Pam Brooks
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My cat Lucas is still sick with Horner’s syndrome. After many tests have not been able to determine a definitive cause. I would like to look into getting a myringotomy for him so I can know what the fluid in his middle ear is. It is causing him to have serious nasal issues every time he eats. Does anyone know if this procedure – myringotomy – is ever done by a regular vet, or does it require a specialist. And what have others paid. Any information would be helpful. See recent photo of Lucas – with his good eye. The other eye is affected by Horner’s syndrome.
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Had CT done of my cat Lucas due to no resolution of respiratory problems with antibiotics. Here are the results.
Moderate to marked thickening of the roof of the nasopharynx
• Otitis media bilaterally
• Lymphadenopathy left medial retropharyngeal lymph node
The marked thickening of the mucosal lining of the roof of the nasopharynx in conjunction withthe enlarged left medial retropharyngeal lymph node are highly suggestive for neoplastic
, and round cell neoplasia is the top differential diagnosis. Differentials include mast-
cell tumor, squamous cell carcinoma, adenocarcinoma, other. The mucosal thickening of the roof
of the nasopharynx can explain the bilateral otitis media due to mechanical obstruction of the
openings of the auditory tubes into the nasopharynx. A differential to neoplastic infiltration is
marked non-infectious inflammation (e.g. lymphocytic plasmacytic, eosinophilic) or
granulomatous inflammation (e.g. Cryptococcosis) but the later one is considered far less likely
here. The findings are not typical for inflammatory polyps.The bilateral otitis media is explains the history of head tilt and Horner’s syndrome.
Rhinoscopy/retrograde pharyngoscopy is recommended for further evaluation including FNA
sampling and biopsy. FNA sampling of the left medial retropharyngeal lymph node is warranted
as well. The prednisolone treatment may influence results of the samples.
I think all the tests and surgeries that may follow will be out of my budget. Already spent over $1000 to date with no resolution.
Wondering if there are veterinarians who would go in and remove the polyp – appears to be a poly under soft palate – just to give the cat some relief and time.
Opinions and suggestions are welcome.
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Sarah Good morning- I’m sorry you’ve been through so much already, and still are having issues. Did you speak candidly with your primary vet already about all of these findings and your wishes? (Meaning the removal of the polyp or at least some relief) That is probably where I would start. I would also make a few phone calls… local rescue organizations that may be willing to help fund your surgery. Or possibly your vet may let you pay a little at a time as you have already paid so much? I hope things get better soon!????????
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Krista Magnifico I agree with Sarah! Ask around to find someone locally to give you affordable options.
My cat was taken in to the vet in May to treat allergies, difficulty breathing (snoring sounds) and a head tilt. Was given an anti inflammatory, antibiotic (convenia), vitamin b-12, ear drops, and an X-ray. Diagnosed with asthma brought on by allergies. Lungs ok. Three weeks later breathing and itching had improved, but third eyelid started showing.
Vet would not see him and said to go to a specialist.
Took the cat for a second opinion. That vet said we should check for nasal polyps. Was sedated and had an exam of ears and throat. No polyps were visible. Vet felt a small enlarged area under the soft palate, but could not confirm this was a polyp. Head tilting stopped after first visit. Recurred a few days ago. Not present now. Second vet recommended going to a specialist for ct scan. It is cost prohibitive and I’m not sure it is necessary. Third opinion from an online site recommended we try antibiotics for the respiratory issues. Started on one antibiotic today for ten days. And started on purina fortiflora.
Looking for any other advice or experience with issues like this. I’ve never had a cat with these problems.
Thanks.
#cats #nasal #headtilt #respiratory #polyps
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Krista Magnifico Hello,
This is a tough one. The problem really lies in the inability to localize and identify the lesion causing all of the clinical signs. I would look into Horners Syndrome and see a cat specialist. I also would consider a long discussion with a trusted vet on what is treatable and what isn’t based on most likely diagnosis. That’s really what you need. Help from someone who will talk about your case within your budget and comfort zone. I have to add one more thing. It really bugs the heck out of me to have a vet who won’t talk to you further after you discuss and confide in your inability to see a specialist (who will likely want a ct that you also can’t afford). Sorry. Soapbox moment.
Keep me posted on your cats status please. -
Pam Brooks Post author Thank you. I just found your videos on removing nasal polyps on you tube. Was so hopeful yesterday that the second opinion vet who did the exam with Lucas under anesthesia would find a polyp in his throat and remove it. But instead she said she felt something kidney bean size under his soft palate. She wasn’t real confident of what it was. I went for the second opinion and told them I could not do the specialist route due to cost. Then I ended up being told I need to go see a specialist and spend 1-2 thousand for a CT. After that I could not pay for anymore treatment. So I searched around and had a vet online recommend the antibiotics. No one yet has given me options. Although the second vet said well he could live with polyps. I said but he is getting worse. The head tilt went away and came back. She said nothing else. I feel like I’m in an airport being moved through the system in the midst of storms that no on wants to discuss. And when I ask questions like can we give him steroids for inflammation – she says oh no I wouldn’t do that.
I am scheduled for a consult with a vet from Cornell on Sunday. Maybe that will help.
The other option I’m considering is just paying for a consult with a specialist – internal medicine I guess. When you call they won’t tell you what anything costs until you beg them. So I am leary of spending more money twith a specialist who may tell me they can’t do anything until I spend even more money on a ct.
Sorry, frustrating week. -
Pam Brooks Post author Here’s Lucas – before the Horners syndrome started.
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Krista Magnifico Hello,
I completely understand your frustration. For al of the reasons you mention we added a storyline section to this site. If you can please add a story of your experience at each vet you went to and include the prices of each visit. I hope it is a way for others to see what the cost of care is and even which bets are affordable and helpful. Stories are entered by service provider. So each visit is entered separately but reference that you added one for each. It is a new feature so let me know if you have any questions or problems. We really are working hard to help people like you. Keep us posted. Good luck. Ps I think Cornell is a great option. -
Pam Brooks Post author For more information on this subject please see these credible resource pages; ACVS Nasopharyngeal Polyps; https://www.acvs.org/small-animal/nasopharyngeal-polyps
Dr Magnifico, this is the link you posted. Figure 5 sounds like what Lucas has – a small polyp under his soft palate. Is this a surgery that a general practice cat vet could perform. Or only a surgeon. Cost is an issue for me. But I want to help Lucas before things get worse. Thanks.
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Pam Brooks Post author It says the mass will regrow with the simple removal shown. But it would be some relief and I’m not sure how fast they grow. Thanks.
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Pam Brooks Post author Went to a new vet today. What a difference from the others! Quiet, calm environment. Cats only patients. The vet was so thorough. Spent a long time with Lucas. When Lucas got anxious, he allowed him to go back into his carrier and calm down. Then he continued the exam by removing the top of the carrier. Lucas stayed in the corner and was much calmer. Going to try a new antibiotic – to hit what might be a middle ear infection. Onward!
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Krista Magnifico Awesome! Sounds like you made great helpful progress. Very best of luck.
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Pam Brooks Post author Thanks Dr Magnifico,
The consulting vet from Cornell recommended I find a good vet interested in pursuing what is going on with Lucas, and listening to me regarding my budget. That was the same advice you gave! By the way the Cornell consult was excellent. The vet was very familiar with nasal polyps – and did not feel like this is the problem.
Hello,
I don’t know enough about your cats case to offer any real advice. I have seen horners take months to resolve. And I’m not sure what triggered your cats condition. My best advice is to see a feline specialist or neurologist to discuss diagnostics and options. I don’t think you will find anyone outside of then to discuss this procedure. I would also strongly recommend that you ask yourself why you are worried about it and what potential side effects you might see if you pursue treatment plans without confirming the underlying cause. I leave Horner s alone unless a pet parent wants to do a CT scan. And I refer them if so. If your cat is happy and eating and ambulatory well I would leave well enough alone. As long as infection does not look like the underlying cause. I also rule out polyps. As these are treatable easily. In my opinion.
Please let me know what happens. Good luck.
Thank you. I read this article http://veterinarymedicine.dvm360.com/skills-laboratory-how-perform-myringotomy?pageID=1 and because Lucas does have Otitis Media bilaterally – as diagnosed from a scan (not an MRI but a less expensive scan done by Sonopath) I wondered if treating it would help resolve the Horner Syndrome. I spoke with my cat’s regular vet earlier and he agrees with you – to see a neurologist before attempting to do anything with the middle ear issue.
Lucas is on gabapentin for nerve pain in his face. It is keeping the pain away. But he hypersalivates and his respiratory system seems to go haywire when he eats. After he eats his nose and face are wet to the touch. He sneezes and flings thick mucous. Then he bathes his face with his front paws and they become wet so that he looks like he’s been doused with water on his head and front legs. That is why I am trying to find out what is causing the Horner syndrome – which seems to be triggering this hyper response to eating and creating nerve pain on one side of his face – the side where one eye has Horner syndrome.
Pam