Bengal leg weakness.

Dr. Marie replied:

Poor Rebel,

This sounds like a very difficult case.

It does sound like your vet has been very thorough. I have had cases like this where I can't figure out what is happening. Unfortunately I do find that Bengal cats are often my patient when this happens.

First, I'll address the Metacam and Cartrophen. These are very safe and there is no problem with using them together. Where the confusion may lie is in the fact that there is another drug called Carprofen (Rimadyl) which you definitely wouldn't want to use with Metacam, but this is a totally different drug than cartrophen.

You may want to ask your vet about the possibility that Rebel has something called lumbosacral syndrome. While some cats with this have changes you can see on xrays, not all do. An odd gait, trembling and constipation could all go along with this. Sometimes, sending the xrays to a radiologist can help us get a proper diagnosis for this condition.

When I hear of hind leg problems and an elevated CK I wonder a little bit about the possibility of a heart problem. Now, the CK has to be very elevated for me to get worried about it. Sometimes just the stress of struggling to get to the vet clinic can be enough to cause elevations in CK and I don't worry about small elevations. A heart problem such as hypertrophic cardiomyopathy (HCM) can cause small clots to form that can interfere with the blood flow to the hind legs and cause pain. Usually the symptoms are obvious and dramatic, but I have had some cases where it wasn't so obvious. The problem is that getting a diagnosis can be tricky. A heart ultrasound could be in order but that is not cheap. It's worth asking your vet if this is even a possibility though. There may be some other clues they can look at such as measuring the blood pressure in each of the limbs to see if there is reduced pressure in one hind leg indicating the possibility of a partial clot.

There are other more rare possibilities such as a muscle parasite like toxoplasmosis or neospora. These are really not common but again, it's worth asking your vet about these.

Where to go from here though is a tough call. If Rebel is insured or if finances are not a concern then there are a good number of additional tests that can be done to help get a diagnosis including heart ultrasound, toxoplasmosis and neospora titres and possibly even an MRI.

But if those are not in the budget then what we would generally do is do our best to treat the symptoms and see how things go. I know that it is frustrating to not know how to help.

Please let me know if you have more questions.

Dr. Marie.


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Dr. Marie replied:

I don't really know if LS syndrome is more common in Bengals. However, LS syndrome shouldn't cause his head to twitch. That almost sounds like a neurological problem.

The blood elevations you mentioned are really not anything I would call terribly significant.

I'm afraid I can't add too much here. This is a tough case and unfortunately even with expensive tests you may not get an answer. There really is no common illness that I can think of that would be causing these symptoms.

It's still worthwhile to ask about lumbosacral syndrome and neospora or toxoplasmosis although these may be a bit of a long shot.

Dr. Marie.