Page 934 - Problem-Based Feline Medicine

926 PART 11 CAT WITH AN ABNORMAL GAIT

continued

NUTRITIONAL
● Thiamine deficiency* (p 938)
Decreased thiamine can result in brain stem disease in cats. Clinical signs initially begin with
lethargy, inappetence and reluctance to walk. Later there is vestibular ataxia and episodes of spas-
tic ventroflexion of the neck or opisthotonos, dilated pupils, stupor and coma.
INFLAMMATORY/INFECTIOUS

● Encephalitis*** (p 930)
Neurological signs are often diffuse and may not localize to a single area within the nervous system.
Fever and leukocytosis are inconsistent findings. Systemic signs of disease such as fever, coughing,
vomiting and diarrhea may accompany the neurologic signs. Feline infectious peritonitis, toxoplas-
mosis and Cryptococcus are more common causes of encephalitis. Non-infectious causes are less
common but include feline non-suppurative meningoencephalomyelitis (“staggering disease”).
● Idiopathic encephalopathy* (p 939)
An encephalomyelopathy of young cats reported in the United Kingdom had clinical signs of
ataxia, paresis and “head shaking”. Cats 3–12 months old were affected, however, the disease was
seen in cats up to 3 years of age. Ataxia of the pelvic limbs was the initial clinical sign noted.
● Otitis media/interna** (p 936)
Clinical signs may reflect either primary ear, vestibular, or auditory dysfunction. Head tilt is most
common, but nystagmus and vestibular ataxia (leaning or falling to one side) may also be present.
A painful external ear and or pain on opening the mouth is often present. The facial nerve may be
involved. On otoscopic examination, the tympanic membrane is often discolored (hyperemic),
opaque and bulging outward with middle ear disease.
Idiopathic:
● Idiopathic peripheral vestibular disease*** (p 931)
Acute onset of peripheral vestibular signs with nystagmus (horizontal or rotary), head tilt (toward
the side of the lesion), rolling and falling. No other neurological signs are seen. Clinical signs, while
initially severe, are restricted to the vestibular system. Otoscopic examination, bulla radiographs and
other advanced imaging studies (computed tomography (CT), magnetic resonance (MR) imaging)
are normal. Signs usually improve dramatically in 1–2 weeks regardless of treatment.
Trauma:
● Head trauma*** (p 932)
Usually associated with an acute onset of clinical signs reflective of an intracranial problem. Signs
present often include alterations in consciousness, paresis and cranial nerve abnormalities. Fresh
blood from lacerations on or around the head, skull fractures, blood in the ear canals, and scleral
hemorrhage may be clues to a previous traumatic incident.
Toxicity:
● Toxins* (p 938)
Metronidazole at high doses has been reported to result in ataxia as the initial clinical sign.
Paresis is usually present, and seizures and cortical blindness may also be noted. Bromethalin