Ataxia in cats

[incendium04]

My foster kitten is... weird, in a word. She's 6 weeks, has stunted growth, a domed head, bug-eyed, small fontanelle, doesn't see well (can't track a rope on the ground.. but doesn't run into walls) and is generally ataxic (falls over easily, doesn't jump well). Several of the vets I work with think cerebral hypoplasia is possible... probably from the mama kitty having panleukopenia. I was just wondering if anyone has had cats like this, how they lived, etc. My vet has already tried to consult with an internal medicine vet and has offered blood work, MRI, x-rays, etc so I don't need a diagnostic plan... just stories

A classmate is interested in adopting her... but before this neurologic/developmental thing was apparent. I just want to get an idea of more people's experience with this sort of condition.

By the way, she is able to eat by herself, clean herself, use the litterbox, etc but will need a little extra care for the rest of her life (or as best as vets/I can tell).

Thank you

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[alliecat44]

FWIW, cerebellar hypoplasia is present as birth and is not progressive--i.e., doesn't get worse. If I'm reading your post correctly, this is a new thing with this kitten. Actually, the more I think about it, it sounds like it might be a type of lysosomal storage disease/mucopolysaccharidosis, especially if the kitten is slowly getting worse. There is testing available for these genetic defects through UPenn's genetics lab (just need a few ml of urine). Might be worth it just to rule it out (the test itself is free--just have to pay for obtaining the sample and shipping it, and it takes several weeks to get results--but hey, it's free!).

Sad thing about these types of diseases--IF that's what it is--is that they are invariably fatal--just a question of when. Probably worth getting it tested.

If the kitten was previously normal neurologically--or was abnormal and just seen to progressively worsen--then the one guarantee is that it is NOT cerebellar hypoplasia.

Good luck!!!

 

[CatVet2Be]

A co-worker of mine took in a kitten who had similar symptoms. He was at the point where the previous owners were going to euthanize so my co-worker took him in and hre was treated for toxoplasmosis (no titer was done due to $ constraints). He eventually caught up in development and is a pretty normal cat.

I took in 4 10 day old kittens 4 years ago and while 3 were completely normal the runt wasn't growing. He was a third of the size of the other kittens and when they were running and pouncing he still couldn't stand without falling over. He also had 2 abscesses which turned into a systemic infection and so he was on antibiotics for a long time. We discussed euthanizing but he was still eating, pooping, and didn't seem to be in pain so I kept at it. An enema when he got constipated, his first bath when he fell into the enema results . Antibiotics for the first few months of his life and after time he finally learned to walk! It turned out he was born without the ball and socket joint in his hips so walking had to wait until his muscles were strong enough.

Long story but the end result is a (mostly) normal, extremely loving, sweet, wonderful cat I wouldn't trade for anything on earth. Everyone that meets him loves him and I jokingly call him my genetic disaster. In some ways a special needs animal tugs at your heart in ways a normal pet never could.

 

[incendium04]

You know, this ataxia and weirdness might have been present since I started fostering the kitten. There has always been something "off" about her... it was not until recently that I was certain. She's the only one in the litter... so developmentally, I didn't have a landmark to go by.

Alliecat44, thanks for letting me know about UPenn's testing! That's good info that I might just have to take advantage of...

CatVet2Be, I definitely am not considering euthanasia at this point. The question is really, how far I want to go financially for this lil gal. However, my bf has shown some interest in adopting her (personally, I think he's absolutely in love with her ) so I want to give him a fair idea of what adopting her will be like. Your 'genetic disaster' sounds like an awesome kitty -- do you know if there will be any long lasting effects from his hips? It just sounds so amazing

 

[rugbychick16]

When I was working at a humane society, we had a kitten with cerebellar hypoplasia (same problem with mother cat being sick while pregnant). Very uncoordinated, wobbly, high stepping when walking...we called him our little drunk kitty. But fine otherwise, and tried his best to keep up with his littermates. Found a woman to adopt him who was willing to take a slightly special needs cat-she blocks off her stairs with baby gates so he can't fall down them, and built him a little ramp to get up on the couch easier.

If that his the problem, your kitten should be able to lead a very happy and long life with few problems.

 

[CatVet2Be]

I talked with an orthopedic specialist about him and he thinks that Mouse will act like a cat with a bilateral FHO. On the bright side, I never have to worry about hip arthritis. On the down side he has limited jumping capabilities which isn't that much of a down side. It lets me keep him on a diet while allowing the other cats 24/7 access to food. He's a total foodie and was starting to look like a tick so now he gets measured portions.

From a financial stand point will she need long term meds and testing or will it be more of environmental modifications? I was also limited on how much I was willing to put into a cat I wasn't planning on keeping (famous last words) so I opted to go with symptomatic treatments (AB's for infections, enema etc) vs running the gamut in testing, x-rays etc to figure out why he couldn't walk and wasn't growing.

 

[starlene45]

I have a double merle BC with CH! He's great, and hilarious... Not sure about in cats but I know in dogs the disease is marked by a stiff, hypermetric gait (he gets a lot of comments about how he "prances like a pony") as well as a "bunny hop" with his hind end at high speeds....

FWIW I have not actually had this confirmed via MRI but we're pretty sure that's what's going on. He has some of the other signs such as intention tremors etc. I don't medicate other than the occasional metacam or baby aspirin if he gets sore from running around like the maniacal herding dog that he thinks he is. I will probably add a joint supplement as he ages to support his joints since he routinely wipes out from running around like an idiot. I do feed him high quality food, and I keep his weight low-- I have a friend with an incredibly overweight CH kitty who is almost non-ambulatory due to the combo of obesity and neurological deficit, to me that's a pretty sad sight and I want my guy to last as long as possible with as little trouble as possible.

One thing my vet did say was that my dog is highly likely to get hip arthritis from the way that he moves behind (swaying in the hips, falling down, etc). Hence considering joint supplements and yet another reason to keep his weight down.

My understanding from my vets is that this is a non-painful, non-progressive condition. And in my opinion it really requires very little special/extra care. It certainly does not seem to affect my guy's quality of life in the slightest, although it means he can't be an agility dog like his sister oh yeah, I have to keep him on leash when we are hiking near steep hills-- were he to get himself on a really steep hill his hind end might not be able to support him and he could have a nasty fall. He has learned to compensate a lot since we got him 2.5 years ago (omg has it been that long!?) and apparently this is common in CH animals-- as they age they kind of figure out ways to use their limbs a little better despite their deficits-- it's pretty cool! I have done some agility stuff with him to make him more aware of his body and legs, and we do a little bit of physical therapy, but that's just because I'm a nerd-- he'd probably do fine without it!

Keep us updated on your kitty! I'm v. interested to know if you can get a confirmed diagnosis.

 

[incendium04]

Thanks everyone for your replies. I haven't done too much reading on CH yet but so far it doesn't sound like the end of the world.

Here are some photos for the interested:

 

[david594]

Long story but the end result is a (mostly) normal, extremely loving, sweet, wonderful cat I wouldn't trade for anything on earth. Everyone that meets him loves him and I jokingly call him my genetic disaster. In some ways a special needs animal tugs at your heart in ways a normal pet never could.

I really want to meet him now. Any chance you happen to have the x-rays for him on hand?

 

[alliecat44]

Sooo cute!!!

Have never seen a cat with CH have such a domey skull/bug eyes....that's not part of the condition, unless there's something else going on, too.

CH definitely does NOT significantly affect their quality of life, except that they shouldn't be in a home with stairs and litter pans/food bowls should be shallow. Their life expectancy is normal.

If you've seen ANY progression of these signs, though--it's not CH.

Link to Penn's submission form/info: https://netapps.vet.upenn.edu/PennGen/SampleTesting/default.aspx

The test I'm referring to is the "Metabolic Screen." You have to register with a password before you can submit a sample, but if you click on "help" it'll walk you through it.

Best of luck--she's adorable!!!!

 

[guppy73]

Came across this some time ago, & have shown it to shelter volunteers/foster people who've had CH kitties:
http://www.youtube.com/watch?v=dJQG6V1MOVY

Do keep us posted on her progress (& diagnosis, especially if it's not CH). I'd love to hear how things turn out!

 

[katryn]

This has me very interested. I just finished fostering a kitten for work who at 8 weeks is only 8 ounces and still looks like an average 4 week old. No signs of ataxia for the little guy, but it has the doctors stumped why he just isn't growing. Keep us posted on your little kitty.

 

[VeganSoprano]

I agree with Alliecat - I definitely don't think it's cerebellar hypoplasia. I'm wondering if hydrocephalus might be a possibility. The dome shaped head stands out to me. My understanding of hydrocephalus is that it is treatable. As far as I understand it, short term prognosis is good without treatment but the cat will have a shorter lifespan.

I also have a weirdly neuro cat. He was completely normal until he developed panleuk at 10 weeks. He survived but acutely developed symptoms of cerebellar hypoplasia at 12 weeks, after he was well on the way to recovering from the initial illness. He's 6 years old now and if you didn't know his history, you'd say with certainty that he has mild-to-moderate cerebellar hypoplasia. He's ataxic, hypermetric, and has mild intention tremors but can walk, run (very clumsily!), pull himself up on upholstered furniture, and climb stairs. Otherwise, he's a perfectly healthy cat with normal to above-average intelligence. His only genuine weirdness is that his symptoms get much worse after a febrile illness. Fortunately, a dose of dexamethasone has thus far been enough to have him back to "normal" (his version of normal, anyhow) within 12 hours.

I'd love to have an MRI done to satisfy my own curiosity but can't really justify the $ at this point when it wouldn't change anything for him. He's a medical anomaly, but a happy and healthy anomaly whose mama loves him lots!

 

[alliecat44]

VeganSoprano, an MRI probably wouldn't give you a definitive answer--you'd probably need a biopsy. You might see some changes on MRI, but they'd be non-specific.

Remember that in neurological cases, the clinical signs are related to WHERE the problem is. Different parts of the nervous system control different things. So, if you have a lesion in, say, your optic nerve, your clinical signs are going to be different (blindness) than if you have a lesion in your sciatic nerve (dropped hock, etc).

Therefore, what you describe as "just like cerebellar hypoplasia" are actually signs related to disease of the cerebellum. (All of the signs others with kitties who have CH are describing are what we call "cerebellar signs"--not "cerebellar hypoplasia signs.") In any given cat, the cerebellum (or any part of the brain) can be affected by infection/developmental issues/metabolic problems/tumor/trauma/toxin/etc and still come up with the same clinical signs. In YOUR cat, sounds like it was the early infection that probably exhibited tropism for the cerebellum (a lot of these viruses really like to hang out in that part of the body, especially in the young ones) and your cat fought it off and now has scars (or whatever you want to call it) on her cerebellum.

As a former head neuro tech (for one of the neurologists at the practice VeganSoprano works at, if I'm correct! ), I think this is a common point of confusion. The neuro exam tells you WHERE, it does not tell you WHAT. Once you figure out WHERE in the nervous system the lesion(s) is by doing a thorough neurological exam, you can begin to figure out WHAT the problem is. And there are a few ways we can look. An MRI is great for looking at certain things, but because your cat isn't actively sick with whatever caused the problem in the first place and because MRIs can't look microscopically, you'd likely see some "gee whiz" changes in the cerebellum and not be able to tell for sure WHAT is going on there. A spinal tap at the time of infection might have shown organisms or inflammation, but now that the kitty's recovered, would be unremarkable. So, you'll probably never know...but FWIW, I think your theory is correct and I'd definitely not waste the money on a scan!!!

Okay, off my soapbox and totally didn't mean to single you out, VeganSoprano--the wording in your post and the posts of others made me feel like it should be brought up to avoid confusion amongst folks reading this--I just think the whole "what you see tells you where, not what" thing is very very commonly confused, even amongst veterinarians.

Hope that's at least a little informative.

P.S. Hydrocephalus isn't very treatable, but it depends on the cause of the hydrocephalus. The domey head and buggy eyes definitely suggest a mucopolysaccharidosis to me--FWIW--again, not a doctor!!! and haven't seen many because the defect is really really rare--but it matches pictures in our pathology book, too. (Which you guys will see soon in school!) Of course, a mucopolysaccharidosis/lysosomal storage disease could cause hydrocephalus--maybe that's why the domed head in those guys?? Interesting! They're so rare that we're still learning about them.

 

[CatVet2Be]

alliecat44 Wow! That was actually really informative, I'd never thought about the where vs. what in terms of symptoms.

incendium04 she is absolutely adorable! I really hope everything turns out well with her.


david594 I do have his x-rays but they were taken before we switched to digital so I'll see if I can take a picture of them that I can post. If not, I'll have them with me when school starts and you're more than welcome to come meet him! I'm a proud mom so I'll take any excuse to show off my "kids"

 

[incendium04]

Alliecat, thanks for great explanation -- can't wait for neuro class!

Guppy73, it didn't even occur to me to look on youtube for what the symptoms of CH are supposed to look like (though it makes me wonder how the cat was diagnosed). I found another youtube video about a CH kitten, and while my foster isn't as bad in the motor skills department, she definitely tumbles and walks very similarly. I will see if I can record her.

Hydrocephaly has also been thrown around as a differential. I'm going to wait to hear from the internal medicine specialist before doing too much diagnostics. Too bad it won't be for almost a week

 

[alliecat44]

incendium04, do you have a neurologist in your area?

I just ask because internists usually have a different way of going about diagnostics in these cases and I'm sure you don't have that much money hanging around waiting to be spent.

 

[incendium04]

There isn't a neurologist in our area... and the only reason I am consulting with internal med is because its free Hate to be so frugal but I'm trying to save money prior to vet school...

 

[incendium04]

Finally! Here's a video of her romping around. It took a while to get her to walk around where I could see her with the camera. She's about 6.5 - 7 weeks of age.

http://www.youtube.com/watch?v=YX8sdV4YhlE

 

[alliecat44]

Thanks for posting the video, incendium!
She is CUUUUTE!

Video is interesting. I see ataxia, and some hypermetria in all four limbs, but nothing jumps out at me as being solely cerebellar. The fine control of her head seems to be quite normal when she's playing with the banana. She's got some balance issues, but to me, this gait doesn't scream cerebellar disease. I'm interested to know what her neuro exam looks like (reflexes, cranial nerves, proprioception, etc). Wonder if she has something multifocal going on with her vestibular system AND cerebellum +/- elsewhere.

Classic signs of cerebellar disease include a wide-based stance in the rear, hypermetria (a "prancing"-type gait), intention tremors (head bobbing/Stevie Wonder-type movements). Their normal movements are exaggerated because in normal animals, the cerebellum provides "inhibitory" input. If you touch your finger to your nose, your cerebellum is what tells your finger to stop and not poke yourself in the eye. However, the excitatory signals from other pathways (initiating movement) are still present. Thus, excitation without inhibition/control/fine-tuning results in exaggerated movements. Thus the prancing and intention tremors--which are even more exaggerated when stimulated (such as when sniffing a treat or playing).

Check out the second half this video of a fairly severely affected CH kitty and you'll see what I mean: http://www.youtube.com/watch?v=FK6IDvPPxj8&feature=related

This also seems like a good one: http://www.youtube.com/watch?v=A8HZWS4hBk4&feature=related

To me, it looks like your kitten is ataxic and has some balance issues, but is not exhibiting classic signs of solely cerebellar disease. IMHO, of course, and not as a doctor.

I guess my point is that the video further serves to encourage the need for a specialist consult and support the idea that this isn't CH--so good on you for getting some free advice from the internist. If it IS CH, looks like a very very mild case. I'd also really recommend asking about the metabolic screen. Again, IMHO.

Thanks for posting!! she is so adorable!! Good luck!

 

[incendium04]

Ironically, the first thing the internal med doctor did was refer me to UPenn. Turns out the metabolic screen is $50. I will most likely submit this within the next week along with some basic chemistries, CBC and FeLV/FIV. Overall, the kitten is doing well.

By the way, her name is "B-T" due to a differnce in opinions on her name... my boyfriend wanted to name her Bongo and a coworker who was helping foster her wanted to name her/him (unsure at that this point) Thor. Hence B-T. I just call her Beat Beat.

She has just learned to climb onto the couch by launching herself at the side than climbing up with her claws. The only problem is she misses the side of the couch 8 times out of 10. It's hilarious!

 

[alliecat44]

Thanks for keeping us posted! Sorry they've started charging for the metabolic screen (the website for it has also changed)--guess they got tired of all the free stuff or their grant ran out.

In any case, good luck!! Let us know what they say!! Their neuro department is absolutely fantastic!

 

[incendium04]

Breakthrough! She has hydrocephalus.

That's an ultrasound of her frontal lobe ventricles. RV being right ventricle and LV being left ventricle. There is a lot more fluid than there should be and her brain is tiny. I'm just grateful she has a fontanelle for us to ultrasound through, it made this diagnosis much easier than a MRI!

The vets are looking into a lot more options... I am so grateful for their hard work So far they've talked to a physician about the options for babies with hydrocephalus and things I can do to monitor the condition. Not much I can do right now... monitor the circumference of her head, make her sleep with her head up to encourage drainage. They are looking into more recent research in kittens but so far it's wait and see whether she degrades and seizures...

Oh and the vet checked her liver and there isn't a liver shunt either.

 

[alliecat44]

Oooh thanks for keeping us posted, incendium04!!

Great news that you got a diagnosis for relatively cheap. Please let us know if there are any recent advancements in therapy for hydrocephalus.

Wow, those ultrasound images are IMPRESSIVE...! Those ventricles are freaking huge. Please let us know how she does!

 

[incendium04]

Had to euthanize her today. I didn't realize how attached I've gotten to her in these last few weeks. Maybe it's just different when you know you'll never see a pet again & the pet is going to a good home... versus when you'll never see a pet again & had to decide when the time was for euthanasia. This was the first animal I've ever had to euthanize. Today has been really hard since I had to work around more kittens about puppies all day...

For those interested, she became a lot worse after the day she was diagnosed. Progressing ataxia until this morning I woke up and she wouldn't eat/drink, unable to stand/walk... tumbling head over heels... very lethargic. It was time because I know I can't afford risky surgery nor did I want her to suffer as I searched for possible treatments... She was obviously distressed whenever she couldn't stand or walk normally.

I'll miss her. I hope some of you guys learned a little from her story.

 

[bunnity]

Sorry to hear that incendium04. At least she spent the last few weeks in a loving home instead of a cage at the shelter - I'm sure she appreciated it.

 

[CatVet2Be]

Aw, I'm so sorry to hear that. It's so hard when you put so much time, effort, and love into a little one and you still can't save them. At least she spent the short time she had being loved, played with and cared for and in that respect she was luckier than many other cats out there and she had you to thank for all of that. I'm really sorry, I know how hard a situation like this is.