The paralyzed cat. Neuroanatomic diagnosis and specific spinal cord diseases

Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines

Feline coronavirus (FCoV) is a ubiquitous RNA virus of cats, which is transmitted faeco-orally. In these guidelines, the European Advisory Board on Cat Diseases (ABCD) presents a comprehensive review of feline infectious peritonitis (FIP). FCoV is primarily an enteric virus and most infections do not cause clinical signs, or result in only enteritis, but a small proportion of FCoV-infected cats develop FIP. The pathology in FIP comprises a perivascular phlebitis that can affect any organ. Cats under two years old are most frequently affected by FIP. Most cats present with fever, anorexia, and weight loss; many have effusions, and some have ocular and/or neurological signs. Making a diagnosis is complex and ABCD FIP Diagnostic Approach Tools are available to aid veterinarians. Sampling an effusion, when present, for cytology, biochemistry, and FCoV RNA or FCoV antigen detection is very useful diagnostically. In the absence of an effusion, fine-needle aspirates from affected organs for cytology and FCoV RNA or FCoV antigen detection are helpful. Definitive diagnosis usually requires histopathology with FCoV antigen detection. Antiviral treatments now enable recovery in many cases from this previously fatal disease; nucleoside analogues (e.g., oral GS-441524) are very effective, although they are not available in all countries.

Feline neurological diseases in a veterinary neurology referral hospital population in Japan

Many of the reports summarizing neurological disorders in cats considered only a limited disease group(s). There is only one large-scale survey on neurological disorders in cats based on the histopathological viewpoint. We described the localizations and frequencies of neurological diseases in a large population of cats that were referred to the Kyoto Animal Referral Medical Center between 2009 and 2016. We attempted to determine the localization of lesions at the time of the examination in each case and to classify the disease etiologies of these 276 cats with neurological disorders retrospectively. There were 174 cases with lesions in the brain region, 14 cases with lesions in the cervical cord region, 34 cases with lesions in the thoracolumbar cord region, and 54 cases with lesions in the peripheral neuromuscular region. High morbidity rates were observed in cases of idiopathic epilepsy and intracranial tumor in the brain region, spinal cord infarction in the cervical cord region, spinal cord infarction and spinal cord tumor in the thoracolumbar cord region, and peripheral vestibular dysfunction arising from otitis media/interna in the peripheral neuromuscular region. It was suggested that there is a higher number of brain diseases than spinal cord and peripheral neuromuscular diseases in cats. Idiopathic and neoplastic diseases were common in the brain region, vascular diseases were common in the spinal cord region, and infectious diseases were common in the peripheral neuromuscular region.

Neurolymphomatosis caused by T-cell lymphosarcoma in a cat: imaging description and treatment review

CASE SUMMARY

A 16-year-old domestic shorthair cat was evaluated for acute-onset right pelvic limb monoparesis localized to the sciatic nerve. MRI revealed a homogeneously contrast-enhancing, well-demarcated mass effacing the right sciatic nerve from its intravertebral origin to the end of the viewable field (mid-femur). Abdominal ultrasound revealed thickened small intestinal loops and enlarged mesenteric lymph nodes. Cytology of the small intestine was suggestive of lymphosarcoma. T-cell lymphosarcoma of the sciatic nerve and small intestines was confirmed with incisional biopsy. Treatment consisted of systemic chemotherapy with vincristine followed by the Wisconsin-Madison feline lymphosarcoma protocol, but despite treatment the patient neurologically worsened and was euthanized after 54 days.

RELEVANCE AND NOVEL INFORMATION

We present herein one of the first descriptions of neurolymphomatosis in the domestic cat that included post-intravenous contrast MRI. Treatment options based on recommendations for people with neurolymphomatosis include systemic chemotherapy, intrathecal chemotherapy and/or localized radiation chemotherapy. The authors recommend that all cats be screened for concurrent non-neuronal areas of lymphosarcoma before undergoing treatment for neurolymphomatosis, regardless of clinical signs.

Epidemiology of road traffic accidents in cats attending emergency-care practices in the UK

OBJECTIVES

To estimate the incidence proportion of road traffic accidents in cats attending emergency out-of-hours clinics in the UK, identify major risk factors for road traffic accident occurrence and for survival to discharge.

MATERIALS AND METHODS

A retrospective study of a cohort of 33,053 cats in the VetCompass database attending emergency-care practice between January 1, 2012 and February 15, 2014. Incidence proportion was calculated and logistic regression was used to identify risk factors for road traffic accident and survival to discharge following road traffic accident.

RESULTS

Incidence proportion was estimated at 4∙2% (95% confidence interval: 4∙0 to 4∙4%). Cats aged 6 months to 2 years were at increased odds of road traffic accident, as were male cats and crossbred cats. Odds of road traffic accident were highest in the autumn. Spinal injury, abdominal injury and increasing count of injuries were associated with increased odds of death.

CLINICAL SIGNIFICANCE

Road traffic accident is a frequent presentation in emergency-care practice. Identification of risk factors for death within the first 24 hours following a road traffic accident can aid veterinarian and owner decision-making for treatment of cats involved in a road traffic accident.

Intervertebral disk disease in 3 striped skunks (Mephitis mephitis)

OBJECTIVE

To describe diagnostic findings, surgical technique, and outcome in 3 striped skunks (Mephitis mephitis) with a history of paraparesis.

STUDY DESIGN

Case series.

ANIMALS

Skunks (n = 3) with paraparesis.

METHODS

Neurologic examination revealed upper motor neuron disease (T2-L2) in 2 skunks and lower motor neuron disease (L3-S3) in 1 skunk. Diagnostic imaging included radiography, myelography, CT, and MRI and confirmed intervertebral disk herniation (IVDH) in each skunk. Because initial treatment with pain medication and cage rest did not result in lasting improvement, spinal surgery was performed.

RESULTS

Hemilaminectomy (2 skunks) and dorsal laminectomy (1 skunk) was performed with removal of extruded disk material. The skunks improved after surgery but all had minor residual neurologic deficits when examined at various times postoperatively.

CONCLUSION

Thoracolumbar intervertebral disk herniation occurs in skunks, and must be included in the differential diagnosis of paraparesis.

Acute intraparenchymal spinal cord injury in a cat due to high-rise syndrome

A 9-year-old spayed female Bengal Red cat was evaluated for high-rise syndrome. The cat had paraplegia of the hind limbs, intact reflexes and pain perception, and hyperesthesia in the caudal thoracic area. Mentation, cranial nerve function, forelimb proprioceptive responses, and spinal reflexes were normal. There were no abnormalities on radiographs or computed tomography scan, but magnetic resonance imaging revealed a hyperintense intraparenchymal spinal cord lesion on T2-weighted and T2 fat saturation images.

CNS disease in the cat: current knowledge of infectious causes

PRACTICAL RELEVANCE

Neurological disease is a relatively common reason for referral, constituting approximately 10% of the feline referral caseload. Nearly one-third to one-half of these cases may be infectious in origin. As such, an awareness of infectious diseases causing central nervous system (CNS) signs in cats, and their clinical diagnosis and management, is relevant to anyone dealing with cats on a regular basis.

GLOBAL IMPORTANCE

Some conditions (eg, rabies) are more common in certain countries than others. Conditions such as feline infectious peritonitis (FIP) and toxoplasmosis are of global significance.

PATIENT GROUP

Many infectious diseases may affect any feline population. Some, such as FIP, are more common in pedigree households, whereas others such as toxoplasmosis, feline immunodeficiency virus (FIV) or feline leukaemia virus (FeLV) infections, are more likely to affect a single cat with an outdoor lifestyle.

EQUIPMENT

All patients benefit from thorough history taking and clinical, neurological and ophthalmic examinations, which all require minimal equipment. Infectious diseases may often be diagnosed on blood samples; however, definitive diagnosis may require more extensive investigation involving cerebrospinal fluid analysis or advanced imaging necessitating access to computed tomography or magnetic resonance imaging.

EVIDENCE BASE

The information in this review, which summarises current knowledge of infectious diseases affecting the CNS, is collated from publications on the infectious diseases comprising previous research papers, review articles, case series, case reports and textbooks, supplemented by the clinical experience of the authors.