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Bengal leg weakness.

Species: Cat
Breed: Bengal
Age: 8-11 years
Rebel has had some undiagnosed rear end lameness and weakness intermitantly since quite young. Symptoms were a strange flexion to his gait when walking which didnt seem to bother him and didnt happen often. Recently that changed the lameness appeared and didnt resolve and he began shivering and twitching (while awake). Metacam and temgesic were given initially whcih kept him quiet but not his happy self. Xrays yesterday showed no bony changes or arthritis and the diagnosis was muscle and or nerve damage. Blood panel also suggested muscle damage, CK and ALT were elevated but all other results fine. He has also had three bouts of idiopathic cystitis. The vet prescribed ongoing metacam (for cats) and cartrophen. I am concerned as I have read these two drugs should not be used together and i still have no real idea what the problem is and what to expect in the future. The trembling is intermitant but the twitching is constant, not so much all the time, but regular. He is also constipated

Online vet, Dr. Marie

Dr. Marie replied:

Poor Rebel,

This sounds like a very difficult case.

It does sound like your vet has been very thorough. I have had cases like this where I can't figure out what is happening. Unfortunately I do find that Bengal cats are often my patient when this happens.

First, I'll address the Metacam and Cartrophen. These are very safe and there is no problem with using them together. Where the confusion may lie is in the fact that there is another drug called Carprofen (Rimadyl) which you definitely wouldn't want to use with Metacam, but this is a totally different drug than cartrophen.

You may want to ask your vet about the possibility that Rebel has something called lumbosacral syndrome. While some cats with this have changes you can see on xrays, not all do. An odd gait, trembling and constipation could all go along with this. Sometimes, sending the xrays to a radiologist can help us get a proper diagnosis for this condition.

When I hear of hind leg problems and an elevated CK I wonder a little bit about the possibility of a heart problem. Now, the CK has to be very elevated for me to get worried about it. Sometimes just the stress of struggling to get to the vet clinic can be enough to cause elevations in CK and I don't worry about small elevations. A heart problem such as hypertrophic cardiomyopathy (HCM) can cause small clots to form that can interfere with the blood flow to the hind legs and cause pain. Usually the symptoms are obvious and dramatic, but I have had some cases where it wasn't so obvious. The problem is that getting a diagnosis can be tricky. A heart ultrasound could be in order but that is not cheap. It's worth asking your vet if this is even a possibility though. There may be some other clues they can look at such as measuring the blood pressure in each of the limbs to see if there is reduced pressure in one hind leg indicating the possibility of a partial clot.

There are other more rare possibilities such as a muscle parasite like toxoplasmosis or neospora. These are really not common but again, it's worth asking your vet about these.

Where to go from here though is a tough call. If Rebel is insured or if finances are not a concern then there are a good number of additional tests that can be done to help get a diagnosis including heart ultrasound, toxoplasmosis and neospora titres and possibly even an MRI.

But if those are not in the budget then what we would generally do is do our best to treat the symptoms and see how things go. I know that it is frustrating to not know how to help.

Please let me know if you have more questions.

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:

Hi Dr. Marie,

In cases of the mystery illness Bengal are disease symptoms and progression similar? Is the lumbosacral syndrome common in Bengals? His vet has 'interests' in orthopedics so I would like to think he would have considered that but I will mention it when I take him back in a week.

The twitching Rebel has I saw around 2 or 3, but it was in his head. Currently its his front limbs that twitch when stationary not the rear and that has settled some. However when I put my hands in his groin while he is standing I can often feel those muscles twitching quite fast. He always looked to me as if he had weakness in his rear end though since a kitten.

His CK was 385 U/L and ALT 197 U/L, also slightly raised potassium 5.2 mmol/L and Hct 0.46 L/L.

The other thing I have noticed is frequent lip licking and swallowing. I have tried to google whats normal but couldnt find anything.

No insurance, and finances are a consideration given the recent 2k spend without real results.

My main concern is keeping him comfortable. If it is lumbosacral syndrome what are the drug options that may help? Should he rest or exercise more?

The constipation has resolved for now and he seems more comfortable, not trembling all over but still not my happy boy.

Thank you for you time, I really just want to make sure we are looking in the right places and the treatment is appropriate.

Customer reply:

An additional note to the above; There was a period many years ago when he went to sit down that there didnt appear to be any muscle resistance, he would start to sit and then just plop down. He also has muscle wastage in his rear end and about 3-4 weeks ago I stepped on him during playtime. I couldnt see very well but I suspect it was near his back end belly region. He initially didnt show any signs of injury but is it possible I have aggravated an exisiting nerve compression? He does seem a little improved, his fore legs have stopped twitching but still not his usual self. From what you have said my instinct suggests some degree of lumbosacral disorder though he doesnt have all the symptoms. Lastly, can you recommend how I address constipation as I suspect with ongoing pain this will continue to present.

Online vet, Dr. Marie

Dr. Marie replied:

I don't really know if LS syndrome is more common in Bengals. However, LS syndrome shouldn't cause his head to twitch. That almost sounds like a neurological problem.

The blood elevations you mentioned are really not anything I would call terribly significant.

I'm afraid I can't add too much here. This is a tough case and unfortunately even with expensive tests you may not get an answer. There really is no common illness that I can think of that would be causing these symptoms.

It's still worthwhile to ask about lumbosacral syndrome and neospora or toxoplasmosis although these may be a bit of a long shot.

Dr. Marie.

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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.