Spinal tumor in a cat with an ambulatory paraparesis
You have an old cat that is not wanting to jump that much and seems slowly when walking…When should I worry about a neurological problem?
WHAT WE CAN SEE ON THIS VIDEO: This beautiful cat has an ambulatory paraparesis. You can observe how the hind limbs move at a different speed from the front limbs. The step is delayed on the hind limbs. On this video we don’t see any ataxia (no wobbliness), we can only observe the paresis, the difficulty creating the step.
Then we perform the postural thrust and we can see how both hind limbs are delayed. The cat should be trying to position them instead of letting them drag. The same for the hoping, there’s a big delayed on replacing the limbs.
One of the most surprising things of this case is to observe the huge tumour this cat had invading the vertebral bone and spinal cord but still the cat seemed so mildly affected. We tend to see this in slow growing tumours where the spinal cord is slowly compressed and kind of learns to compensate.
THE FULL HISTORY AND NEURO EXAM: This cat was over 13 years old and have been slowing down for few months. She was not able to jump so well but she was not losing weight or having any other general clinical signs.
She had a normal mentation, an ambulatory tetraparesis with normal spinal and cranial nerves examination. We could not elucidate the cutaneous trunci reflex.
The anatomical localisation was T3L3 and the differential diagnosis was: tumour, disc disease and inflammatory disease.
What could be the treatment for this huge mass?
Usually we will advise surgery to remove as much as possible and then radiation therapy +/- chemotherapy depending on the type of cancer we’re dealing with.
However, with such a big mass, affecting the vertebral tumour and localised so cranially a surgery will be very very difficult and invasive: It will allow us to get a biopsy but it will not allow to remove all the cancer. Radiation therapy will be an option here to shrink as much as possible and also sometimes control the pain where it’s present.
What are the most common spinal tumours in cats?
Neoplasia of the spinal cord is typically subdivided based on their location of origin: extradural, intradural–extraparenchymal, or intraparenchymal. Tumors in cats that arise within the intradural space are the most common and include lymphoma, meningioma, and histiocytic sarcoma. Intraparenchymal neoplasia is much less commonly recorded in cats and includes tumors that arise from glial cells (or their progenitors), including astrocytes, oligodendrocytes, ependymal cells, and microglial cells. In the cat, extraparenchymal lymphoma and osteosarcoma are reported to be the most common tumors affecting the spinal cord whereas intraparenchymal neoplasia is uncommon with only brief case reports of astrocytomas and oligodendrogliomas.