Chingis had a seizure last night

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nepenthe

Member Since 2010
My 16.5 yr old Bengal had a seizure last night.

He has been diabetic since 2008 and pancreatitis as well. He had three reabsorbtive teeth removed on March 2. At that time his creatinine was 202. He did recover from the surgery well and held that way until the last week of May when I noticed he'd lost weight. On May 30th, his creatinine was the same however, at 205.

On June 2, he had an abdominal ultrasound which showed pancreatitis (his Spec fPl was 11) and one irregular kidney, maybe inflamed.

The past few days, I've beeb noticing neurological symptoms/twitching with him, pretty much since that ultrasound early this month. It was subtle until last night.

Example, yesterday am he was on my desk beside me and I saw his front paws twitch, then moments later his abdomen, and then his head. His attention and pupils seemed normal though. Later on when he was on the floor beside my desk, I moved my chair back and he twitched about a half dozen times or so. So, I would call this some sort of exaggerated startle response.

Then I tried to replicate the twitching last night so that I could show my vet, and this triggered what looked like a grand mal. I was finding that all day he would startle to auditory stimuli, so this time I tried to replicate it by tapping my fingers on the door frame beside where he was lying, and seconds later he had what looked like a grand mal. Within 3-4 minutes, he was back to normal again and eating (so, doesn't look like a stroke/ischemic event):

https://drive.google.com/file/d/0BzccQr4bJuL0VXp0enkwZlJEa2s/view?usp=sharing


That tapping my fingernails against the metal door frame triggered a massive seizure at that moment which looked exactly like this in this Youtube video of someone's cat having grand mal:

After the seizure last night, I took him to an emergency clinic and the only thing in all of his blood that was elevated was creatinine, which was now at 331. His USG was 1.016 and the weird thing is that there was no protein in the urine (it is still being cultured).

There is no drooling, vomiting, hiding, crying, weakness, head drooping, depression, other abnormal behavior, etc and otherwise seems fine/interested in food and friendly to me. He is eating, and the only thing is very noticeable PU/PD. His blood sugar has also been good the past 4 days or so too.

This morning I took him to my regular vet to see if they could overnight him on IV, and she said that I am better off to keep giving him subq fluids at home, as this particular cat doesn't do well at the clinic and gets super stressed there, and that they worry that if he had another seizure, there is no one there overnight. She told me that the seizure and the elevated kidney values are likely due to two different causes. She said that if he seizures again, he would have to go on Phenobarbital to prevent this. (she also said that it could be a brain tumor, but then there are no other symptoms other than him twitching to auditory stimuli; he doesn't startle when touching him unexpectedly, no confusion, not using the litter box etc etc. So this is very weird)

The only drugs he has been on since the beginning of the month of June are Cerenia (8mg/day, 2 on, three off) and metronidazole 50mg/day for about three weeks straight. I mentioned to her that metronidazole can cause neurotoxicity, but she doubted that it would at such a low dose.

She did send me home with Clavamox in the case there is a kidney infection and to up his daily subqs and re-test his creatinine etc again in a few days to see how its trending. I think that ever since the dental surgery he hasn't really been the same and worry that a latent infection could have been causing this rise in creatinine.

I wonder if the seizure could be due to some aspect of the diabetes?

Edit: from what I could Google, this sounds like something called Startle syndrome (Hyperekplexia). So, like an exaggerated startle response.
 
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My cat Charlie started having seizures after being given a deworming medication at the vet. He lived many years on phenobarbital. He was never diabetic.
 
So sorry your poor kitty had to go through that, how frightening it must be for both of you!

I don't know much about Feline Tooth Resorption, but I do know that these teeth are very fragile and shatter frequently during removal. I would imagine a fragment of tooth that went undiscovered could cause inflammation/irritation that maybe could lead to seizures. Just a thought. I have never heard of Feline Diabetes leading to seizures. but who know? Anything is possible, I guess. I hope you find some answers, soon! :bighug:
 
Sorry to hear about Chingis - what a scary experience! I'm not familiar with diabetes specifically being linked to seizure activity in a cat outside of hypo episodes. I've never heard of Startle Syndrome, I'm afraid. I have had 2 cats with seizure activity.

I lost my civie Kaleigh to a brain tumor (pituitary macroadenoma) in December. The first symptom I noticed with her was peripheral vision loss. When she started circling a few days later, I knew it was neurological. She progressed to focal motor seizures in her left front leg and facial twitching, but those resolved with an increased pred dose. Her symptoms developed pretty quickly (about 2-3 weeks from me realizing something was wrong to the pred increase). She also had some behavioral changes (increased aggression towards one of my other cats and over-grooming) in the months preceeding, but I don't know for sure if that was caused by the tumor or from stress.

My sugar cat Jason had a absence seizure almost a year ago that was caused by hypoglycemia (he had been in remission and off insulin for 4.5 years at that time). The only reason I know it was from hypoglycemia is because he happened to have his routine bloodwork done earlier that day and I got the results shortly after the seizure; I immediately tested his BG and sure enough he was in hypo numbers. My vet thinks he has an insulinoma (tumor on the pancreas); we adjusted his feeding schedule and he hasn't had another since.
 
I don't know if this is caused by diabetes, but could be a combination of several things. One, he had (until a week ago) been getting Metronidazole over 3 week, and off and on for several months before that. Albeit apparently 50mg/day isn't enough to cause neurotoxicity, I did find online that when it does, it does so by messing with the GABA receptor, and they use Diazepam (Valium) to reset the inhibitory, relaxing GABA receptor. So, I would argue that under any dose, the effect of Metronidazole is not innocuous to its effect on the nervous system.

Then he has been getting Mirtazapine every other day for appetite. And this raises serotonin levels. My vet asked me if I give this cat n-acetylcysteine for his kidneys like I do to my other one. I did this for exactly 6 days before the seizures started. n-acetylcysteine does a lot of things: increases kidney filtration rate, decreases blood pressure in the kidneys, and also chelates toxins and metals.

So, if this isn't a tumor in the brain, I wonder if it is a perfect storm of metronidazole messing with him neurologically, while the sudden spike in creatinine have caused more toxins to reach the brain, which might have already been made worse with some sort of side effects of n-acetylcysteine. And this when serotonin is going up and down.

Today, he is still showing startle. Eg, I put a plate in the microwave, and the slight sound of the plate touching the glass plate in the thing caused a slight twitching. Then when I moved my old wooden creaky chair, he did it again, reacting to the sound. So, it's like a neurological over-reaction to sounds. Visual or tactile stimuli don't affect him.

Real weird. So far three vets don't understand it. (but when we deal with meds/polypharmacy, I bet anything is possible)
 
Just to update this. I am very very sure what is going on here. Apparently in the last several years there have been a spate of reports of mid-aged/geriatric cats in UK suffering from an auditory induced type of epilepsy called Feline audiogenic reflex seizures or FARS.

As with my Chingis, common everyday sounds like tinfoil or paper rumpling, glasses clanking together, keys on a keyboard etc etc or similar sounds can induce various degrees of seizures, typically lasting several minutes.

My vet sent me home with Phenobarbital and liquid Diazepam to deal with these seizures, so will see how this goes. Meanwhile, check this out - very unusual:

Feline audiogenic reflex seizures (FARS)
Feline audiogenic reflex seizures (or FARS, also known as ‘Tom and Jerry syndrome’) is a recently discovered and important type of epilepsy in cats. It appears to be more common in older cats and Birmans, and is triggered by various high-pitched noises."

Cat seizures can be triggered by high pitched noises including tinfoil
 
I had been thinking on this for the last day and wondered if cats got this as there is a rare form of epilepsy in humans triggered by loud/sudden noises. How interesting.
 
I had been thinking on this for the last day and wondered if cats got this as there is a rare form of epilepsy in humans triggered by loud/sudden noises. How interesting.

One wonders too why this is happening. Would be interesting to see a study like that one with the 96 cats, correlate how many of them had anesthesia/surgery in the past year, or correlation of which drugs they were on prior to these episodes. (on the other hand, one could also wonder the effect of wifi signals etc on mammals)
 
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