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Clinical reasoning in feline spinal disease: which combination of clinical information is useful?
Mella, Stephanie L; Cardy, Thomas Ja; Volk, Holger A; De Decker, Steven.
  • Mella SL; Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.
  • Cardy TJ; Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.
  • Volk HA; Cave Veterinary Specialists, West Buckland, Wellington, UK.
  • De Decker S; Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.
J Feline Med Surg ; 22(6): 521-530, 2020 06.
Article in English | MEDLINE | ID: covidwho-828632
ABSTRACT

OBJECTIVES:

The aim of this study was to evaluate if a combination of discrete clinical characteristics can be used to identify the most likely differential diagnoses in cats with spinal disease.

METHODS:

Two hundred and twenty-one cats referred for further evaluation of spinal disease were included and categorised as follows non-lymphoid neoplasia (n = 44); intervertebral disc disease (n = 42); fracture/luxation (n = 34); ischaemic myelopathy (n = 22); feline infectious peritonitis virus myelitis (n = 18); lymphoma (n = 16); thoracic vertebral canal stenosis (n = 11); acute non-compressive nucleus pulposus extrusion (n = 11); traumatic spinal cord contusion (n = 8); spinal arachnoid diverticula (n = 7); lumbosacral stenosis (n = 5); and spinal empyema (n = 3). Information retrieved from the medical records included signalment, clinical history and clinical presentation. Univariate analyses of variables (clinical history, breed, age, sex, general physical examination findings, onset, progression, spinal hyperaesthesia, asymmetry, ambulatory status and neuroanatomical location) were performed, and variables were retained in a multivariate logistic regression model if P <0.05.

RESULTS:

Multivariate logistic regression revealed that intervertebral disc disease most often occurred in middle-aged, purebred cats with a normal general physical examination and an acute onset of painful and progressive clinical signs. Ischaemic myelopathy occurred most often in older cats with a stable or improving, non-painful, lateralising, C6-T2 myelopathy. Spinal fracture/luxation occurred most often in younger cats and resulted most often in a peracute onset, painful, non-ambulatory neurological status. Concurrent systemic abnormalities or abnormal findings detected on general physical examination were significantly associated with feline infectious peritonitis virus myelitis, spinal lymphoma or spinal empyema. CONCLUSIONS AND RELEVANCE This study suggests that using easily identifiable characteristics from the history and clinical examination can assist in obtaining a preliminary differential diagnosis when evaluating cats with spinal disease. This information could aid veterinary practitioners in clinical decision-making.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Spinal Diseases / Spinal Injuries / Cat Diseases / Clinical Reasoning Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Animals Language: English Journal: J Feline Med Surg Journal subject: Veterinary Medicine Year: 2020 Document Type: Article Affiliation country: 1098612X19858447

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Spinal Diseases / Spinal Injuries / Cat Diseases / Clinical Reasoning Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Animals Language: English Journal: J Feline Med Surg Journal subject: Veterinary Medicine Year: 2020 Document Type: Article Affiliation country: 1098612X19858447