Possible neurological condition?

[Eilio]

My cat Eilio is a ~6 yr old neutered male.  He has asthma and hypertrophic cardiomyopathy.  However, both these conditions are under control w/out meds.  One morning last Thursday he awoke and couldn't swallow, eat and could barely breathe.  He was taken both to our regular vet and to the local university emergency clinic.  He had a full work up, including a chem panel, esophagram and esophagoscopy.  He was put on steroids (dexamethasone and prednisone, cisipride and famotidine; note that he also takes 2.5 mg of paroxetine daily for another condition) and released 2 days later.  Test results were mostly inconclusive, though the VERY young vet assigned to his case did find a large hairball in his throat, which was removed.  He continues to have problems swallowing, though not severe, and last night he experienced something I might call a seizure.   He yowled suddenly, then acted confused and lethargic.  When he got up to walk into another room, he wobbled.  I plan to take him back to the vet school for further evaluation.  Here's my question:  do I send him to neurology?  Internal medicine?  How fast do I need to make the appt.?  In fairness I realize this last question cannot be answered online since a physical exam is lacking, but I have no idea what's wrong, where I should go and how fast I need to move, if at all.  I worry that the stress of all the vet visits is also deleterious.  He has lost one pound in a week (from 12 pounds to 11).  Is Myasthenia Gravis, though rare in cats (?), the place to start?  Is a blood test the usual diagnostic procedure for this disease?

Please help.  Thank you.

[Dan Sims, DVM]

Internal Medicine is a good starting point.The yowling may have been more distress than a seizure .Myasthenia  Gravis is uncommon in cats and usually results in a megaesophagus which is readily picked up on radipgraphs.An esophageal foreign body should be considered and may show up on radiographs.