Page 929 - Problem-Based Feline Medicine

42 – THE WEAK AND ATAXIC OR PARALYZED CAT 921

Prognosis Signs include cervical and thoracic limb hyperesthe-
sia and rigidity due to extensive confluent exostosis in
Prognosis depends on the type of congenital anomaly
the cervical and thoracic spine, thoracic limb lame-
and the degree of dysfunction.
ness, ataxia, reluctance to move, and tetraparesis to
Cats with mild signs due to a surgically treatable paralysis.
hemivertebra or block vertebra, have a guarded to good
Other signs include lethargy, anorexia, constipation,
prognosis for improvement.
weight loss and an unkempt haircoat due to an inability
Morbidity and mortality is high with surgical stabi- to groom.
lization of atlantoaxial subluxation.
Exostoses develop insidiously with the above signs
● With successful stabilization, however, cats with
occurring only after the disease is advanced.
initially mild to moderate neurological dysfunction
have a fair to good prognosis.
Diagnosis
Prognosis for cats with spina bifida or sacrococcygeal
dysgenesis with anomalies associated with the spinal Non-contrast spinal radiographs show new bone for-
cord or cauda equina, is grave. These cats should be mation involving the cervical vertebrae.
euthanized if the neurological dysfunction is incompat- ● The sternum, costal cartilages, and long bone meta-
ible with a good quality of life. physes also show new bone formation.
● Joints may show arthrodesis.
Cats with spinal cord tethering (spina bifida) have a
potentially fair to good prognosis with surgery.
Differential diagnosis
Prevention Based on the clinical and neurological examinations,
other differentials include infectious meningitis and
Prevention of further congenital malformations is best
myelitis, vertebral neoplasia, mucopolysaccharidosis
achieved by a spay/neuter program.
and discospondylitis (rare).
Non-contrast spinal radiographs eliminate all differen-
HYPERVITAMINOSIS A*
tials with the possible exception of mucopolysacchari-
dosis VI, a rare autosomal recessive storage disease
Classical signs
produced by deficiency of the lysosomal enzyme, aryl-
● Cervical and thoracic limb hyperesthesia sulfatase B.
and rigidity. ● Mucopolysaccharidosis VI occurs in 4–7-month-
● Thoracic limb lameness. old Siamese cats, producing spinal cord com-
● Chronic progressive ataxia. pression secondary to fusion of the cervical
● Reluctance to move. and thoracolumbar vertebrae with bony proli-
● Chronic tetraparesis to paralysis. feration.
● These cats also have a flat, broad face, widely
spaced eyes, corneal clouding and enlarged feet.
Pathogenesis
Treatment
Hypervitaminosis A is a skeletal disease, secondary to
excessive intake of vitamin A (liver or vitamin A sup- Remove excess vitamin A from the diet to prevent
plementation (cod liver oil) (> 1000 IU/ml). further development of exostoses.
Use a balanced commercial cat diet.
Clinical signs
Skeletal improvement is monitored by radiography and
Affected cats are usually 2–9 years of age. neurological examinations.