9F Cat no longer eating biscuits, develops horner's syndrome

Species: Cat Age: 9 Sex/Neuter status: Yes Breed: Standard moggy Body weight: 5.4kg History: Previously had cat flu as a kitten, scarring along her lungs and throat. It was an issue when she was a kitten but has since resolved. Clinical signs: Horners syndrome, lack of interest in hard food Duration: 4 days Your general location: Ireland Links to any test results, X-rays, vet reports etc. that you have: none My cat developed Horner's syndrome on Tuesday 4th Oct, it came on in the space of a few hours. It wasn't there when I woke up but was by lunch time. Her left pupil does not react to light as much, it can go larger but only if very dark. The eye looks sunken back and the eye lids droops. We took her to the vets, they had never seen horner's syndrome in a cat before which is why I am a little dubious. They gave her an antibiotic injection and an anti-inflammatory. I was then given an anti-inflammatory liquid to give her for 4 days. She hadn't been eating her biscuits like usual, she never leaves food behind, but she was for a couple days prior to the eye issue. I thought, since it is a scheduled feeder, that the biscuits may be tasteless so I bought more on Wednesday and she wasn't keen, she would crack the biscuits but not eat the rest. I have since moved her onto a mousse/soft food that she is eating happily. I find she is able to have a biscuit treat (Dreamies) when on the medication but by the time the next dose comes around, she is not keen again. I had a look at her teeth, god this cat puts up with a lot, and I cannot see any dark sections or broken teeth. Of course, I am limited by her tongue being in the way around the bottom teeth so I cannot see as easily, they look okay. My biggest concern is cancer, my husband, FIL, father, friend have it and the friend just died. It's an ever-present fear in my life. I want to get an xray done, since she would be under this would mean she could have her teeth looked at too, right? I'm afraid of what may be wrong and if I can even afford it.

I know I'm not supposed to judge owners, but I think its okay to comment that that's a really beautifully-presented medical history, one of the best I have seen on here.  I'm so sorry to hear about your family members.  I have heard that statistically, cancer will prematurely end the lives of perhaps one in three people, which doesn't make it any less painful for any one of their close friends and relatives, every time it happens and for years afterwards.  What it does mean, however, is that support should be available.  It is extremely common than an illness in a pet wakes up suppressed pain after the passing of other pets and humans alike.  It is important that you ask for emotional support when you need it and there are Hospices, doctors, NHS clinics and charities which have been set up to help.  The likelihood of passing with cancer is perhaps lower in cats than in humans, but  I can't tell you not to worry;  this is also a real possibility for cats presenting with Horner's, although it is not the only possible outcome.  Whatever the outcome of your cats' illness, it is okay to ask for support in facing it, at any stage.  If terminal illness may be a possibility - even a small one - we recommend The Ralph Site which was set up by a lovely vet Shailen Jasseni when he lost his own pet cat, Ralph.  There is a section there on 'Anticipatory Greif'.  I will follow this up with another post.

Horners' in cats is less common than Horners' in dogs, but vets will be able to recognise it.  Horners' is a syndrome - a collection of symptoms occurring together - and not a specific disease.  The outcome of the syndrome therefore depends very much on the cause, so there may be sense in trying to pinpoint what the cause is.  The best questions for your vet are direct ones:  What is the likelihood of this being cancer in this case?  If we did scans and found cancer, what would you do differently?  How would more diagnostic tests improve my cats' quality of life / change what we do?  What would the treatment be if a cancer was found vs if it wasn't?  What other causes could there be?  If this was your cat and you were working to my budget, what would you do?  And most of all, whether further investigations are planned or not, What do you think of my cats' quality of life at the moment?  How can we help?

Regarding imaging, it may be a good idea to ask about an X-ray vs an MRI, and ask how each outcome may be useful.  What % of cats scanned can be usefully helped?  Vets mostly work in private practice and are therefore used to the difficult reality of opting for tests based on their usefulness-given-the-cost.  It is possible that vets who work with MRI machines, for instance, will know where to access the best figures as to how likely a scan is to make a difference.   It is often a relief to vets to be asked to discuss how finances may affect the outcome;  even in the NHS, where healthcare is 'free' on the surface, cost vs benefit decisions are being made every day and vets will certainly think no worse of you for asking to discuss such matters.  Finally, I want to wish you the best in the journey from here and please do keep us updated as to what happens next in your cats' story.

Finally-finally, your cat is not eating - in particular, as the medication dose appears to wane.  This could be a sign of inflammatory pain or the steroid could periodically be stimulating the appetite.  Whatever else may be going on, a cat going off their food is worth paying attention to and we would recommend discussing this with your vet as soon as you can.