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Possible seizures?

Species: Cat
Breed: DSH
Age: 11-15 years
Our cat, Teddy, started having episodes of rigid front legs, swaying, and staggering on Friday night. He would cry out once and seem disoriented and sway around like his back legs were like jelly. He would circle too. He then ran to the litter box and had small liquid stools after the 1st 2 episodes. These episodes lasted anywhere from 30 seconds to maybe up to 2 minutes. 3 episodes occurred within roughly 2.5 hours. After he had the second episode, we took him to an emergency vet. All of his blood work was fine, his liver enzymes were slightly elevated, but nothing concerning per the vet. B/P was 150's. He had the third episode there in the office. The vet said it was a neurological event but not a seizure. The possibility of a brain tumor was brought up. I realize we can have an MRI but Teddy is 15 years old and I do not want him going through a spinal tap/biopsy/surgery when it won't necessarily improve his life. His chest x-ray was clear except for a very small white spot in the lung lining/abd area that the vet said he'd expect to see more white spots if this was cancer. Could this have been a stroke/tia? He is hyperthyroid and has been treated for roughly 5 years for that. His last check up was last month and his thyroid level was normal. He takes methimazole 10mg twice daily currently. He has been completely normal since the events Friday. I know there is no way to tell without definite MRI but does this seem more like a tumor or a stroke or are there other possibilities? Would a stroke present in 3 episodes as such with him returning to normal in between? Or is this more likely a tumor? He has never had any other neuro symptoms before Fri. night, not even slight things. We called our personal vet Saturday and he was started on prednisolone 2.5 mg twice daily but we are unable to get an appointment until late this week. With no MRI, what is the outlook for something like this? Is it possible he could still be fine? Thanks for your time.

Online vet, Dr. Marie

Dr. Marie replied:

Oh dear...I don't like the symptoms that you are describing with Teddy.

If your vet feels that these episodes are neurological then unfortunately, with Teddy's age, a brain tumor is the most likely explanation. It is often very hard to know though as we can't officially diagnose a brain tumor without an MRI or CT scan. If this is a tumor then there is likely little that can be done. Sometimes anti seizure medicines such as phenobarbital will help for a while, but not always. Sometimes steroids such as prednisone or prednisolone can help temporarily as well.

The other possibility that I can think of is something called a partial saddle thrombus, or (aortoiliac thrombosis). This is something like a stroke, but instead of affecting the brain it affects other blood vessels. A saddle thrombus happens when a blood clot forms in the large vessel that supplies blood to the back legs. Cats end up having trouble moving their back legs and it is quite painful. Sometimes if the clot is just a partial one the symptoms can come and go like this.

A saddle thrombus only happens in cats with a heart problem. Heart problems are common in cats with hyperthyroidism. Sometimes the heart problem can be hard to diagnose without expensive tests.

If this is a saddle thrombus then you will probably find that there are more episodes like this and eventually he may lose use of his back legs. There is no treatment that reliably treats this condition.

One other possibility is something called vestibular syndrome. This is much more common in dogs than in cats. It is an episode that is like a stroke but not exactly. Animals can make a full recovery if this is what it is.

I wish I had a more clear answer for you. At this point, I think all you can do is try the medicine that your vet has prescribed and see how things go. Looking at things logically (which is hard to do when dealing with a cherished pet), this is likely something that is either going to get completely better or get drastically worse. If this is a tumor or a saddle thrombus then there is not much that can be done and the symptoms will increase. If this is happening then it is a good idea to have the family discuss euthanasia.

Please let me know if you have questions. I really do hope things improve.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Dr. Marie-
I appreciate your insight. Is there a possibility that this could have been a stroke or tia at all with three episodes appearing within 2.5 hours with complete recovery in between?
The vet at the emergency clinic didn't feel it was heart-related as his heart sounded ok and b/p was good. He did have some difficulty hearing with the purring though. He offered to do an echo but said it wasn't his first thought.
It has been 5 days and Teddy has seemed totally normal since the night the symptoms appeared.

Thank you so much

Online vet, Dr. Marie

Dr. Marie replied:

We really don't see many strokes in cats. And a stroke is usually a one time thing, not multiple episodes like this. It does sound like these are some kind of seizure activity.

While a tumor is the most common reason for seizures in an older cat I have seen some animals that have episodes like this that scare everyone and then they are perfectly fine afterwards and we never figure out what the problem was. Hopefully that's the case for Teddy!

Customer reply:

I certainly hope this is the case. Thanks so much for your time and knowledge. It is so appreciated!

Angie (and Teddy)

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.