Expert: Jessica - 9/8/2011

Question
Hi, I've taken my cat to the vet 3 times, she is 15 and her blood work says all is normal and healthy. I'm surprised because my vet is very good but I think she has misdiagnosed her with gastritis. Extensive research points to a likely a brain tumour or something similar causing seizures.

So you know she has had 5/6 episodes now, spaced over 6 months or so. Some worse than others, all begin with violent vomiting when she had been sleeping peacefully, excessive drooling and salivation and then at some point, sometimes 10 minutes later, sometime quite quickly, emptying her bowels - not making it to the litter tray although she tries. The drooling then continues and on two occasions she has tried to walk and had difficulty so stumbling and uncorordinated and coming to sit with her stomach flat to the ground while recoveriny and seemingly in a lot of pain. I believe these are definately seizures, which are terrifying but there is not a lot I can do. She recovers well, within 1/2 an hour of sitting quietly and then sleeps and by the next day is eating, sleeping normaly and has normal toilet habits.

I can't afford an MRI, it seems crazy to spend thousands to have them confirm a tumor? I'm not sure if can/should be taking her back to the vet for further tests (my vet thinks I'm a pet hypocondriac I think!) but from research there doesn't seem like much more I can do for her. She had a tumor removed from her leg last year so again, this is not a good sign as suggests other tumors may be present.

What I really need to know what I can expect for the future. This is my question. Obviously she is not well but I can't find any thing regarding what to EXPECT. I make sure I am home every night but I am terrified one of these episodes will bring an immediate death? Do they need to become more frequent before I start panicking about losing her? Do they normally become worse first - I would assume so if a tumor is growing. Her quality of life presently though is excellent. Will I come home from work to find her? I'm really need to know how a tumor plays out I suppose because in all honesty apart from these episodes she is as good as gold between them. I expect they will get worse over time as the last one was the worst with pacing and restlessness beforehand and seemed to last longer. Occasionally it appears her pupils are very dilated and she stares or sniffs constantly so I'm guessing she is slightly affected with no other obvious symptoms sometimes.

I will take her anyway back to the vet to get advice now that I can tell my vet they are seizure episodes but I would really appreciate if you could share any experience if any regarding expectations of this. If my vet didn't diagnose seizures I doubt she has seen this before. I live in Spain (although my cat is from Australia) but "Spanish" cats rarely live past 10 years here due to diet and lack of care. I know you can't give a life expectancy or prognosis but does she need to get a lot worse, seizure more frequently before the evitable. I am losing sleep over worrying more than anything - checking her all the time, anticipating another more serious episode. I'm feeling very helpless and misinformed. If you could share any advice to help me prepare I would be most grateful.

Answer
Hi Miranda,

You know your cat better than anyone - you observe her behavior every day and you see what these episodes are like. So you are these best one to describe them. I'm not entirely sure that what you're describing would seem to fit the description of a seizure as much as it would gastritis to be completely honest. Her posture after the episodes sounds like she’s coping with pain, but seizures aren't painful, and gastritis is. Nausea would explain the excessive salivation. Also, she would probably empty her bowels involuntarily during a seizure. Her attempts to get to the litter box seem to suggest she is fully conscious but that cramping and pain make it impossible for her to hold it. Cats suffering gastrointestinal ailments often do vomit and then need to visit the litter box almost immediately. If your kitty isn’t on prednisone to try to manage this problem, that would be my personal recommendation. Cats generally respond to this quite quickly (within a couple weeks) and with very few side effects, so you can try the treatment and see if she improves. If not, I don’t think you have lost anything. If she does, she may need to be on a low dose of the medication permanently.

However, if you still believe these to be seizures, I think you should talk to your vet about an anticonvulsant. While a brain tumor is certainly a possibility, most seizures have no known cause. She should have her liver values checked prior to starting the medication, and then a couple times a year, because it shouldn’t be used in cats with liver problems. Again, I don’t think you have anything to lose by trying the medication if she is having seizures, even if it’s caused by cancer. If she doesn’t respond, then there was no harm done, but if she does respond, all the better.

As for what you can expect, it’s extremely rare that a cat would die suddenly from either gastritis or seizures. Cancer, depending on the location, can kill quickly if it suddenly blocks an airway or blood vessel. An x-ray is relatively inexpensive and can often help detect masses in the areas where it can do a lot of sudden harm – in the chest cavity around the heart and lungs. Most of the time, you will notice your cat’s body condition deteriorating quite a bit by the time either gastritis or cancer is getting to a terminal stage. You will feel bones as the body becomes malnourished in the case of untreated gastritis, or as cancer takes away all the nutrients from healthy tissue. Generally, the cat’s appetite is going to start suffering. Seizures will probably become almost constant very quickly if there is a brain tumor, and your kitty may lose her sight. Unfortunately, every case progresses at a different rate in each cat. One cat may survive for 3 weeks with the same type of cancer that another cat survives for 2 years with, so monitoring body condition and behavior are really the best way we have to decide when our cats are getting close to the end. When her appetite is lost and no medications encourage it, seizures are happening several times a week, or she develops other neurological symptoms, then it’s time to have her peacefully put to sleep, as you are in danger of losing her while she is all alone.

I hope she’s feeling better soon!

Jessica