Horner's Syndrome Average Cost

From 372 quotes ranging from $300 - 2,500

Average Cost

$600

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What is Horner's Syndrome?

This occurrence is referred to as “Horner’s Syndrome”. It is a neurological disorder that is common in cats and often shows as abnormal eye and facial muscle positioning. The syndrome is usually unilateral, affecting only one side of the face. Damage to the sympathetic nerve path is classified into three areas. A first order injury is called a central lesion, where damage has occurred somewhere from the brainstem to the spinal cord. The second location differentiation is called a preganglionic lesion, referring to damage anywhere between the spinal cord and the superior cervical ganglion synapse (located near the mandible). A third order, or postganglionic lesion is found between the superior cervical ganglion synapse and the ocular nerves.

The autonomic nervous system of a cat is composed of two parts; the sympathetic and parasympathetic nervous systems. The sympathetic nervous system controls automatic or involuntary responses to fight or flight instincts. This involves pupil dilation, blinking, muscle tone and heart rate. The sympathetic nerve pathway is long, ranging from the brain to the chest. Damage to these nerves anywhere along the pathway can lead to the parasympathetic nervous system taking over the normal functions of the sympathetic nervous system. 

Symptoms of Horner's Syndrome in Cats

Most of the visible signs of Horner’s Syndrome involve the cat’s eyes. Other symptoms may be present depending on the underlying cause of the syndrome. Signs to watch for are as follows:

  • Ptosis (drooping eyelid)
  • Anisocoria (unequal pupil size)
  • Conjunctival hyperemia (protruding third eyelid)
  • Narrowing of the eye opening
  • Sunken eye appearance
  • Warmth and redness around eye and ear on affected side
  • Drooling
  • Head tilt
  • Stumbling

Causes of Horner's Syndrome in Cats

The most common cause of Horner’s Syndrome is trauma from serious injury of the head, neck or spinal cord. Some instances of Horner’s Syndrome are idiopathic, carrying no obvious reason for nerve issues. Possible causes include.

  • Car accident
  • Bite wound
  • Benign or malignant tumors in the chest, neck, brain or spinal cord
  • Retrobulbar (behind the eye) disease
  • Middle ear issues
  • Intervertebral disc disease
  • Blood clots

Diagnosis of Horner's Syndrome in Cats

To diagnose your cat, the veterinarian will need its full medical history for signs of any underlying problems. A complete physical examination will be made of the cat. If the cat is suffering from traumatic injuries, life-threatening issues will be addressed first. In an attempt to identify any causative health issues, the vet will also complete a neurological evaluation and an otoscopic (ear) examination. Horner’s Syndrome will have to be differentiated from other problems that share symptoms such as ear infections, facial paralysis, and Key-Gaskell Syndrome. 

A phenylephrine test may be performed to locate any sympathetic nerve path damage. The longer the pupil takes to return to normal size after drop administration, the further from the eye that the damage is. Full blood work will be taken including a complete blood count and a biochemical profile to help identify any health issues in the body. Urinalysis may also be used for this purpose. If spinal cord or brain damage is suspected, cerebrospinal fluid samples may be collected for testing.

Treatment of Horner's Syndrome in Cats

Horner’s Syndrome is a group of symptoms and not a disease itself. If no underlying cause can be identified, the issue may resolve on its own. Treatment of symptoms can provide relief as the cat experiences them. If a primary health issue has been found, proper treatment can reverse the syndrome. 

Eye Drops 

If the cat’s eyes are irritated from the many effects of Horner’s Syndrome, eye drops may be prescribed to help ease blinking and to soothe and minimize any ocular ulcers. If the cat is suffering from an inappropriately dilated pupil, phenylephrine drops may be used to correct the issue.

Surgical Removal

If a tumor has been identified as causing the nerve damage, removing it may relieve symptoms. This may or may not be possible depending on the location of the tumor. Surgery should only be performed if the risk is less severe than the symptoms that exist, or if the tumors are cancerous. General anesthesia is used for the procedure.

Recovery of Horner's Syndrome in Cats

If your cat has undergone surgery, be sure to follow all at-home instructions for care. Monitor the incision site daily to check for swelling or bleeding. If tumors have been found as the cause of Horner’s Syndrome in your cat, prognosis may be guarded. If the syndrome was a result of trauma and the cat survives all other injuries, the chance of recovery is quite good. 

In cases which the syndrome develops suddenly and no cause is identified, the nerve issues may resolve on their own. Sometimes this can take up to 16 weeks to occur. In some instances, Horner’s Syndrome may be permanent due to irreversible damage, however, this is rare. 

Horner's Syndrome Questions and Advice from Veterinary Professionals

Izze
tabby
10 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Normal Temperature
Conjunctival hyperemia
Ear Itching
different dilation of pupil
Head Tilt

My cat just got back form the vet earlier today. She has her second eyelid over 1/3 of her eye, and her pupil in that eye is differently dilated than the other. The vet was very short and new since we just moved. He told me to give her Clindaymycin over the weekend and if she is not better by Monday/Tuesday bring her back for blood test. He said the underlying causes was likely neurological, but he did not expand upon what that meant. I am thinking the worse (she's going to die level of worse).

She is perfectly fine other than that eye issue. Her ear is fine (he checked it), she eats well still, drinks, uses the litter box, and plays. She did not have a fever and her temp was normal. She was so ok, they went ahead and gave her a rabies vaccine today (she was due in a couple of weeks anyways).

What else could be causing her eye issue? No trauma. what are the possible neurlogical disorders and what is the probability that the clindamycin will work. I am worried sick about her and I am not sure if I should seek another opinion becuase she seems fine besides her eye.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2499 Recommendations
It certainly does sound like Horner’s Syndrome with the unequal pupil size, third eyelid showing on affected side, head tilt etc… Many times these cases may be idiopathic; but other causes like middle ear infection, trauma, poisoning among other causes may also lead to these symptoms. If Izze doesn’t improve over the weekend (since she seems otherwise in good spirits) you may return to the Veterinarian or visit another one to get another opinion. Regards Dr Callum Turner DVM

Thank you. The night of your reply went to the emergency vety because Izze started to act like she had trouble walking with her left front paw (she kept it up when walking and would lay down every couple of steps). Izze walked fine as soon as we got the emergency vet. But the emergency vet went ahead and examined her and diagnosed a middle ear infection and put her on an additional antibiotics. She told me it could take up to 3-6 weeks for the Horner's syndrome to clear up. I am not sure if I should just wait to see if it happens? It seems like a long time to just let it ride out, and hope for the best. I know the middle ear infection can get worse, especially since the ear drum thing was intact (which it is for Izze). If she were in any pain or showing any other symptoms this would be easier. But she is fine as long as you do not touch her left ear. If you touch the left ear she shakes her head or sometimes tilts it. It has the black discharge in it, she has had since I adopted her over 10 years ago.

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Miner
Shorthair
15 Years
Moderate condition
-1 found helpful
Moderate condition

Has Symptoms

Third eyelid

My 15 year old cat went to the vet for a routine blood draw to monitor his thyroid. That night I noticed his third eyelid covering about 1/2 of his eye. The next day it was diagnosed as probably an infection and he was given Bausch and Lomb Neomycin Polymyxin B Sulfates and Dexamethasone Opthoet said it Opthmalmic Suspension. After 10 days and no improvement our vet said Horners syndrome and continue the eye drops.Both eyes are very dilated. Could the trauma from a difficult blood draw in the neck have caused this?
Should he still be on an antibiotic/steroid eye drop for possibly weeks or something simply to moisturize his eyes?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2499 Recommendations
Horner's Syndrome isn’t an uncommon finding in cats especially older ones and may be caused by a variety of conditions; many cases are idiopathic meaning that we don’t know what the underlying cause is. You should continue with treatment given by your Veterinarian and to continue to monitor for improvement. Regards Dr Callum Turner DVM

The question I asked wasn’t answered.

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ellie
Idk
3 Months
Fair condition
1 found helpful
Fair condition

Has Symptoms

idk

my kitten has an eye infection and im worried it might be horner syndrome. her left eye has this puss and the boogers and a scrach on the outer eye lid and she holds the eye closed. Is is horner syndrome and if so how do i hep her and is it fatle for her age? if not then what is it and is it serros?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2499 Recommendations
From your description, there is nothing that indicates that this is Horner’s syndrome; however it is evident that there is an infection of the eye. You should use a warm damp cloth to remove any pus or discharge, flush the eye out with sterile saline and use an ophthalmic antibiotic ointment; but given Ellie’s age I would recommend a visit to your Veterinarian for an examination. Regards Dr Callum Turner DVM

thank you. i was worried

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Patty Wak
DSH tabby
4 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Paralysis
dilated eye
Poor Appetite
loss of coordination
Incontinence

We rescue cats and took one in the first week of November whose owners could no longer care for her for financial and housing reasons. She was borderline diabetic, underweight, had bald patches, and suffered from a raw throat and bowel issues after accidentally ingesting some concrete powder. We got her treatment right away and saw a significant improvement in the first month...she gained 1-1/2 lbs, the fur she had lost began to grow back, and she was having normal bowel movements. A few weeks later, she went through a bout of appetite loss...she'd nibble around, but not enough to fill her up. When her appetite began to return, we then noticed that she was having trouble coordinating her hind legs...trouble jumping, getting in the litter pan, and eventually stumbling when walking. It was obvious to the vet that it wasn't muscular or skeletal. She was able to get around and didn't seem to be in pain, so he gave her some steroids, and we saw some improvement over the next two weeks, though she was still unsteady. Then last week, she lost her appetite again, began to suffer incontinence, and had weakness in her front left leg. Yesterday, her pupils were two different sizes, and we took her to the vet right away. He did a thorough exam. Her neck and jaw muscles were stiff and her tongue was paralyzed. It was definitely a neurological cause, and he felt that, based on her symptoms over the past 2 months, she would only continue to deteriorate. We made the humane decision and had to say goodbye to our sweet Patty Wak. So...do you think that this could all have been a result of the concrete powder she ingested, or is it more likely that it was an ongoing issue and her previous owners simply didn't notice the small symptoms along the way?

Dr. Michele King, DVM
Dr. Michele King, DVM
1079 Recommendations
Thank you for your email. I am very sorry for the loss of your Patty. I am thankful that you were able to give her the care that she needed for the short time that you had her. It seems unlikely that her signs were as a result of concrete powder ingestion, but more likely that she was having subtle neurologic signs all along, indicating a larger disease. I'm sorry for your loss.

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Bella
TORTOISE shell
5 Years
Fair condition
0 found helpful
Fair condition

Has Symptoms

Enlarged Pupils
One Dilated pupil

Hi, we came home to find one of our cats pupils enlarged, early in the day it was normal. I have been reading on the Internet and not sure what has caused it suddenly. She is about 5 years old and in seems to be in good health apart from this. Could this have been a injury to the eye or some kind of Anisocoria.

Dr. Michele King, DVM
Dr. Michele King, DVM
1079 Recommendations
Thank you for your email. Two different pupil sizes is called Anisocoria, and the challenge is figuring out what might have caused it. It may have been an injury, infection, or neurologic event. It would be best to have her seen by your veterinarian to have her eyes looked at, and get medication if needed to correct the problem. I hope that she does well.

Bella visited vet last Friday, they pressure tested eyes, then applied cream to dilate the eyes more as they had going halfway back to normal. But vet said the couldn't see anything in any area of the eye and to keep her out of bright light. But a couple of days on her eye is still dilated, so maybe it may take awhile to go back to normal or maybe not? They checked her all over but came up with nothing, so it's a mystery. Maybe she bumped her head jumping around ? But she doesn't seem to be in any pain anywhere. Thanks

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Munchie
tabby
5 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Loss of Balance
Lose stool
Defecating outside of litter box
Pupil smaller than the other
Third eye lid raised
Not Eating

Medication Used

Claro
antibiotics

Hello, I had my five-year-old cat treated for minor ear buildup. He was administered claro. My veterinarian has been in business for 30 years and I do trust him. However, after leaving his office my cat immediately showed signs of Horner's syndrome. It has now been over 36 hours and he is not showing any signs of recovery. His symptoms include falling down to the side, not using his litter box properly, lifting of the third eyelid, pupil not dilating properly and overall just not himself. I have taken him back to the same vet two times since the medication was given, he was then administered an anti-inflammatory, and antibiotic, a dietary supplement and fluid for hydration. My veterinarian did not tell me it was Horner's syndrome until after we told him that we knew it was. He then admitted that his eardrum was most likely ruptured while administering the claro which caused the trauma to lead to Horner's syndrome. I would like to know if you agree with this advice, if you have any advice on what I should do next other than "wait it out" and do you think with this type of injury he will recover from Horner's syndrome? Thank you so much and any information is extremely helpful as I am greatly concerned.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2499 Recommendations
I understand your concern, Horner’s Syndrome may occur for a variety of reasons but inner and middle infections are two of the possible causes. Normally the Horner’s Syndrome doesn’t need to be treated directly as it is a symptom of another condition, when the primary condition is cured the Horner’s Syndrome will improve as well. I know this is a distressing time, but waiting it out is all you can do really until treatment for the ears is completed. Regards Dr Callum Turner DVM

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Pinky
Cornish Rex
9 Years
Moderate condition
0 found helpful
Moderate condition

Hornets srndrom and inner ear infection

My cat recently developed this unfortunate issue for which he has been to the vet. He's been examined and had his ears flushed as it looked like the ear on the same side had experienced quite a bit of trauma and irritation. No mites etc. We're the cause, he is a Cornish rex and they can be prone to ear problems. Although his ears do not seem to be bothering him now, his eye has not returned to normal. I'm wondering if I should follow up by giving him drops? Also if I should be concerned there is another underlying issue?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2499 Recommendations
Horner’s Syndrome may be caused by a few different condition, but middle or inner ear infections are commonly the cause; other causes may be due to trauma, cervical spine issues, tumours among other causes. Around half of cases of Horner’s Syndrome are idiopathic meaning that we do not know the underlying cause; if the Horner’s Syndrome was caused by the inner ear infection, it may take a while for symptoms to disappear but if the eye is getting dry in the meantime application of artificial tears may be required. Regards Dr Callum Turner DVM

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Trufa
Mutt
4 Years
Fair condition
3 found helpful
Fair condition

Has Symptoms

Conjunctival hyperemia
Ptosis

Medication Used

Rilexine 75 mg and Meloxitabs 0,5 mg

Hi. My cat has undergone castration surgery and since returning home has symptoms of horner syndrome. Does this usually occur? I am worried. The vet said it could be from stress and that it will pass. It's been five days since the surgery and the cat's eye continues with the symptoms. Should I look for another vet? Many thanks for any help.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2499 Recommendations

Post surgical ptosis is rare but may occur; it may resolve itself after a few weeks (around four to six). Other causes include trauma, inflammation, neurological conditions, poisoning or idiopathic; an examination of the ears and a neurological examination will rule out other causes. Eye drops will be required if Trufa cannot blink so that the conjunctiva will remain moist. Regards Dr Callum Turner DVM

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Nyau
Bengal
4 Years
Mild condition
1 found helpful
Mild condition

Has Symptoms

Eyelid dropping
Horners syndrome

Hi. My cat has never had any operation, its active around the house and outdoor as well. 3 days ago, the eyes were looking strange and looks like the eyelid is dropping, its not feeding well but looks healthy apart from the eyes. What can be the problem? I hope that it will be ok, i have had the cat for 4 years.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2499 Recommendations

Horner’s Syndrome (and similar conditions) can be caused by local inflammation, trauma, poisoning, tumours etc… which would explain the drooping eyelid and eating difficulties. Many times, these occurrences resolve themselves; however I would still recommend visiting your Veterinarian to be on the safe side. Regards Dr Callum Turner DVM

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