Feline Dysautonomia, otherwise known as ‘Key-Gaskell Syndrome,’ is a rare condition of the autonomic nervous system. To understand how the disease affects cats, it is helpful to have an idea of what the autonomic nervous system (ANS) does. The ANS controls automatic function in our bodies; for example, breathing, blood pressure, heart rate, salivation, sweating, digestion, and urination. These functions occur in the background of our existence, not requiring any conscious thought to operate. It is these functions that malfunction in feline dysautonomia. 

What causes feline dysautonomia? 

Despite decades of research and advances in medicine and science, we still don’t know what causes this debilitating illness in cats. However, there have been some tentative theories circulating, including: 

  • genetics
  • geographic influence (most cases are found in the United States, United Kingdom, and Scandinavia) 
  • post-exposure to botulism, a bacterium that releases a toxin in the body and binds to nerves, causing paralysis 

What are the signs of feline dysautonomia? 

As it affects so many systems of the body, the signs of feline dysautonomia can vary for each cat. Symptoms normally develop quickly, over three to four days, and can leave them completely incapacitated. Depending on how much the disease has progressed, it ordinarily involves a range of the following:

  • A fear or avoidance of looking at light 
  • Dilated pupils
  • Prominent third eyelid
  • Vomiting or regurgitation 
  • Not eating 
  • Dribbling urine or straining to urinate 
  • Hunched, painful abdomen 
  • Constipation OR diarrhoea
  • Difficulty breathing 
  • Coughing 
  • Fatigue
  • Muscle wastage
  • Dry nose and gums
  • Weakness and loss of reflexes

When the basic functions of the body are impacted, it can quickly lead to severe health complications. Diagnosing this disease can be challenging as there is no specific sign or test that will confirm it. Your vet will make a diagnosis of the dysautonomia based on your cat’s history, clinical examination, bloodwork (to rule out other issues), and x-rays or ultrasound of the chest and abdomen. X-rays may show a distended oesophagus, intestines and bladder. They may perform a tear test as well, which will show that your cat is not producing the optimal amount of tears, which can support the diagnosis. 

Whats the treatment for feline dysautonomia? 

There is no working cure for feline dysautonomia currently, which means that treatment is symptomatic and based on the clinical signs your cat presents with. Treatment will involve supporting the affected body systems, as opposed to treating the underlying disease itself. 

Fluid therapy will normally be initiated to ensure that they maintain adequate hydration, and to help their blood pressure. It is important to ensure they are getting some nutrition, so often a feeding tube will be placed if they are unable to eat in an upright position. 

Constipation and urinary issues will be treated, and they may be put on medication to help their bowels and bladder function better. Nursing care will involve administering eye drops, ensuring the cat is warm, assisting with grooming, emptying the bladder, steam inhalation and monitoring respiratory function. Unfortunately, some patients develop pneumonia when liquid or food is mistakenly inhaled into the lungs, so further support and treatment may be needed to treat this.

What is the outlook for feline dysautonomia? 

Unfortunately, the prognosis is usually very guarded for cats with this disease. Often, cats are euthanised on the grounds of suffering. Some cats that do improve on treatment initially, may relapse within days, weeks, or months. Cats that do recover take a long time to improve and may have lasting neurological impact. 

More studies are required to gain a better understanding of this devastating disease. However, it is quite a rare illness, which makes these investigations challenging. If you have any concerns about your pet, please contact your local vet. 

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