 | Christopher presents to the VMTH Neurology Service for
a 4 month history of collapsing episodes. |
| The episodes last approximately 5 seconds after which
he is normal. The episodes normally consist of falling to one side and
reaching/clutching with his forelimbs. |
| Yesterday he had an unusual episode
where he went rigid, stuck one forelimb out, fell
over against a wall and then fell down. Afterward he got up and was normal.
Three minutes later as he was walking into the house the owner noticed that
he was staggering like he was drunk. This quickly passed and he became
normal again. |
| He does not appear to know when an episode is going to happen.
He does not urinate, defecate or salivate during an episode. There is no
particular time of day that they occur although they may occur at feeding
time or when he is picked up. He appears to lose consciousness during the
episodes although the clients have never tried to rouse him.
|
| When he first
began having the episodes the clients would see 4-6/day, but he was an
outdoor cat and was often away from home. He has begun staying closer to
home and the clients estimate that he experiences 10 episodes a day. They do
believe that the number of episodes he has in a day has been progressively
increasing and that this increase is not due to an increase in time spent at
home. He also has begun hiding in a cubby in the bedroom.
Between episodes he is normal. |
| At one point the referring
veterinarian noted a systolic BP of 120mmHg, a heart rate of 80-90
beats/minute, and a gallop rhythm.
|
| He has had two
cardiology consults, one 4 months ago and one
3 days ago. |
| Ultrasound images and an ECG from
January are available for review. One undated record is available and
indicates a 1-2/6 systolic murmur with regular rhythm and
a heart rate of 132
beats/minute. |
| Echocardiogram revealed changes consistent with
idiopathic hypertrophy of the basilar septum, mild mitral valve
thickening, mild
regurgitation, and mild left atrial enlargement.
No obvious cause of syncope was noted. |
| One record dated
from 3 days ago indicates a 1-2/6 systolic murmur with intermittent
premature beats with an overall slow rate.
An ECG showed occasional junctional premature
beats and an intermittent
conduction abnormality but little change in heart rate (per record).
His echocardiogram was similar to his previous
exam showing mildly enlarged
left ventricular and atrial chambers. At this time
he was prescribed aminophylline 25mg PO BID. |
| He is on no other medications
at this time. Prior to being started on aminophylline he may have been
feeling a little ill which may have improved on this medication, but it has
not changed the frequency of his episodes. |
| He has a good appetite and energy level, although he
may not be cleaning himself as well.
|
| He is an
indoor/outdoor cat who lives on an acre with two dogs and one other cat.
|
| He
has had no C/V/D/Pu/Pd/Pp although he sneezes occasionally.
|
| He eats a handful of
Science Diet kibble BID and a can of Fancy Feast/day.
|
| He is vaccinated annually at a vaccine clinic and is up to date.
|
| He is often
exposed to ticks, has not traveled, and was hit by a car 7 years ago, but
suffered no ill effects. |
| The clients do not put
pesticides or rodenticides out in their property, but he does have access to
other people's property. |
| He has previously been tested for FIV/FeLV and
feline heartworm, all of which
were negative. |
