Presumptive acute non-compressive nucleus pulposus extrusion in 11 cats: clinical features, diagnostic imaging findings, treatment and outcome

Abstract

Objectives The aim of the study was to describe the clinical features, diagnostic imaging findings, treatment and outcome in cats diagnosed with presumptive acute non-compressive nucleus pulposus extrusion. Methods Medical records and imaging studies of cats diagnosed with presumptive acute non-compressive nucleus pulposus extrusion were retrospectively reviewed. Information on long-term outcome was acquired from patient records and from either owners or referring veterinary surgeons via a telephone questionnaire. Results Eleven cats met the inclusion criteria. All cats had a peracute onset of clinical signs, with eight cats experiencing witnessed (n = 6) or suspected (n = 2) external trauma based on imaging findings. Neuroanatomical localisation included C1–C5 (n = 1), T3–L3 (n = 7) and L4–S3 (n = 3) spinal cord segments. MRI revealed acute non-compressive nucleus pulposus extrusions located at C3–C4 (n = 1), T12–T13 (n = 1), T13–L1 (n = 1), L1–L2 (n = 1), L3–L4 (n = 3), L4–L5 (n = 1) and L5–L6 intervertebral disc spaces (n = 3). Treatment included supportive care and 10 cats were discharged with a median hospitalisation time of 10 days (range 3–26 days). One cat was euthanased during hospitalisation owing to complications unrelated to neurological disease. All cats that presented as non-ambulatory regained an ambulatory status with the median time to ambulation of 17 days (range 6–21 days). Overall, the outcome for cats diagnosed with acute non-compressive nucleus pulposus extrusion was successful, with almost 90% returning to ambulation with urinary and faecal continence. Conclusions and relevance The majority of cats diagnosed with acute non-compressive nucleus pulposus extrusion had good outcomes. Acute non-compressive nucleus pulposus extrusion should be considered as a differential diagnosis for cats presenting with peracute onset of spinal cord dysfunction, particularly if there is a clinical history or evidence of trauma.