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      Demographics, clinical findings and diagnoses of cranial thoracic myelopathies (T1–T6 vertebrae) in cats

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          Abstract

          Objectives

          The aim of the study was to describe the patient demographics, clinicopathological features and presumptive or final diagnoses in cats with myelopathies between the T1 and T6 vertebrae.

          Methods

          This retrospective multicentre case study enrolled cases between 2015 and 2022 that were diagnosed with myelopathies between the T1 and T6 vertebrae as the primary cause for the presenting clinical signs.

          Results

          A total of 21 cases matched the inclusion criteria, 13 males (11 castrated and 2 entire) and 8 spayed females (median age 93 months; range 5–192). Most of the cases presented with a chronic and progressive history (76% and 86%, respectively), with a median duration of 29 days (range 1–2880). At the time of presentation, 90% of the cases were localised to the T3–L3 spinal cord segments based on neurological examination. The most common underlying pathology was neoplasia (42.9%), followed by inflammatory (24%), anomalous (19%), degenerative (9.5%) and vascular (4.8%) disorders. The most common location was T3–T4 (29%), followed by T2–T3 and T5–T6 (19% each). The cutaneous trunci reflex was normal in 86% of the cases and most of the cases (71%) did not show spinal discomfort upon admission.

          Conclusions and relevance

          Neoplasia was the most common cause of cranial thoracic myelopathy in this study. The lack of pathognomonic clinical signs for this specific region highlights the importance of assessing the entire thoracolumbar region up to and including at least the T1 vertebra when investigating cases with signs consistent with a T3–L3 myelopathy.

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          Most cited references24

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          Feline injection-site sarcoma: past, present and future perspectives.

          Feline injection-site sarcomas (FISS) have been known since the early 1990s. After an initial correlation with rabies and feline leukaemia virus vaccination, subsequent studies have demonstrated that an abnormal reaction of feline tissues to chronic inflammation was mainly responsible for the disease. The low incidence of FISS in the population is explained by its multifactorial aetiology, since individual genetic characteristics are also implicated. FISS is an infiltrative tumour with low metastatic potential but local recurrence is common. Multimodal treatment (extensive surgery, radiotherapy, chemotherapy) is recommended. The use of sophisticated imaging techniques can improve diagnosis and help in surgical planning. After the initial enthusiasm in understanding the disease, only few advances have been made in the last few years. New promising therapies may arise from a better knowledge of the molecular pathogenesis of FISS and the successful development of drugs modulating the immune system.
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            Prevalence of diseases of the spinal cord of cats.

            A retrospective review of records of 205 cats with histologically confirmed disease of the spinal cord was performed to identify the prevalence of disease in this nonrandomly selected population of cats. Clinical records were reviewed, and age, duration of neurologic illness, and clinical and histopathologic findings in cats with spinal cord disease were abstracted. Disease processes were classified into 7 categories and 23 groups. The most common diseases affecting the spinal cord of cats were feline infectious peritonitis (FIP), lymphosarcoma (LSA), and neoplasia of the vertebral column secondarily affecting the spinal cord. Information on age, onset and duration of clinical signs, and lesion localization at the postmortem examination in cats belonging to the 7 categories of disease were analyzed to create a practical list of differential diagnoses. Cats were also subcategorized into 3 groups based on their age at death. FIP was the most common disease of cats younger than 2 years of age. LSA and vertebral column neoplasia were the most common diseases affecting cats between 2 and 8 years of age. Vertebral column neoplasia was the most common disease affecting cats older than 8 years of age. Results of this histopathologic study showed that FIP and LSA were the most common disease processes affecting the spinal cord of cats. However, at least 21 other groups of diseases and their relative prevalence were identified.
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              Feline Spinal Cord Diseases

              The objective of this article is to review the recent literature that reports on the most common diseases affecting the spinal cord of cats, and to draw some general conclusions that will be useful to formulate diagnosis and prognosis for feline spinal patients. The most common types of feline spinal cord diseases documented were inflammatory/infectious diseases, and feline infectious peritonitis was the most common disease, representing approximately 50% of all feline myelitis. Neoplasms were documented in approximately 25% of cases; lymphosarcoma was the most common tumor affecting the spinal cord of cats, with reported prevalence between 28% and 40%. Cats diagnosed with spinal lymphosarcoma were significantly younger (median age 4 years) than cats with other spinal cord tumors (median age 10 years). Cats with clinical signs of intervertebral disc disease had a median age of 8 years, and 67% had Hansen type I disc protrusions. The most commonly affected intervertebral disc was at the L4 to L5 intervertebral disc space. Fibrocartilaginous embolism-affected older cats (median age 10 years), seemed to predominate in the cervicothoracic intumescence, and clinical signs were markedly lateralized, especially when the cervical region was affected.
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                Author and article information

                Journal
                J Feline Med Surg
                J Feline Med Surg
                JFM
                spjfm
                Journal of Feline Medicine and Surgery
                SAGE Publications (Sage UK: London, England )
                1098-612X
                1532-2750
                4 October 2023
                October 2023
                : 25
                : 10
                : 1098612X231199731
                Affiliations
                [1 ]Anderson Moores Veterinary Specialists, Part of Linnaeus Veterinary Limited, Winchester, Hampshire, UK
                [2 ]Hamilton Specialists Referral, Part of IVC Evidensia, High Wycombe, Buckinghamshire, UK
                [3 ]Southfields Veterinary Specialists, Part of Linnaeus Veterinary Limited, Basildon, Essex, UK
                [4 ]School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
                [5 ]Department of Veterinary Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
                [6 ]Hospital de Referencia Veterios, Madrid, Spain
                Author notes
                [*]Miguel Benito Benito DVM, MRCVS, Anderson Moores Veterinary Specialists, Part of Linnaeus Veterinary Limited, The Granary, Hursley, Winchester, Hampshire SO21 2LL, UK Email: miguelbenitoben@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-9973-3137
                https://orcid.org/0000-0002-3570-2542
                Article
                10.1177_1098612X231199731
                10.1177/1098612X231199731
                10812017
                37791892
                e997a79d-d704-43f4-ba2d-ed906d479789
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Categories
                Original Article
                Custom metadata
                October 2023
                ts1

                Surgery
                cutaneous trunci reflex,neoplasia,spinal cord meningioma
                Surgery
                cutaneous trunci reflex, neoplasia, spinal cord meningioma

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