Outcomes of surgically and conservatively managed thoracolumbar and lumbosacral intervertebral disc herniations in cats.

Abstract

Limited information is available regarding intervertebral disc herniation (IVDH) and its treatment in cats. Describe outcomes after surgical or conservative treatment of cats with thoracolumbar and lumbosacral IVDH. Ninety-two cats from 2 referral populations (2012-2022) with compressive IVDH between the T3 and S1 vertebrae. Retrospective cohort study evaluating outcomes of surgical (49 cats) and conservative (36 cats) management of IVDH; 7 cats were euthanized at diagnosis. Outcome was assessed using hospital and referring veterinarian records and client questionnaires. Successful outcome was defined as regained or improved ambulation, urinary and fecal continence, and no requirement for analgesic medication. Incidence of IVDH during the study period was 0.44% (92/20849). Surgical treatment resulted in 62% (6 weeks) and 74% success (6 months). Conservative treatment resulted in 54% (6 weeks) and 65% success (6 months). Neurological grade at presentation was higher in cats treated surgically (median, 2; range, 1-5) than in those treated conservatively (median, 2; range, 0-4; P = .001). Regardless of treatment type, cats suffering trauma were more likely to have a successful outcome 6 weeks after treatment compared with those without history of trauma (odds ratio, 5.3; 95% confidence interval, 1.05-26.78; P = .04). Neurological deficits remained in the majority of cats for both treatment types (92%, conservative; 86%, surgical at 6 weeks). Acute-on-chronic IVDH with characteristics of both extrusion and protrusion were identified in 10% of cats. Conservative treatment could be as effective as surgical decompression in cats with thoracolumbar or lumbosacral IVDH.