By Michele Rohyans
March 8, 2012
Early one May evening, while watching TV, my otherwise “normal,” (then 14 year old) calico, Chiquitita, flipped herself from the coffee table she was sitting on, and landed on her back, on the tile floor of my living room. The “episode” lasted less than a minute, and she came out it relatively quickly. In a separate incident, later that same evening, I was able to observe what had caused her to fall from the coffee table; she was having seizures. Needless to say I made the first possible appointment for her to see her veterinarian. However, before going into the results of that initial diagnosis let me list all of her symptoms at that time: she had licked a “bald” patch on her inside thigh (which I had been keeping an eye on and making sure it was not becoming infected; I would later learn it was related to her seizures), when in the grips of a seizure her entire body would go completely rigid resulting in the temporary loss of motor function and bladder control, finally at the conclusion of each seizure, she would pull large tufts of hair from her chest area.
The first veterinarian to see her was reluctant to concede that what I had described was actually a seizure. Instead, the vet focused on the bald patch on her thigh and the appearance of a flea, and diagnosed her as being stressed from the fleas (we were living in Florida, and the fleas were awful that spring). We were using Advantage to control the fleas at the time, and the vet recommended that we try Capstar followed by Revolution; Chiquitita was also put on the steroid prednisone for the irritation causing the bald patch on her thigh. These medications seemed to help, however, it was not long before the seizures started up again, and again we went to the veterinarian. This time, however, her regular vet was unavailable due to emergency surgery and we saw a substitute vet. This doctor, who spent all of ten minutes with us, informed us that she was “infested” with fleas, and that we were witnessing what happens when a cat is not properly cared for! So, once again she was given Capstar and we were told to administer the Revolution every two weeks instead of once a month. However, the seizures did not stop. One night she had one that lasted longer than all of the others, so my mother drove, and I carried a trembling Chiquitita to the after-hours emergency vet. Both mom and I were certain that she was not going to come home that night. The veterinarian, who saw us, still was reluctant to concede to our having witnessed seizures, but was willing to do blood work; the blood work showed no sign of illness. By this point it was early July and we had been going back and forth to the veterinarian’s office for about 6 weeks. The seizures were growing less frequent, yet they were still occurring.
In the end of July, I had to get her ready to move from Florida to Mexico City. The seizures had slowed down dramatically and I was hopeful that the trouble was all behind us. Again we went to the vet and Chiquitita was given a clean bill of health. Mid-August she had began having seizures again. Then one day in September she had the worst seizure of them all. She was sitting next to me on the sofa when the seizure came on; her body went rigid, she bit me on the hand when her jaw froze and she fell onto the floor dragging me down with her. She started to recover when a second seizure overtook her and she ended up under the love seat across from the sofa and began to “scream” because she had gotten her legs wrapped around the love seat leg and could not get up. I loaded her in her carrier and I took to the streets of my little corner of Mexico City in search of a vet, preferably one who spoke English.
I was directed to a veterinarian not far from my house that just happened to specialize in veterinary ophthalmology, and did his specialist training at the University of Florida! Even though we had no appointment, because it was an emergency the doctor agreed to see my Chiquitita. I was told they needed to look into her eyes because with seizures (what? They believed me?) the retinas will give indication of brain damage, or in cats, indication of other illness. As it turned she had a parasitic infection from a cuterebra (parasite found in the south eastern United States), and the seizures were caused by the migration of that parasite through her brain; to breath the parasite must poke holes in the brain tissue, and the resulting damage can result in seizures. Right away her new doctor put the appropriate protocols into action: a high dose of prednisone, a high dose of an antihistamine, and two hours later a high dose of ivermectin to kill the parasite. It was explained to me that she needed the steroid and antihistamine because a toxin is released from the parasite as it dies that can result in anaphylactic shock. She survived the removal of the parasite and for two weeks continued on the prednisone, at the end of those two weeks she had a follow up visit and appeared to be doing much better. Then yes, the seizures started up again and now they were occurring more and more frequently.
I went back to the new veterinarian’s office, and it broke my heart to see how much my news of the increase in seizures seemed to hurt him. The next day we arranged for an appointment with a veterinary neurologist to be held at my vet’s office. The neurologist prescribed phenobarbital every twelve hours, stating that this drug has proven very successful in treating epileptic cats. She did very well on the phenobarbital for about 3 months (we were down to about 1-3 seizures per week, a huge improvement). However, she began to show signs of depression and slight motor loss in her hind legs. She also began to get aggressive and the seizures became more frequent (3-5 per day). She was also showing some other symptoms such as: odd vocalization, extreme sensitivity at the base of her tail (the hem of my robe once brushed her there triggering a seizure), aggression, a “rippling” or twitching of the skin, the seizures, and she would “attack” her own tail. These are all symptoms of another very rare condition known as feline hyperesthesia syndrome (FHS). FHS, when diagnosed, is mostly found in Siamese cats, however it can result from trauma to the brain or spine. Like seizure disorders, FHS can be extremely difficult for veterinarians to diagnose. However, given her history and my description of the new symptoms we decided that she met enough of the criteria to treat the symptoms as FHS. Following one of the protocols for FHS, she was given tramadol to manage the pain; resulting in a terrible reaction where she chewed the tip of her tail off. We discontinued the tramadol immediately.
I was sure I was going to lose her; she became increasingly depressed, and the loss of motor function was increasing. For example, she would begin to walk across the room and her hind legs would stop moving until she was lying down, she would struggle to stand again and the process would repeat. I contacted the vet and resigned myself to the possibility that it was time to end her pain, and was told that we had one more option; this recommendation coming directly from the former head of the European College of Veterinary Neurology, put her on gabapentin, 1/8 of a capsule 2 times a day increasing to 3 times a day if symptoms worsen. I am thrilled to say that as of March 1st Chiquitita is one year seizure free!!! There is simply no way to thank the team of veterinarians she has here in Mexico City- We LOVE You ALL!
Foot Notes: I mentioned the bald spot being a symptom of her seizures, the cuterebra releases a toxin as it is living in the host and that can cause what appear to be “hot spots”. Also, in the case of my Chiquitita, the FHS resulted from the brain damage caused by the parasitic infection, otherwise the two conditions are completely unrelated. From everything that I have read since this whole ordeal began, it is extremely difficult for a veterinarian to diagnose epilepsy in cats. The percentage of cats that suffer from seizures is quite low, and often the trick to prescribing the correct medicine is in identifying the cause for the seizures. One recommendation I would make is to keep a very detailed diary of your cats seizures: times they occur, is there any correlation to medications, definitely make detailed descriptions of every episode, and if possible a video. I have only described the type of seizure that I witnessed, but feline seizures take on a wide variety of behaviors and looks.
Finally, if you have witnessed or suspect that your cat is having seizures see your vet as soon as you can, and if possible see a veterinary ophthalmologist and/or a veterinary neurologist.
For more information on these two disorders:
Feline Hyperesthesia (FHS)
Cuterebra Infestation in Cats
Brain Parasite (Cuterebra) in Cats
This is a video of a cat on youtube and it’s a mild case but still shows symptoms:
Update: July 9th, 2014
Sadly Chiquitita passed away due to chronic renal failure. She lived a long and adventurous life with her mom and I’m so blessed to have known them both. Fly free sweet girl.