Cat occasionally stumbling

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mr_frisky
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Cat occasionally stumbling

Post by mr_frisky »

Hi

One of my cats (around 13 y.o.) ocassionally stumbles (ever so slightly) when walking, particularly around obstacles (such as the keyboards and mice on my desk). Today she went for her walk and I'm not convinced her back legs are working as well as her front ones. I first noticed this a few weeks ago.

About two years ago she developed a reluctance to jump down the 7 foot fence at the side of the house (onto a concrete floor), not surprisingly. She still does it sometimes, though), even though I have given her something to jump onto half at the side of the fence (about three feet down, which she and others sometimes use).

She is still able to climb trees and fences, but I was concerned this might be something serious.

She is not dragging her legs (not has she ever), and this has come on over time. She is completely normal otherwise (eating for her country and playing with her daughters).

Is it possible this is arthritis, or could it be something more serious? I once had a dog, who at age 16, had a blood clot in his leg and couldn't move it. This seems different, as that came on suddenly, and his legs could give way completely for a while.
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Re: Cat occasionally stumbling

Post by fjm »

I would book a vet appointment. If it is arthritis which sounds very probable) then pain relief and some replanning with ramps etc will help enormously; if it is something more sinister then the sooner it is addressed the better the outcome is likely to be.
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Re: Cat occasionally stumbling

Post by mr_frisky »

She went to the vets today, and the vet was surprisingly quite thorough (finally allowed to get inside the examination room with the cats, had to wait outside in the car park for the last year due to covid concerns).

He examined her for ages and could see no signs of clots, neurological issues or injury and her heart is normal. I showed him videos of her walking and gave him a fact sheet of observations. He believes it is, indeed, arthritis. She certainly wasn't passive when I put her in the carrier.

He also took a blood test to rule out anything else (results coming later today) and gave some pills (not metacam due to her history of pancreatitis).

Will update later.
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Re: Cat occasionally stumbling

Post by fjm »

Good that you have a diagnosis, and have ruled out more dangerous possibilities. I hope the medication soon has her more comfortable.
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Re: Cat occasionally stumbling

Post by Mollycat »

Oh gosh. Good to have something concrete to go on and know what you're dealing with.
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Re: Cat occasionally stumbling

Post by mr_frisky »

She's on Gabapentin for the next 2 weeks.

Blood test came through all clear, and she went for her walk up the road with a normal gait this evening.

Probably just age catching up with her.
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Re: Cat occasionally stumbling

Post by mr_frisky »

Waiting for their dinner on the roof:
dinner.jpg
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Re: Cat occasionally stumbling

Post by mr_frisky »

I took her to the vet for a follow up today, and the (different vet) says that arthritis is very uncommon in cats (although the internet says different) and it may be neurological.

Since we got back from the vets today she's been stumbling more, although I hadn't noticed anything in 2 weeks previously. She even jumped down a 7 foot high fence onto concrete ground a week and a half ago.

Bloods were fine 2 weeks ago, and everything else is normal, such as appetite and activity. No head twitching or anything.

Anyway, she has an X ray booked on friday.

Anyone have any similar symptoms (back leg a bit stiff causing stumbling)? I'm worried sick.
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Re: Cat occasionally stumbling

Post by fjm »

Don’t panic. If she was significantly better while on pain killers that would usually be taken to indicate a problem with pain, either arthritis or a pinched nerve or something like that. Neurological doesn’t necessarily mean paralysis is just around the corner, any more than arthritis means never jumping again. Although I am surprised at a vet saying arthritis is uncommon in cats, as the evidence seems to indicate that it is very common in older cats, just under diagnosed.

One of my dogs had a trapped nerve in her lower spine (slipped disc) and had similar symptoms, weaving her hind legs slightly. She was on pain relief and strict rest for three weeks, and made a full recovery. Occasionally if she jumps awkwardly the nerve will again get pinched, and she gets sciatica-like symptoms, which I now know to treat with rest, pain relief and a trip to the osteopath. She has had maybe four short episodes in six or seven years, but is fit and healthy at over 12 years old, and still runs zoomies when the mood takes her.

I would play safe and try and arrange step ups and ramps so that your cat is avoiding stressing whatever the problem proves to be. Rest and low stress, gentle exercise will help almost all joint problems, I have found.
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Re: Cat occasionally stumbling

Post by Mollycat »

To be honest there are so many possibilities, and we tend to be most awake to the ones we've experienced. Just as fjm's dog had a slipped disc, someone else's cat had this and another had that, mine has an occasional twitch that is nothing at all but as she was low on potassium she has been on a supplement for 2 years. I'm forever worrying that it's too little or too much, now that I've reduced the dose because of a long drawn out series of logical steps ending up with her not needing it any more, or maybe just less of it. Too much or too little of that affects the nerves and muscles.
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Re: Cat occasionally stumbling

Post by mr_frisky »

Thanks, both. The vet was palpating her legs a lot this morning, maybe he hurt her, I don't know.

She climbed up the fence onto the flat roof and back down again today.

Will observe her and film her walk, as the phone video where she stumbled once was what the vet based his idea on.
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Re: Cat occasionally stumbling

Post by booktigger »

Fingers crossed for the x-ray. I've never heard a vet say that arthritis is uncommon in cats, even the Pets at Home articles say it's common!
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Re: Cat occasionally stumbling

Post by mr_frisky »

booktigger wrote: Tue Aug 03, 2021 6:18 pm Fingers crossed for the x-ray. I've never heard a vet say that arthritis is uncommon in cats, even the Pets at Home articles say it's common!
I know, it says it's common everywhere. The vet just freaked me out.

Two of them went for a half hour wander this evening with me. Her back left leg looked very stiff but she was still doing her normal stuff.
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Re: Cat occasionally stumbling

Post by mr_frisky »

She went back in yesterday for her X ray, but the vets did blood electrolyte tests first, as the had a main blood test 2 weeks ago.

He phoned me up at 12ish and says she has very low potassium (2.9 mmol/l when normal range is 3.4-5.6). I asked if I could have a copy of the blood test. The sodium to potassium ratio is 52, whereas a normal range is 26-40 (not sure of the significance of this).

He seemed to think it was worth trying a potassium substitute for 2 weeks before having an x ray (which was to check her spine and legs), as he'd seen cats with similar symptoms before.

When I arrived the nurse asked me if I wanted another vet (the third) to examine her first, which she did. She ruled out thrombotic issues, as the muscle mass is strong in her legs, meaning the blood supply must be (like runners' and body builders' big veins, I suppose).

The potassium supplement is liquid, and suprisingly, she drank it all when on her dinner (plate was licked clean, and she was away from other cats).

As her kidneys and heart are fine (the most common cause of low potassium), he considered it idiopathic hypokalaemia. He checked for thyroid problems and that was fine.

In the evening she seemed to be stumbling when climbing across furniture. Later she went out for her walk and no stumbling at all. She is still eating normally and is showing no signs of distress.

Most perplexing. Has been going on for about 6 weeks since I first noticed it, although she has been reluctant to jump down from high places for two or three years (she is around 13), although still does jump down from lower heights (about 3 feet) and climbs up fences and jumps onto the roof every day.

Anyone else with experience of low potassium in cats?
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Re: Cat occasionally stumbling

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Here!

Molly was found to be hypokalemic by Langford when she was in for hyperthyroid treatment with radioactive iodine. She was sent home with two weeks' potassium supplement in powder form to last 6 weeks :roll: so she had it until it ran out and then believe me I had other things to worry about and that was that. Her 6-week check didn't happen and became a 6-month check, at which she was still hypo and the same was prescribed again. When it ran out I bought direct from the manufacturer at significantly under half the price despite being warned I was likely to need a prescription, I didn't.

My reading does not convince me. Research it for yourself but potassium is funny stuff - balance is essential and concentration at cellular level is very important, but blood concentration level is unreliable as a measure of what's going on at cellular level. In Molly's case she was checked again this March, 2 years after her radioiodine, and despite supplementation for 18 months it was still low. I don't have the numbers to hand at the moment but it's likely due to losing it through her urine. As far as I can tell it appears they maintain the balance, so if the blood level is low it's going to stay low because that's where the cat's body is maintaining it, though a supplement is important as it makes certain the low level is not due to a genuine shortage. I'm going to get Molly retested when I can go in with her because things may have changed for her now that her kidneys are being treated.
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Re: Cat occasionally stumbling

Post by mr_frisky »

Was she exhibiting any stumbles?
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Re: Cat occasionally stumbling

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No, no symptoms at all ... of low potassium. System was messed up, she was obese and hyperthyroid diagnosed by chance because she had some kind of liver crash, yellow coming out both ends and drastic weight loss in the middle putting her in the risk zone for hepatic lipidosis.

I don't see stumbling listed as a symptom of potassium imbalance anywhere, only muscle weakness and nerve issues. Could muscle weakness or nerve mixups cause the stumbling?

More recently my Molly went lame and I can't remember how I came to the idea it might be due to too much potassium supplement so I cut it down and the lameness resolved, I increased it again and it came back, I have now settled at a dose where she is not lame but there are other factors so I can't guarantee the potassium level is the true cause.
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Re: Cat occasionally stumbling

Post by mr_frisky »

Below is typical of what the internet says:

In moderate or more severe cases, low blood potassium results in extreme muscle weakness and can make walking or holding up the weight of the head difficult.

https://wagwalking.com/cat/condition/lo ... -potassium
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Re: Cat occasionally stumbling

Post by Mollycat »

Exactly, it was one of the many pieces I read that essentially said the same thing. So you could make a case that stumbling might be caused by low potassium, or not. What the vet thinks would matter, does the vet think cause and effect, or coincidental discovery?
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Re: Cat occasionally stumbling

Post by mr_frisky »

I don't know, but the vet thought it might be the cause, as he didn't think it was worth having an X ray that day. She's going back on friday for another follow up.

I will have to video her walking again. Doesn't seem any different.
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Re: Cat occasionally stumbling

Post by mr_frisky »

The vet didn't even look at her videos on my phone, just booked her in for an X-ray in 2 week's time.

That will be her 5th appointment in one month.

He just said it looks like ataxia, and is probably neurological.
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Re: Cat occasionally stumbling

Post by Mollycat »

What does he hope an x-ray can reveal in terms of a diagnosis of something treatable? You don't sound very happy about having an x-ray?
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Re: Cat occasionally stumbling

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I'm a bit puzzled as to why if he thinks it is neurological, an x-ray would help?
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Re: Cat occasionally stumbling

Post by mr_frisky »

I'm happy to have an X-Ray, but she was due one 2 weeks ago, but he cancelled it, so there will be a 4 week gap now between the originally scheduled one and the new appointment.

He said the X-ray would be to look at her spine (presumably for tumours?).

He doesn't think it's a brain tumour, as the symptoms aren't consistent.

From the internet:

Sensory Ataxia

Lastly, sensory ataxia means the wobbles come from something related to the ascending sensory tracts in the spinal cord, most commonly the general proprioceptive tracts. The ascending tracts are the neural pathways that transmit sensory information from the peripheral nerves to the cerebral cortex. More simply, the ascending tracts transfer sensory information (like the feeling of heat) from, say, the paw pads to the brain. The proprioceptive tracts support the body’s unconscious awareness of where the body is located within space, what makes sure the cat doesn’t run into something while walking. In sensory ataxia a lesion is located within the spinal cord, usually in the upper cervical (spinal) area, and affects all fours limbs. If the lesion occurs further down in the spinal cord then just the lower limbs may be affected or the body’s motor strength will be affected.

Some common causes of sensory ataxia include:

Spinal trauma
Tumour on the spine
Diabetes
Spinal stroke
Bacterial infection
Degenerative myelopathy (loss of spinal cord tissue)


Not sure how many of these would be picked up by an X-Ray.
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Re: Cat occasionally stumbling

Post by mr_frisky »

I've uploaded three 20 second maximum videos to Youtube, two to show stumbling and normal walking gait, one to show not stumbling when running.

https://www.youtube.com/channel/UCYCFcT ... QCUWOxXGhQ
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Re: Cat occasionally stumbling

Post by mr_frisky »

X-ray today didn't find anything (spending a fortune in the process).

Have metacam to try for the next week or so.

She's no different to the videos I posted above, occasional stumble, stiff walking.
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Re: Cat occasionally stumbling

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The whole gait is peculiar, very accentuated wiggle.

I'm guessing the xrays rule out vitamin A toxicity then. Have you discussed micronutrient deficiency and electrolyte imbalances?
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Re: Cat occasionally stumbling

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At least it has ruled out a tumour, although doesn't help with a treatment plan
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Re: Cat occasionally stumbling

Post by mr_frisky »

I don't know if it has truly ruled out a tumour, as they say only an MRI scan can tell for sure, but no obvious ones visible.

Her potassium level is the only electrolyte that is still below par.
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Re: Cat occasionally stumbling

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mr_frisky wrote: Fri Sep 03, 2021 12:01 pm I don't know if it has truly ruled out a tumour, as they say only an MRI scan can tell for sure, but no obvious ones visible.

Her potassium level is the only electrolyte that is still below par.
Ah, that can affect muscles and nerves, I said all this before didn't I?

Was anything else out of balance before?

From what I've read it seems it might be difficult to raise blood levels because the balance part happens in the cells where it's needed and excess according to the body's regulatory systems is simply eliminated. Are any of her levels high? Sodium, calcium etc?
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