when I put it through the bars of her carrier, so we started to be hopeful.

Got her home, opened her carrier door .. and she strolled out. Walked slowly but purposefully around the sofa, brushed against our legs and then took herself to the litter box. After a short rest to cool down and get some petting, something upstairs took her interest and she - slowly - climbed a full flight of stairs!

Still not walking *quite* right - a touch of stiffness in the back legs - but it's pretty obvious she can see where she's going and recognize us by sight. She's kind of acting like she's woken up from a long sleep. From what we can tell, her personality is unchanged - she is still reacting the same way to petting. We got her up on the bed with us and she clambered on top of us, seeking the highest point, as she's always done.

At this point, we've got to be optimistic that she'll make a full recovery. Even if the recovery were to stop at this point, seems like she's well enough to live a full, enjoyable life.

Now I truly understand why they say cats have nine lives!

thanks again for all your kind words and advice.
posted by geekgirl397 at 2:27 PM on July 24

Yay! Thanks for the update - it's been on my mind. She does sound very special. That's a pretty darn steep uptick in her improvement - seems very good!
posted by mightshould at 5:48 AM on July 27

You can see video of her as she is now - completely recovered & as sharp & agile as ever. http://www.youtube.com/watch?v=70rCpNH9yRo
posted by geekgirl397 at 11:03 AM on August 8

Thanks so much for the update. I hope she's still doing well and will be demanding things from you for many, many years to come!
posted by cooker girl at 10:20 AM on September 22