Little kitty possible hydrocephalus

Re: Little kitty possible hydrocephalus

Hannah Wynne Richards — Tue, 03 Feb 2015 11:30:19 GMT

Congratulations Suzanne. Take every day you can give this little fellow good quality of life as a bonus. I'm sure his owners are spoiling him rotten, so, even if his life will be short, it will be happy.

Wynne

Re: Little kitty possible hydrocephalus

Anthony Dennison — Tue, 03 Feb 2015 09:42:12 GMT

Anecdote alert:

I was at aneuro CPD about 18 months ago, and the speaker was talking about odd cases; there was one boxer that they always joked was a little special; when they had to do a brain MRI later in life for seizures, they found a massive hydrocephalus, which had been present for some time, so animals can do ok with it

Re: Little kitty possible hydrocephalus

Suzanne Kelly — Tue, 03 Feb 2015 00:38:55 GMT

Hi, kitty update. I hope I've managed to upload the video, I tried to upload it in Movie Maker but couldn't, so hopefully I've managed it in windows media player, but it'll be sideways.

Anyway he's doing way better than expected. He's flying around, very playful and happy.He was 1kg 2 weeks ago, he's 1.4 kg now, so not bad. The owners have another normal kitten the same age, so they can compare their behaviour. When he presented originally he was dull and not very playful or active. Now he's just as playful as his "sibling". He was full of fun in consult this evening, playing and purring. He didn't have any seizures at all for a week ( he was having several a day) but recently has had the odd one. He's still on metacam and phenobarbitone, if the seizures continue I'll try the Levetiracetam. I've started frusemide this week and I'm going to get him back in weekly. Pred and ranitidine are on the list to try too, but for now I'm really happy with him and so are the owners. I'm not naive or stupid, neither are the owners. I appreciate the prognosis is poor, but the little guy has an excellent QOL at the moment and I don't see what's wrong with trying to do my best to help him. ( That's a rhetorical statement btw, I'm sure some of you would love to enlighten me, please don't!)

www.vetsurgeon.org/.../5078.IMG_5F00_2779.MOV

Re: Little kitty possible hydrocephalus

Anthony Todd — Mon, 26 Jan 2015 09:33:08 GMT

This is another example of a worrying trend in veterinary medicine as I said on another thread:

What do people think are the chances of recovery to "home and happy"?

When is the point reached when someone asks "Is further treatment fair to the dog?"

or kitten in this case.

Just because you can doesn't mean you should.

Sometimes the quality of the pet's life must be considered before the quality of an uncertain treatment just because it is available.

Re: Little kitty possible hydrocephalus

Anthony Dennison — Mon, 26 Jan 2015 08:46:02 GMT

Ranitidine can be used to reduce CSF production can't it? I know a couple of syringiomelia cases on ranitidine for this purpose.

Re: Little kitty possible hydrocephalus

Alex Gough — Sat, 24 Jan 2015 20:32:32 GMT

Referral job. There are medical options for treatment though.

Alex

Re: Little kitty possible hydrocephalus

Suzanne Kelly — Fri, 23 Jan 2015 16:35:32 GMT

Hi all, I'll try and post better pics but this is the kitty's scan, I think this confirms the diagnosis. He's doing remarkably well on metacam, flying around, being playful and naughty. Is the ventriculoperitoneal shunt a referral job or could a brave GP have a go?

Suzanne

Re: Little kitty possible hydrocephalus

Hannah Wynne Richards — Wed, 21 Jan 2015 17:18:41 GMT

Poor little kitten

Wynne

Re: Little kitty possible hydrocephalus

Suzanne Kelly — Wed, 21 Jan 2015 17:09:08 GMT

Thanks Mark, I'm going to try ultrasound tomorrow. Our scanner is old and the probe is huge so I'm not sure of the quality of image I'll get. I'll post the images if I can.

Re: Little kitty possible hydrocephalus

Mark Lowrie — Tue, 20 Jan 2015 09:26:25 GMT

Hi Suzanne,

Hydrocephalus sounds very likely whether this is congenital (most likely) or acquired (e.g. from FIP infection). Other causes possible and hence why a quick ultrasound probe on the skull is a good idea – and costs nothing other than your time! Ultrasound is very easy and certainly worth attempting. In theory we try and place the probe between suture lines but in practice, many of these patients have such thin skulls you can just place them directly on the top of the skull and get reasonable images. You are looking for big fluid filled ventricles to be compatible with hydrocephalus – i.e. big black symmetrical cavities. A normal patient will have very little fluid whereas an abnormal patient will have lots of fluid so very straightforward to give a rough idea of whether hydrocephalus is present and certainly no need to perform MRI/CT.

Ultimately, I agree this patient has a grave prognosis and whether congenital or acquired hydrocephalus the outlook is grim. You can trial anti-inflammatory pred (0.5 mg/kg BID) for a few days to see if this improves demeanour but realistically this cat will have not thrive and is unlikely to live much beyond a few months. Surgical treatment via ventriculo-pertioneal shunting etc is only really a viable option in my opinion if they respond initially to medical management for hydrocephalus. Also seems reasonable to start an anti-epileptic medication. Levetiracetam is the best option in my opinion as less sedating than other choices and is very cheap if the generic form is obtained. Failing this, phenobarbital is also a reasonable choice though likely to add to the cat’s obtunded state.

If you get ultrasound images you can always post them on here for us to see. It should be obvious.

Good luck!

Mark

Re: Little kitty possible hydrocephalus

Michael Woodhouse — Tue, 20 Jan 2015 09:00:42 GMT

Tap on the head?

(that's a joke and possibly the kindest thing to do).

I've used meloxicam and phenobarb together without problems.

Sounds like a genetic freak who is not going to have a long or fulfilling life. I'd advise PTS rather spending money.

Sorry.