Disk disease: It's not just for dogs - Firstline
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Disk disease: It's not just for dogs
When her cat became sick, this technician discovered that she had a lot to learn about feline lumbosacral disease. Now she recounts her cat's experience so others can learn from it.


FIRSTLINE


We all want to do what's best for our pets. As technicians, we hold ourselves to a higher standard because of our additional training and education, but even we can still fall into typical assumptions. This article is about my cat's experience with feline lumbosacral disease. Through this process, as a pet owner, I discovered that it's a disease technicians need to be better informed about.

History


Jennifer Keefe and Pollux
Pollux is a male, neutered, 14-year-old, gray, domestic longhaired cat that is missing his left eye and has a stumped tail. He had a two-year history of stiff hindlimbs, an inability to jump, and sensitivity when his hind end was touched. All of these signs slowly worsened over time. Pollux's appetite had steadily decreased, but he was still eating fairly well.

I assumed Pollux had arthritis partly because of his habit of jumping off of a second-story porch, which had once resulted in an inguinal hernia. Initially, Pollux was treated for his current clinical signs conservatively with the oral supplements glucosamine and chondroitin sulfate. This amounted to the contents of one Cosequin For Cats (Nutramax Laboratories) capsule mixed in his food daily. Radiographs were not obtained at this time because of Pollux's temperament, which would have necessitated heavy sedation.


Feline disk disease at a glance
Further evaluation was pursued when it appeared the glucosamine and chondroitin sulfate were not helping and some muscle atrophy was noticed.

Initial evaluation


Glossary
A board-certified surgeon initially evaluated Pollux. He received sedation and orthopedic, neurologic, and radiographic examinations. Physical examination results revealed generalized muscle atrophy that was visibly worse over both hindlimbs. No evidence of patella luxation, cruciate disease, or hip osteoarthritis was present. The remainder of the orthopedic examination results were normal. The neurologic evaluation revealed consistent caudal lumbar or lumbosacral pain on direct palpation and tail manipulation. There was no evidence of proprioception (see "Glossary" for definitions of italicized words throughout the article) deficits or other reflex deficits of the hindlimbs. Pollux appeared to have both fecal and urinary continence.


1. A lateral radiograph of the lumbar spinal region. Marked narrowing of the lumbosacral (L7-S1) intervertebral and intervertebral foraminal spaces is seen. There are also marked ventral spondylosis deformans of the L6-L7 and L7-S1 regions and mild osteolytic changes to the adjacent vertebral endplates (white arrows).
Radiographs revealed marked narrowing of the lumbosacral (L7-S1) intervertebral and intervertebral foraminal spaces. There also was marked ventral spondylosis deformans of the L6-L7 and L7-S1 regions and mild osteolytic changes to the adjacent vertebral endplates (Figure 1). The differential diagnosis list included degenerative lumbosacral stenosis, a spinal compressive lesion from a disk protrusion or neoplasia, diskospondylitis, or another nonspecific orthopedic or neurologic cause for the pain.

Palliative medical therapy was started with a combination of a nonsteroidal anti-inflammatory (NSAID) and gabapentin, an anticonvulsant that can help with neurogenic pain when given in lower doses as an adjunct medication. Pollux was given 2.5 mg/kg of gabapentin orally twice a day and meloxicam at a loading dose of 0.1 mg/kg orally once a day for three days and then at a maintenance dose of 0.025 mg/kg orally two or three times a week. Note that though these drugs are commonly used with success in such cases, it is extralabel use. Gabapentin is not FDA-approved for use in dogs and cats, and meloxicam is only FDA-approved for injection in cats. Pollux was much more comfortable and active initially, but the clinical signs recurred several months later.


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Source: FIRSTLINE,
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