Clinical presentation, magnetic resonance imaging features, and outcome in 6 cats with lumbar degenerative intervertebral disc extrusion treated with hemilaminectomy.

Authors: 
Hamilton-Bennett SE, Behr S.
Vet Surg. 2019 Mar 3. doi: 10.1111/vsu.13182. [Epub ahead of print]

OBJECTIVE: To describe the clinical presentation, magnetic resonance imaging features, and outcome of cats treated with hemilaminectomy for intervertebral disc extrusion (IVDE).

STUDY DESIGN: Short case series.

ANIMALS: Six cats.

METHODS: Medical records were reviewed for signalment, onset, duration, and severity of clinical signs, magnetic resonance imaging features, surgical findings, and clinical outcome with a minimum postoperative follow-up of 4 weeks.

RESULTS: Our population included 6 cats with a median age of 8.6 years, consisting predominantly of males (n = 5) and purebred cats (n = 4). An acute onset and short duration of progressive clinical signs of myelopathy was the most common presentation; spinal hyperesthesia was present in 3 cats. A large volume of extradural material was identified by MRI within the lumbar vertebral column of each cat, causing marked spinal cord compression. The most common sites affected were L2-L3 (n = 2) and L6-L7 (n = 2). Follow-up after hemilaminectomy was available in 5 cats: 4 had normal voluntary motor function, and 1 had recurrence of acute paraplegia, compromised nociception, and an extensive T2w hyperintense intramedullary lesion according to MRI. All 4 cats with preoperative urinary incontinence remained incontinent for at least 1 week despite good voluntary motor function of pelvic limbs.

CONCLUSION: Intervertebral disc extrusion was diagnosed by MRI in all 6 cats, most commonly at L2-3 and L6-7. Hemilaminectomy resulted in a good to excellent outcome in 4 of 5 cats.

CLINICAL SIGNIFICANCE: Feline IVDE can be diagnosed by MRI and carry a good prognosis after surgical decompression, although urinary continence may be delayed despite good pelvic limb voluntary motor function.

Small animal: