neurological problem?

Question
Dr. Frey, Hi, its me again. I have a 16 1/2 yr old neut. male cat who I took to the vet last week because he was grinding his teeth when he ate. My vet has been apprehensive about dental cleanings on him because of his age.  Well, Chester, the cat, got very upset over there and in the exam room exhibited left paw weakness, foot knuckling under and walking sideways. He was fine at home. Anyway, my vet said it could be a host of things in a cat this age from brain tumor to toxoplasmosis.  I elected to go with just supportive care with antibiotics (Clindimycin 150mg 1 capsule a day) for 2 weeks.  On day three, he vomited and for the next 4 days was lethargic and would not eat except when I fed him with a syringe baby food mixed with a multi cat vitamin. On Sunday, he was fading so I got my cat books out and looked up all his symptoms (vomiting,black runny stool, digestive ailments and they all pointed to steroids. So I gave him a
dexamethazone and within 30 min. he was up and eating on his own. His balance is good, I cannot fill him up , I guess since he did not eat for so many days.  Anyway, any thoughts on this? I have him on amoxicillin now instead of the clindimycin as I suspect the latter upset his digestive system. Just guesssing though.
  Thanks, Lisa Shirley

Answer
The dose of Clindamycin to treat Toxo is MUCH higher than that used for dental infections and often times cats will get sick on this high dose, therefore, we try to break it up throughout the day to try to avoid stomach upset.  However, at 16 yrs old I would not have Toxo high on the differential list.  Most times neurological problems are treated with steroids and depending on the severity, will depend on the response.  My guess is that maybe he had a bit of vestibular disease which could be due to inflammation of the nerve, inner ear infection (or yes, a brain tumor).  

For dental disease, I prefer Clavamox 62.5 mg twice a day or Clindamycin 25 mg twice a day for the average 10 pound cat.  Human dentists do use Amoxi a lot due to the fact that it is so much cheaper than the other 2.  I would make sure to get some probiotics into him...this can be done with plain yogurt, Benebac or Probiocin...to help prevent side effects from antibiotic use.  

I would also recommend a BLAND DIET of meat baby food, boiled chicken and/or burger, cottage cheese, cooked rice, etc to ease the stress on his digestive tract.

I must tell you that the symptoms you describe of BLACK (digested blood) runny stool and digestive upset points to a stomach ulcer and STEROIDS ARE NOT the treatment of choice, FYI, because steroids can induce these symptoms.  So I would be careful with the use of steroids.