Liz Buchanan BVSc MRCVS
Keymaster
Hello and here is a huge hug. It sounds as if you are having an horrendous run of bad luck and as though the last thing you need at the moment is another poorly family member.
Frustratingly, Horners' Syndrome is just that - a syndrome. A syndrome is a group of symptoms that appear at the same time, but different things can cause that collection of symptoms; it is not the name of a single disease. I cannot see the patient and nor am I their vet, but the hallmarks of Horners are ptosis, miosis and endopthalmos. Ptosis is where the upper eyelid droops. Miosis is where the pupil goes smaller, with the net effect usually being two pupils of different size. Endopthlamos is where the eyeball retreats somewhat into the head. It sounds as though your vet has recognized Horners' (which is much less common in cats than in dogs). However, having recognised the syndrome, it is much more difficult to pin-point a cause. Causes, I'm afraid, can often include tumours affecting the nerves involved (perhaps in the brain or the chest); they can include trauma and they can involve ear disease.
You could play the numbers game; I am sure that your vet will find a pathologist or neurological expert who can explain which is currently thought to be the most likely cause in the cat. However, the only way to know what is happening in YOUR cat, would be to do what is known as a 'work up' in order to get as close as possible to the cause. This may involve neurological exams, brain scans and so on, and might be carried out by your own vet or by a specialist, depending on their situation.
When deciding how far to go into a work-up, good questions include 'What might we find that we could do something about?' 'What if it wasn't that?' 'How would referral to, or consultation with, a specialist help in this case?' and 'What would you do if you were in my situation?' (you may or may not want to talk about money in that question - because although everyone wants what is best for your cat, vets have a careerful of experience in deciding and finding compromises between the 'best' and the 'affordable' options).
I hope that this helps to some extent and please, do keep us in touch with decisions that you make and how you get on. Your experience might indeed help someone else.
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