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It sometimes happens that cat problems arise and are severe, but even with exhaustive examination and testing, an answer is difficult to find. The following case is an example of such a "mystery diagnosis".

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Doug from Melbourne, Australia wrote in
with the following cat problems:

Our 6-year-old feline family member has gone off his usual strong appetite and is wobbly and can't jump like usual. A visit to the vet and 2-day stay in the hospital included x-rays, blood tests, a urinary test and a thousand dollar bill to say that they can't tell what's wrong with him.

He was dehydrated and was put on an iv fluid drip to help. Vet thought a snake bite was possible but discounted the theory after all results were in and there was no evidence of tissue damage. Temperature was normal, a slight trace of blood was found in his urine, the ears were checked and x-rays showed no obvious injury although 3 vets examined it and one felt a shady section on the spine was suspect.

They recommended a possible specialist exam, but I cannot afford any further treatment. I had to borrow the initial hospital and exam fees. He was given an anti-inflammatory and antibiotics but completed treatment with no real visible improvement. The main symptom is "wobbliness". He looks up at you and tips over or when turning can tip sideways and can't even jump onto a chair. There is no obvious swelling or painful areas. Please advise as we are at our wit's end and feeling terrible for our little feline family member.

Doug, I feel so badly for you and your precious kitty. It really hurts when cat problems arise in our own kitties and it's even worse when an answer cannot be found.

It sounds like a very good diagnostic work-up has been performed. Without examining him myself and reviewing x-rays and bloodwork, it is hard to give much of an opinion. Even if I did have that opportunity, it sounds like something is going on that is not readily discerned on physical exam or tests. Cat problems can sometimes present in that manner and it is very frustrating.
When a cat has serious symptoms and nothing shows up in the bloodwork, two main areas of the body come to mind. The nervous system (including brain and spinal cord) and also the digestive tract. We see advanced disease in those areas with no change in blood work quite often. X-rays are sometimes helpful, but often even they are limited.

His symptoms do not sound like those that would be exhibited from a digestive tract problem. You mention a decreased appetite, but you did not mention vomiting or diarrhea.

The way he wobbles and falls over is most suggestive of neurologic disease. Unfortunately, there's very little in the way of neurologic disease that has a good prognosis. One slight possibility to be hoped for that does have a good prognosis is something called idiopathic vestibular disease. It is one of many cat problems that is seen most often in older cats, but not necessarily. It shows up suddenly, causes the signs you describe, is sometimes attributed to an inner ear problem, and over time resolves, usually leaving a slight head tilt. Did any of the vets mention that to you as a possibility? There's usually no definitive way to diagnose the disorder and no real treatment needed although many vets will prescribe cat medicines such as feline antibiotics and steroids.

As far as not being able to consult a specialist, I would suggest you don't beat yourself up over that. If they find anything at this point, it's probably not going to be something very amenable to treatment. Unfortunately, the situation you're in probably just requires watch and wait.

The most important part of feline medical care is to keep him eating, whatever it takes. If he is feeling dizzy, that interferes with appetite. Nutrition is important and often is the reason cats with any disease decline, rather than the primary disease itself.

Good luck and I'm so sorry you're going through this.

Dr. Neely