"Myelopathy"-any disorder or disease affecting the spinal cord



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Causes

  • Degenerative disease of the spinal cord

  • Inherited disease of the spinal cord

  • Abnormal structural development of the backbones (vertebrae) or spinal cord

  • Metabolic abnormalities

  • Tumors or cancer (such as lymphoma, osteosarcoma, fibrosarcoma, and cancer that has spread to the spine/spinal cord [known as “metastatic cancer”])

  • Inflammatory or infectious disease (such as feline infectious peritonitis [FIP], toxoplasmosis, and feline leukemia virus (FeLV)-associated disorder of the spinal cord [known as “FeLV-associated myelopathy”])

  • Trauma (such as fractures or dislocations of the backbones [vertebrae] and penetrating wounds [bite wounds, BB pellets])

  • Abnormal blood flow to the spine/spinal cord

Risk Factors

  • Outdoor cats—at risk for traumatic and infectious inflammation of the spinal cord (known as “myelitis”)

  • Feline leukemia virus (FeLV)-positive cats—at risk for lymphoma and FeLV-associated myelopathy

Treatment

Health Care

  • Emergency evaluation and possible surgery—when a traumatic cause of weakness (paresis)/paralysis is suspected

  • Inpatient medical management—for severe nervous system deficits, such as paralysis and lack of control of urination (urinary incontinence)

  • Cats that cannot walk (known as being “non-ambulatory”) should be confined to a soft padded crate or enclosed area, they should be kept dry and clean and turned every 6 hours, if they are unable to stay lying on their chests

  • If the cat has lack of control of urination (urinary incontinence), the bladder should be emptied every 6–8 hours

  • Prevent/treat “bed sores” (known as “decubital ulcers”) and skin lesions that develop due to contact with urine, when the hair and skin remain damp (known as “urine scald”)

  • Treat constipation

  • Physical therapy is useful to prevent loss of muscle mass (muscle atrophy) and to keep joints flexible, especially for post-operative rehabilitation

Activity

  • Restricted—especially when a traumatic cause of weakness (paresis)/paralysis is suspected, but also to prevent spinal trauma secondary to the paresis/paralysis

Surgery

  • Surgical management—for fractures or dislocations of the backbones (vertebrae), intervertebral disk disease, and some tumors or cancer

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive



  • Not recommended until a diagnosis has been established

  • Spinal trauma—methylprednisolone administered within 8 hours from the time of injury

  • Antibiotics, if the cat develops a urinary tract infection

Follow-Up Care

Patient Monitoring

  • Repeat nervous system examination—at a frequency determined by the severity and progression of the cat's nervous system status

Preventions and Avoidance

Possible Complications

  • Urinary tract infection

  • Skin lesions that develop due to contact with urine, when the hair and skin remain damp (urine scald)

  • Constipation or lack of control of bowel movements (fecal incontinence)

  • Loss of muscle mass (muscle atrophy)

  • “Bed sores” (decubital ulcers)

Expected Course and Prognosis

  • Depend on underlying cause

Key Points

  • If the cat is treated as an outpatient, it is important to understand all aspects of nursing care and possible complications; discuss the care of your cat with the veterinarian




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Blackwell's Five-Minute Veterinary Consult: Canine and Feline, Fifth Edition, Larry P. Tilley and Francis W.K. Smith, Jr. © 2011 John Wiley & Sons, Inc.
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