6Feline Intervertebral Disc Disease
Michael Farrell and Noel Fitzpatrick
Introduction
The extensive literature concerning canine and human intervertebral disc disease (IVDD) contrasts with the comparatively sparse literature detailing this condition in cats. This is probably a consequence of the relatively low prevalence of clinically significant feline IVDD. Estimates for clinical feline IVDD (i.e., signs of IVDH) prevalence vary between 0.02 and 0.12% [1, 2], whereas canine IVDD accounts for more than 2% of all diseases diagnosed in dogs [3]. Interpretation of the available literature on feline IVDD can be confusing because much of the published epidemiological data are derived from postmortem studies performed on clinically normal animals [4–6]. Between 1958 and 2012, there have been four histopathological studies (including a total of 355 cats) investigating the prevalence of feline spinal cord diseases [4–7]. Over the same period, 18 reports have described a total of 45 clinically affected cats with 57 IVD herniations, and 2 systematic reviews have been published summarizing the important clinical features of feline IVDD (Table 6.1). When reviewing these data, it is important to recognize that there are significant differences between clinically unaffected and clinically affected cats in the incidence of IVDD, the common predilection sites for IVDD, and the frequency of Hansen type I versus type II disease (see the following text). It is also important to exercise caution when interpreting the literature concerning the relative frequency of feline IVDD compared with other causes of myelopathy. The list of differential diagnoses for cats presenting with myelopathy includes spinal fractures or luxations, infectious or inflammatory disorders, vascular disease, spinal neoplasia, and IVDD [7]. Epidemiological studies including sample populations of spinal cord segments submitted postmortem have the potential to bias results toward conditions carrying a poorer prognosis, which would in turn result in underestimation of the relative frequency of IVDD [7, 21]. Nevertheless, the only antemortem prevalence study of cats with clinical signs referable to spinal cord disease confirmed a relatively low incidence of IVDD [21]. In this study, magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis findings were reported in 92 cats affected by spinal cord disease. The diagnostic categories, in order of descending incidence, were neoplasia (n = 25), inflammatory or infectious (n = 13), traumatic (n = 8), vascular (n = 6), degenerative (IVDD) (n = 5), and anomalous (n = 3). The largest group in this study was the group in which no diagnosis was made (n = 32).
Table 6.1 Summary of the presenting features, lesion localization, treatment, and outcome for 88 cats affected by IVDD

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Reference | Signalment | Grade | Comment | IVD space | Hansen type | Treatment | Outcome | Notes |
Cervical neurolocalization | ||||||||
Fitzpatrick [8] | 6y, FN, British shorthair | II | Chronic | C2–C3 (also C3–C4, C4–C5, C5–C6, T3–T4) | I | Non-surgically Managed | LTFU | |
Lu [9] | 5y, MN, DSH | III | Acute (suspected trauma) | C3–C4 | HVLV | Non-surgically Managed | Fair | Residual mild hemiparesis |
Heavner [10] | 1.5y, M, Russian blue | III | Acute; monoparesis progressing to nonambulatory quadriparesis | C5–C6 | II | Euthanasia | Euthanasia | |
Maritato [11] | 10y, MN, DLH | III | Acute (indoor cat) | C2–C3 | I | Ventral slot | Poor | Died 3d postoperatively |
Littlewood [12] | 4.5y, MN, DLH | IV | Chronic; dyspneic on presentation | C5–C6 | II | Euthanasia | Euthanasia | |
Thoracolumbar neurolocalization | ||||||||
Munana [2] | 13y, FN, DLH | I | Chronic pain only | T13–L1 | I | HL | LTFU | |
Fitzpatrick [8] | 9y, FN, DSH | I | Chronic pain; reluctant to walk | T10–T11 | II | Non-surgically Managed | Good | Good improvement in 2 weeks |
Munana [2] | 9y, FN, DLH | I | Chronic pain only | T11–T12 | II | HL | Excellent | |
Fitzpatrick [8] | 4.5y, FN, British shorthair | I | Chronic pain only | L4–L5 | II | Non-surgically Managed | Excellent | Slow improvement over months |
Fitzpatrick [8] | 8y, MN, Oriental | II | Chronic | T12–T13, T13–L1 | I | Non-surgically Managed | Excellent | Slow improvement to weak ambulation over 2 months |
Wheeler [13] | 6y, F, Siamese | II | Chronic progressive ataxia | T9–T10 | I | DL | Poor | No improvement |
Knipe [14] | 3y, FN, Himalayan | II | Chronic; ambulatory paraparesis; urinary and fecal incontinence | T13–L1, L4–L5 | I | HL | Poor | Residual urinary incontinence |
Fitzpatrick [8] | 12y, MN, Burmese | II | Acute | T13–L1 | HVLV | HL | Poor | Significantly worse neurological status postoperatively |
Fitzpatrick [8] | 6.5y, MN, DSH | II | Acute trauma (fell on stairs) | L5–L6 | HVLV | Non-surgically Managed | Fair | Ongoing ataxia |
Fitzpatrick [8] | 4.5y, MN, DSH | II | Acute (unknown trauma) | T11–T12, T12–T13 | I | HL | Fair | Ongoing ataxia |
Fitzpatrick [8] | 9y, FN, DSH | II | Acute (unknown trauma) | T13–L1 | I | HL T12–L1 | Fair | |
Knipe [14] | 6y, MN, Persian | II | Acute; ambulatory paraparesis and urinary incontinence | T12–T13 | I | HL (durotomy) | Fair | Residual pelvic limb ataxia |
Knipe [14] | 3y, FN, DSH | II | Chronic | T13–L1 | I | HL | Good | |
Choi [15] | 14y, MN, DSH | II | Acute | T2–T6, L2–L5 | I/II | Non-surgically Managed (acupuncture) | Good | |
Fitzpatrick [8] | 7y, FN, DSH | II | Acute; urinary incontinent; sluggish CP | L4–L5 | HVLV | Non-surgically Managed | Good | |
Fitzpatrick [8] | 12y, FN, DLH | II | Acute | T12–T13 | II | HL | Good | Slight residual ataxia |
Kathmann [16] | 12y, FN, Persian | II | Acute | L4–L5 | I | HL | Excellent | |
Gilmore [17] | 10y, FN, Siamese | II | Acute | T11–T12, T12–T13, T13–L1 | I | DL | Excellent | |
Munana [2] | 8y, MN, DLH | II | Acute | L5–L6 | I | HL | Excellent | |
Bottcher [18] | 7y, FN, DSH | II | Acute | T3–T4 | II | Lateral corpectomy | Excellent | |
Fitzpatrick [8] | 14y, MN, DSH | II | Chronic; severe thoracolumbar pain | T11–T12 | I | HL | Excellent | |
Fitzpatrick [8] | 8y, FN, DSH | II | Acute | L1–L2 | I | HL | Excellent | |
Fitzpatrick [8] | 5 m, M, DSH | II | Chronic | T4–T5 | Discospondylitis | Non-surgically Managed | Excellent | |
Munana | 4y, FN, Persian | III | Acute | T13–L1 | I | HL | LTFU | |
Fitzpatrick [8] | 11 m, FN, DSH | III | Acute (unknown trauma) | T10–T11 | HVLV | Non-surgically Managed | Excellent | |
Knipe | 9y, FN, DMH | III | Acute | T13–L1, L4–L5 | I | HL | Poor | Residual urinary incontinence |
Munana | 10y, MN, DSH | III | Acute; flaccid tail; urinary and fecal incontinence | L5–L6 | I | Non-surgically Managed | Poor | Residual urinary and fecal incontinence |
Fitzpatrick [8] | 6y, MN, DLH | III | Acute (unknown trauma) | L4–L5 | HVLV | Non-surgically Managed | Fair | Ongoing UMN bladder |
Munana | 8y, MN, DSH | III | Acute paraparesis | L4–L5 | I | Non-surgically Managed | Good | |
Seim | 2y, FN, DSH | III | Chronic (1 week) | T12–T13 | I | DL | Excellent | |
Fitzpatrick [8] | 5.5y, FN, DSH | IV | Acute (RTA) | L5–L6 | HVLV | Euthanasia | Euthanasia | |
Munana | 17y, MN, DSH | IV–V | Acute | L1–L2 | II | Euthanasia | Euthanasia | |
Munana | 11y, FN, DSH | IV–V | Acute | L1–L2 | I | HL | Poor | Residual urinary and fecal incontinence |
Fitzpatrick [8] | 6y, FN, DSH | IV | Acute | T13–L1 | HVLV | Non-surgically Managed | Poor | Ongoing severe ataxia |
Fitzpatrick [8] | 9y, FN, Persian | IV | Chronic progression | L3–L4 | II | HL | Fair | Ongoing mild ataxia |
Fitzpatrick [8] | 7y, MN, Ragdoll | IV | Acute (unknown trauma) | T13–L1 | HVLV | Non-surgically Managed | Fair | |
Fitzpatrick [8] | 6y, MN, British shorthair | IV | Acute (unknown trauma) | L3–L4 | HVLV | Non-surgically Managed | Fair | |
Salisbury | 12y, FN, DSH | IV | Acute | L4–L5 | I | HL (durotomy) | Excellent | |
Bagley | 4.5y, MN, DLH | IV | Acute paraplegia and urinary incontinence | T13–L1 | I | HL | Excellent | |
Munana | 8y, FN, DLH | IV–V | Acute | L4–L5 | I | HL | Excellent | |
Munana | 10y, MN, DSH | IV–V | Acute | L4–L5 | I | HL | Excellent | |
Wheeler | 6y, MN, Siamese | V | Chronic (10 days) | T13–L1 | I | Fenestration | LTFU | |
Fitzpatrick [8] | 3y, MN, DSH | V | Acute (unknown trauma) | L1–L2 | HVLV | HL | Euthanasia | Euthanasia after lack of improvement over 2.5 weeks |
Knipe | 7y, MN, DSH | V | Acute | L2–L3 | I | HL (durotomy) | Fair | Residual mild paraparesis |
Knipe | 7y, MN, DMH | V | Acute | L4–L5 | I | HL (durotomy) | Excellent | |
Fitzpatrick [8] | 10.5y, FN, DSH | V | Acute | L2–L3 | I | HL | Excellent | Strongly ambulatory within 10 days |
L4–S3 neurolocalization | ||||||||
Fitzpatrick [8] | 6y, FN, Bengal | L4–S3 localization | Chronic; pain and paresis | L5–L6 | I | Non-surgically Managed | Good | Recurrent UTI for 1 year after diagnosis |
Fitzpatrick [8] | 7y, MN, DSH | L4–S3 localization | Acute loss of tail sensation; dysuria; fecal incontinence; good anal tone; LS pain | L6–L7, L7–S1 | I | DL L6–S1 | Excellent | Manual bladder expression for 2 weeks after surgery |
McConnell | 5y, M, DSH | L4–S3 localization | Acute; absent anal tone and left pelvic limb nociception | L5–L6 | HVLV | Euthanasia | Euthanasia | Large amount of IVD material breached dura |
Sparkes | 7y, MN, Siamese | L4–S3 localization | Chronic; paraparesis and absent tail nociception | L6–L7 | I | HL | Good | |
Kathmann | 6y, MN, Oriental | L4–S3 localization | Acute; paraparesis and flaccid tail | L6–L7 | I | HL | Excellent | |
Smith | 6y, MN, DSH | L4–S3 localization | Acute; absent pelvic limb nociception (digits); dysuria | L6–L7 | I | HL | Excellent | |
Fitzpatrick [8] | 10y, MN, DSH | L4–S3 localization | Chronic; difficulty jumping; flaccid tail; moderate LS pain | L6–L7 | I | HL | Excellent | Large amount of IVD material breached dura |
Fitzpatrick [8] | 7y, MN, DSH | L4–S3 localization | Chronic; right pelvic limb lameness | L6–L7 | I | HL | Excellent | |
Fitzpatrick [8] | 6y, FN, DSH | L4–S3 localization | Acute; flaccid tail; right pelvic limb paresis | L6–L7 | I | HL | Excellent | |
Fitzpatrick [8] | 11y, FN, DSH | L4–S3 localization | Acute; right pelvic limb lameness | L7–S1 | II | Non-surgically Managed | LTFU | |
Fitzpatrick [8] | 10y, MN, DSH | L4–S3 localization | Chronic; reluctant to jump | L7–S1 | II | Non-surgically Managed | LTFU | Recurrent FLUTD |
Fitzpatrick [8] | 9y, MN, DLH | L4–S3 localization | Chronic; pelvic limb stiffness; lumbar transitional vertebra | L7–S1 | II | Non-surgically Managed (including acupuncture) | Fair | Intermittent L/T constipation; L/T oral analgesia |
Fitzpatrick [8] | 11y, MN, Burmese | L4–S3 localization | Chronic; reluctant to jump | L7–S1 | II | Non-surgically Managed | LTFU | |
Fitzpatrick [8] | 7.5y, MN, DSH | L4–S3 localization | Chronic intermittent left pelvic limb lameness | L7–S1 | II | Non-surgically Managed (including acupuncture) | Good | |
Fitzpatrick [8] | 1.5y, MN, DSH | L4–S3 localization | Chronic; pelvic limb paresis; lumbar transitional vertebra | L7–S1 | II | Non-surgically Managed | LTFU | |
Fitzpatrick [8] | 1y, MN, Ragdoll | L4–S3 localization | Chronic; Reluctant to jump | L7–S1 | II | Non-surgically Managed | Excellent | |
Fitzpatrick [8] | 4.5y, MN, DSH | L4–S3 localization | Chronic; right pelvic limb lameness | L7–S1 | II | Non-surgically Managed | Excellent | |
Fitzpatrick [8] | 10.5y, MN, DLH | L4–S3 localization | Chronic; excessive grooming over lumbar spine; concurrent surgical MPL | L7–S1 | II | Non-surgically Managed | Excellent | |
Fitzpatrick [8] | 3y, FN, DLH | L4–S3 localization | Acute onset ataxia; constipation | L7–S1 | II | Non-surgically Managed | Excellent | |
Fitzpatrick [8] | 10.5y, MN, DSH | L4–S3 localization | Chronic; reluctant to jump | L7–S1 | II | DL | Excellent | |
Fitzpatrick [8] | 10y, MN, DLH | L4–S3 localization | Chronic; spontaneous pain; bilateral pelvic limb lameness | L7–S1 | II | LSDF | LTFU | |
Fitzpatrick [8] | 12y, MN, DSH | L4–S3 localization |