Presumptive acute non-compressive nucleus pulposus extrusion in 11 cats: clinical features, diagnostic imaging findings, treatment and outcome

• Published in: Journal of feline medicine and surgery 2017-01, Vol.19 (1), p.21-26
• Main Authors: Taylor-Brown, Frances E, De Decker, Steven
• Format: Article
• Language: English
• Subjects: Animals; Cat Diseases - diagnostic imaging; Cat Diseases - therapy; Cats; Diagnosis, Differential; Intervertebral Disc Degeneration - diagnosis; Intervertebral Disc Degeneration - veterinary; Lumbar Vertebrae; Magnetic Resonance Imaging - veterinary; Male; Nucleus Pulposus - pathology; Retrospective Studies; Spinal Cord Ischemia - diagnosis; Spinal Cord Ischemia - veterinary
• ISSN: 1098-612X; 1532-2750; 1532-2750
• DOI: 10.1177/1098612X15605150

Objectives The aim of the study was to describe the clinical features, diagnostic imaging findings, treatment and outcome in cats diagnosed with presumptive acute non-compressive nucleus pulposus extrusion. Methods Medical records and imaging studies of cats diagnosed with presumptive acute non-compressive nucleus pulposus extrusion were retrospectively reviewed. Information on long-term outcome was acquired from patient records and from either owners or referring veterinary surgeons via a telephone questionnaire. Results Eleven cats met the inclusion criteria. All cats had a peracute onset of clinical signs, with eight cats experiencing witnessed (n = 6) or suspected (n = 2) external trauma based on imaging findings. Neuroanatomical localisation included C1–C5 (n = 1), T3–L3 (n = 7) and L4–S3 (n = 3) spinal cord segments. MRI revealed acute non-compressive nucleus pulposus extrusions located at C3–C4 (n = 1), T12–T13 (n = 1), T13–L1 (n = 1), L1–L2 (n = 1), L3–L4 (n = 3), L4–L5 (n = 1) and L5–L6 intervertebral disc spaces (n = 3). Treatment included supportive care and 10 cats were discharged with a median hospitalisation time of 10 days (range 3–26 days). One cat was euthanased during hospitalisation owing to complications unrelated to neurological disease. All cats that presented as non-ambulatory regained an ambulatory status with the median time to ambulation of 17 days (range 6–21 days). Overall, the outcome for cats diagnosed with acute non-compressive nucleus pulposus extrusion was successful, with almost 90% returning to ambulation with urinary and faecal continence. Conclusions and relevance The majority of cats diagnosed with acute non-compressive nucleus pulposus extrusion had good outcomes. Acute non-compressive nucleus pulposus extrusion should be considered as a differential diagnosis for cats presenting with peracute onset of spinal cord dysfunction, particularly if there is a clinical history or evidence of trauma.