Dermoid cyst of the spinal cord associated with ataxia in a cat

A young adult Balinese cat developed complete hindlimb paralysis which persisted for six weeks. Clinical findings suggested a lesion compressing the spinal cord and this was confirmed at necropsy. A dermoid cyst was present at the level of the third thoracic vertebra. The cyst was lined by stratified squamous epithelium and contained desquamated keratinised material and hair fragments. Sebaceous glands and hair follicles were present in the connective tissue wall. This is the first report of a dermoid cyst in the spinal cord of a cat. The lesion is considered to be a congenital anomaly.     

CORRELATIVE IMAGING FINDINGS IN SEVEN DOGS AND ONE CAT WITH SPINAL ARACHNOID CYSTS

Information regarding 7 dogs and 1 cat with a spinal arachnoid cyst is presented. All patients were evaluated with survey radiographs and myelography. Computed tomography (CT) following myelography, magnetic resonance (MR) imaging, and sonography, were used in some of the patients. These imaging techniques were evaluated to determine their efficacy in diagnosing arachnoid cysts, ascertaining the extent and internal cyst architecture and detecting associated spinal cord abnormalities. Survey radiographs were nondiagnostic in all patients. Myelographically, the arachnoid cyst was visible in all patients, with partial blockage to flow of contrast medium. CT provided additional information on localization and lateralization of the cyst, and allowed measurement of the degree of spinal cord compression. MR imaging enabled identification of an associated syringomyelia. Sonography was useful for defining the cyst wall and characterizing the internal architecture of the cyst cavity and adjacent spinal cord. Measurements of the degree of spinal cord compression could be made and were similar to measurements made from CT. Additionally, sonography was considered a useful technique for orientating the surgeon to the location and extent of the cyst. In the absence of the availability of CT or MR imaging for evaluating patients with an arachnoid cyst, sonography is considered a valuable technique for directly assessing the spinal cord for associated disease. Decompressive surgery was performed on 4 dogs and 1 cat, all with successful outcomes.     

Acquired arachnoid cyst in a cat

A 5-year-old Birman cat presented with paraparesis associated with a fracture of the third thoracic vertebra and was managed conservatively. Voluntary function was regained over the next 6 months, but the cat was referred 4 years after the trauma because of recurrence of hindlimb paresis and ataxia. Magnetic resonance imaging (MRI) showed a spinal arachnoid cyst at the level of the fourth thoracic vertebra, which was treated surgically by dorsal laminectomy and durectomy, and hindlimb function subsequently recovered. The cat re-presented 4 years later for recurrent hindlimb paresis. Myelography and computed tomography–myelography (CT-M) showed dorsolateral pooling of cerebrospinal fluid (CSF) at the previous laminectomy site. The neurological signs after the second surgery improved, but not as much as after the first surgery and the cat remained ataxic with moderate paresis. Seven months later repeat CT-M revealed an atrophic spinal cord, but negligible pooling of CSF at the previous site of the arachnoid cyst. The cat could walk, but was being treated for self-induced trauma of the left hindlimb that was thought to be related to paraesthesia. The neurological signs gradually deteriorated over 3 months and the cat was euthanased.     

Disseminated sarcocystosis in a cat with lymphosarcoma

Cysts of the protozoan Sarcocystis sp were found in skeletal and cardiac musculature in a 1.5-year-old cat with lymphosarcoma. The cat was FeLV-positive and had grossly visible neoplastic involvement of the spinal cord, mediastinum, bone marrow, and kidneys. Ultrastructural examination of the parasitic cyst wall suggested that the species in this case was different from that described in the only other reported case. It was hypothesized that immunosuppression from FeLV infection permitted an aberrant life cycle with encystment of Sarcocystis sp in this cat.     

SPINAL SUBARACHNOID CYST IN A CAT

A 7-year-old neutered female domestic short hair cat was presented with hind limb ataxia. A subarachnoid cyst in the T10-T11 spinal cord region was identified by myelography as a collection of contrast medium in the subarachnoid space.     

Spinal dural ossification causing neurological signs in a cat

A six-year-old Ragdoll cat underwent examination due to a six-month history of slowly progressive gait abnormalities. The cat presented with an ambulatory tetraparesis with a neurological examination indicating a C1-T2 myelopathy. Radiographs of the spine showed a radiopaque irregular line ventrally in the vertebral canal dorsal to vertebral bodies C3-C5. In this area, magnetic resonance imaging revealed an intradural extramedullary/extradural lesion compressing the spinal cord. The spinal cord was surgically decompressed. The cause of the spinal cord compression was dural ossification, a diagnosis confirmed by histopathological examination of the surgically dissected sample of dura mater. The cat gradually improved after the procedure and was ambulating better than prior to the surgery. The cat’s locomotion later worsened again due to ossified plaques in the dura causing spinal cord compression on the same cervical area as before. Oral prednisolone treatment provided temporary remission. Ten months after surgery, the cat was euthanized due to severe worsening of gait abnormalities, non-ambulatory tetraparesis. Necropsy confirmed spinal cord compression and secondary degenerative changes in the spinal cord on cervical and lumbar areas caused by dural ossification. To our knowledge, this is the first report of spinal dural ossification in a cat. The reported cat showed neurological signs associated with these dural changes. Dural ossification should be considered in the differential diagnosis of compressive spinal cord disorders in cats.     

Degenerative myelopathy associated with cobalamin deficiency in a cat

A severe myelopathy was observed in a 9-year-old neutered male cat with a clinical history of chronic pancreatitis associated with deficiency of serum cobalamin and folates concentrations, and progressive spinal ataxia. The spinal cord lesions mainly involved the dorsal columns of the caudal cervical and cervico-thoracic segments, and were characterized by diffuse vacuolated myelin sheaths and axonal degeneration, marked gliosis, fibrosis and presence of gitter cells. The pancreas showed severe atrophy of the exocrine tissue, periductular fibrosis and infiltration of inflammatory cells, consistent with chronic interstitial pancreatitis. This condition can be accountable for cobalamin deficiency, as the pancreas is the only source of intrinsic factor in cats. The spinal cord lesions in the cat of this report resembled the subacute combined degeneration of the spinal cord described in human beings with cobalamin deficiency and hence a similar pathogenetic mechanism is hypothesized.     

Recurrent spinal arachnoid cyst in a cat

Spinal arachnoid cysts (SACs) are uncommon expanding lesions in the spinal canal. They are rarely diagnosed in dogs, and there are only four published cases in cats. We report a case of a 12-year-old cat with recurrent signs of intermittent urinary incontinence and hind limb ataxia 2 years after surgical marsupialisation of a spinal arachnoid cyst at T11/12. Recurrence of a cyst was diagnosed by myelography. Repeated marsupialisation after laminectomy was successful and the cat recovered satisfactorily although intensive physical therapy was necessary. SACs are very rare in cats and seem to occur mainly as a secondary lesion to spinal and meningeal trauma or irritation due to bony changes of the vertebrae.     

Surgical management of a recurrent spinal meningioma in a cat

A 13-year-old male neutered Persian crossbred cat was evaluated for hindlimb paresis, ataxia and urinary incontinence that had been progressing over the previous 3 months. Neurologically, the cat had thoracolumbar spinal cord deficits and a myelogram detected the presence of a mass compressing the thoracic spinal cord. A hemilaminectomy was performed to excise the soft tissue mass, subsequently identified histologically as a psammomatous meningioma. The cat regained ambulatory function and continence following surgery until a recurrence of paresis and ataxia 36 months later. A second myelogram suggested local recurrence of the tumour, which was confirmed by histological examination of the tumour after its removal at a second laminectomy. The cat again regained normal neurological function, until a further recurrence 16 months after the second surgery. The meningioma was surgically debulked a third time and the cat regained ambulation and continence postoperatively. This case demonstrates the successful use of repeated surgical resection in the management of a recurrent spinal meningioma in a cat. The cat was ambulatory and continent at a follow-up examination 63 months after the initial presentation.     

MRI characteristics of suspected acute spinal cord infarction in two cats, and a review of the literature

A 10-year-old neutered male Persian cat and a 4-year-old spayed female domestic shorthair (DSH) cat were evaluated for acute-onset severe lateralising tetraparesis and hemiplegia, respectively. Both cats also had left-sided Horner's syndrome. Neurological examination of the cats localised the lesion to cranial to C5 in the Persian and the left cervical intumescence (C6-T2) in the DSH. Physical examinations were otherwise generally unremarkable. Routine laboratory tests and spinal radiography were normal for the Persian cat and were not performed for the DSH cat. A cerebrospinal fluid (CSF) tap was attempted for the Persian cat but aborted because of gross blood contamination, and was not performed for the DSH cat. Magnetic resonance imaging (MRI) of the Persian cat revealed a lesion within the spinal parenchyma at segments C1 to C3 (slightly more left-sided) which was iso- to hypointense on T1-weighted scans and hyperintense on T2-weighted scans, and which enhanced slightly with gadolinium. MRI of the DSH cat revealed a lesion within the spinal parenchyma at segment C7 (predominantly left-sided) which was hypointense on T1-weighted scans and hyperintense on T2-weighted gradient echo scans. Contrast was not administered. The MRI findings in both cases were highly suggestive of acute spinal cord infarction, based upon comparison to human cases. Both cats made full neurological recoveries with supportive treatment only. This paper describes two cases of suspected acute spinal cord infarction in the cat, demonstrates the potential diagnostic value of MRI, and discusses the clinical syndrome of this condition with a brief review of published cases.     

Surgical removal of an intramedullary chopstick fragment penetrating the spinal cord in a cat

A 3-year-old male domestic shorthair cat presented with sudden ataxia. Neurologic examination showed complete loss of proprioception in the thoracic and pelvic limbs. Computed tomography and magnetic resonance imaging revealed a non-metallic foreign body penetrating the spinal cord. The foreign body was removed by the ventral approach to the atlanto-occipital junction. Mild improvement of proprioception was observed the day after surgery. In a follow-up two months after surgery, the owner reported a complete recovery of the patient, showing a normal gait. To the author’s knowledge, this is the first case report describing successful removal of an intramedullary foreign body penetrating cervical spinal cord by ventral approach in a cat.     

Intraspinal epidermoid cyst in a dog

A 2-year-old female Rottweiler was examined because of progressive gait deficits consistent with transverse myelopathy between the T2 and L3 spinal cord segments. Myelography confirmed an intramedullary spinal cord lesion between T13 and L1, so the dog was euthanatized. At necropsy, an intramedullary epidermoid cyst was confirmed in the T13 and L1 spinal cord segments. The epidermoid cyst probably resulted from a congenital cause.     

Hydrocephalus and syringomyelia in a cat.

A 3-month-old male Japanese cat with feline parvovirus infection, showing central and cervical nerve abnormalities, was diagnosed as hydrocephalus and syringomyelia by use of magnetic resonance imaging (MRI). The cat was maintained clinically by medical treatment even though he could not stand. The MRI scans obtained about 5 months later showed that the ventricles had increased in size and the cervical syrinx had extended into the thoracic spinal cord. Ventriculoperitoneal (VP) shunt was performed. One week after surgery, neurological conditions had improved. At the postoperative MR images, the ventricles had decreased in size and the syrinx in the cervical and thoracic spinal cord could no longer be seen. The cat was still alive and was able to walk well.     

Acute intervertebral disc extrusion in a cat: clinical and MRI findings

A 5 year old, neutered male, domestic shorthaired cat had acute left hemiparesis and Horner's syndrome. Magnetic resonance imaging (MRI) revealed a loss of the normal signal from the nucleus pulposus of the intervertebral disc at C3/4, narrowing of the ventral subarachnoid space and slight dorsal displacement of the spinal cord and a focal hyperintense lesion affecting the left side of the spinal cord at the same level. The presumptive diagnosis was focal spinal cord oedema associated with intervertebral disc extrusion. A traumatic aetiology was suspected. The cat was treated conservatively and improved gradually over a period of 6 months.     

Intramedullary epidermoid cyst in the thoracic spine of a dog

A 5 yr old female spayed mastiff was evaluated for a 3-4 mo history of paraparesis and 3 days of acutely worse paraparesis and incontinence. On magnetic resonance imaging, a spinal cord lesion was present at the ninth thoracic vertebra. The lesion was hyperintense on T2-weighted images (T2-W), and a hyperintense rim was present on T1-weighted postcontrast images. Histologic examination showed a cystic mass lined by squamous epithelial cells. Histopathologic diagnosis was an intramedullary epidermoid spinal cyst. Epidermoid cyst should be a differential diagnosis in young dogs with a myelopathy and an intramedullary spinal cord lesion on magnetic resonance imaging examination.     

Fibrocartilaginous embolism in a cat

A nine-year-old cat was presented with a history of an acute onset of paraplegia. On the basis of the neurological examination, the lesion was localised between the fourth lumbar and third sacral segments (L4 to S3) of the spinal cord. Investigations included radiography, myelography, cerebrospinal fluid analysis, routine haematology and biochemistry, feline leukaemia virus testing and urinalysis. A definitive diagnosis was not achieved and the cat was euthanased 12 days after presentation. Post mortem examination revealed infarction of the spinal cord secondary to fibrocartilaginous embolisation. This is the first reported case of fibrocartilaginous embolism in the cat in the UK.     

Hydromyelia in a Reeves' muntjac (Muntiacus reevesi).

A 24-day-old, 2.2-kg, female Reeves' muntjac (Muntiacus reevesi) acutely developed left hind limb lameness that resolved with rest and anti-inflammatory drugs but recurred at 8 mo of age. Magnetic resonance imaging (MRI) of the lumbar, sacral, and coccygeal spine revealed a fluid-filled dilatation of the central canal of the spinal cord, which was interpreted as a hydromyelic cyst. Surgical exploration and drainage of the cyst were attempted. Despite initially improved mobility, severe plantar ulceration of both hocks developed. The animal was euthanatized. Gross necropsy of the central nervous system revealed a 1.5-cm-long, mild depression with associated yellowing of the dorsal spinal cord in the lumbosacral region, dilatation of the central spinal canal that extended from the cranial thoracic spinal cord with diameter increasing caudally, and mild herniation of the brainstem at the foramen magnum. Histopathologic lesions of the central nervous system were restricted to the spinal cord, with equivocal enlargement of the fourth ventricle. Pathologic changes included irregular dilatation of the central canal, flattening to the absence of the ependymal cells, spongiosis of the gray matter neuropil, and dystrophic calcification. The gross and histologic findings confirmed the diagnosis of hydromyelia.     

Dural tear and myelomalacia caused by an airgun pellet in a cat

An 8-year-old cat was presented with severe neurological deficits secondary to a traumatic cervical spinal cord injury caused by an airgun pellet. This report describes, for the first time, the myelographic findings of a dural rupture in a cat and also describes a bilateral Horner’s syndrome in a cat.     

Tetraparesis in a cat with fibrocartilaginous emboli

An 8-year-old cat, with a history of ataxia that progressed to tetraparesis over a 5-day period, was evaluated. A lesion was localized to the sixth cervical (C6) to second thoracic (T2) spinal cord segments based on physical and neurological examination findings. Blood work was unremarkable, as was survey radiography of the thoracic and abdominal cavities. Cerebrospinal fluid analysis showed moderate neutrophilic inflammation. A definitive diagnosis was not made until necropsy, at which time intravascular fibrocartilaginous embolization (FCE) of the cervical spinal cord was identified. This is only the third published report of FCE in the feline species and the first such case involving the cervical spinal cord.