Stroke in Cats: Causes, Symptoms, and Prevention

Strokes in cats, which are sudden interruptions in blood supply to a part of the brain, are luckily quite rare. As pet parents, it’s still important to be familiar with the symptoms and causes of cat strokes so that you can get your cat help immediately should they have signs of one.  

What Is a Stroke in Cats?

Your cat’s brain needs blood to work. A sudden interruption in blood supply to any part of the brain is called a stroke. This interruption can happen due to a blockage in a vessel (ischemic stroke) or a brain bleed (hemorrhagic stroke). Strokes can cause serious damage to your cat’s brain. In some cases, strokes are fatal. 

Pet parents often think their cat has had a stroke when they truly have vestibular disease, which is a neurologic condition that affects the cat’s balance and coordination. When a cat has vestibular disease, they may have rapid eye movements, fall to one side, and have a head tilt. While these can also be symptoms of a stroke (more on that later), cats usually recover well from vestibular disease. Vestibular disease is more common than stroke in cats. 

A stroke is considered a medical emergency. If your cat is showing signs of a stroke, you need to contact your veterinarian or go to an emergency clinic immediately.  

If you are unsure if your cat is having a stroke or vestibular disease, seek emergency attention. 

Symptoms of a Stroke in Cats

The specific symptoms of a stroke depend on which part of the brain has an interrupted blood supply and how severe the stroke is. 

Symptoms may include: 

• Head tilt 

• Loss of vision 

• Unequal pupil sizes 

• Walking in circles 

• Stumbling or uncoordinated gait 

• Shaky pupils (nystagmus) 

• Disorientation 

• Seizures 

• Behavior changes, such as sudden aggression or hiding 

• Collapse or coma 

• Sudden death 

Causes of a Stroke in Cats

Strokes are caused either by blockage of an artery that takes blood to the brain or by brain bleeds. 

Potential causes of strokes include: 

• Blood clots 

• High blood pressure (hypertension) 

• Heartworms 

• Head trauma 

• Blood clotting disorders 

• Exposure to certain toxins like rodenticides (which affect blood clotting) 

In most cases of feline strokes, the exact cause is unknown. There are many underlying medical conditions that can increase the risk of stroke, including certain cancers, heart disease, and liver disease. The age at which a stroke occurs depends on the underlying cause.  

Cats who are not on heartworm prevention are more likely to have stroke-like events due to embolism (blockage) of dying worms or abnormal worm migration within the brain. 

How Veterinarians Diagnose a Stroke in Cats

In most cases, strokes are diagnosed based on ruling out other possibilities with extensive testing.  

These tests may include: 

• Routine blood work to check systemic health  

• Heartworm testing 

• Blood clotting analysis 

• Blood pressure readings 

• Cerebrospinal fluid testing (often done by a specialist) 

• MRI to look for brain damage (often done by a specialist) 

• CT scan to help rule out inner ear disease (often done by a specialist) 

An MRI is the best diagnostic test for a stroke. It can show which part of the brain was affected and how much damage there is.  

If your cat will be undergoing cerebrospinal fluid testing, an MRI, or CT scan, then anesthesia is necessary. Make sure to speak with your veterinarian about whether you should withhold food, water, or medications before anesthesia.  

Treatment of a Stroke in Cats

If possible, it’s important to find and treat the underlying cause of the cat’s stroke.  

Often, strokes are managed with supportive care rather than targeted treatment. Cats are usually hospitalized so they can get supplemental oxygen, fluids, and medications via an intravenous (IV) catheter, and get help with feeding. They’ll also be checked around the clock. 

A cat with seizures should get anticonvulsant medications for at least three to six months after the stroke. Examples of medications that may be used include phenobarbital or levetiracetam. 

For cats who have issues with balance after the stroke, nausea is a real concern. Maropitant or meclizine are recommended to help with any motion sickness or nausea.  

A lot of cats who’ve had minor strokes that only affect a small portion of the brain will regain their normal movement over time. Larger strokes are often fatal.  

Recovery and Management of a Stroke in Cats

The first one to three days are often the worst for cats who have had a stroke. After that time, symptoms usually stabilize. Cats who will regain function usually do so over the course of several weeks.  

It is possible that a cat may only make a partial recovery. For example, they may continue to have an abnormal gait (walk). 

Some cats who have had a stroke may benefit from physical therapy. Your veterinarian may refer you to a physical therapist or recommend exercises that you can do with your cat at home. 

Prevention of a Stroke in Cats

Not all strokes in cats are preventable, but the following are tips that may help reduce risk: 

• Get the recommended annual or six-month check-ups for your cat to find underlying health conditions early. 

• Keep your cat on heartworm prevention. 

• Prevent access to toxins like rodenticides.