Page 925 - Problem-Based Feline Medicine

42 – THE WEAK AND ATAXIC OR PARALYZED CAT 917

6 days, the prognosis is hopeless and the cat should be thrombus in the left atrium also decreases the long-term
euthanized. prognosis.
Various other treatments have been advocated but
there are no studies showing increased survival. These Prevention
include aspirin, periactin, acepromazine and vasodilator
Little can be done to prevent aortic thromboembolism
agents.
if the underlying cardiac disease has not been previ-
Aspirin may be beneficial during and after an episode ously recognized.
of thromboembolism due to its antiplatelet effects and
If cardiac disease is diagnosed, the risk of thromboem-
decreased production of the vasoconstrictor thromb-
bolism may be reduced by appropriate treatment of
oxane A , as well as analgesic effects. The dosage is
2 the cardiomyopathy (see Chapter 6). Efficacy of long-
1/4 × 325 mg adult aspirin (81 mg) every second to
term aspirin (low dose 1–5 mg/cat q 24 h or a regular
third day. Blockade of prostacyclin production by the
dose 81 mg/cat, q 48–72 h PO) or warfarin therapy in
endothelium with aspirin is of concern, and some advo-
preventing thromboembolism has not been demon-
cate lower doses of aspirin more frequently (1–5 mg/cat
strated, and most cats rethrombose.
q 24 h). Prostacyclin inhibits platelet aggregation and
vasoconstriction.
FELINE POLIOENCEPHALOMYELITIS*
Acepromazine (0.1–0.5 mg subcutaneously three
times daily) can be used for sedation and vasodilation.
Classical signs
Vasodilation with alpha-blockers is advocated by some
● Stiff staggering gait.
but unproven.
● Inability to jump.
Long-term warfarin therapy may decrease the fre- ● Chronic pelvic limb ataxia and paraparesis.
quency of rethrombosis, but needs careful monitoring ● Inability to retract their claws.
using the International Normalization Ratio (INR) for ● Thoracolumbar hyperesthesia.
PT to achieve a INR between 2 and 3. Doses of ● Thoracic limb paresis and ataxia.
0.06–0.20 mg/kg PO q 24 h have been advocated. ● Decreased mentation and seizures.
A lower dose of 0.5 mg/cat PO q 48 h has also been ● Fever (in 50% of cases).
used.
Pathogenesis
Prognosis Feline polioencephalomyelitis is a chronic, progres-
sive disease affecting the spinal cord and brain of
Only 30–50% of cats survive the initial episodes and go
cats.
home.
The cause is unknown, although neuropathology is
Most will re-embolize – long-term prognosis is poor
suggestive of a neurotrophic virus.
(average survival is 6–11 months with therapy) with
less than 50% surviving 1 year. Recently, specific antibodies to the Borna disease
● 50% of cats have rethrombosis even when treated virus have been found in 44% of cats with feline
with warfarin. polioencephalomyelitis in Sweden.

Most cats that survive an initial episode will show vary- Feline polioencephalomyelitis is a sporadic worldwide
ing degrees of neurological recovery to their pelvic disease.
limbs, although this often takes weeks to months.
Rarely does the neuromuscular function fully recover.
Clinical signs
Hypothermia and azotemia prior to therapy and hyper-
Affected cats range from 4 months to 12 years of age.
kalemia during thrombolysis are negatively associated
with survival. Echocardiographic evidence of another Both male and female cats are affected.