title: Presumptive acute non-compressive nucleus pulposus extrusion in 11 cats: clinical features, diagnostic imaging findings, treatment and outcome.
abstract: 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.
authors.affiliation: Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.
authors.forename: Frances E
authors.initials: FE
authors.lastname: Taylor-Brown
authors.affiliation: Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: De Decker
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D002415:Cats; D003937:Diagnosis, Differential; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis / Q000662:veterinary*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging / Q000662:veterinary; D008297:Male; D000070614:Nucleus Pulposus / Q000473:pathology*; D012189:Retrospective Studies; D020760:Spinal Cord Ischemia / Q000175:diagnosis / Q000662:veterinary*