Meningitis at a glance
About: Meningitis is an inflammation of the protective membranes covering the brain and spinal cord.Causes: There are a number of causes including infection, medications, tumours, immune-mediated disorders and unknown causes.
Symptoms: Lethargy, loss of appetite, neck stiffness, sensitivity to light, wobbly gait, disorientation, paralysis, coma.
Treatment: The goal of treatment is to address the underlying cause and manage symptoms. This may include corticosteroids to reduce inflammation, anti-seizure medication, and supportive care.
What is meningitis?
Meningitis is an inflammation of the protective membranes covering the brain and spinal cord (meninges). The central nervous system (CNS) comprises of the meninges, the brain, and the spinal cord. Any of these can become inflamed if the brain is affected it is known as encephalitis if the spinal cord is affected it is myelitis. One of a combination can become affected.
- Brain and meninges = meningoencephalitis.
- Meninges and spinal cord = meningomyelitis.
- Brain, meninges, spinal cord = meningoencephalomyelitis.
Meningitis is not a disease itself, rather a symptom of an underlying disorder which has resulted in the meninges become inflamed or infected. It is an extremely painful and potentially fatal condition which requires urgent medical attention.
Any cat can develop meningitis however it is seen most often in older cats and immunocompromised cats. The condition can be chronic (slow and progressive) or acute (sudden onset).
There are a number of possible causes which may be infectious or non-infectious. The most common cause is due to viral, fungal or protozoal infection and less commonly, bacterial.
- Cryptococcosis, histoplasmosis, and blastomycosis are fungal which in healthy cats usually remain localised. In immunocompromised cats, it can disseminate (spread) to other parts of the body including the brain.
- Toxoplasmosis is a protozoan infection in cats which usually produces no signs, immunocompromised cats may develop disease.
- Feline infectious peritonitis (FIP) is an almost always fatal viral disease. In most cats, the coronavirus is self-limiting, however, in some cases, it mutates into a lethal form. Feline immunodeficiency virus (the feline equivalent of HIV in people) and rabies can also cause meningitis in cats.
- While rare, bacterial meningitis can occur when a nearby infection spreads to the brain, this may be from a localalised infection of the eyes, ears or nasal cavity, bacteria in the blood usually from a heart valve (endocarditis) or urinary tract infection or direct inoculation via a penetrating bite wound. Bacterial may be caused by tularemia, staphylococci, Pasteurella spp, Nocardia spp.
- Certain medications (NSAID’s, antibiotics (amoxicillin, sulfamethoxazole), immunosuppressive medications, Ranitidine)
- Immune-mediated disorders
- Idiopathic (unknown cause)
It is often hard to determine if a cat is sick as they are so good at hiding signs of pain and discomfort, so it is up to us to keep a diligent eye on them and look for changes in behaviour as well as other clues.
Symptoms can range from generalised to CNS type and may include:
- Loss of appetite
- Intermittent fever
As CNS symptoms progress, your cat may experience the following:
- Cervical rigidity (neck stiffness)
- Photophobia (sensitivity to light)
- Ataxia (wobbly gait)
- Hyperesthesia (rolling skin)
- Sensitivity to touch
Your veterinarian will perform a complete physical and neurological examination of your cat and obtain a medical history from you including the onset of symptoms, any medications or toxins your cat may have ingested, underlying medical conditions. He will need to perform some diagnostic tests to determine if your cat has meningitis as well as finding the underlying cause.
Baseline tests: Biochemical profile, complete blood count, and urinalysis to evaluate organ function. If an infection is present, there may be an increase in white blood cells, low white blood cells may occur in cats with FIV or FIP. Anemia may also be present in cats with FIP. Bacteria may be present in urine samples if your cat has a urinary tract infection.
Imaging studies: CT or MRI of the brain may reveal inflammation or other abnormalities such as lesions, bleeding or tumours.
Cerebrospinal fluid tap (CSF): This test involves obtaining a sample of the fluid from the subarachnoid space which surrounds the spinal cord and brain. The fluid is then sent to a laboratory for culture and evaluation.
If endocarditis is suspected, a heart murmur may be heard via stethoscope.
Echocardiogram: Ultrasound of the heart to evaluate the heart valves for signs of infection.
Blood tests: To detect antibodies to viral infections such as FIP or FIV. Many cats have had exposure to the coronavirus which is responsible for FIP, so a positive test isn’t always necessarily proof a cat has FIP.
Blood tests: To detect antibodies to toxoplasmosis. A positive test doesn’t necessarily mean your cat is currently infected, only he has been exposed at some time in the past. Fecal samples will be analysed for the presence of oocysts. Most cats with toxoplasmosis show few symptoms of infection when cats do become sick it is usually due to an underlying disorder which has weakened the immune system such as FIV or FeLV.
PCR or ELISA tests: If FIP is suspected in addition to blood tests to look for antibodies, your veterinarian may also take a sample of fluid in the abdomen for evaluation as well as specialised tests to detect the virus in the blood
Cytology: Microscopic evaluation of nasal or ocular discharges.
The goal of treatment is to manage symptoms and address the underlying condition, which may include:
- Broad-spectrum antibiotics will be prescribed to treat bacterial infections and toxoplasmosis.
- Fungal infections will be treated with anti-fungal medications.
- Corticosteroids will be prescribed to control inflammation.
- Anti-seizure medications will be administered if necessary.
- Cats with meningitis are usually extremely sick, and supportive care is vital. This may include fluids to treat dehydration, nutritional support, and analgesics to relieve pain.
- FIP is almost always incurable although there have been recent advancements with this heartbreaking disease.
- Rabies is incurable and euthanasia is sadly the only outcome.
- Administer medications as prescribed.
- Rest is vital while your cat recovers. Keep your cat indoors and in a calm, quiet environment.
- Contact your veterinarian if your cat’s symptoms become worse.
Prognosis depends on the cause of meningitis, if it is viral or fungal, the prognosis is poor, bacterial infections have a slightly more favourable outcome.
Prompt medical treatment of eye or nasal infections and penetrating head wounds can reduce the chances of bacteria spreading to the brain.
- Desex cats to reduce their risks of contracting FIV.
- Keep cats indoors in areas where rabies, fungal infections, and ticks are present.
- A healthy cat has a stronger immune system, which can help him avoid the spread of infection to the brain.