Why Your Cat Might Be Weak, Wobbly, or Dragging the Back Legs

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  • Have you recently noticed that your kitty is walking funny, as if the back legs are sinking towards the ground? Maybe your cat seems wobbly or is even dragging the back legs trying to move around. There is likely a medical cause for this strange appearance. This article will go over the common symptoms and causes of weakness in the back legs (paraparesis) and paralysis of the hindlimbs (paraplegia) in cats and what to do if you notice your cat exhibiting these signs.

    Symptoms

    • Appears wobbly and uncoordinated when walking
    • Weakness in the hindlegs
    • Lowered position of the back end
    • Walking on the whole foot instead of just the toes (plantigrade stance)
    • Dragging and unable to move the back legs
    • Difficulty with or unable to get up
    • Sitting with legs splayed out
    • Unable to jump up
    • Other signs like going outside of the box, not grooming the back end, or pain near the back end

    Causes of hind leg abnormalities

    Saddle thrombus

    One of the most common causes of hind leg paralysis in cats is arterial thromboembolism. This occurs when heart disease causes poor blood flow and leads to blood clots that can travel through the blood vessels. One place that the blood clots lodge is where the arteries branch into the hindlimbs, causing interruption of blood flow. Cats can suddenly become weak or paralyzed and will often vocalize loudly, be in extreme pain, and have difficulty breathing.

    Cats typically need to be hospitalized and monitored intensively, as this can be a life-threatening disease. The outcome for treatment of blood clots is usually poor and cost of treatment is high. The disease causing the clot, which is usually a heart condition called hypertrophic cardiomyopathy, needs to be managed as well. Unfortunately, recurrence of clot formation after treatment is possible. In one study, at least one episode of recurrence was reported in 46.7% of cats who survived at least 7 days past the first occurrence of thromboembolism.

    Diabetes

    Cats with diabetes may develop a complication affecting the nervous system that causes weakness and muscle loss in the hindlimbs, leading to a flat-footed posture. Cats may appear to stand or walk on the whole foot instead of just the toes. This condition can be fully or partially treated with management of diabetes and recovery to normal blood sugar levels.

    Physical Injury

    Traumatic injuries can cause changes to a cat’s back legs in different ways. Fractures and dislocations of the spinal cord can result from common injuries such as falling, being hit by a car, or attack by an animal. If the injury is severe enough that a cat has lost the ability to feel pain, full recovery is unlikely. In cats that are still able to detect pain in their legs but can’t use them, a combination of rest, medications for pain and inflammation, and surgery may be recommended.

    Two other types of injuries include tail pull injury and rupture of the Achilles tendon. When a cat’s tail is pulled or caught, many of the nerves supplying the limbs, bladder, and tail can be disrupted. This can cause problems in the back legs in addition to inability to control urine and bowel movements and inability to move the tail. Rupture of the Achilles tendon is less common but can cause a posture and gait like that of cats with diabetes.

    Intervertebral disc disease (IVDD)

    The material in between each vertebra in the spinal column is called an intervertebral disc. A condition called intervertebral disc disease (IVDD) can cause compression and inflammation of the spinal cord, leading to different neurologic symptoms depending on the location. In older cats, age-related tissue changes can cause this, whereas in younger cats, a sudden rupture of the disc related to physical activity and trauma is more common. Treatment of cats with IVDD is often successful, especially with surgical decompression of the spinal cord.

    Infection

    The most common infectious disease causing weakness and incoordination, especially in much younger or much older cats, is feline infectious peritonitis (FIP). This disease can cause other symptoms such as fluid accumulation in body cavities, general fatigue, fever, weight loss, loss of appetite, and other nervous system problems such as seizures. There is currently no known effective treatment for this disease, and much research remains to be done.

    Other infections that may cause nervous system problems include toxoplasmosis and cryptococcosis. Cats get toxoplasmosis when they accidentally ingest the parasite in infected prey or raw meat. This parasitic infection is treatable with antibiotics. Cryptococcus is a type of fungus that cats can be exposed to by breathing in infectious spores. The health outcome of infected cats is typically good if they are treated early with antifungal medications.

    Cancer

    Tumors can form in the spinal column and cause compression of the spinal cord, preventing normal function and causing problems such as clumsiness, inability to use certain muscles, or complete inability to feel pain. Cats that are positive for feline leukemia virus or feline immunodeficiency virus may be at increased risk for cancers such as spinal lymphoma.

    Certain cancers may be treatable with combinations of surgery, chemotherapy, and radiation.

    Is your cat in pain?

    Cats may show pain in different ways and sometimes not at all. Cats in severe pain might cry loudly and bite or hiss if approached or touched in the painful area by the lower spine, hips, or tail. They may stop eating, hide, avoid people, and generally behave differently than normal for them if they are more stoic or have mild to moderate pain. It is important to bring your cat to see a vet as soon as possible if you notice obvious signs of pain.

    When to take your cat to the vet

    It is best with any situation involving weakness or paralysis of the hind legs to have your cat evaluated by a vet.

    When emergency care is needed

    If your cat is suddenly unable to use the back legs, is dragging the back legs, or appears in severe pain with loud vocalizing, difficulty breathing, and cold temperature in the hind legs and feet, it is best to take your cat to the emergency vet right away. Cats with this presentation likely need treatment and pain relief as soon as possible.

    What you can do at home

    If your cat does not appear to be in pain and you want to help keep them comfortable before the vet visit, you may:

    • Keep your cat in a warm, padded space away from stairs and other areas where a fall could occur
    • Make sure food and water bowls and a litterbox are close by for easy access
    • If your cat is having problems with the litterbox, try offering a shallow litter pan that does not require jumping or going over a lip.
    • Ensure your cat is clean and dry around the back end if they are not able to groom themselves
    • Handle your cat gently, especially around the spine, hips, and back legs

    What to expect at a vet visit

    Medical history and exam

    The vet staff will ask for information such as vaccine status, exposure to the outdoors or other cats, and description of your cat’s symptoms. In addition to the general exam, the vet may perform a neurologic exam. This involves watching your cat move around in an exam room and additional tests such as checking reflexes and spatial awareness. Occasionally, a doctor might notice during the exam that a cat is limping instead of being weak or wobbly. These signs can be hard to distinguish at home, and that’s why a veterinary evaluation is important. The causes of limping are different, relating to the muscles, bones, and joints as opposed to the nervous system, and therefore require different treatments as well.

    Cats can often become stressed even when feeling well, so it’s possible they may be reluctant to be examined, prefer to hide, or sometimes defend themselves by biting or scratching. In some cases, your vet may recommend a mild sedative or pain medicine.

    Bringing a video of photos of what you’ve observed your cat doing abnormally at home can be especially helpful, as cats may attempt to hide their pain and problem areas when they’re excitable or stressed.

    Potential tests

    • Blood test
    • Urine test
    • Spinal x -rays
    • In certain circumstances, your cat may be referred to a veterinary neurology specialist for additional tests such as a magnetic resonance imaging (MRI) or analysis of spinal fluid.

    Is your cat’s condition treatable, and how much will it cost?

    Treatments and their costs will vary depending on the cause and severity of the condition. Many causes of weakness in the hindlimbs are treatable, but some, including the cancer type lymphosarcoma, infection causing feline infectious peritonitis, and saddle thrombus may not result in a good outcome even with intensive treatment.

    Mild injuries and infections that are easily treatable with medications may require just a few visits to the vet for diagnosis, treatment, and follow up. Conditions that require emergency visits, hospitalizations, extensive monitoring, or surgery generally have a higher associated cost, from a few thousand dollars for a few nights in the hospital to closer to ten thousand dollars for diagnosing and performing certain spinal surgeries.

    Nervous system problems leading to long-term changes in ability to move around

    Sometimes, treatment can lead to a cat’s life expectancy being prolonged due to elimination or management of the underlying problem, but the nerves or spinal cord may not be able to fully return to normal function. Cats with permanent disabilities can still lead long and happy lives with families who understand the responsibilities of their care. Long-term care of cats with mobility problems may include frequent help with urinating and defecating, keeping them clean and dry, preventing pressure sores, continued veterinary bills, and sometimes the use of mobility devices like wheelchairs.