Stroke in Cats

Strokes in cats can be either ischemic (the blood supply is cut off) or hemorrhagic (blood is leaked out into the brain). Blood vessel blockages often occur because materials have broken off elsewhere in the body and become stuck in the veins or arteries leading to the brain. Blood clotting problems can also create obstructions of blood to the brain. Trauma from injury may lead to the rupturing of blood vessels, allowing them to bleed out into the cranial area. Both genders seem to be affected by strokes equally. A stroke is a medical emergency and immediate veterinary care should be sought.

The brain of all mammals needs constant and consistent blood flow to operate properly. When a rupture or obstruction decreases the amount of blood supply to the brain, this depletes the brain's oxygen levels and leads to brain damage. In cats, this occurrence is often referred to as a Feline Ischemic Encephalopathy (FIE), or a stroke. It was long thought that cats did not experience strokes, however, advances in medicine have made it very clear that feline strokes do happen and are not uncommon. However, they can be over diagnosed by owners and it is important a cat is seen by a veterinarian to confirm the diagnosis.

The signs of a stroke happening in a cat differ greatly from symptoms commonly noticed during a stroke in a human. Symptoms will rapidly manifest, with conditions holding steady after 24 hours. Signs to watch for are listed as follows:

• Loss of balance 
• Ataxia (unbalanced gait)
• Circling
• Confusion 
• Depression 
• Head tilting 
• Aggression 
• Fearfulness 
• Behavioral changes 
• Loss of appetite 
• Vomiting
• Loss of vision

For a number of reasons, strokes happen more often in outdoor cats during the summer. There are many underlying diseases that increase a cat's risk of stroke including:

• Trauma to the head
• Trauma to the body that dislodges fat or cartilage parts 
• Genetic defects
• Heart disease
• Liver disease 
• Kidney failure 
• Diabetes 
• Parasitic infection 
• Ingestion of toxins
• Hyperthyroidism 
• Hypertension 
• Hyperadrenocorticism 

If you suspect your cat is exhibiting signs of a stroke, take it to a veterinary clinic or animal hospital at once. Be sure to provide the veterinarian with your cat's full medical history to assist in identifying possible underlying causes of the stroke. If your cat has suffered significant trauma from an injury, multiple life-threatening problems may need to be addressed at once to stabilize the animal. The veterinarian will perform a physical examination, checking for other injuries, enlargement of organs and other symptoms that may be present. 

Full blood work including a complete blood count and a biochemical profile will be needed to assess the cat's condition and identify potential underlying problems. Urinalysis can help reveal issues with the kidneys or the liver. Thyroid levels in the blood should be measured to see if hormonal disorders exist. Blood pressure must be measured. For a complete diagnosis, a CT scan or MRI will be needed to get a close and clear view of the compromised blood vessels. This may not be available in some areas. If a parasitic infection is suspected, a fecal sample may be collected for microscopic examination.

The cat may need to be kept for observation to watch for possible signs of a second stroke occurring. If an underlying cause has been diagnosed, further treatment is generally required to address the issue. 

Supportive Care 

During the stroke and in the hours that follow, keeping the cat's condition stable can greatly affect the outcome of a stroke in a cat. This may involve administering intravenous fluids and giving anti-inflammatory medications to the cat. Hospitalization is required for this process. The goal is to keep the cat as comfortable as possible to promote healing.

The prognosis of a cat who has experienced a stroke will vary depending on the primary issue that has caused the event to happen. Many health issues such as heart or liver disease, hyperthyroidism and diabetes will require life-long treatments. Kidney failure can carry a very guarded prognosis. Long-term medication prescriptions may be needed and the costs can add up. Any damage to the brain that has taken place in the first 24 hours is often permanent. If a vital area of the brain has been destroyed, the cat may need to be euthanized.

If the stroke has been identified and treated quickly, there is a good chance of a full recovery taking place. It may be best to keep your cat indoors to lower the chance of injury or parasite and poison exposure. Ensure all toxic materials are kept out of your cat's reach within the home. The recovery process may take a prolonged period of time and include a lot of vigorous physiotherapy and ongoing at-home care.