Collapse in Cats

Summary

Collapse is the inability to maintain a normal, standing posture, and is a rare symptom in cats. Cat owners may see their cat suddenly fall or intentionally lie down, then be unable to stand up. Both forms of collapse may be caused by serious medical conditions, and require prompt veterinary attention. 

One of the first steps to diagnosing collapse is deciding whether the episodes are due to fainting, inadequate blood flow to the brain, or a condition affecting the function of the brain, nerves, or muscles. A combination of a physical examination, blood work, diagnostic imaging and specialized tests are useful for determining  the type of collapse. Identification of the specific underlying condition is crucial for developing a treatment plan and understanding the prognosis. 

Some types of seizures can be confused with  collapse. In ambiguous cases, diagnostic testing can help distinguish which symptom is occurring.

Guidelines

Collapse is rare in cats, but when it happens it indicates a potential emergency. A cat who collapses needs emergency medical care. Sudden collapse can be a sign of shock, which is a serious medical emergency. Signs of shock in cats include:

• Cool extremities • Extreme lethargy • Weakness • Pale pink to gray gums

Other serious symptoms that may be seen with collapse include:

• Rapid breathing (tachypnea) • Labored breathing (dyspnea) • Severe lameness • Inability to use the back legs

• Vocalizations; pain and distress • Significant locomotion changes such as an uncoordinated gait (ataxia)

• Walking into walls • Inability to lift the head •Partial paralysis (paresis)

• Complete loss of function and sensation in the limbs (paralysis). 

Cats displaying these symptoms require immediate medical attention.

Possible Causes

Collapse can be an indicator of many different conditions, affecting many different body systems. Potential conditions associated with collapse include :

• Heart conditions such as hypertrophic cardiomyopathy, arrhythmias, or shock

• Blood vessel conditions such as saddle thrombi

• Respiratory conditions such as feline asthma, anaphylaxis, or pyothorax

• Blood conditions like those that lead to anemia or sepsis

• Endocrine conditions such as diabetic ketoacidosis, or hyperthyroidism

• Metabolic disorders such as hypoglycemia, or hyperkalemia

• Conditions of the nervous system such as myasthenia gravis

• Severe musculoskeletal pain such as from fractures, or arthritis

• Toxicities like pyrethroids, ethylene glycol, NSAIDs, lilies, or rodenticides

Essentially any injury or illness can lead to collapse if it is serious enough.

Risk Factors

There are three presentations of collapse that an owner may identify:

• Sudden collapse as a singular event • Repeated episodes of sudden collapse • Intentionally lying down for a long period, with an inability to walk

In general, collapse results from severe conditions and requires immediate medical attention.

Testing and Diagnosis

Diagnosing the cause of collapse in cats is often challenging since there are many potential conditions that could lead to such an occurrence. Veterinarians often start with a thorough history to understand more about the episode of collapse.

A complete physical examination can help the veterinarian identify additional symptoms. Diagnostic tests that might be recommended include:

• Blood work: routine blood work indicates overall organ and immune system function as well as markers of specific types of conditions like infection

• Urine analysis: Changes in the urine may be associated with certain conditions 

• Diagnostic imaging: Ultrasound or X-rays can help identify traumatic injuries, respiratory conditions, or heart conditions. Advanced diagnostic imaging like MRI, CT, or myelography may be required 

• Electrocardiograms: This test examines the electrical activity of the heart, and can help diagnose heart conditions. In some cases, portable electrocardiogram machines can be sent home with the patient if episodes of collapse occur infrequently. 

Treatment protocols vary widely, depending on which underlying condition is diagnosed.

Similar symptoms

In general, collapse is easily recognized and described by owners. In some cases, seizures can present similarly to collapse. Features of seizures that can help distinguish them from collapse include:

• Convulsive activity • Excessive salivation and chomping • Urinating or defecating during the episode • Lethargic or dull for minutes to hours after the episode

Associated Symptoms

Collapse can be associated with many other symptoms, depending on the underlying condition leading to the collapse episode.