My cat was sedated and now is having seizures--temporary reaction to the shot, or something serious?
July 11, 2010 7:17 PM   Subscribe

Seeking insight into sudden onset cat seizures after short-term anesthesia.

My 19-year-old black American Shorthair cat Evel has been walking like an old man for a while now, and on Friday one of his hind legs was splayed out sideways. I touched his legs carefully up and down and he had no pain, but figured it was time to get him to the local vet and see if there's anything more than age happening.

The vet wanted to do x-rays, and called after the first one to say Evel was unhappy with the process, and it would be easier if he gave him a shot to sedate him. I didn't immediately equate shot/sedation with anesthesia, and gave the okay. That afternoon, the vet showed us the x-rays and pointed out white areas on the back leg joints and spine that showed arthritis, but no breaks or dislocations. His blood panel showed doubled creatine since his last panel two years ago, when reduced kidney function was noted, but his weight has been stable and he seemed to be in good shape overall. We left with instructions to change his home-made Anitra Frazier diet to a raw food renal diet, sprinkle Cosequin on his food and increase his twice/weekly saline drip (for kidney function) to 4x/week.

Saturday morning Evel suddenly had a seizure of about two minutes, shaking uncontrollably followed by panting and a lolling tongue. We took him back to the vet, who hydrated and observed him until early afternoon and noted nothing unusual. The vet said the seizure might be because the sedative was toxic and needed to be flushed, to give him saline drips daily until Tuesday, then come in and talk about the possibility of putting Evel on anti-seizure meds.

Today, Sunday, morning at 6am, Evel had a shorter seizure, maybe 30 seconds, in which his back legs shook and he peed on the bed. When it ended, the fur on his tail about an inch from his butt was puffed out, and he couldn't stand up on his hind legs right away.

He was fine until 5pm, when he was lying down, moving his paws as if in a dream, when he suddenly stood up, moved confusedly in circles, laid down and peed on the bed. After about five seconds of confusion, he got up.

Then around 6:15pm he was in the hall when he fell over unable to stand on his hind legs, howled, drooled thick clear fluid, shook for about 20 seconds, paused, then twisted his head and neck to the left and moved in a circle twitching. He then laid down with his head up, front paws splayed and slowly sliding on the wood floor, still drooling. After this, he could walk but seemed exhausted. We gave him 100cc of saline and now he's alert but resting.

None of these incidents seems to have caused him any pain, but he's definitely confused and worn out by them. And I'm concerned that the last two came so close together.

The plan is to take him to office hours tomorrow morning at the miracle worker vet in Hollywood, who saved Evel's life several years ago when he had a bad virus and wouldn't eat. Hopefully he'll have some insight into what's happening and how we can help him get through this. Before we see him, we'll call the local vet and find out exactly what the sedative he was given on Friday was. Till then, we'll just keep an eye on him and hope there are no more incidents today.

If any of these symptoms ring a bell, I'd be grateful for suggestions and advice. This little cat is a great soul, and I'd like to see him get to the other side of this crisis very soon.
posted by Scram to Pets & Animals (12 answers total)
I have 2 cats (brother and sister), and there is very little information on seizure activity in cats. I do not use anti-seizure medication, because Phenobarbitol is not a nice drug, and I really prefer to not have pet carrots. One thing that I did pick up from a holistic vet was to provide them with a bowl of milk. His idea was that the seizures were caused by a calcium deficiency. (this idea, for reasons I won't go into, is flawed) But the milk did decrease the fequency of the seizures. And I keep valium on hand if they have a very long one or cluster seizures. They only happen once every couple of months now.

In my opinion, it seems possible that this is something entirely separate from the sedation. You didn't mention what drugs were used, but the common drugs don't generally have that effect. The fact that it appeared after sedation could be coincedental. The fact that his leg was splayed out may actually be a clue. It would be easy to dismiss as arthritis, but subtle neurological signs could be creeping in. If it was just arthritis, I would think it would be mildly painful.

Here's an example of why: my pug started dragging her right hind foot, just slightly, and her tail was a little droopy. Took her to her then-regular vet, who dismissed it as arthritis. I took her to another vet and got a referral to the veterinary teaching hospital (I go to Purdue). MRI showed a herniated disk, but when the surgeon actually opened her up, she had shoulder capsule tissue pressing on her spinal cord. $5000 later, she is doing very well.

Neurology is tricky. Best to get a second opinion.
posted by bolognius maximus at 7:40 PM on July 11, 2010

My cat had seizures for a couple of days after being spayed. The vet said that it was probably due to the anesthesia, and that it would go away in a day or two. It did, but it was scary until then.
posted by spikeleemajortomdickandharryconnickjrmints at 7:48 PM on July 11, 2010

My old cat Mandy has arthritis and the back leg splaying out when she walks is her classic symptom, that's how we know she's having a bad day. It doesn't usually hurt when I touch her legs either, although it does when the vet pinches in just the right place, even though she's clearly stiff and in pain at times (it is treated, but she has liver issues complicating things so not always as well as we'd like). For a cat as old as Evel arthritis is expected rather than unusual because cats jump and stretch and work their joints so much through their life, so the splaying could be a different neurological problem or it could be the arthritis.

Mandy's brother Wolfy had seizures just like you're describing. In his case it was because of advanced liver damage which meant he didn't detoxify his food properly and ammonia built up causing his brain to swell (hepatic encephalopathy). He did have other symptoms develop but the seizure was first, which I don't actually think is standard. I think the symptoms were the same as what you're describing simply because it was a seizure though, not because the cause is necessarily the same.

Did Evel's blood panel include liver function etc? Something metabolic but bad enough to cause seizures should show up but the tests have to be done correctly (we had issues with delayed diagnosis because of this). It seems like going to a good vet is the right next stage, and you should definitely ask about what blood tests were done and what can still be done. Rule out a metabolic cause and investigate that kidney issue as well as look at the neurological side. Ask them about treatments for the arthritis too if you haven't already, I've been very impressed at how much Mandy's quality of life is improved.
posted by shelleycat at 8:03 PM on July 11, 2010

IANAV. This is a 19 year old cat with reduced kidney function. He has had multiple seizures in a 24 hour period, and the time between seizures is decreasing. Chances are that even if this is sedative-related, the situation as a whole is not good.

I would probably have taken him to emergency after the 6:15 seizure, if not the 5PM one. The only hesitation I'd have about rushing him in right now rather than waiting until the morning is that he's not currently seizing, so given his age, and that seizures in and of themselves are not painful events, and...I would not be looking at this with the idea of a perfect outcome, I don't know what emergency would do except admit, draw blood for endocrine/liver/everything else* panels that they may or may not be able to run tonight, put him on fluids, and observe until morning. I'm not even sure if they'd administer any diazepam unless they observed a seizure.

Of course, I have numerous people who I would be on the phone with who'd school my ass immediately if this were a bad plan. I have been known to come up with dumb plans. That's my safety net--having friends generous enough to share their hard-earned skills/knowledge off-the-record in a scary situation, when they really are under no obligation to do so.

If he seizes again, I strongly recommend taking him in immediately.

Please don't take our words for any of this, though. Here's why: I have epilepsy myself, and neurology/seizure disorders in domestic animals is a particular interest of mine. So I can tell you that the information about phenobarb in domestic critters above is not quite accurate. Phenobarbital can dull human intelligence noticeably, especially when given for long periods of time, because the human cerebral cortex is exquisitely developed and also exquisitely sensitive to disruption. Domestic animals do have plenty of cerebral cortex of their own...but many of the functions we regard as 'conscious' because the behaviors are conscious--or at least controlled by the cerebrum--for us, are brainstem or basal ganglia-governed behaviors in other species. It's not a lesser way to run the ship, nor does it mean that they lack sentience--it's just a different way to do things. In their favor it means that things that wreak havoc on our fragile minds have less effect on theirs. They just make do much better than we can. Critters are amazing--they really are.

So here you have two non-veterinarians disagreeing about the appropriate use of phenobarb in cats and dogs. This is why veterinarians--and specialties like veterinary neurology--exist. I'm very glad you're taking him in to see someone tomorrow AM at the latest.
posted by Uniformitarianism Now! at 8:45 PM on July 11, 2010

I missed the part where he's had three in one day. I have to agree that if it happens again before tomorrow morning you should at least ring the emergency vet. They'll know if it's still likely to be due to the sedative and how worried you should be.
posted by shelleycat at 8:54 PM on July 11, 2010

Thanks, everyone. I appreciate the insights and suggestions.

Evel's been fine since the last incident three hours ago, alert and mobile. If nothing else happens, we're just going to keep an eye on him until morning, get the blood panel and sedation details from the local vet, and get in to see the Hollywood vet during his early office hours tomorrow. I hope that's the right decision. Will revisit it if anything changes.
posted by Scram at 9:24 PM on July 11, 2010

I may be coming in here a bit late, but we had cats with bad seizures under very different conditions about ten years ago. We cannot be completely certain, but the only remotely plausible cause was food poisoning. (No products in the house would fit the bill, no houseplants, etc., but they all ate from the same can, all had seizures around the same time.) In our case, they went temporarily blind and were partially paralyzed for some time. Eventually, they regained some motion and would walk in circles. There were some steroids at the time, and the toxicity seemed to clear their systems. They have looked normal over the ten years since.

None of that is likely to be helpful in finding a cause for the seizures Evel is having. But I can say that as a short-term solution, phenobarbital was good for our three. It seemed to stop the seizures once they could take it, and they did not have to stay on it for long. While it made them dopey and wobbly, that was a pretty small price to pay after the agony of violent seizures. I would think twice if the vet said your cat had to be on high doses of phenobarbital for the rest of its life, but it helped ours through a particularly rough period.
posted by el_lupino at 8:41 PM on July 12, 2010

Update: Evel actually seized up on the vet's table, so at least the doctor could see what we've been dealing with. The doctor gave him an injection of Valium and sent us home with needles and more Valium to keep him calm until the liquid (oral) phenobarbital he also gave us builds up in Evel's system. The plan is that we'll try the phenobarbital for 4-6 weeks, then if there are no more seizures, see if we can safely reduce the dosage without them coming back. Evel's sleeping soundly now, and before I got to bed I'll put him in our big cat carrier with lots of towels, so he won't hurt himself if he seizes overnight. (Gonna miss cuddling with him, though!)

el_lupino, do you recall, how long were your cats on the phenobarbital before you took them off, and how long the weaning off process lasted?
posted by Scram at 9:06 PM on July 12, 2010

Scram, I went down and dug up the vet records in our basement, which do confirm that they used it at the clinic, but we don't have records of the prescriptions they gave us afterward. I know we were giving them pills for at least 3 or 4 weeks after they came home*, but I can't say with certainty whether phenobarbital was still in the mix. I want to say that it wasn't - that they gave them a couple of shots while at the clinic and none thereafter. They were really messed up and off-kilter when they got back, and normalized considerably after a few days. But I don't think we were giving them pills at all within a month, so certainly no further out than that.

*-Yep. Three cats, multiple pills per day for weeks. It's good training, though. I can probably take the tonsils out of an ocelot now.
posted by el_lupino at 11:21 PM on July 12, 2010

I'm el_lupino's wife. I am quite sure our three were not on phenobarbital after they left the veterinary neurologist's clinic. They were there for about a week, and when we got them home, the pills he's remembering were the steroids they had started them on there that we were tapering down. Hope Evel is feeling better soon.
posted by jocelmeow at 7:59 AM on July 13, 2010

Thanks for digging into the archives and memory banks, el_lupino and jocelmeow.

For anyone else dealing with feline seizures, I found a blog discussion thread that seems to have become the go-to place for people seeking support and feedback. It's encouraging to read about people whose cats have seizures but otherwise are healthy and happy.

Evel's had several seizing incidents of varying severity since coming home from the vet, but the Valium shot immediately ends the attack. When we brought him home he was completely stoned and could barely walk, but was ravenous, so he lay on his side and ate everything on his plate. This morning he was walking fine and is alert, except after these incidents, when he's spacy and tired.

We're checking with the vet to find out how often is too often for Valium shots, since he had a small incident less than two hours after his last shot. So the upshot is he's still seizing, but they seem to be lessening in severity, and the Valium is working to end the attacks. It should take some time for the phenobarbital to start working, and we hope that will be a working solution. Glad we have the phenobarbital in oral solution, as it is very easy to dose him with a needle-less syringe.
posted by Scram at 1:51 PM on July 13, 2010

Well, the marvelous old kitty didn't make it through this crisis. While his seizures did stop with the phenobarbital twice a day, during that time he lost his ability without being supported. We kept in constant contact with the vet and cared for him at home until early August, when he seemed to be growing weaker, could no longer walk when supported and didn't want to eat anymore. Based on the way his front paws had started crossing when he tried to walk, the vet believed he had a brain tumor, which combined with his already low kidney function (further impeded by the drugs) and an abscessed tooth, had him in a bad way. We made the decision to euthanize him to spare any further suffering, and he passed peacefully in seconds.

A warning to anyone with a seizing cat: despite the urge to comfort your animal, stay well clear of them during the spasms. Evel bit me during one, resulting in a trip to the emergency room and a heck of a scar to remember him by. As if I could ever forget The King of the Cats.
posted by Scram at 2:17 PM on August 11, 2010

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