Brief Answer:
You may need additional testing

Detailed Answer:
Good evening. My name is Dr. Saghafi and I am a neurologist.

I understand you were recently bitten by a cat and that the animal died. You have a complaint of "major neurological issues and no balance." You admit to being treated for MS. You were bitten on the neck and are experiencing ear pain and inability to walk.

Unfortunately, you've provided very little detail as to how your symptoms of imbalance, difficulty walking, and other problems since the cat bite compare to those same functions PRIOR to the cat bite.

Also, you did not state what your baseline MS symptoms are at baseline (i.e. prior to the cat bite). While it is certainly possibly that the cat's bite could be infected and that could be complicating your MS symptoms- without the above information it will be very hard for me to give you any firm opinion on the matter.

Hopefully, you've reported the cat and the fact that the cat died to the animal control authorities in the place where you live. One of the first things they would wish to do is to recover the body of the cat and have it tested for significant diseases that could be of importance to you. Next, I hope you have seen a doctor to look at and treat the area of the bite which may be infected at this point with the way you're describing things. If you have not done these things then, please consider doing them immediately.

A 3rd thing to do is to schedule as quick an appointment with your neurologist as possible so that in fact, they can assess you for any dramatic changes in your MS baseline of symptoms so as to ascertain as to what may be due to the cat bite vs. what is strictly due to your MS.

If you would like to write your specific questions to me in the future (if you don't have a neurologist) I'd be happy to answer them at: bit.ly/drdariushsaghafi

Also, I'd greatly appreciate it if you'd close the query from your end if there are no further questions or comments. In that way, this information can be processed, archived, and ready for future use as necessary.

This response required 15 min. of physician directed review, research, and, response for patient envoy.

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Brief Answer:
Doesn't sound like cat scratch was significant

Detailed Answer:
Good morning and thanks for the updated responses.

So it doesn't sound like that cat's body is available anymore for testing of any sort. It would've been optimal to have had the cat examined by the Health Dept. after it died 2 days later since it had bitten you. The other thing is that if you had PURCHASED the cat when you acquired it should've had all its shots and been up to date on vaccinations...assuming of course, you got it from a pet store. If from a friend or acquaintance do you know anything of the medical history of the cat in terms of its vaccinations, any illnesses it may have had, etc.? If it is was a stray cat and you did not take to a vet for review or examination then, of course, we don't know anything really of what it could've had....Do you know WHY it died? Was it s cat or kitten? Did it appear sickly to you before it died?

Since you went to the neurologist after having been bitten by the cat I am assuming you said something to the them about this injury. Doesn't sound as they felt it was significant enough to explain what was going on with the lesions found on the MRI so based upon this set of assumptions again, my conclusion it that it seems less likely that the cat inflicted injury was anything more than coincidental to when everything else came about.

But again, there are a lot of details missing from this story including the all important FILMS of the MRI that show the lesions which were diagnosed as MS. If the lesions are being misinterpreted for example, for another type of problem such as a zoonotic infection (infection contracted from an animal to human) that you may be thinking was transmitted by the cat then, that's something else....but we would need to see the films to determine if that's a valid suspicion or not.

Also, you've not really said anything about the actual time frame between the bite and when the MRI was obtained since there is a time lag with animal infections that affect people's brains/spinal cord before you start seeing "spots" or lesions on the scans. Also, if your diagnosis is MS and that's a recent diagnosis the symptoms you're experiencing of imbalance as well as other things you haven't mentioned probably predated the diagnosis and the MRI ordered by the neurologist by weeks, months, or even years....that is typically what we see. Whereas, if your symptoms were purely on the basis of the cat bite/scratch then, symptoms would've only started following the bite and not before. Can you say anything about that point?

Therefore, and in conclusion- Putting everything together that you've told me and despite the questions that still arise from this sequence of events I still come up with the most likely possibility being that of MS as diagnosed by your neurologist without any significant contribution to THAT discovery by whatever the cat did to you.

If you would like to write any other specific comments in response to questions I'll be happy to answer them at: bit.ly/drdariushsaghafi

It would also be awesome if you had the MRI images and the report to upload to this system so I can see the actual films. Also, perhaps the neurologist ran some blood work...maybe even some antibody titers looking for anything having to do with possible infections that the cat could've transmitted that you didn't know about. If you can upload those as well then, that would give us even a more complete set of data to work with.

If on the other hand I've adequately answered your concerns and questions then, I'd greatly appreciate it if you'd close the query from your end. That way, this information can be processed, archived, and ready for future use as necessary.

Have a Happy New Year in the Big Apple if you're heading to Times Square...weather may be cooperative!

This response required 34 min. of physician directed review, research, and, response for patient envoy.

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