Cat with vestibular? Brain cancer?
April 14, 2017 12:22 AM Subscribe
My 11 year old cat has been very sick for a month and we’ve got no conclusive answers after an MRI, spinal tap, urinalysis, bloodwork, and X-ray. His symptoms are ataxia and dizziness. He’s still eating, using his litterbox, alert, talkative, no vomiting.
It started at the beginning of March when my roommate noticed him fall over. We’d had superloud construction on the building and he’d seemed a bit lethargic for those weeks, but nothing abnormal. I brought him to the vet and bloodwork/urinalysis/xrays happened, all clean. He got an antibiotic shot, and since his symptoms became much worse over the course of a week to the point that he couldn’t walk, I then made an appointment with a neurologist. The neurologist diagnosed central vestibular disease and did the MRI and spinal tap. I was told that the results from both were inconclusive and lymphoma was suspected.
The cat made a spectacular recovery over a week and a half since his ordeal, but then became increasingly lethargic over the space of two days, and I took him back to the vet. I got another antibiotic and he became a little perkier, but ataxic. So then we started prednisolone, and the two weeks he’s been on it have been great, though he is still a bit dizzy.
I’m weirded out because the neurologist first said the MRI just showed inflammation in his nose and meninges (because we were waiting on the spinal tap), then that it was inconclusive and we could do it again, and lastly, two weeks after the procedure, she told the cat’s normal vet that there were mass lesions in the nose and brain. Without that information, his normal vets seemed to think it was some sort of inflammation or infection that could be knocked out with antibiotics and/or pred. Now everyone seems sure (or mostly sure) that it’s lymphoma; the neurologist wants to biopsy his nose and kidneys and start chemo, whereas his normal vets advise against both and want to keep him comfortable on the pred. I don’t want to put him through more invasive tests and medications, so I’m on board with that.
To make matters worse, I have to leave the country for research in six weeks for two months. If he’s still around then, he’ll be staying with my parents. Knowing that his symptoms are being masked by medication is frightening; the last vet I talked to said that he could start seizuring at any time, and that would be the signal to put him down. At the same time, I’m hoping against hope that this is a misdiagnosis, partially because it’s been all over the board for six weeks.
Basically, I have no idea how to talk to these vets, or what to expect from a cat on prednisolone. If I have to euthanize him soon, I’d rather it be before I have to leave and before he is in pain, but if he’s doing as well in six weeks as he is now, I don’t think I could. He’s my best friend in the world and this is devastating. Hope me, help me, anything.
It started at the beginning of March when my roommate noticed him fall over. We’d had superloud construction on the building and he’d seemed a bit lethargic for those weeks, but nothing abnormal. I brought him to the vet and bloodwork/urinalysis/xrays happened, all clean. He got an antibiotic shot, and since his symptoms became much worse over the course of a week to the point that he couldn’t walk, I then made an appointment with a neurologist. The neurologist diagnosed central vestibular disease and did the MRI and spinal tap. I was told that the results from both were inconclusive and lymphoma was suspected.
The cat made a spectacular recovery over a week and a half since his ordeal, but then became increasingly lethargic over the space of two days, and I took him back to the vet. I got another antibiotic and he became a little perkier, but ataxic. So then we started prednisolone, and the two weeks he’s been on it have been great, though he is still a bit dizzy.
I’m weirded out because the neurologist first said the MRI just showed inflammation in his nose and meninges (because we were waiting on the spinal tap), then that it was inconclusive and we could do it again, and lastly, two weeks after the procedure, she told the cat’s normal vet that there were mass lesions in the nose and brain. Without that information, his normal vets seemed to think it was some sort of inflammation or infection that could be knocked out with antibiotics and/or pred. Now everyone seems sure (or mostly sure) that it’s lymphoma; the neurologist wants to biopsy his nose and kidneys and start chemo, whereas his normal vets advise against both and want to keep him comfortable on the pred. I don’t want to put him through more invasive tests and medications, so I’m on board with that.
To make matters worse, I have to leave the country for research in six weeks for two months. If he’s still around then, he’ll be staying with my parents. Knowing that his symptoms are being masked by medication is frightening; the last vet I talked to said that he could start seizuring at any time, and that would be the signal to put him down. At the same time, I’m hoping against hope that this is a misdiagnosis, partially because it’s been all over the board for six weeks.
Basically, I have no idea how to talk to these vets, or what to expect from a cat on prednisolone. If I have to euthanize him soon, I’d rather it be before I have to leave and before he is in pain, but if he’s doing as well in six weeks as he is now, I don’t think I could. He’s my best friend in the world and this is devastating. Hope me, help me, anything.
Best answer: Oh man. This is really tough and I'm so sorry that you're going through it. I know I'm just a random internet stranger, but if you ever need to chat, feel free to send me a MeMail.
I have found that the more medical jargon you use when you speak with vets and their staff, the more candid and straightforward answers they will give you. Honestly, even things like consistently saying "lethargic," "ataxic," and "urinating" instead of "tired," "wobbly," and "peeing" has yielded much better information from vets for me. Ask specific questions like "How well should I expect the prednisone to control x and y symptoms?" instead of vague ones like "What's next for [Cat]?"
As for prednisone, you should be aware that it can cause irritability and aggression in pets, so be alert for that.
Hang in there.
posted by schroedingersgirl at 8:01 AM on April 14, 2017
I have found that the more medical jargon you use when you speak with vets and their staff, the more candid and straightforward answers they will give you. Honestly, even things like consistently saying "lethargic," "ataxic," and "urinating" instead of "tired," "wobbly," and "peeing" has yielded much better information from vets for me. Ask specific questions like "How well should I expect the prednisone to control x and y symptoms?" instead of vague ones like "What's next for [Cat]?"
As for prednisone, you should be aware that it can cause irritability and aggression in pets, so be alert for that.
Hang in there.
posted by schroedingersgirl at 8:01 AM on April 14, 2017
I'm sorry this is happening with your kitty. I wish they could live forever.
The doctors really do want to help. Make an appointment just to talk, without the cat. It's totally ok to do that.
The neurologist wants to biopsy his nose and kidneys and start chemo, whereas his normal vets advise against both and want to keep him comfortable on the pred. I don’t want to put him through more invasive tests and medications, so I’m on board with that.
The doctors know your kitty best, and you can totally ask them to explain anything you don't understand. In case it helps, here are some explanations:
Central vestibular = There's something wrong in the brainstem
Lymphoma = They looked for and did not find infectious diseases, abscesses, and other things. Taken as a whole, everything points to lymphoma, but actual tissue samples (biopsy) will be needed to be sure. They need that tissue diagnosis before starting chemotherapy. Chemotherapy gives a chance at possibly suppressing the lymphoma for a longer period (going into remission), but it might not work, or for long.
Prednisone = a steroid that will shrink lymphoma tumors partially and temporarily, but the lymphoma will break through it eventually. In the short-term, it makes the kitty eat more and feel better.
The doctors are there to help guide you in making the right decision for you and your cat, taking into account all the things including your travel schedule. Make that appointment, so they can set aside time and not be in a rush. Bring a printout of this post, as it will help them understand your perspective and concerns.
Depending on where you live, you can find a housecall or even a hospice care veterinarian to help you and your cat. They can come to your parents' house if and when the disease takes a turn or they are worried about the cat for any reason.
posted by metaseeker at 9:25 AM on April 14, 2017 [1 favorite]
The doctors really do want to help. Make an appointment just to talk, without the cat. It's totally ok to do that.
The neurologist wants to biopsy his nose and kidneys and start chemo, whereas his normal vets advise against both and want to keep him comfortable on the pred. I don’t want to put him through more invasive tests and medications, so I’m on board with that.
The doctors know your kitty best, and you can totally ask them to explain anything you don't understand. In case it helps, here are some explanations:
Central vestibular = There's something wrong in the brainstem
Lymphoma = They looked for and did not find infectious diseases, abscesses, and other things. Taken as a whole, everything points to lymphoma, but actual tissue samples (biopsy) will be needed to be sure. They need that tissue diagnosis before starting chemotherapy. Chemotherapy gives a chance at possibly suppressing the lymphoma for a longer period (going into remission), but it might not work, or for long.
Prednisone = a steroid that will shrink lymphoma tumors partially and temporarily, but the lymphoma will break through it eventually. In the short-term, it makes the kitty eat more and feel better.
The doctors are there to help guide you in making the right decision for you and your cat, taking into account all the things including your travel schedule. Make that appointment, so they can set aside time and not be in a rush. Bring a printout of this post, as it will help them understand your perspective and concerns.
Depending on where you live, you can find a housecall or even a hospice care veterinarian to help you and your cat. They can come to your parents' house if and when the disease takes a turn or they are worried about the cat for any reason.
posted by metaseeker at 9:25 AM on April 14, 2017 [1 favorite]
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I think I would want to speak to someone at the specialty vet who can break this all down for you with the understanding that you have this work commitment and you need to understand as well as possible what you need to set your parents up for in terms of your cat's health while you are gone. I think it's fine to call up the specialty vet and your actual vet and tell them that you are confused and you need to get a handle on this before you leave so that you can make sure your parents have good information. As for how to talk to them, just be honest and state when you are confused or do not understand. There are no stupid questions.
As for prednisone, cats tolerate steroids very, very well. It takes a while before they show any side effects, and they tolerate the treatment better than dogs or humans. Cats who are on long term steroid therapy should be at the vet quarterly for an exam + urine test, and blood tests every six months. That is what I know from my cat being on them.
Good luck, this sucks. <3
posted by Medieval Maven at 6:07 AM on April 14, 2017 [1 favorite]