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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 30343
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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Cat is lethargic and disoriented. What could it be?

Customer Question

My cat Bella is lethargic. She does not want to climb stairs or jump up on furniture. She seems disoriented and walks a lot in circles, not small tight circles but circles around the perimeter of a room. Is still eating and drinking and using the litter box. She spends a lot of time sleeping. I took her to a vet 4 days ago and they ran blood work and urine test. Nothing seemed out of the ordinary. She seems to have improved minimally but sleeps a lot. She also has problems with corners like she can’t back up to get out.
She is 6 years old and has had no significant health problems. She was a very verbal cat before but now not so much.
Submitted: 1 year ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry to hear of this with Bella. The wide circling you're seeing is pathognomonic (specifically indicative) of encephalopathy (brain disorder). Tight circles indicate vestibular (balance) disorders. Her disorientation and wall hugging/problems with corners are supportive evidence of encephalopathy. Conservative testing in the form of blood and urine tests may not reveal the cause of an encephalopathy particularly if the problem resides in the brain itself (an intracranial encephalopathy such as brain tumor). We need to examine the cerebrospinal fluid of these patients and/or MRI them. Extracranial (outside the skull) encephalopathies such as a poorly functioning liver or kidneys intoxicating the brain should be considered but appear to have been ruled out by her normal blood and urine tests.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Thank you for your information. Upon awakening this morning, she was still off balance but as the day goes on, she seems improved, no longer doing the wide circling but still slow moving. More verbal also but not near the volume she had before. Urine output is normal as well as bowel functions. She seems to have weakness in her hind legs, will go down stairs today but not able to go back up. While I appreciate your information, is it possible that she could be exhibiting signs of having a stroke?
Expert:  Dr. Michael Salkin replied 1 year ago.

It's a consideration but unlikely at 6 years of age. Strokes in cats most often arise secondary to hypertension as seen with advanced heart and kidney disease as well as hyperthyroidism. Bella's behavior is most consistent with an alteration in her forebrain - cerebrum and thalamus. There is still conservative testing available such as testing for infectious etiologies causing an encephalitis such as by the FIP virus and toxoplasmosis. Please continue our conversation if you wish.