Question Details
Seizures In A Cat
by drakedoc - April 24, 2016    View Case Report
Nutmeg is an 11 year DSH. She presented to her DVM 1 year ago with the complaint of having generalized seizures. At that point she had 2 which were 2 weeks apart. Fungal titers were negative, labwork normal at that time. The owners declined a workup for the suspected culprit (meningioma) and chose to watch the cat. Within 2 months her seizures were weekly to every other week and she was put on a Prednisone trial which made her lethargic and did not effect the frequency. The seizures occur randomly. At times weekly, sometimes a month is skipped then they come Q 2 weeks. They can happen any time of day but may be more common late night or early AM. Her appetite and mentation are normal between. They came to see me because after a 6 week break from the seizures she began having them every 2 weeks again. She is unconscious and urinates during the seizure. She had also developed a dry cough X 1 month. She was "clumsy" on exam and intermittantly stumbled which the owners said Nutmeg has done her whole life. She has also always been timid. She was normal her whole life otherwise, no GI signs and appetite always good.She sleeps "too deeply" and can be hard to awaken per her owner. Her tongue was purple, her pulses thin, toned but weak. I was expecting TBO but these pulses were really not consistent with that. Quite honestly they felt more consistent with a blood deficiency pulse but I haven't heard of using XFZYT for seizures. I was considering an XCHT derivative because of the cough but now am considering San Ren Tang because it can also help with TBO and pulmonary issues (she has a bronchial pattern on xrays). Her labwork and blood pressure were normal. I doubt this is cancer though. Her signs have not appreciably progressed and she looks great otherwise.
Sorry Steve, I know this is a little all over the place, Kathy
Replies
by naturevet
April 25, 2016
Hi Kathy,

The seizures, deep sleep and cough can all indicate Phlegm accumulation as the cause if the seizures. It is a common cause of pathilogy in middle-aged cats if eating standard dry or canned diets. So that's the first thing I'd change, assuming that's the case. Definitely at least the early am seizures are consistent with Damp as the cause, as is a weak pulse.

Given all of the above. I would try. Ban Xia Bai Zhu Tian Ma Tang first. I see your points about SRT and XFZYT, although its anti-seizure effects aren't as reliable. BXBZTMT is the first thing I'd try and has a minimal downside if we're wrong here

Hope that's not the case!

Steve
by drakedoc
April 25, 2016
I will order it today, thank you so much, Kathy
by drakedoc
July 3, 2016
Good Morning, I rechecked Nutmeg yesterday. She went 6 weeks with no seizures then 2 weeks ago and yesterday had one. She has been on Ban Xia Bai Zhu Tian Ma Tang 550mg BID for 2 months. Her owners think she is doing well but none of her parameters have changed. She still sleeps deeply, still coughs daily, no change in irregular seizure frequency, still has the same tongue and pulse. She is a sweet, happy little thing but won't eat anything besides kibble (the owners tried). I will give them more pointers though. I'm consideringadding XCHT because of the cough and seizures and tongue. The pulses don't really fit though. Any ideas (I know you have some!) Thank you
by naturevet
July 4, 2016
Hi Kathy,

The diet may prevent resolution of this problem, or even meaningful improvement. How about freeze-dried diets? Anything other than canned or kibble...even sardines would be fine!

The fact that the seizure pattern is the same month to month, and year to year, strongly suggests a food sensitivity

What time is the coughing occurring?

S
by drakedoc
July 6, 2016
Hi Steve, Sorry the owners were out of town for the holiday. The coughing primarily occurs between 2 and 4 AM. She occassional coughs at 7am as well. This girl does have an increased bronchial pattern on xrays. I wound up starting XCHT tabs (500mg) from Kan SID and I decreased her Ban Xia Bai Zhu Tian Ma Tang to SID so that they are still just giving 1 tab AM and 1 tab PM. I was going to increase the XCHT to BID if we had no problems with it at SID. I'd love to hear your thoughts, Thank you
by naturevet
July 6, 2016
Sure, let's go with your protocol for now

The timing of the cough suggests Phlegm, which implicates diet as the ultimate cause

Steve
by drakedoc
July 6, 2016
Ok, I will work hard on getting her diet changed and let you know how it goes. Thank you so much for getting back so quickly, Kathy
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