Outcomes for cats diagnosed with ischemic spinal cord injury by MRI

Abstract

Previous publications on ischaemic myelopathy in cats are limited to single case reports and small case series. The overall prognosis appears poor, with 42% of cats being euthanased. In this study the clinical outcome of 19 cats with a presumptive diagnosis of ischaemic myelopathy [based on clinical and magnetic resonance imaging (MRI) findings] was evaluated retrospectively. The degree of neurological dysfunction at the time of presentation was similar to previously reported cases, ranging from ambulatory paresis to plegia with intact nociception. The most common lesion localisations (based on MRI) were to the C1-C5 (30%) and C6-T2 (30%) spinal cord segments, with the T3-L3 and L4-S1 spinal cord segments accounting for 25% and 15%, respectively. Potential inciting or predisposing causes for development of spinal infarction were identified in 12 cats, including physical exertion, trauma, general anaesthesia, renal disease, hyperthyroidism, hypertension and hypertrophic cardiomyopathy. The median time to recovery of ambulation was 3.5 days (3-19 days). Four cats (21%) were euthanased within 2 months of diagnosis. The remaining 15 (79%) cats had a favourable outcome. Follow-up ranged from 6 months to 10 years and 4 months, with a median of 3 years and 1 month. Even when plegia was present at the time of presentation, all surviving cats with long-term, owner-derived follow-up were reported to return to a normal quality of life, suggesting that the long-term prognosis for recovery from presumed ischaemic myelopathy is favourable in the majority of cats.