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These were the results of the tests... Lycan 1 Yrs. 2 Mos. Shorthair, Domestic Neutered Male 5 kg (05/24/2012) Thank you for bringing Lycan in for examination yesterday, May 24, 2012. At the time of examination, Lycan was receiving phenobarbital (15 mg tabs) 1/2 tablet once daily. After completing my distant, physical, neurologic, orthopedic and dilated ocular fundic examinations, the following were revealed: • Lycan was bright, alert, and appropriately responsive to external stimuli • Lycan's body condition score was approximately 5/9 • Lycan was reluctant to move in the examination room to fully evaluate his gait. Lycan was shy and nervous.Of the little movement I did observe, I could not appreciate and gait abnormalities. Lycan's body temperature was 39.3 deg C, his heart rate was 200 bpm, no heart murmurs or arrhythmias were detected. Femoral pulses were present in both hindlimbs and of appropriate character, there was no evidence of pulse deficits. Mucous membranes were pink with CRT < 2 seconds. No observable oral ulcerations or masses were present. Head, neck, and body were symmetric with no abnormal postures. Lycan had full voluntary range of motion of his head and neck. No pain response was detected upon dorsal palpation along his spine. Thoracic ausculation revealed increased breath sounds though it was difficult to discern if these sounds were referred from the upper airways. No findings consistent with peripheral lymphadenopathy. No masses detected on abdominal palpation. Lax patella bilaterally but unable to luxate. • Neurologic examination did not reveal any significant findings. Cranial nerve examination was unremarkable. Tactile placing was present and appropriate for all four limbs. Patellar, cranial tibial, and sciatic notch-stimulated reflexes were present and appropriate for all four limbs. Voluntary tail movement was present. Anal reflex was present and appropriate. • Orthopedic examination was unremarkable. • Dilated ocular fundic examination unremarkable. No evidence of keratic precipitates or iridal discolouration. • History from you included a description of progressive clinical signs beginning with periodic eyelid tremor, to stretching, spasm of hindlimbs at rest. Clinical signs began to involve forelimbs. Video recordings evaluated by me revealed lycan having hypertonicity of hindlimb during walking after episode, difficulty jumping up fully onto objects, hypermetria of left hindlimb. Lycan has been alert and responsive during these episodes. Clinical signs have progressed in frequency and severity. You indicated that last night, Lycan abnormally began wrecklessly running around the house for approximately 2 hours(atpyical for this cat). You also indicated that he was vocalizing more frequently. You indicated that you have not detected any vermiform skin/muscle movements. • Lycan's clinical signs have worsened despite phenobarbital trial by your veterinarian. • Lycan's appetite has, at present, remain unchanged. Given my clinical examination findings, and taking into account Lycan's clinical history and video recordings of his episodes, I am concerned that he has a disease process involving multiple regions of his central nervous system. It may be possible that he has primary muscle disease also, however, though this may not account for his seemingly recent change in behaviour (i.e. wrecklessly running around and increased lethargy). Given this, and taking into consideration Lycan's clinical history and age, etc, the following disease processes are considered: • Infectious disease (e.g. FIP (feline infectious peritonitis), FeLV/FIV, Toxoplasma, etc) • Inflammatory disease (e.g. immune-mediated disease) • Neoplasia (i.e. cancer -primary vs. secondary) • Metabolic disease (involving whole body and brain, and/or muscle) • Myopathic disease (primary vs. secondary) As such, I recommended the following diagnostic work-up: • CBC, serum biochemistry, urinalysis • Infectious disease testing (FeLV/FIV testing, Toxoplasma testing) • 3-view chest and abdominal radiographs (x-rays) • CT of brain and cerebrospinal fluid collection and analysis (pending results of above tests) • +/-electrodiagnostics of nerves and muscles +/-muscle and nerve biopsy After discussing my clinical examination findings, the rationale behind the diagnostic plan, and the various disease processes being considered, you elected to pursue non-invasive testing first. You understood that diagnostic testing is a process and that in completing these diagnostics we may not have a definitive diagnosis (esp. with regard to FIP). You also recognized that without performing appropriate diagnostic testing and determining a cause for Lycan's clinical signs it is impossible to offer an accurate prognosis. Chest and abdominal x-rays did not reveal any significant abnormalities (see radiology report). FeLV/FIV tests were negative. Urine was unable to be collected (bladder too small for collecting urine) CBC and serum biochemistry did not reveal evidence of underlying systemic disease (not always present with certain diseases involving the central nervous system). There was no evidence of active muscle disease (e.g. no change in CK enzyme). Toxoplasma test results are thought to be available early next week. At this time, I recommend waiting until we have the Toxoplasma test results available, then bring Lycan here for re-examination, and have a discussion of what, if any, further diagnostic tests you may want to do further. As mentioned, I am suspicious of Lycan having infectious or inflammatory disease. One of the considerations is a disease known as Feline Infectious Peritonitis (FIP). Please review information provided regarding FIP. Please monitor Lycan for any change in his behaviour, how he moves, etc. Please try and video record these behavioural changes. It is not uncommon that patients, especially feline patients, to act differently in the clinic environment compared to how they act at home. Please seek immediate veterinary attention should Lycan's condition suddenly deteriorate or if you have questions or concerns about Lycan. Be certain to take this information with you should you seek veterinary attention. It has been a pleasure meeting and working with you and Lycan. I have sent a copy of these discharge notes to your veterinarian and I have also spoken with her personally. |
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I am so sorry to read this about Lycan but on a possitive note you have done all the tests you can possibly have done to determine what may be happening with him. I have a few articles on FIP but none of them mention anything about convulsions, what ever the outcome I am sure you will make the remainder of his life as comfortable as you possibly can. My thoughts are with you both xxx. http://www.winnfelinehealth.org/Pages/FIP_Update.pdf http://www.winnfelinehealth.org/Health/FIP.html The above site might help you to understand the condition a little, should it be FIP. x |
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What a detailed report from your vet, I'm impressed at their diligence. However, that doesn't take away that Lycan is possibly quite unwell I agree that you have to draw the line at invasive procedures, after all the poor cat doesn't understand what's happening and we have to balance full diagnosis against risk and distress. Wish you much luck and hoping that Lycan is able to live a good quality of life for a good while yet. |
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Thanks. I wish I knew what was wrong. The Neurologist doesn't really think it's FIP now because there are still no signs, from the second round of tests. He's very confused. Usually with FIP there is bleeding behind the eyes, and red flags in the bloodwork. Still nothing. But something is terribly wrong, and I don't know what to do! My poor Lycan! I've been reading up on Hereditary Myotonia, and it fits the profile, but the Neurologist doesn't seem to think so. Now I'm worried that his lungs are malfunctioning. Maybe that's why he is spasming - his lungs are contracting uncontrollably. I don't know. I want to help him but I don't know how. I feel so lost. |
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Oh dear this all sounds very distressing both for you and for Lycan. I sincerely wish there was something we could say or do to help, we are all thinking of you both xxx |
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I was thinking Lycan may have had slight neurological damage from birth, but vet has ruled that out. I know you desperately want to find out what it is and future ramifications...but the main thing is for now it doesn't seem to be really worrying him and he seems to be breathing ok. He actually looks an otherwise healthy cat. Sounds like you are doing all you can for now, try not to worry too much in the interim, cats are very good at absorbing our concern and it can affect them. |
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Update on Lycan: We still we have no diagnosis for Lycan. The good news is: THE FULL BODY SPASMS ARE GONE! Perhaps the phenobarbital (for seizures) has helped, or maybe it's a coincidence. But he is still having problems. His back legs bother him a lot and he seems edgy. His tail has developed this weird "shiver" when he gets excited. I have never seen a cat's tail do that. He also experiences small twitches in his face and has difficulty walking/jumping. But he's happier than he was, because he doesn't have the spasms to keep him up a night. So now he can sleep peacefully. Thank ******* god. But yeah, we did more and more and more tests, and the only out-of-normal results we've come up with is that he has an extremely high Corona Virus Titer Level, which supports but does not prove a diagnosis of FIP (cats can have high levels and never get FIP), and his Thyroid levels arel normal, but a little low for someone of his age. He has been checked for everything, including Hyper and Hypothyroidism, but now I'm wondering, though rare, if he may have Hyperparathyroidism. There's so little left to check, unless we do a spinal tap, which seems extreme and dangerous, considering the results of disease discovered through spinal fluid is usually grave and incurable. He's been biting/licking at his right back leg (the one he seems to have the most trouble walking with) and he has some cuts on it - we don't know if this was a rough-play injury that he keeps bothering so it can't heal, or if it's a lesion that has developed randomly, which also supports an FIP diagnosis. He seems less interested in food and water than he used to be. He lost weight within a two-week period, but then he gained some back, so we're not sure if that is a factor, or if he was just eating less because of the hot weather. This is very frustrating. I have spent so much time researching cat diseases and symptoms, and have used many resources, including a Veterinary Encyclopedia. Lycan is an anomaly to Medical Science thus far. He is not alone, because I've found various other cases of cats with idiopathic spasms, and they never received a diagnosis either. Unfortunately, a lot of these cats ended up dying prematurely due to lung/heart/blood issues, so maybe there is something to look into there. I have checked his heart/lungs/blood/liver/kidney/thyroid/etc. But still no conclusive results. Something is hiding somewhere. I hope I can find out what's wrong before it is too late. It is unlikely, but I have to try, while keeping in mind that he may in fact have FIP (which can have neurological signs), which means he may be dying, so I should be careful what I'm willing to put him through (less stress is best), I want him to be happy and stress free, even if that means I may not discover the truth. It is a very difficult situation. |
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I must admit, reading the description made me think of toxoplasmosis, as it sounded similar to our Mustard. Is he hypersensitive to stimuli, how is his eyesight. Both toxo and FIP are hard to diagnose, it's basically a process of elimination. This may help- http://www.dr-addie.com/ |
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