Question Details
Cluster Seizures In A Cat
by pindvm - March 16, 2021    View Case Report
Twink is a 14 month old DSH Brown Tabby. He was found at about 4 months of age and lives with 5 other cats. 8/2020 he had a bout of vomiting for 2-3 days. This happened again in January 2021 with hot yellow diarrhea that lasted a week. The cats pass around a URI leading to runny eyes and sniffles. A week ago owner notices he was meowing a lot and drooling. This slowly increased over 3 days to a 3 minute long grand mal seizure. Owner took him to the vet and he had 4 more seizures while starting Keppra and Phenobarbital. After a cluster of 3 seizures in an hour overnight the started him on IV midazolam. It took 18 for the seizures to stop and they weaned him off midazolam and sent him home on Keppra and phenobarbital. He is unsteady and very sedated. During time change owner got confused and dosed at 5.5 hours instead of 8 hours. He was extremely sedated for 12 hours. He seemed to be recovering when I saw him today. He is currently on Phenobarbitol 7.5mg BID, Keppra 150mg TID, Prednisolone 5mg SID, Clindamycin 50mg BID and Proviable SiD. MRI results rostral recess ventriculomegaly and falx enhancement with medial retropharyngeal lymphadenopathy.. Spinal tap NSF. Tongue was pink and wet. He eats raw food rabbit or chicken. Pulses weaker on the L and soft. St 40 improved pulses. Thinking BXBZTMT or TMGTY but pulses aren’t matching. Guessing it’s the drugs? Should I treat for possible viral involvement? He is on and off Lysine.
by naturevet
March 16, 2021
Hi Deborah

Assuming the enhancement indicates CNS inflammation, then given the lymphadenopathy and time of year of onset and aggravation, my suspicion would be a Shao Yang disharmony - your favourite new diagnosis!

To confirm, you'd want to see the pulse improve with massage or acupuncture to key GB points like GB 20 and GB 34 for example. Try the latter first. If the pulse improves, for sure that is what is going on.

In terms of treatment, you'd need Minor Bupleurum on board. That should resolve the inflammation. I assume the pred is there to address the enhancement? If so, the XCHT should do a better job of resolving it, making it less necessary.

Tian Ma Gou Teng Yin can be used with XCHT to control seizure tendencies.

The longer he is on Phenobarb, the harder it is to discontinue without triggering seizures. It's also likely the drug that is sedating him. Perhaps after robust herb dosing (if you can accomplish that) for a week or so, try lowering the phenobarb. Not too much though. Just a 15 or 20% reduction, if you can swing it. If that produces no seizures and the cat improves, then look at lowering it again if you like.

Once you're at that point, you can start looking at discarding drugs. The probiotic is a good idea in Shao Yang cases, but the clindamycin (for the lymphadenopathy?) and the pred will hopefully be expendable if you can dose consistently with XCHT. Check the acupuncture points to see if it's likely to help

by pindvm
March 21, 2021
ST 40 was the only point that helped his pulse but I sent the herbs any way and we talked about weaning off Phenobarb. He stopped eating and his fever spiked 106 and he ended up in ICU again. two days at 104-106. May be having partial seizures but its hard to tell. Owner hasn't been able to start herbs yet. Hoping to get him home and start herbs tomorrow as fever was finally back to 101 this am. He has abdominal lymphadenopathy and intestinal swelling now and they wanted to open him up and do a biopsy but the o declined. Have you seen Covid cases in cats? He hasn't been exposed as far as we know but he has been in the hospital a lot.
by naturevet
March 21, 2021
Sounds almost like FIP or something. Anyway, with a deep-seated infection on board, XCHT at a minimum is the way to go, even if you continue the conventional drugs

Reply to this question.
You must be logged in to reply