Signalment

• Age: 9 years
• Sex: female spayed
• Breed: DSH
• Species: cat

Disease Notes

• Certainty: tentative
• Final Status: slightly better as of day 102 of treatment

Treatment and Outcome

• Hypoglossal Nerve Or Tongue Dysfunction: Pinky is a special kitty who I bottle raised with her litter since she was 1 day old. She was always a little special and was the runt. She is timid but very sweet and outgoing even though she chooses to live in our bedroom. She has a wonky rear leg and is very quirky - she pees on designated towels and poops under the dresser.
  
  Her first episode started seemingly abruptly mid-April where she stopped eating, drinking and grooming. We did a thorough medical workup and dental - she had some resorptive lesions, but did not do better after the dental. She tanked and despite supportive care, onsior, gaba, etc... no improvement. We gave a Hail Mary dose of 1mg methylprednisolone and within 30 minutes, she ate for the first time in probably a month, but a duck food different than the same chicken food she ate for 8 years (by choice despite many offerings).
  
  She did well for a month on 1mg/2mg alternating days methylpred for a month and then stopped eating again, but this time was obsessively tongue flicking. Internal med specialist ultrasound, sedated mouth exam and stumped. Increased her methylpred to 3mg and she started eating within 24 hours, but this time a different duck and turkey food.
  
  She was good for another month and then relapsed. This time, 4mg and then 5mg methylpred (twice the high end of my normal dose) and no better and some diarrhea - I reduced her back down to 4mg and then added weekly injections of B12 and she starting eating, but no drinking or grooming. I found a write up where a B12 deficiency can cause hypoglossal nerve dysfunction so also submitted bloodwork for Cobalamin/Folate and awaiting results. We are giving fluids every day and B complex vitamins by mouth.
  
  We went to a neurologist and no insight, but offered an MRI/spinal tap - I chickened out as she had just started eating again and I was afraid the stress would cause her to regress.
  
  I consulted with an animal communicator along the way and she helped fill in some blanks - she said that the issue was due to a lack of sensation of her tongue which makes sense due to neuroanatomy and her moving the tongue without asymmetry but unable to control it as she wants. Also she said it was an immune mediated issue due to glyphosate in chicken - all makes sense except the increasing need for steroids and relapses.
  
  She is not easy to medicate, but I could do it if herbs would help. I have access to a thermal camera via the animal chiropractor that I use. It may be hard to image her, but I can try.
  
  Has anyone ever seen anything like this? Any insight into where to go from here? She is her kind of normal in every way except her tongue and maybe hyperesthesia or weakness in her back end - she has always sank a bit when pet, but it is worse.
  
  Thank you,
  Penny Jacobs, DVM