Feline Intervertebral Disc Disease

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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  4. What Constitutes Spinal Cord Decompression?

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Nov 27, 2016 | Posted by in GENERAL | Comments Off on Feline Intervertebral Disc Disease

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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