Saved two birds with one stone

It's not every day that my diagnosis saves TWO lives.


Last weekend, a 15 year old cat arrived at the clinic for evaluation.  His clients rushed in the front door, stating that he had been attacked by their 2 year old boxer. 

The patient, "Stewart" was tilted to the right, with frequent eye movements (nystagmus) and meowing.  He could not stand, but could move all four of his legs.  We placed an IV catheter, and gave him oxygen.  I looked over his entire body, and I found dirty ear canals, dental disease, and a cat who could not stand, but nothing to support a trauma event.  No saliva, no open wounds, no fractured legs, no blood, nothing.

I went into the exam room to discuss the history in more detail. 

"What happened tonight?" I asked. "Did you see Stewart get attacked by your dog?"

"No," the clients said. "We heard no scuffle, no indication of a fight, but all of a sudden, while Stewart was in the other room, we heard him start meowing loudly.  When we went to go see what was going on, he was like this."

I smiled, realizing that this was a case of a wrongly accused boxer.

Stewart's clinical signs included brown foul smelling discharge in both ears, a head tilt, inability to stand, especially falling to one side, and nystagmus.  These symptoms point to dysfunction of the vestibular system, which is the part of the brain responsible for balance.  Common causes of this include stroke, inner ear infection, blood clot, or brain tumor.  Trauma is a possible, but much less likely cause, given the cat's indoor only status and the specific nature of the symptoms.

I discussed with the clients these facts.  They simply could not believe that the boxer was not responsible.  Apparently, he had been known for rough play, and was responsible for an accidental broken limb of their other pet about 6 months prior.  Again, I poured over the cat, looking for any evidence of injury. I found nothing.  I looked at his ear debris under the microscope, and found a raging infection.  I took radiographs and found again, nothing.

The clients started to take a deep sign of relief. Inner ear disease is treatable, and the most likely cause of the symptoms for Stewart that evening.

 With tears in their eyes, they earnestly told me, "Doc, you've just saved a boxer's life tonight. We didn't want to have to put him down for his behavior, and now you've helped to prove that he probably wasn't responsible for Stewart's illness.  Thank you so, so much."