Cat with facial paralysis for a month and increasing imbalance
My soul cat Rufus (12y male FIV+) has been dealing with complex medical issues for the past few months. Here is a little background
We believe this all started with allergies/ asthma. We started noticing him having some congestion that was mild and would come and go starting in December. We moved to a new home with an enclosed lanai he loves to go on. Feb, March and April is high pollen season where I live. He started to develop more congestion and wheezing. He was brought to the vet and we were told he did have wheezing (likely due to the increase pollen exposure). He was given a steroid injection and prescribed oral steroids to be tapered. After a couple days post injection he had a severe asthma attack with audible wheezing that lasted about an hour and half in the early morning. He was brought to the ER where is symptoms spontaneously resolved. However they suggested starting him on a Flovent inhaler.
About two days after starting the inhaler we started noticing him being unable to close his left eye. We immediately took him to his vet where he was diagnosed with paralysis on half his face (left ear, eye and whisker do not respond to any stimulation). The vet had not seen a cat presenting like this and wanted to consult a local veterinary neurologist and would follow up. We were advised to continue the steroid, Flovent and to lubricate his eye several times a day to prevent a corneal ulcer.
Our vet reached back out a few days later informing us of what they think it could possibly be. It was suggested he has a deep ear infection, polyp, brain tumor/lesion or just idiopathic. To get a possible definitive answer it was suggested to do imaging.
At the time we decide to try more conservative measures and start an antibiotic (levaquin) for the possible ear infection (although he had no noticeable/ obvious symptoms of infection)
About 4 days into the antibiotics he started to lose his appetite. The vet suggested stopping the antibiotics in favor of him eating
We started noticing him have some imbalance when he jumped up on things and completely lose interest in playing.
Things did not improve and we decided to pursue blood work. It was found he was severely hyperthyroid and his urine specific gravity was high indicating some dehydration. He was started on transdermal methimazole for the hyper thyroid and restarted on a new oral antibiotic (veraflox) and given another steroid injection given no improvement.
About 5 days into the new antibiotic we started noticing an increase in imbalance coordination and a complete loss of appetite and desire to drink water.
He was brought back to the vet with another provider for an evaluation. They gave him subcu fluids and suggested again stopping the antibiotics for 2 days to allow his appetite to come back. He was also prescribed an appetite stimulant Meanwhile still dealing with the facial paralysis and we have been giving him oral steroids every other day for almost a month.
The appetite stimulant helped a little bit however he still didnt want to drink much water. After two days the vet suggested not restarting the antibiotics in favor of getting him to eat and drink. The vets also suggest a toxoplasmosis blood draw.
Over the past few days we notice that he has a slight improvement of his symptoms on the days we give him his steroids. His desire to eat and drink is starting to return with needing the appetite stimulant some days but not every day and a lot of trialing different ways to get him to eat (warming up wet food, tuna water, new water fountain, etc). However his balance and coordination is progressively getting worse. He almost always loses balance now when trying to jump on furniture or anytime he shakes his head. The other day he completely fell when trying to jump onto our bed. He’s weak, sometimes seems disoriented and clearly not himself while other moments he seems to be doing ok
We are going to do the toxoplasmosis draw. We also discussed doing advanced imaging (MRI/CT) and possible anesthesia, but this has been incredibly stressful because of his age and overall condition as well as cost. Part of me wants every answer possible, but another part of me is scared of putting him through invasive testing and stress if it won’t meaningfully change outcomes. My husband and I have honestly been struggling emotionally trying to decide what the “right” thing is.
I feel guilty constantly. Guilty if I pursue more testing. Guilty if I don’t. Guilty wondering if I’m missing something treatable. Guilty every time I bring him back to the vet.
He still has moments where he cuddles, sleeps with us, purrs, and seems comforted being close to us. But I also can’t ignore that he is unwell.
Has anyone dealt with anything like this before? Did imaging give you meaningful answers? How did you decide how far to go diagnostically vs focusing on comfort and quality of life? As you can see this is complex, I don’t want to give up on my baby if this is something easily treatable. We’re just looking for any sort of advice and supports
TLDR: My cat initially developed what seemed like allergies/asthma and was treated with steroids and a Flovent inhaler after a severe asthma attack. Shortly after, he suddenly developed left-sided facial paralysis. Possible causes discussed were deep ear infection, polyp, brain lesion/tumor, or idiopathic paralysis, with imaging recommended but not yet pursued.
Since then, he’s developed worsening neurological symptoms including imbalance, weakness, falls, decreased appetite/thirst, and episodes of seeming disoriented. Blood work also revealed severe hyperthyroidism. We’ve tried steroids, antibiotics, methimazole, fluids, and appetite stimulants with mixed results. Steroids seem to help temporarily, but overall his coordination continues to decline and we’re struggling with whether to pursue advanced imaging or focus on comfort/quality of life.