Abstract
The aim of this study was to evaluate if a combination of discrete clinical characteristics can be used to identify the most likely differential diagnoses in cats with spinal disease. Two hundred and twenty-one cats referred for further evaluation of spinal disease were included and categorised as follows: non-lymphoid neoplasia (n = 44); intervertebral disc disease (n = 42); fracture/luxation (n = 34); ischaemic myelopathy (n = 22); feline infectious peritonitis virus myelitis (n = 18); lymphoma (n = 16); thoracic vertebral canal stenosis (n = 11); acute non-compressive nucleus pulposus extrusion (n = 11); traumatic spinal cord contusion (n = 8); spinal arachnoid diverticula (n = 7); lumbosacral stenosis (n = 5); and spinal empyema (n = 3). Information retrieved from the medical records included signalment, clinical history and clinical presentation. Univariate analyses of variables (clinical history, breed, age, sex, general physical examination findings, onset, progression, spinal hyperaesthesia, asymmetry, ambulatory status and neuroanatomical location) were performed, and variables were retained in a multivariate logistic regression model if P <0.05. Multivariate logistic regression revealed that intervertebral disc disease most often occurred in middle-aged, purebred cats with a normal general physical examination and an acute onset of painful and progressive clinical signs. Ischaemic myelopathy occurred most often in older cats with a stable or improving, non-painful, lateralising, C6-T2 myelopathy. Spinal fracture/luxation occurred most often in younger cats and resulted most often in a peracute onset, painful, non-ambulatory neurological status. Concurrent systemic abnormalities or abnormal findings detected on general physical examination were significantly associated with feline infectious peritonitis virus myelitis, spinal lymphoma or spinal empyema. This study suggests that using easily identifiable characteristics from the history and clinical examination can assist in obtaining a preliminary differential diagnosis when evaluating cats with spinal disease. This information could aid veterinary practitioners in clinical decision-making.
Highlights
Assessment of cats with suspected spinal disease can be daunting for veterinary practitioners
Neurophobia is the fear of neuroscience and clinical neurology, which was first recognised in medical students and young physicians.[1]
These five cats were diagnosed with traumatic intramedullary haemorrhage (n = 2), suspected poliomyelitis, toxoplasmosis (n = 1) and vertebral malformation caused by mucopolysaccharidosis (n = 1)
Summary
Assessment of cats with suspected spinal disease can be daunting for veterinary practitioners. Neurophobia is the fear of neuroscience and clinical neurology, which was first recognised in medical students and young physicians.[1] It is associated with the belief that neurology is a complex subject that is academically challenging and difficult to apply in clinical practice. It results in decreased confidence and the inability to apply basic knowledge into clinical practice, essentially leading to paralysis of analysis or ‘paralysis of thinking’.1–3. Following a surge in veterinary neurology research in the last 15 years, neurological diseases are more frequently recognised. Despite the accompanying rise in understanding of neurological disorders, the ‘neurophobia’ phenomenon remains prevalent, among young veterinarians.[4,5]
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