Encephalitis in Cats: Welfare and Care
Causes of Feline Encephalitis
Encephalitis (brain inflammation) in cats can be caused by infectious agents (viruses: FIP, FIV, feline herpesvirus; bacteria; protozoa: Toxoplasma gondii, Neospora caninum; fungi: Cryptococcus neoformans), immune-mediated conditions (meningoencephalitis of unknown origin/MUO), or less commonly trauma or neoplasia. FIP (feline infectious peritonitis virus) is a particularly important cause and is now treatable. Cryptococcus is most common in cats exposed to bird droppings.
Clinical Signs and Welfare Impact
Encephalitis causes varying combinations of seizures, behavioural changes, ataxia, head tilt, circling, blindness, neck pain, and altered consciousness. Seizures cause acute suffering; status epilepticus is life-threatening. Disorientation and pain are significant welfare concerns. Affected cats may be unable to perform normal behaviours including grooming, feeding, and social interaction.
Diagnosis
Diagnosis involves neurological examination, MRI (preferred over CT for brain detail), CSF (cerebrospinal fluid) analysis, serology/PCR for infectious agents, and urine/nasal swabs for Cryptococcus. FIP can now be confirmed with PCR and specific tests for the mutated spike protein. Advanced diagnostics are necessary to guide appropriate treatment.
Treatment Options
FIP is now treatable with antiviral drugs (GS-441524, remdesivir). Cryptococcal encephalitis is treated with long-term antifungal therapy (fluconazole, amphotericin B). Toxoplasmosis responds to clindamycin. MUO is managed with immunosuppressive drugs (prednisolone, cyclosporine, cytosine arabinoside). Anti-seizure medications control seizures. Prognosis varies significantly by cause and severity.
Nursing Care and Welfare
Hospitalised cats with encephalitis require intensive nursing: quiet, darkened environment, soft bedding, regular turning for recumbent cats, assistance with feeding and toileting, and careful monitoring for seizures. Pain and anxiety management are essential. Owners and veterinary teams must regularly assess quality of life and have honest discussions about prognosis, particularly for rapidly progressive or treatment-refractory conditions.