What Is Inappropriate Mentation in Cats? Signs, Causes, and Treatment

Cats, unlike dogs, are discerning and less eager to please their owners. A cat probably won't come when called and rarely will even respond to its name. And while a rare forgotten trip to the litter box or food bowl shouldn't be cause for concern, when a cat seems unusually confused, disoriented, or uncoordinated, a visit to the vet is warranted. It could be suffering from acute sickness, a seizure disorder, or could have been exposed to an environmental toxin, causing a temporary lapse of normal behavior. Any abnormal behavior that continues for more than 24 hours or several times per week could be the result of a serious health issue. Note that a neurologic anomaly can only be diagnosed by a vet.

What Is Inappropriate Mentation?

Inappropriate mentation in cats refers to a host of disorders that can lead to disrupted cognitive functioning. This type of brain misfiring can result in memory loss, incoordination, and basic malfunctioning in everyday cat life. Sometimes these issues are small and acute, caused by temporary injury or inflammation. And sometimes brain disorders can be major, resulting in a compromised quality of life. Assessing the signs and discussing your concerns with your vet are the initial steps in the diagnosis and treatment of mentation disorders in cats.

Signs of Inappropriate Mentation

Cats learn by remembering, but a kitten who suffered an head injury early in life may have damaged the portion of the brain that affects short-term memory. A traumatic brain injury could account for difficulty remembering the location of food bowls or litter boxes. It can also explain an unsteady gait, incoordination, and balance issues. Traumatic injuries can also cause stunted growth. A new pet that seems to be on the smaller side for its age and breed, or a kitten who fails to grow, may have previously succumbed an injury. Seizure disorders can also cause disorientation, pacing, and confusion just following an episode. And old age can result in senility, presenting as forgetfulness, anxiety, and uncoordinated behavior. When witnessed over and over again, this could be confused for a more serious brain injury. Some infections (e.g. feline infectious peritonitis) cause damage to the portion of the brain that controls balance and walking. Affected kittens show severe trouble walking, but can otherwise live a normal and happy life.

Causes of Inappropriate Mentation

There is much debate over whether or not a cat can have a mental illness. If your cat's behavior seems off, it could be ill or could have a more serious problem with its nervous system. "Slowness" can be the result of brain damage due to injury, infections, environmental toxins, seizure disorders, genetic mutations, and even cognitive dysfunction in older cats. In the case of brain injury or infection, a functioning cat is a happy cat. If its setback doesn't interfere with your cat's daily functions, there's little you need to do about it. Get a firm diagnosis so you can take appropriate measures to prevent further seizures and neurological damage.

Cognitive dysfunction (or feline dementia) occurs most frequently in cats greater than 9 years old. If you adopt an older cat and feel like its personality is "off," it could be suffering from senility. In addition to general uncoordinated behavior, cats with dementia can also show unnecessary aggression and may display incontinence.

Diagnosis

At the vet's office, any potential brain injury is treated as an emergency, especially if it was a result of head trauma. So in addition to stabilizing your pet, the vet will perform an exam specifically looking at your cat's neurological system. The vet may determine an MRI or CT scan is needed. In the case of environmental toxin exposure—most specifically lead ingestion (which can cause a slew of neurological issues)— your vet will perform a blood test. If you cat has a seizure disorder, bloodwork is also recommended to rule in/out metabolic causes of seizures. MRI scans are done to rule out inflammatory conditions or tumors. Severe seizure cases require an EEG to measure the electrical activity in your cat's brain. For feline dementia, a vet will discuss your cat's full health history and, if necessary, perform blood tests to rule out other health conditions such liver or kidney disease.

Treatment

Any cat that suffers a potential head injury needs to be examined by a veterinarian. A vet will first stabilize the injured kitty using IV fluids and oxygen. However, a full recovery is not always guaranteed. After the injury, your cat may act different, lose its laser-sharp coordination, or have a change in personality. If this happens, the best you can do is provide a loving and supporting environment, reduce stressors, and eliminate unpredictable events as much as possible. Observe your cat's limitations and provide a lifestyle that works within them. Your veterinarian is an excellent resource for options.

Cats exposed to environmental toxins also need to be inspected by a vet, as the extent of exposure could be fatal. Treatment by a vet may include inducing vomiting, feeding your cat charcoal to absorb the toxin, administering IV fluids and medication, and time to process the toxin. If your cat has a full recovery, any neurological signs should eventually subside.

For seizure disorders (brought on by genetic conditions or other), a vet will prescribe medications to control the seizures. Most cats go on to live happy and healthy lives and any post-seizure temperament disorders should be alleviated.

There is currently no cure for feline dementia. Maintaining a good routine, providing options for exercise, and feeding your cat a high-quality food will help treat further decline. Supplements like omega-3 fatty acids, SAMe, and melatonin may improve brain function in older cats and aromatherapy with essential oils can ease anxiety.6 However some oils can be toxic to cats so you must seek your veterinarian's advice before exposing your cat to these products.

If you suspect your pet is sick, call your vet immediately. For health-related questions, always consult your veterinarian, as they have examined your pet, know the pet's health history, and can make the best recommendations for your pet.

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Cat Health

Idiopathic Epilepsy in Dogs

Epilepsy is a general term for neurological disorders that are characterized by recurrent seizures. In some cases, the seizures are caused by trauma, a toxin, a brain tumor, an infection, or an issue with your dog’s blood, kidneys, or other organs. At other times, the epilepsy is referred to as “idiopathic,” which simply means that there is no identifiable, underlying cause.

Seizures commonly fall into two categories: generalized (grand mal) or partial (focal). Generalized seizures commonly appear as involuntary jerking or twitching movements of all four limbs with loss of consciousness. Partial seizures may involve one limb, side of the body, or face. Partial seizures may progress to generalized seizures. Seizures may also result in abnormal behavior, vocalization, salivation, chomping/chewing, and involuntary urination and defecation.

Dogs with idiopathic epilepsy typically have their first seizures between the ages of 6 months to 6 years. Though idiopathic epilepsy can occur in any breed, it is considered an inheritable disease in many breeds and in some breeds a genetic basis has been identified. Therefore, dogs diagnosed with idiopathic epilepsy should not be used for breeding. Commonly affected breeds include:

• Labrador retrievers

• Golden retrievers

• Poodles

• Keeshonds

• Beagles

• German shepherds

• Dachshunds

• Irish setters

• Cocker spaniels

Symptoms of Epilepsy in Dogs

Prolonged seizures lasting more than 5 minutes or two or more consecutive seizures without full recovery are referred to as status epilepticus. This is a true emergency and you should seek immediate veterinary care for you pet. Two or more seizures in 24 hours are referred to as cluster seizures and are an indication for beginning anti-seizure medication.

In dogs, seizures often occur in three distinct phases:

1. The first is called the aural phase and the most common signs are behavioral changes. These changes may be subtle and include restlessness, attention seeking or anxious behavior.

2. The second phase, called the ictal phase, is when the seizure itself takes place. A seizure can last from just a few seconds to several minutes.

3. The final phase is called the postictal phase, which occurs after the seizure. During this phase, your dog may seem restless, incoordinated and/or disoriented. Occasionally, temporary blindness, deafness or other neurologic abnormalities may occur.

It may be difficult to watch your pet have a seizure but most are of short duration and cause no permanent harm. Avoid being bitten by keeping your hands away from your pet’s mouth during a seizure. If it can be done safely, provide padding and move your pet away from stairs to prevent injury.

Diagnosis of Epilepsy in Dogs

Your veterinarian will take a complete history and perform a thorough physical and neurological exam to determine if there is an identifiable, underlying cause of your dog’s seizure.

In order to do so, the following tests may be recommended:

• Chemistry tests to evaluate kidney, liver, and pancreatic function, as well as sugar levels and electrolytes

• A complete blood count to screen for infection, inflammation, anemia, and other blood-related conditions

• Urinalysis

• PCR testing and/or serology to evaluate for infectious diseases that may cause seizures

• Referral to a neurologist for advanced testing including MRI and cerebrospinal fluid analysis

• Cultures, PCR testing, and other specialized tests that can identify if specific parasites or diseases could be the cause

Treatment of Epilepsy in Dogs

Epilepsy cannot be cured, but it can usually be controlled with anticonvulsant drugs. If your veterinarian determines that your dog’s epilepsy is idiopathic, one or more of the following medications may be prescribed:

• Phenobarbital helps reduce the frequency of your dog’s seizures and is the most prescribed medication for dogs with idiopathic epilepsy. It is generally a well-tolerated drug.

• Potassium bromide is another seizure medication that may be added to your dog’s treatment, if she does not respond well to phenobarbital alone.

With these medications, as with all drugs, some patients experience side effects. In order to make sure an adequate dose is being given, and to monitor for side effects, it is important that blood levels of each medication as well as complete blood counts and blood chemistry profiles be monitored periodically. Liver function tests may also be indicated. Your veterinarian will advise what monitoring needs to be done and how often. Medication dosages should not be changed without talking to your veterinarian.

Dogs diagnosed with idiopathic epilepsy may require treatment for life, and sometimes more than one drug is needed for adequate seizure control. And while many dogs are well controlled, some are not despite multiple medications. In addition, adequate seizure control does not necessarily guarantee that a dog will be entirely seizure free. The degree of seizure control may need to be balanced against potential side effects of the medications.

Management of Epilepsy in Dogs

Besides medication, there are many ways for you, yourself, to help manage your pet’s epilepsy:

• Maintain a seizure log that lists date, time, length and severity of seizures as well as videotape and share this with your veterinarian

• Do not change or discontinue medications without consulting your veterinarian

• Have blood work and other lab work done when recommended by your veterinarian

• Consult your veterinarian whenever you notice a change in your pet’s condition

• Put a medical alert tag on your pet’s collar so that if he becomes lost, whoever finds him will be aware of their seizure disorder and need for medication.

Several treatments are available for pets with epilepsy. By working closely with your veterinarian, you can maximize the chances of controlling the disorder and giving your pet a long, happy, and comfortable life.

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4 Rainy Season Dangers You Might Not Know Of

Each year, certain parts of North America are bombarded with rain. While this may be good for the garden, high rainfall can potentially pose some real threats to your dog.

1. Mushrooms

During the rainy season, mushrooms may pop up in your yard with more frequency. There are thousands of species of mushrooms, but thankfully only about 100 are poisonous. That said, mushroom identification is very difficult, so it's hard to tell which are poisonous versus which are benign. As a result, whenever you see mushrooms growing in your yard, make sure to remove them immediately and throw them away to prevent accidental ingestion by your dog. If your dog does get into a mushroom, contact your veterinarian immediately about inducing vomiting to get any potential toxin out.

Certain types of mushrooms may cause organ injury including:

• Gastrointestinal injury (signs include drooling, not eating, vomiting, diarrhea)

• Liver linjury (signs include vomiting, black tarry stool, yellow skin)

• Kidney injury (signs include abnormal urination and thirst)

• Cardiovascular injury (signs include a very slow or rapid heart rate)

• Neurologic injury (signs include hallucinations, tremors, seizures)

When in doubt, get to your veterinarian immediately as it's easier - and less expensive - to treat early on versus once clinical signs have developed.

2. Leptospirosis

Leptospirosis, a bacteria-like spirochete, is carried naturally by wildlife, like rodents and raccoons. In high rainfall situations, it’s prevalent in the environment. In dogs that have exposure to water sources, contaminated by wildlife urine (puddles, streams, ponds, etc.), transmission can occur. Canine leptospirosis can result in liver injury and acute kidney injury.

Signs of leptospirosis include:

• Vomiting

• Not eating

• Malaise

• Yellow skin

• Excessive thirst

• Urination

As leptospirosis can accidentally be transmitted to humans, it's important to talk to your veterinarian about prevention, including vaccines.

3. Mosquitoes

While mosquitoes may seem like just a pesky insect to you, they can be life-threatening to your dog. That's because mosquitoes can carry Dirofilaria, which transmits heartworm infection to your dog. Thankfully, there is a very effective preventative in either a topical or oral form. When in doubt, use year-round control to prevent problems from mosquitoes. If your dog has thin fur or skin and is more predisposed to getting bitten, use Skin So Soft or a topical insect repellent that repels mosquitoes. Talk to your veterinarian to be safe before applying anything.

Click here to learn more about heartworm disease in dogs.

4. Toads and frogs

Depending on where you live in the United States, certain types of toads - specifically the Bufo marinus or Bufo alvarius - can be poisonous to dogs. In fact, a dog drinking water from an outside dog bowl, that had a poisonous toad sitting in it, can result in clinical signs of:

• drooling

• panting

• walking drunk

• a racing heart rate

• a very slow heart rate

• even seizures

Frogs are not toxic, but can cause gastrointestinal upset when ingested.

To be safe, supervise your dog outside to prevent accidental ingestion of dangers like toads and frogs. When in doubt, contact your veterinarian or ASPCA Animal Poison Control Center at 888-426-4435 if you think your dog is ill or could have ingested something poisonous.

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

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Encephalitis: Brain Inflammation in Dogs

Encephalitis in Dogs

The term encephalitis refers to an inflammation of the brain. However, it also may be accompanied by the inflammation of spinal cord (myelitis), and/or the inflammation of the meninges (meningitis), membranes which cover the brain and spinal cord.

German short-haired pointers, Maltese, and Yorkshire terriers are all found to be predisposed to encephalitis.

Symptoms of Encephalitis

Although symptoms may vary depending on the portion of brain affected, they typically appear suddenly and are rapidly progressive. Such symptoms include:

• Fever

• Seizures

• Behavioral changes (e.g., depression)

• Decreased responsiveness

• Head tilt to either side

• Paralysis of face

• Uncoordinated movements or circling

• Unequal size of pupils (anisocoria)

• Smaller sized pinpoint pupils

• Decreased consciousness, which may worsen as disease progresses

Causes of Encephalitis

• Idiopathic (unknown cause)

• Immune-mediated disorders

• Post-vaccination complications

• Viral infections (e.g., canine distemper, rabies, parvovirus)

• Bacterial infections (anaerobic and aerobic)

• Fungal infections (e.g., aspergillosis, histoplasmosis, blastomycosis)

• Parasitic infections (e.g., Rocky Mountain spotted fever, ehrlichiosis)

• Foreign bodies

Diagnosis of Encephalitis

You will need to give your veterinarian a thorough history of your dog’s health, including the onset and nature of the symptoms, and possible incidents that might have precipitated the unusual behaviors or complications. Your veterinarian may then perform a complete physical examination as well as a biochemistry profile, urinalysis, and complete blood count (the results of which will depend on the underlying cause of the encephalitis).

If your dog has an infection, the complete blood count may show an increased number of white blood cells. Viral infections, meanwhile, may decrease the number of lymphocytes, a type of white cells (also known as lymphopenia). And abnormal reduction in platelets (small cells used in blood clotting) is a good indicator of thrombocytopenia.

To confirm lung involvement and related complications, your veterinarian may require chest X-rays, while MRIs and CT-scans are used to evaluate the brain involvement in detail. Your veterinarian may also collect a sample of cerebrospinal fluid (CSF), which is then sent to a laboratory for cultures. This is necessary for definitive diagnosis and to determine the severity of the problem. If culture assays are unsuccessful, a brain tissue sample may be necessary to confirm the diagnosis, but this is an expensive procedure.

Treatment of Encephalitis

Your veterinarian will focus on reducing the severity of the symptoms, such as brain edema and seizures, and halt the progression of the disease. Severe forms of encephalitis require immediate hospitalization and intensive care. For instance, those suspected of having bacterial infections will be given broad spectrum antibiotics, which can reach the brain and spinal cord.

Living and Management

With proper treatment and care, symptoms gradually improve within two to eight weeks; however, the overall prognosis depends on the underlying cause of the condition. For example, in some dogs, symptoms may reappear once treatment is discontinued. In such instances, a second round of treatment (or long-term treatment) may be required to save the dog's life.

Your veterinarian will schedule regular follow-up exams to evaluate the effectiveness of the treatment and the dog's state of health. Your vet may even recommend a new diet for the dog, especially if it is frequently vomiting or severely depressed.

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Diabetes Ketoacidosis (DKA) - A Complication of Diabetes in Cats and Dogs

Unfortunately, as veterinarians, we are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). You're probably wondering if you just had a dog or cat diagnosed with diabetes mellitus—what do you do? First, we encourage you to take a look at these articles for an explanation of the disease:

• Diabetes in Cats

• Diabetes in Dogs

This article will teach you about life-threatening complications that can occur as a result of the disease; specifically, a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it.

What is DKA?

When diabetes goes undiagnosed or difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells — resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body.

Symptoms of DKA

Clinical signs of DKA include the following:

• Weakness

• Not moving (in cats, hanging out by the water bowl)

• Not eating or complete anorexia

• Vomiting

• Excessive thirst and urination (clear, dilute urine)

• Large urinary clumps in the litter box (anything bigger than a tennis ball is abnormal)

• Weight loss (most commonly over the back), despite an overweight body condition

• Obesity

• Flaky skin coat

• Excessively dry or oily skin coat

• Abnormal breath (typically a sweet “ketotic” odor)

• Diarrhea
  

In severe cases DKA can also result in more significant signs:

• Abnormal breathing pattern

• Jaundice

• Abdominal pain (sometimes due to the secondary problem of pancreatitis)

• Tremors or seizures

• Coma

• Death

What can cause DKA?

When DKA occurs, it’s often triggered by an underlying medical problem such as an infection or metabolic (organ) problem. Some common problems that we see with DKA include the following:

• Pancreatitis

• Urinary tract infection

• Chronic kidney failure

• Endocrine diseases (e.g., hyperadrenocorticism [when the body makes too much steroid], or hyperthyroidism [an overactive thyroid gland])

• Lung disease (such as pneumonia)

• Heart disease (such as congestive heart failure)

• Liver disease (such as fatty changes to the liver)

• Cancer

Diagnosing DKA

While diagnosing DKA is simple, by looking at the blood sugar levels of dogs and cats and by measuring the presence of these fat breakdown products in the urine or blood, treatment can be costly (running between $3-5000). A battery of tests and diagnostics need to be performed, to look for underlying problems listed above, and treatment typically requires aggressive therapy and 24/7 hospitalization.

Treatment of DKA

Treatment, typically, is required for 3-7 days, and includes the following:

• A special intravenous catheter called a “central line” (placed to aid in frequent blood draws)

• Aggressive intravenous fluids

• Electrolyte supplementation and monitoring

• Blood sugar monitoring

• A fast acting or ultra fast acting insulin, regular or Lispro, typically given intravenously or in the muscle

• Blood pressure monitoring

• Nutritional support (often in the form of a temporary feeding tube)

• Anti-vomiting or anti-nausea medication

• Antibiotics

• Long-term blood sugar monitoring and a transition to a longer-acting insulin

Thankfully, with aggressive supportive care, many patients with DKA do well as long as pet parents are prepared for the long-term commitment (including twice-a-day insulin, frequent veterinary visits to monitor the blood sugar, and the ongoing costs of insulin, syringes, etc.).

Preventing DKA

By following your veterinarian’s guidelines and recommendations you can help regulate and control your pet’s diabetic state better and monitor your pet carefully for clinical signs. For example, if your pet is still excessively thirsty or urinating frequently despite insulin therapy, they are likely poorly controlled and need an adjustment of their insulin dose (of course, never adjust your pet’s insulin or medications without consulting your veterinarian).

When in doubt remember that the sooner you detect a problem in your dog or cat, the less expensive that problem is to treat. If you notice any clinical signs of diabetes mellitus or DKA, seek immediate veterinary attention. Most importantly, blood glucose curves (when a veterinarian measures your pet’s response to their insulin level) often need to be done multiple times per year (especially in the beginning stages of diabetes mellitus).

If you have any questions or concerns, you should always visit or call your veterinarian.

Related reading:

• Diabetes in Cats

• Diabetes in Dogs

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