Feline ischemic encephalopathy and Cuterebra larva myiasis in a domestic shorthair cat

Our patient, an approximately 3 year old castrated male domestic shorthair cat presented to the Emergency Service at the Cornell University Hospital for Animals on 08/08/2011 with a 5 day history of neurologic signs. His owners first noted that he was bumping into things. He was taken to their local veterinarian who suspected an inner ear infection and prescribed prednisone (5mg once daily for 3 days then 5mg once every other day for three days) and valacyclovir (500mg every 8 hours) and recommended cage rest. After returning home the owners believed that he was not able to see out of his left eye (this was later revealed to be a deficit in the left visual hemisphere), his left hindlimb was in extension with his left forelimb in flexion and he was not responding to touch sensation on the left half of his body. His owners believe he responded to the medications as his gait and limb carriage improved but he still displayed concerning neurologic signs. He had no history of vomiting or diarrhea, and his urination habits were normal. The owners had not seen him drink since 08/05/2011 and felt his appetite was diminished, although he was still eating. Our patient is an indoor/outdoor cat that was up to date on vaccines. He was FeLV/FIV negative when tested 2 years ago. He is otherwise healthy with no other relevant medical problems except for presumptive feline asthma which he has been treated for with steroids twice, once in 12/2010 and again in 06/2011