How to detect and treat stroke in cats

Disclaimer: This article, its content, and its related references do not constitute veterinary advice and should not be considered a substitute for veterinary care. If your pet is showing any symptoms that could indicate a medical emergency, please seek immediate emergency care.

A stroke is a disruption of blood flow in the brain due to a blocked or leaking blood vessel, starving part of the brain of oxygen. Strokes are rare in cats, but certain underlying medical conditions may increase the risk of stroke. Signs of stroke in cats, such as head tilt and abnormal eye movements, also occur with other, more common feline medical conditions. If you have a cat, read on to discover:

• What causes strokes in cats
• Signs of feline stroke
• How strokes in cats are diagnosed and treated
• What cats are at risk for stroke

Because strokes are so rare in cats, there’s not much data on their clinical signs. However, symptoms are thought to be similar to those seen in other mammals, such as in dogs. Strokes may be associated with more common health issues found in cats, such as heart disease and kidney disease. An accurate diagnosis from a veterinarian is needed to determine the underlying cause of any neurologic symptoms and to develop an effective treatment plan. Treatment of stroke in cats depends on what’s caused the stroke, its severity, where in the brain it occurred, and the presenting symptoms.

A stroke, or cerebrovascular accident (CVA), is a disruption of blood flow to an area of the brain. A lack of blood supply deprives the affected brain tissue of the necessary oxygen to survive and function normally. There are two types of stroke:

• Ischemic: Lack of blood flow to the brain or in it, often caused by a blood clot
• Hemorrhagic: Blood leaking out of vessels in the brain and compressing brain tissue, preventing normal blood flow

When neurons (nervous system cells) in the brain die due to a lack of oxygen, they can no longer control bodily functions appropriately. Strokes are rare in cats, and the symptoms associated with them can occur as a result of more common health issues. Any medical condition that affects the brain or other parts of the nervous system can show similar clinical signs to stroke in cats.

Causes of stroke in cats

Though feline strokes are rare, it can be assumed they are the result of the same processes in cats as they are in other species that have strokes. Any event that disrupts blood flow to the brain can result in a stroke. Medical conditions in cats that have the potential to cause an ischemic stroke include:

• Kidney disease
• Cushing’s disease
• Heart disease
• Cancer

Health conditions in cats that have the potential to cause a hemorrhagic stroke include:

• Hyperthyroidism
• High blood pressure
• Rat poison toxicity
• Clotting disorders

Many of the underlying conditions that have the potential to cause a stroke are more common in senior cats. “The most common feline diseases that have the potential to cause a stroke are hyperthyroidism, hypertrophic cardiomyopathy, and kidney failure,” explains Dr. Jo Myers. “However, of the few reported cases of feline strokes, many have no identifiable cause.”

Clinical signs of stroke vary depending on what part(s) of the brain is affected, how much of the brain is affected, the type of stroke, and how long the event has been going on prior to treatment. Cat stroke symptoms may include:

• Abnormal body posture
• Head tilt
• Difficulty walking (ataxia)
• Falling to one side
• Abnormal eye movement or positioning
• Sudden blindness
• Seizures

Symptoms often have a sudden onset and may progress over 24–72 hours, followed by a slow or partial recovery. Hemorrhagic strokes often have more severe symptoms than ischemic strokes. When neurologic signs are due to a stroke, they’re not expected to continue to get worse after 72 hours. However, strokes can cause permanent brain damage, resulting in lifelong problems with mobility, coordination, balance, or other things, depending on what part of the brain has been damaged. The prognosis of strokes in cats varies widely, depending on the underlying cause, and can be lethal, even with prompt treatment.

Other medical conditions with similar clinical signs

Strokes in cats are rare, and other conditions with the same symptoms are much more common, such as:

• Vestibular disease
• Infections, such as feline immunodeficiency virus (FIV) and feline leukemia (FeLV)
• Toxicoses, such as rat bait or antifreeze
• Saddle thrombus
• Spinal or brain tumor

Vestibular disease is a common neurologic condition in cats that is often incorrectly referred to as a stroke. This confusion is understandable because the sudden onset of symptoms such as abnormal eye movement, head tilt, and difficulty walking occurs in cats with vestibular disease.

It’s important to seek veterinary care when any clinical signs associated with stroke are observed. An accurate diagnosis is needed for proper treatment, whether the symptoms are being caused by a stroke, vestibular disease, or other health issue.

Diagnostic testing is often necessary to determine what’s causing the presenting neurologic symptoms. Testing may include:

• Physical and neurologic exam
• Blood tests and measuring blood pressure
• Urinalysis
• Diagnostic imaging, such as X-rays, ultrasounds, MRIs, or CT scans
• Cerebrospinal fluid analysis

An MRI is needed to confirm the presence of a blood clot or bleeding in the brain. A referral to a veterinary neurologist may be recommended to confirm a stroke diagnosis.

Treatment for strokes in cats primarily focuses on supportive care. There’s no specific treatment that’s been shown to be beneficial in cats for treating the stroke itself, but possibilities are currently being investigated. Treating symptoms that arise from the stroke and managing any underlying conditions that may have contributed to the stroke are often the priority. A treatment plan for a feline stroke patient may involve:

• IV fluids
• Oxygen therapy
• Seizure medication
• Physical therapy
• Blood thinners
• Pain medication
• Feeding tube placement
• Treatment for underlying health concerns

Hospitalization for stabilization, 24-hour monitoring, and nursing care may be needed while the cat recovers. Stroke symptoms tend to stabilize within 24–72 hours; however, a cat who’s had a stroke may have permanent brain damage, resulting in lasting symptoms that require life-long management. Because so little is known about stroke in cats, it’s difficult to predict how much or how quickly a cat will recover.

Cats at risk of stroke

Strokes are rare in cats, but some cats are more at risk for stroke than others. Senior cats are more likely to have an underlying condition that may contribute to a stroke, such as kidney failure or heart disease. It’s possible for any cat of any age to have a stroke.

If you believe your cat is having a stroke, it’s important to seek immediate veterinary help. If you’re unsure, online vets through the Vetster platform can help evaluate your cat’s symptoms and give you the information you need to decide what to do next.

How can you tell if your cat has had a stroke?

Signs of stroke in cats include abnormal eye position and movement, head tilt, difficulty walking, and abnormal body posture. However, strokes are rare in cats, and vestibular disease, which is very common, shares these common symptoms. The typical signs of a stroke also occur with other medical conditions, so it’s difficult to know if your cat has had a stroke based only on the symptoms. Since a stroke is the result of a leaky or blocked blood vessel in the brain, special diagnostic imaging, such as an MRI, is necessary to confirm a stroke.

Can a cat recover from a stroke?

It’s hard to predict the outcome for a cat who’s had a stroke because so little is known about feline strokes. Some cats may fully recover from a stroke, while others may have lasting symptoms. Some feline strokes are lethal. The prognosis depends on what part of the brain is affected, how much of the brain is affected, and how long the event lasts before treatment is provided. Even with treatment, some strokes are life-threatening.

What should you do if your cat has had a stroke at home?

Without diagnostic tests, it’s impossible to know if your cat has had a stroke at home. Symptoms of stroke vary widely in type and severity but may include rapid eye movement, falling to the side, abnormal body posture, head tilt, and difficulty walking. These same symptoms occur more commonly with other neurologic disorders. Because it’s impossible to know what is causing symptoms, the most important thing for you to do if you think your cat has had a stroke is to seek immediate veterinary help.