Abstract
The literature is lacking data concerning the prognosis in cats suffering from naturally occurring acute onset of thoracolumbar (TL) spinal cord injury that are undergoing rehabilitation therapy. Therefore, we investigated the effect of physical rehabilitation in cats suffering from naturally occurring TL spinal cord injury. The medical records of 36 cats with acute onset of TL spinal cord injury that were selected for rehabilitation treatment were reviewed. Twenty-nine cats underwent an intensive physical rehabilitation protocol in the clinic (group 1), whereas the owners of seven cats declined physical rehabilitation (group 2). In group 1, seven cats had pelvic limb deep pain perception (DPP), which was significantly associated with the functional recovery of voluntary ambulatory status (p = 0.010) and voluntary micturition (p < 0.001). Spinal walking was achieved in 10/22 (45%) of the cats without DPP, and none regained voluntary micturition. In group 2, no cats regained ambulatory status or voluntary micturition, although pelvic limb DPP was present in three patients. Treatment with a clinic-based rehabilitation program and the presence of a crossed extensor reflex were significantly associated with a higher possibility of regaining functional ambulatory status (p < 0.010), but there was no difference in the recovery of voluntary micturition between the groups. Thus, cats with severe, naturally occurring, acute onset of TL spinal cord injury may benefit from physical rehabilitation. In the case of the loss of DPP, the acquisition of spinal walking is possible, despite the high possibility of a persistent neurologically dysfunctional bladder.
Highlights
In the last decade, the use of physical therapy in veterinary medicine has increased and an abundance of research describing its role in the outcome of dogs with thoracolumbar (TL) intervertebral disk herniation (IVDH) has been published [1,2,3,4,5,6]
Cats were considered eligible for the study if they satisfied the following criteria: (1) the presence of complete clinical records, including physical examination data and neurological status, assessed by a neurological examination performed by the neurologist at admission and at the end of the treatment; (2) diagnosis of acute onset of TL spinal cord injury, confirmed by survey radiography of the spine or advanced imaging techniques; (3) availability of data regarding the physical rehabilitation protocol performed
Thirty-six cats met the inclusion criteria; 29 were enrolled in the study as group 1 because they underwent an intensive physical rehabilitation protocol, and seven cats belonged to group 2 because they were managed at home without physical rehabilitation treatment (Figure 1)
Summary
The use of physical therapy in veterinary medicine has increased and an abundance of research describing its role in the outcome of dogs with thoracolumbar (TL) intervertebral disk herniation (IVDH) has been published [1,2,3,4,5,6]. Physical therapy seems to have a beneficial role in dogs with severe traumatic injuries of the spinal cord [5]. Many studies performed under experimental conditions have shown the usefulness of treadmill activity in promoting the recovery of motor function after incomplete and complete spinal cord lesions [7,8,9]. Rehabilitation seems most beneficial in dogs with a functionally complete spinal cord injury, highlighting the possibility of achieving an involuntary reflex gait, commonly described as spinal walking (SW) [5]. To the best of the authors’ knowledge, the veterinary literature is lacking data related to the role of rehabilitation in cats with naturally occurring, acute onset of TL spinal cord injury In the absence of superior control by the brain after a complete spinal cord injury, the acquisition of SW is made possible by dynamic interactions between the pelvic limb central pattern generator and proprioceptive feedback from the body [10,11].
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