Cat occasionally stumbling

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mr_frisky
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Re: Cat occasionally stumbling

Post by mr_frisky »

Thanks for the link. I've read other articles but not that one.

Her potassium is 2.9 (was 3 three months ago), blood pressure is normal and sodium is a bit high.

The email on friday was as so:

"As you know the toxoplasma and coronavirus testing have returned as unremarkable. As such the spinal cord condition is most likely to be a meningomyelitis of unknown origin but lymphoma or other metastases are still possible. We have increased prednisolone dosages and Mr_frisky feels there may be some improvement in ataxia but we will catch up about this in around 2 weeks’ time to organise a recheck.

The aldosterone level has returned as high at 394 pmol/l (RI 87 - 224) but the renin is normal 1.37 ng/mL/hr (RI 0.14 - 3.85). This sample was taken after 12h of potassium supplemented fluids. Given this result and the in house potassium of 2.9mmol/L (on Kamiknox therapy) alongside the nodule seen on ultrasound I think a primary hyperaldosteronism secondary to an adrenal tumour is a likely diagnosis.

Given that Cocos prognosis with the spinal condition is variable we have elected to manage the suspected adrenal tumour/hyperaldosteronism conservatively at this time. This is also in part due to high dose corticosteroids increasing the risk with any abdominal surgery at this time. If Coco is doing well with her spinal cord condition we can consider surgery at a later date. At this stage I would suggest we recheck potassium levels and blood pressures at our recheck and consider reviewing these every month at your vets before considering repeat ultrasound of the adrenal mass in 3-6 months. We have discussed there is a small risk with this plan that a tumour could spread in the meantime."
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Re: Cat occasionally stumbling

Post by mr_frisky »

She has finished her first dose of prednisolone at high doses, and the neurologist is reasonably happy with her progress (I showed him the 3 videos starting with 'LATEST' on https://www.youtube.com/channel/UCYCFcT ... QCUWOxXGhQ), which were taken last saturday.

I have noticed she's been scooting a bit in the last 3 weeks, and defecating outside her box on occasions. The neurologist doesn't think this is relevant (ie I feared that it is caused by a progression). Colitis can be one side effect of the medication, so I don't know if this is relevant.

She climbed up the fence along the tree branch and back down later (not observed by me, but must have got onto the roof and down again somehow).

I took her to the local vets to check for anal glands yesterday, but they were fine. Have just given her wormer (haven't done that for months).

The neurologist wants to check her again next week and give at least one administration of intravenous cytarabin to see if it helps.

Interestingly, a swaying rear end can be a sign of arthritis (which she also has) in 1:43 on https://www.youtube.com/watch?v=YzfvGE4 ... ehringerUK
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Re: Cat occasionally stumbling

Post by Mollycat »

A little cautious optimism it seems. Thanks for the updates, it's good to hear of progress especially with something so unclear as Coco's symptoms.
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Re: Cat occasionally stumbling

Post by mr_frisky »

How is Molly doing?
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Re: Cat occasionally stumbling

Post by Mollycat »

Different issues altogether, it seems. She isn't limping so I think in her case maybe it was either potassium or early arthritic changes, I have her on the +mobility Hills dry and various renal pouches plus Devils Claw, and she is fat, confident, affectionate and sleepy, almost like a normal cat!
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Re: Cat occasionally stumbling

Post by mr_frisky »

That's good she's doing well.

I've just replaced one of their trays with a grow bag tray (low sided and large). Let's see if they prefer it.
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Re: Cat occasionally stumbling

Post by Mollycat »

I don't know about doing well, you never know what's happening on the inside when the outside looks passable. It's so hard, isn't it, as they get older, to know what's normal and when to worry.

Would pond lining material be thick enough to stay waterproof? I wonder if a home made wooden crate lined with thick rubber matting would give the potential for exactly the shape, dimensions and size needed.
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Re: Cat occasionally stumbling

Post by mr_frisky »

Maybe, never though about pond liner.

Could you also try a grow bag tray? I know they are large, but are shallow and plastic.
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Re: Cat occasionally stumbling

Post by Mollycat »

I see you've had success with that, we are nowhere near that here, she is still jumping 3ft with no problem but just beginning to prefer an easier route down but the trays present to problem at all.

The Pets at Home ones with detachable rim is what we have. For a while we had something different for Bobby because of he charming way of emptying half the tray all over the floor, so high sides were needed. I hoped when the original trays were restored that Madam would go back to her very funny habit of perching on the rim to do her business, but she has not.

I see stainless steel trays are a thing now, much more hygienic as every deep scratcher of plastic trays owner knows!
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Re: Cat occasionally stumbling

Post by mr_frisky »

Coco is also jumping up and down three feet, but seems to struggle over uneven ground and obstacles, so I thought I'd try it.
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Re: Cat occasionally stumbling

Post by Mollycat »

Probably a silly question but is her eyesight ok?
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Re: Cat occasionally stumbling

Post by mr_frisky »

Yes, seems fine as far as I can tell.

Hyperaldosteronism can also add to an ataxic gait.

She has to go to the specialists again tomorrow for another neuro check up, another blood test and probably intravenous cytabarin.
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Re: Cat occasionally stumbling

Post by Mollycat »

Hyperaldosteronism fits with the potassium deficiency anyway.
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Re: Cat occasionally stumbling

Post by mr_frisky »

True. She's at the veterinary hospital now having low level intravenous cytarabine administered over 7 hours.

The follow up neuro exam went well, but he wanted to step up treatment despite relatively positive results on prednisolone.

He also mentioned that the possible adrenal gland tumour is tiny at this stage (which would be causing the hyperaldosteronism) . He's also redoing the electrolyte blood tests to check potassium levels.

He said that potassium supplements do make a difference (ie Kaminox) and can be administered at very high levels, just that they'd remove any excess in their urine.
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Re: Cat occasionally stumbling

Post by mr_frisky »

Got her back home today and she's responded fine to the treatment. Now we have to see if it has any effect on her gait.

The diagnosis latest sheet doesn't even mention spinal lymphoma, just MUA, which is good I suppose.

After giving her a wormer a few days ago I haven't noticed any further scooting whilst defecating so far.

She was distressed coming back in the car (25 mile journey) and was panting through her mouth at one point.
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Re: Cat occasionally stumbling

Post by Mollycat »

Poor love she has been through an awful lot of tests, handling, journeys ... hopefully she can have a break from it all now. Fingers crossed for the treatment, please keep on keeping us updated.
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Re: Cat occasionally stumbling

Post by mr_frisky »

She scooted again on sunday when eliminating, caught it on video, but the neurologist (a different one this time as the other one is away) reiterated that she doesn't think it is related. Latest videos are on the Youtube channel on page 1 under 'NEW' if anyone's interested.

She started on gabapentin yesterday as well as prednisolone. I'm not sure what sort of improvements to expect.

She slipped when walking tonight, the first time I'd noticed that for a couple of months. Not sure if significant. Apparently, paradoxically, gabapentin can have a side effect of ataxia (when that's what it's been prescribed to eliminate).

Everything else normal so far otherwise. Still eating for her country.
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Re: Cat occasionally stumbling

Post by Mollycat »

I'm sorry Mr Frisky would you mind giving us the link to your You-tube again please? I had a quick look but can't find it again at the moment.
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Re: Cat occasionally stumbling

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Re: Cat occasionally stumbling

Post by Mollycat »

Thank you.

That very latest one looks nothing like arthritis and you can see sometimes she is walking slightly crabbing to one side or with back legs together for stability. It's nothing like Molly's awkwardness anyway, though it looked similar in earlier videos. Coco's right rear seems not to be really fully under her control and her gait peculiar doesn't it, as though she is already compensating for a loss of control or function.
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Re: Cat occasionally stumbling

Post by mr_frisky »

We know she has neurological issues. Doesn't seem to be any worse (touch wood).
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Re: Cat occasionally stumbling

Post by mr_frisky »

The neurologist phoned me up before Christmas saying he's happy with her progress so far (after seeing the videos preceeded by '20211223' on the Youtube site), and doesn't want to see her again until April, unless there is a relapse.

Cutting down on steroids currently and still taking gabapentin (which he says can cause ataxia for a few days, and can take a couple of weeks to kick in fully).
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Re: Cat occasionally stumbling

Post by Mollycat »

Sounds positive
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Re: Cat occasionally stumbling

Post by mr_frisky »

No change at the moment, still about the same as she has been.

Steroids down to half a day now.
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Re: Cat occasionally stumbling

Post by Mollycat »

No worsening is positive, so compared to how she was when you first noticed there was something not right is she the same as then, or did she get a little worse than that and now about the same as that?
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Re: Cat occasionally stumbling

Post by mr_frisky »

She hasn't stumbled since she started on the steroids. I'd say she is better than when first started in that respect, but she still is stiff and has a wobble when walking.

How is yours?
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Re: Cat occasionally stumbling

Post by Mollycat »

Sounds good Coco, could stiffness be arthritic rather than part of the neurological issue?

Molly had a full check with the only vet I trust for her, her kidneys are doing very well and despite the loose flat-footed front feet vet didn't think there was much pain there, but she did find a very tender area between hip joints and tail. She has some fur matting there which I am doing my best to work on, they could be pulling as well. Plus if her back has a problem in the same place as mine it will affect her ability to eliminate normally, and as she occasionally strains to produce a drop of mucus with a tiny bit of poop and/or blood, a lower back minor issue does make sense. Anti inflammatory pain killer and steps to her favourite places, that also helps me to evaluate how much pain she has. Jumping across is fine, up and down are a bit more challenging.
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Re: Cat occasionally stumbling

Post by mr_frisky »

She definitely has some arthritic issues, is a bit slow climbing the stairs but very fast going down them. She climbed the fence yesterday and jumped onto the flat roof extension, so not too bad. She will be evaluated again in a month or so, so we'll see what the neuorologist says.

She hasn't been scooting lately when defecating, which was a concern for a while.

I often wonder how much cats slow down due to age, rather than a specific condition. I'm certainly stiffer and slower than I used to be.

Glad Molly is doing well.
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Re: Cat occasionally stumbling

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My mother says the ground gets lower as we get older. I accidentally threw the dog's toy over a fence yesterday, if I'd been 20 years younger I might have considered scrambling over but these days it's worth a search for the school caretaker and walk all the way across the field and back.

Nature is exactly the same musings that occupy me a great deal, especially when organising steps to make her life a little easier and potions to make it more comfortable. I'm sure they do as much as we do, if we let them, but especially with the rise of insurance now I fear we (collectively) maybe have a harder time accepting general wear and tear as normal, and too many feel entitled to years of youth that an unhealthy lifestyle simply cannot deliver. The difference between us and cats is that in their natural state and until the last 100 years or so, a slow creeping managed long drawn out old age simply didn't happen, and a natural life expectancy might be about 12, and once hunting became difficult decline would be fairly rapid. With food on a plate and vets with technology, all kinds of aches pains and conditions can emerge. Then, the mantra of "preserve life" becomes a little more complicated when we have to adapt to "preserve quality of life" and that's when the debate begins.
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Re: Cat occasionally stumbling

Post by mr_frisky »

No particular change recently. She's down to 0.5 prednisolone every two days, and is still climbing fences and going for walks.

She may not be as mobile in jumping as a year ago, but isn't currently stumbling.
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