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VSCD profiles interesting and instructive cases and pet owner
stories as they present.
Jerry
the Paralyzed
Feline |
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Name: Jerry
Breed: Domestic
Short Hair
Age: 12
years
Condition: Inability
to walk |
LIn early April 2008 “Jerry,” a 12-year-old male
neutered Domestic Short Hair (Figure 1), presented to Veterinary
Surgical Centers of the Delta at VetCare for evaluation of inability
to walk.
Physical examination of Jerry revealed a normothermic patient
with good femoral pulses bilaterally, an easily expressable urinary
bladder, and a mild left systolic heart murmur. Neurologic
evaluation of reflexes revealed decreased withdrawal reflexes,
decreased sciatic and femoral reflexes, deceased tail and anal
tone. Jerry
had superficial pain sensation with no motor function in either
hindlimb. Based
upon these findings, neurologic lesion localization was L4-S1
myelopathy. No
obvious orthopedic abnormalities were detected.
Differential diagnosis at this time included trauma (vertebral
fracture), intervertebral disc disease, neoplasia, fibrocartilaginous
emboli (FCE), and inflammatory/infectious etiologies.
Minimum data base including routine blood work, U/A and radiographs
found no evidence of metabolic, orthopedic or traumatic etiologies.
At this time, we elected to perform an MRI, and a type I ventral,
right-sided intervertebral disc herniation was discovered at
L5-L6 on cross-sectional images. (Figure
2 and 3 –see arrows).
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Saggital
MRI image showing extra-dural spinal cord compression at
disc interspace L5-L6 |
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Transverse
MRI image through disc interspace L5-L6 showing predominately
right sided extra-dural compression. |
Based on Jerry’s neurologic status, he had a very good
prognosis with surgery. A right hemilaminectomy was performed. The
ruptured intervertebral disc material was removed, and the spinal
cord was decompressed. Jerry’s
spinal cord did not grossly appear bruised or swollen.
Over the subsequent
week, Jerry underwent physical therapy treatments 4-6x/day consisting
of standing leg activities, passive range of motion activities,
and sling assisted activities. He
was able to walk with moderate ataxia, and he regained the ability
to urinate appropriately by the end of the first week! At
four weeks post-operative, he was able to walk with very mild
ataxia.
Jerry is just
one of two feline patients that have presented to VetCare Surgical
Services since April with this diagnosis. The veterinary literature
is sparse with isolated feline case studies. In most
case studies, the prognosis for felines with intervertebral disc
disease was excellent, and a recurrent theme is that many feline
patients (unlike canine patients) do not have spinal hyperpathia
(back pain).
Best of
luck to Jerry and his continued recovery!
Heather Towle, DVM, MS, DACVS
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