Any advice for a very grumpy and aggressive cat?

Re: Any advice for a very grumpy and aggressive cat?

Gareth Dowdeswell — Wed, 17 Aug 2011 15:26:18 GMT

Owner reported today no better but no worse on Phenobarbitone so will give Amitriptyline a try now and see if there's any improvement with that. Will keep this thread updated...

Re: Any advice for a very grumpy and aggressive cat?

Gareth Dowdeswell — Tue, 26 Jul 2011 17:14:30 GMT

Thanks for the replies, sounds like we'll be trying a therapeutic trial with phenobarb intially and seeing how it goes from there...

[quote user="Eamon McAllister"]

I had a cat which behaved something like this due to very impacted anal glands.

[/quote]

I did check the glands under GA, they were fine. Was amazed it hadn't expressed them during the struggle to get it into the crush cage!

Re: Any advice for a very grumpy and aggressive cat?

Eamon McAllister — Tue, 26 Jul 2011 16:23:23 GMT

I had a cat which behaved something like this due to very impacted anal glands.

Re: Any advice for a very grumpy and aggressive cat?

David Mills — Mon, 25 Jul 2011 23:17:21 GMT

Evidently they are not full seizures - no one is suggesting such - but they do look like periodic severe neurological derangements with repetive sterotypy-like events, much like one gets in partial limbic seizures.

Be aware that using any of the TCAs like amitriptyline needs at least 7 days to have any effect. Phenobarb needs 2-3wk for steady plasma state but 'works' much more quickly than this. Gabapentin would improve neuropathic pain immediately, but is expensive. A week's gabapentin followed by a week's phenobarb might well give you an answer re pain/neuro.

Re: Any advice for a very grumpy and aggressive cat?

Noweia — Mon, 25 Jul 2011 22:46:37 GMT

We have a CP cat just like this and it is currently doing well on Phenobarb. Had a burmese with the mouth version - also grand on the same treatment. We have had multiple weeks clear in the first cat so are now trying to taper the dose with view to stopping it completely.

Re: Any advice for a very grumpy and aggressive cat?

Kate Richardson — Mon, 25 Jul 2011 22:11:15 GMT

Poor cat. Whilst bloods etc would be great to rule things out, I think you may find them unremarkable, other than possibly elevated muscle enzymes and if finances are limited, it becomes about choosing the most appropriate diagniostics, This looks like neuropathic pain, a bit like Feline Oro Facial Pain syndrome- acute self traumatic pain. Xrays may be the most useful diagnostic, but the tail is moving normally, which I think would rule out a fracture or dislocation but neoplasia or osteomyelitis could be considered as an underlying cause. As funds are limited, I would trial amitryptilline or phenobarbitone- gabapentin would be good, but finances will likely rule out. Phenobarbitone can be good for neuropathic pain not just for seizures. Amitryptilline also can help with neuropathic pain, but also will help if there is an anxiety issue (also SID which may be helpful if cat not easy to medicate. If these don't work, consider amputating the tail? Although would have to warn re possible neuroma/continued pain sensation despite no tail.

Re: Any advice for a very grumpy and aggressive cat?

Stephen Courtney — Mon, 25 Jul 2011 21:39:40 GMT

If you think pain is the issue gabapentin liquid can be useful, assuming the owner can get it in - is a TID med, and the liquid is a special order through your pharmacist. Costly too...but can work wonderfully.

Re: Any advice for a very grumpy and aggressive cat?

Amanda Nicholls — Mon, 25 Jul 2011 21:32:46 GMT

[quote user="David Mills"]

Cat looks hyperaesthetic on the videos - v wide eyed and wired.

Pancreatitis unlikely given lack GIT signs. Surprised if this is pain with benefit of videos and flexibility of cat and you don't describe any obvious lameness/musculoskeletal problems. Looks very neurological, and central. Any ataxia/falling? Limbic/partial seizures have been described, just like in young tail-chasing dogs.

Biochem useful for metabolic derangements. Toxo serology. FIP possible.

If no money trial phenobarb.

[/quote]

I agree with what David has said. Unfortunately you can't work it up to get a diagnosis so treatment trials are your only option and hope you find one that will work. I would start with phenobarb and consider clomicalm if no response to phenobarb.

Re: Any advice for a very grumpy and aggressive cat?

Mark Hedberg — Mon, 25 Jul 2011 20:42:54 GMT

[quote user="Mark Hedberg"]Had a similar case; amitryptilline works a treat, along with the preds to control itching. The cat essentially has OCD. Dose as per BSAVA formulary.

[/quote]

Sorry, what I mean is that I had almost the exact same thing - cat would lick the base of his tail until the skin was showing, then chew it until it was really read; preds and amitryptilline seemed to break the cycle. Preds alone weren't enough. I would have loved to investigate as well; but the owner couldn't afford extensive tests, so I wasn't able to go down that route. It was a touchy and irritable cat until he went on amitryptilline, at which point he settled down well. Not doped, but much more relaxed. Even purred. :)

(I don't think pheno is indicated here - that's not seizures the cat is having...)

Re: Any advice for a very grumpy and aggressive cat?

Alan Tevendale — Mon, 25 Jul 2011 20:24:10 GMT

Certainly a tricky one. I would agree that central neuro conditions cannot be ruled out and the same would go for primary pain causing musculoskeletal lesions. Without further investigation I don't think you'll be getting too much further towards a diagnosis. I'd certainly want to run biochem/xrays/toxo serology.

The difficulty is always going to be around the aggression though - makes a good neuro exam impossible and seriously drives up the cost of any investigation. In these situations I'll sometimes offer to take a blood sample but not run it until the owner has decided that they want further work up. Obviously excludes certain elements of a blood profile.

I'd agree that other than going for further diagnostics trialling on meds may be your only option.

Re: Any advice for a very grumpy and aggressive cat?

David Mills — Mon, 25 Jul 2011 20:14:47 GMT

Cat looks hyperaesthetic on the videos - v wide eyed and wired.

Biochem useful for metabolic derangements. Toxo serology. FIP possible.

If no money trial phenobarb.

Re: Any advice for a very grumpy and aggressive cat?

Gareth Dowdeswell — Mon, 25 Jul 2011 19:50:38 GMT

Thanks for the replies so far, I've uploaded the videos of the cat and added them to my original post.

[quote user="Utlendigur"]

I'd want at least a basic biochem. (eg hypocalcaemia can cause facial rubbing, hyperaesthesia and restlessness) - plus Spec FPLi to r/o pancreatitis (pain?)

[/quote]

I did try and persaude them to do bloods when the cat was asleep, a shame they declined as it'll need sedating again to take any blood adding another £50-75 to their bill. Hadn't really thought about pancreatitis, cat's eating well, no known vomiting and seems mainly interested in its tail.

[quote user="Richard Carter"]

Sounds like genuine pain - tail fully functional? not any crepitus, chance of RTA/ sacral damage/ vasculitis in tail?

[/quote]

Tail seems functional, apart from the wounds on the tail which are due to self-trauma everything else felt fine under GA. Cat does go outside so could have had an RTA, would have been nice if the owners had let me take x-rays...

[quote user="Louise Alexander"]

Definitely not got fleas or flea allergic dermatitis?

[/quote]

No flea dirt found and other than self-trauma to the tail all the rest of the skin looked normal. Can't rule it out 100% but would have expected a better response to the preds?

Re: Any advice for a very grumpy and aggressive cat?

Richard Carter — Mon, 25 Jul 2011 18:10:15 GMT

Sounds like genuine pain - tail fully functional? not any crepitus, chance of RTA/ sacral damage/ vasculitis in tail?

Re: Any advice for a very grumpy and aggressive cat?

Sandra Milburn — Mon, 25 Jul 2011 16:15:21 GMT

Would also consider a bit more of a work-up if finances allowed it (at least basic bloods/ urine). There was an article in the Vet Times a few weeks ago about 'feline hyperaesthesia' (Rippling skin syndrome/ neuroderamtitis), which is possibly an idiopathic or compulsive disorder. According to the article it is thought to be as result of a combination of neurological and behavioural factors and along with skin signs often behavioural changes are noticed (avoidance of people and other pets). Bizarre behaviour is possible together with highly charged emotional state and is usually associated with alarm. It is thought that contributing factors include external stimuli as well as environmental and social stressors. Aggression towards the owners was what was described in the case mentioned in the article.

Treatment that was suggested include making the environment more cat friendly and using pheromone therapy.

I think in your case the fact that a young puppy has entered the picture could be part of the issue. Hope this helps :)

Re: Any advice for a very grumpy and aggressive cat?

Utlendigur — Mon, 25 Jul 2011 15:30:11 GMT

I'd want at least a basic biochem. (eg hypocalcaemia can cause facial rubbing, hyperaesthesia and restlessness) - plus Spec FPLi to r/o pancreatitis (pain?)

Re: Any advice for a very grumpy and aggressive cat?

Mark Hedberg — Mon, 25 Jul 2011 15:12:00 GMT

Had a similar case; amitryptilline works a treat, along with the preds to control itching. The cat essentially has OCD. Dose as per BSAVA formulary.

Re: Any advice for a very grumpy and aggressive cat?

Louise6732 — Mon, 25 Jul 2011 14:15:10 GMT

Definitely not got fleas or flea allergic dermatitis?