Suspected acquired hypocobalaminaemic encephalopathy in a cat: resolution of encephalopathic signs and MRI lesions subsequent to cobalamin supplementation

Presenting signs and initial investigations: An 8-year-old female spayed British shorthair cat was presented with a history of waxing and waning neurological signs. Neuroanatomical localisation was consistent with a diffuse forebrain disease. Blood ammonia concentration was increased. Abdominal ultr...

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Bibliographic Details
Published in:Journal of feline medicine and surgery 2012-05, Vol.14 (5), p.350-355
Main Authors: Simpson, Katherine, Battersby, Ian, Lowrie, Mark
Format: Article
Language:English
Subjects:
ammonia
Animals
bile
blood
brain
Brain Diseases, Metabolic - diagnosis
Brain Diseases, Metabolic - etiology
Brain Diseases, Metabolic - veterinary
Case Report
Cat Diseases - blood
Cat Diseases - diagnosis
Cat Diseases - drug therapy
Cats
Dietary Supplements
encephalopathy
Female
Hyperammonemia - diagnosis
Hyperammonemia - etiology
Hyperammonemia - veterinary
image analysis
magnetic resonance imaging
Magnetic Resonance Imaging - veterinary
pets
Treatment Outcome
ultrasonography
urea
Vitamin B 12 - administration & dosage
Vitamin B 12 Deficiency - complications
Vitamin B 12 Deficiency - diagnosis
Vitamin B 12 Deficiency - veterinary
vitamin B12
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Description
Summary:Presenting signs and initial investigations: An 8-year-old female spayed British shorthair cat was presented with a history of waxing and waning neurological signs. Neuroanatomical localisation was consistent with a diffuse forebrain disease. Blood ammonia concentration was increased. Abdominal ultrasonography and a bile acid stimulation test were normal. Magnetic resonance imaging (MRI) revealed hyperintense, bilaterally symmetrical, diffuse lesions on T2-weighted sequences, predominantly, but not exclusively, affecting the grey matter. Serum cobalamin (vitamin B12) concentration was low. Hypocobalaminaemia resulting in a urea cycle abnormality was considered a likely cause of the hyperammonaemia. TREATMENT: Daily cobalamin injections resulted in a rapid clinical improvement. Eight weeks into treatment neurological examination was unremarkable and there was complete resolution of the MRI lesions. Clinical importance: This is the first reported case of acquired feline hypocobalaminaemia resulting in an encephalopathy. Additionally, this case is unique in describing reversible brain MRI abnormalities in a cobalamin-deficient companion animal.
ISSN:1098-612X
1532-2750
1532-2750
DOI:10.1177/1098612X12439358