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Dysautonomia in Cats

By William B. Thomas, DVM, MS, DACVIM (Neurology), Professor, Neurology and Neurosurgery, Department of Small Animal Clinical Sciences, University of Tennessee
Kyle G. Braund, BVSc, MVSc, PhD, FRCVS, DACVIM (Neurology), Director, Veterinary Neurological Consulting Services
Cheryl L. Chrisman, DVM, MS, EDS, DACVIM (Neurology), Professor of Veterinary Neurology, College of Veterinary Medicine, University of Florida
Caroline N. Hahn, DVM, MSc, PhD, DECEIM, DECVN, MRCVS, Senior Lecturer in Veterinary Clinical Neuroscience, Royal (Dick) School of Veterinary Studies, University of Edinburgh
Charles M. Hendrix, DVM, PhD, Professor, Department of Pathobiology, College of Veterinary Medicine, Auburn University
Karen R. Munana, DVM, MS, DACVIM (Neurology), Associate Professor, Department of Clinical Sciences, College of Veterinary Medicine,North Carolina State University
T. Mark Neer, DVM, DACVIM, Professor and Hospital Director, Center for Veterinary Health Sciences, Oklahoma State University
Charles E. Rupprecht, VMD, MS, PhD, Director, LYSSA LLC
Robert Wylie, BVSc, QDA,

Also see professional content regarding feline dysautonomia.

Feline dysautonomia is a disorder of the autonomic nervous system, which controls many reflexes and other neurologic functions. All breeds and age groups are susceptible. Feline dysautonomia was first reported in 1982 and initially became widespread in the UK; the incidence declined considerably but recently seems to have risen again. Cases have been reported throughout Europe, a few have been documented in North America, and sporadic cases have been seen in Dubai, New Zealand, and Venezuela. The cause is unknown.

Signs range widely in severity and can develop rapidly or be slowly progressive. Initial signs include mental dullness, loss of appetite, upper respiratory signs, or diarrhea. Additional signs include dilated and unresponsive pupils, drooping or protruding eyelids, difficulty swallowing, vomiting, constipation, and dehydration. The heart rate may slow down, and the cat may develop urinary or fecal incontinence.

Definitive diagnosis requires a tissue sample. Feline leukemia virus infection can also cause some of the signs seen in dysautonomia.

The main aim of therapy is first to rehydrate the cat and then to maintain adequate fluid balance. Supportive care includes keeping the cat warm, supporting respiratory function, administering eye drops, and assisting with grooming. A laxative may be needed for constipation. A small number of cats have recovered, and others are able to survive with lingering signs. However, such improvements often take up to a year. In general, the outlook is poor for severely affected cats.