My cat is 20 years old and began having renal failure around 5 years ago and was placed on a renal diet 5. His renal function has not changed significantly in 5 years. Otherwise, he is healthy, continues to run around and play,still chases me when I come home,etc. Two weeks ago he began having seizures. Took him to the vet immediately; did full work up and nothing found on CBC, glucose normal, thyroid normal, etc. X-ray did show a mass in kidney so we assumed this tumor has mets to the brain. Did not want to put my baby through an MRI at age 20 so we opted on a trial of steroids hoping to shrink the tumor. After the steroids he had two more seizures and then went one week without any. Then began having them again. We started him on phenobarbitol 0.25mg,on Wed and continues to have seizures. After the seizures he wants to eat. My first question is can I give him food after his seizure safely when he is walking around and begging to eat? Another question is how long does it take for the pheno to work and my lastly how can I keep him safe during the day when me and my husband are at work. When he is having the seizures now, I am able to grab him and hold him as comfortably as possible in my lap while stroking him after the seizure. He recovers well. I’m worried about him harming himself when we are not here. Will he recover as well if no one is around? I have an intermediate dog crate which I have placed blankets in and have covered with blankets which he loves to lay in. I am thinking about padding the sides and locking him in while we are gone to work but this upsets me also because I don’t want to confine him. I would also have to put a litter box and food and water in the crate which could harm him during the seizure. I am very stress out and worried about leaving him. I have taken three weeks off from work, hoping to resolve the seizures, and now have to return on Monday. Can you please let me know how to keep him safe when he is at home alone?
We apologize for the delay in responding and understand your concern with Mr Boots seizure illness. I will try to answer your questions.
First, without a complete diagnosis treatment remains empiric, essentially an educated guess, made based on liklihoods, but without an expectation of accuracy. Mr. Boots could have a kidney tumor which metastasized to the brain, however, he could also have a second completely unrelated problem and the enlarged kidney has been an incidental finding. His history of kidney disease is likely associated with the abnormally sized and shaped kidney, but we really dont know what is happening in the brain. An MRI does require anesthesia, but would also tell us if there is tumor in the brain or whether there is no structural abnormality at all and Mr Boots has developed an acquired epilepsy. Additionally, an ultrasound exam of the kidneys would provide information as to whether the enlarged kidney is more likely to be a tumor or another problem, such as enlargement due to chronic obstruction or infection.
If your plan is to avoid further diganostics and attempt to suppress seizures with medication, you should know that seizure-suppressing medications are incmpletey effective and Mr Boots is likely to continue having some seizures, but hopefully fewer, shorter ones. Phenobarbital requires 10-14 days to reach a steady state in the blood and doses may need modification or progressive increases to maintain a relatively seizure free condition. Sometimes the side effects (sedation) of the medications become as objectionable and worrisome as the seizures themselves, but only ypu can judge that.
Once recovered from a seizure there is no reason Mr. Boots could not eat if desired.
As far as unobserved seizures, they may well have been going on occasionally for a long time before you became aware of it. Certainly preventing Mr Boots from being on high surfaces at the onset of a seizure is a good idea and perhaps caging him when you are not observing him is reasonable. He will get used to it. He is less likely to get hurt in confined space with a litter pan and water than in the house loose.
Finally, seizure recovery is unrelated to actions you may take such as holding or stroking. If you feel it comforts him, and you to do so, that makes sense but you shouldnt feel guilt for not being there to do so after unobserved seizures. As I said, they likely were happening unobserved before and Mr. Boots was as you said, he is back to almost normal fairly quickly.
I hope this is helpful. I reiterate that completing the diagnostic process may give information that could alter the treatment protocol or at least offer a prognosis. You need a name on the condition to get that information. The imaging studies are the way to get that. Good luck with Mr. Boots and please keep us informed. Thank you.
Arnold L. Goldman DVM, MS
and on behalf of the MedHelp veterinary crew
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