FRESH STEP® CAT LITTER TOXOPLASMOSIS WARNING:
We would like to remind our customers, especially pregnant women and immunosuppressed persons, that cat feces can sometimes transmit a disease called toxoplasmosis.* Therefore, always remember to wash hands thoroughly after handling used cat litter. For further information, consult your doctor. Unused cat litter poses no toxoplasmosis threat.
*Toxoplasmosis, an illness characterized by cold or flu-like symptoms, can be transmitted by cat feces. It is especially serious in pregnant women because it can cause birth defects. Immunosuppressed persons may also be susceptible to toxoplasmosis.
March 10, 2015 – Tuesday
With winter still hanging on, MISTER C and I were having a quiet afternoon at home. “C” was cap-napping on top of the love seat, sound asleep on his favorite cushion right in the middle, where on a good day he can be straddled by two loving humans. My husband was away, so he had the love seat to himself while I was reading on the sofa.
Engrossed in my story, it took a second or two for me to register that C had suddenly jumped up and started running around in frenzied circles on the living room carpet, just beyond the love seat where I couldn’t see him. When I got up to see what he was chasing (ick)—or, worse, what was chasing him (ugh)—I found him on his side, convulsing and foaming at the mouth. Feeling powerless, I had no idea what to do. Instinctively, I bent down and put my hand on his side to let him know I was there, even though I was otherwise useless. Fortunately, the seizure stopped within about a minute. But he was dazed and couldn’t stand up. In that semi-dreamlike state that kicks in during emergencies—the one that protects us from our emotions while still allowing us to take action—I called the vet’s office. They told me to bring him right in.
During the exam, C’s pupils were dilated and nonreactive to light or the approach of a finger, so it looked as if he couldn’t see. He also didn’t seem to be able to hear because he didn’t react to loud clapping. The vet held him so that his back legs dangled over the metal exam table to see whether one side or the other was affected by a possible stroke. But when C scrabbled to try to gain purchase on the table, both legs were working. He still couldn’t stand on his own once he was up.
I petted him the whole time and talked softly to him to let him, even though he couldn’t hear, to let him know that his pet parent was there and seeing to it that he got good care. But I needed support as well. With my husband traveling, I was terrified that I would have to make the “big decision” on my own.
The vet shaved C’s neck in the same spot where he had had his partial thyroidectomy last year (see the August 19, 2014 post) to take blood samples. The battery of tests would check his remaining thyroid gland function, his general health, and also whether he had picked up one or more infections—some of which could be fatal (such as leukemia or AIDS) and/or could have been in his system for years, causing slow damage. Despite the lack of paralysis, the vet said he could also have had a stroke. I was, of course, worried and alarmed, because that “big decision” might still have to be made after we got the test results. The vet gave him an injection of cortisone to reduce brain inflammation, and he also gave him a shot of phenobarbital to prevent additional seizures.
I brought him home just over an hour after the seizure, expecting him to be dazed and unresponsive. To my happy amazement, though, as soon as I opened his carrier he pranced right out of it as if nothing had happened. He could see and hear and was walking without difficulty, not at all disoriented. He knew where he was and certainly recognized the hand that feeds him. It was close to his dinnertime, and he started crying for food, which he gobbled up. He also had the strength to jump back up onto his favorite cushion.
Here, a few hours after his seizure, Mister C is looking up at his cushion, ready to return to normal. He might seem a little depressed, but this expression is quite normal when I ask him to do something—including look into the camera to have his picture taken.
This was all very weird, but I was grateful I was here when it happened so I could get him prompt care. The vet said that seizures in cats are rare and are always caused by a problem (whereas in dogs, they can be hereditary). The fact that he had serious neurological symptoms and was fine about an hour later was surprising. But the vet said there was no telling whether or when he might have another seizure, so I would have to keep a close eye on him.
March 13, 2015 – Friday
After our ordeal on Tuesday, Mister C continued to be fine. As far as I could tell, he was completely back to normal. Although we were supposed to get the blood work results on Wednesday, we didn’t get them until Friday—all except one titer, which was sent to the University of Colorado for analysis of possible infection. All of the other tests were negative. So, after a terrible fright, a visit to the vet, hundreds of dollars worth of blood tests, and careful monitoring, all the vet could say (before getting the final test result) is that he probably had had a TIA (transient ischemic attack), or mini stroke. In the meantime, while waiting for the final result, the vet advised me to give him 1/4 of a low-dose aspirin twice a week.
Not allowed to go out while waiting for the final blood test results, Mister C is looking wistfully out on the deck and backyard, his former (occasional) stomping grounds, although he is essentially an indoor cat.
March 18, 2015 – Wednesday
A week and a day after the seizure, I finally received the last blood test result on my little buddy. It showed that he has toxoplasmosis. In this test, two immunoglobulins are analyzed, IgM suggesting recent infection, and IgG suggesting chronic infection. The former was negative, but the latter was positive. This means that sometime within the past few years, the little mister got hold of a rodent—or, as I shudder to remember, a baby rabbit—that was carrying the Toxoplasma gondii protozoa. This common parasite affects the nervous system and thus seemed to explain Mister C’s seizure. So we stopped the aspirin and started the antibiotic Antirobe (clindamycin hydrochloride) 75 mg twice a day for a month.
The vet said that humans who handle cat feces that has been sitting in a litter box for three or more days, or who eat plants from gardens where the feces has been parked, can become infected and will need antibiotic treatment. As stated at the top of this post, toxoplasmosis is especially dangerous for pregnant women or women who may become pregnant, as well as for immunosuppressed people. So good feline-human hygiene is necessary to prevent cross-contamination.
April 18, 2015 – Saturday
A month later, having completed his course of antibiotic treatment on Friday, April 17, Mister C was doing well and showed no signs of impairment. The next afternoon, however, again while sleeping peacefully on his favorite cushion, he suddenly jumped up, ran around in circles, and fell to his side in another convulsion.
This time my husband was home, and we both stayed with him during the minute or so that the seizure lasted. It was Saturday, and the vet’s office was closed. I called the emergency number and was told I would have to take him to an animal clinic several towns away. But when we checked little mister, we saw that he had recovered very quickly, and within minutes he showed no signs of deafness, blindness, or weakness. So we decided to wait it out and contact the vet on Monday.
Here’s the little guy asleep post second seizure in his favorite place behind my shoulder.
I told the vet I was afraid that toxoplasmosis had not been the cause of Mister C’s seizures or that the antibiotic hadn’t worked. At C’s age of almost 15, I said I was not inclined to put him through a lot of difficult and expensive tests. But the vet said this latest seizure didn’t mean a failure of diagnosis or treatment. The antibiotic can’t undo old neurologic damage, but it will halt progress of the disease. These protozoa cause severe neurological damage and dysfunction, and it is possible that he will have more seizures. The vet said that if he has more than one seizure a month, or if the seizures become severe, we can consider putting him on phenobarbital, which is inexpensive and has few side effects other than temporary lethargy, although in some cases it affects the liver. His advice, though, was to just monitor him for the foreseeable future.
May 4, 2015 – Monday
Now that we are into spring and experiencing some lovely days, it is heartbreaking to see my little guy staring out the deck door or gravitating toward any open window for a breath of fresh air. He still thinks of himself as a wild man, although he had only a few misadventures in the past (including two baby bunny attacks, for which he is now paying). Most of the time, we didn’t ask questions about his escapades.
Sadly, though, the fear of his picking up another infection—or worse, having a seizure outside where we can’t find him—means he will need to adjust to a window-peering version of experiencing nature.
Our job is to keep him safe and as healthy as possible for the rest of his days, which we are happy he is spending with us.