Cat with forelimb neuro issues

Re: Cat with forelimb neuro issues

listhestar — Mon, 23 Nov 2009 19:06:11 GMT

[quote user="Martin Jones"]Some supination of left fore paw, bilateral muscle atrophy. Able, just about, to stand on a grippy floor but not in consult room[/quote]

I guess the muscle atrophy suggest more lower motor neuron signs. Is withdrawal reflex intact and is the sensory feeling normal all over the cutaneous areas of the foot? If withdrawal lacking then likely LMN and the the ddx are limited- normally brachial plexus tumours are painful. Could have a tumour at that level and wouldn't be painful initially until became too big. Which muscles in particular area affected or generalised- as they may help in id the partcular nerve(s) involved.

I presume perpherial forelimb pulses are ok and that they are warm (rare to have thrombosis without pain but have seen it).

I don't currently recognise it as a clinical entity but I've only been qualified 3 years so I have limited experience.

Hope that's of some help, good luck.

Lisa

Worth clindamycin as it may be toxo-cheap enough to trial

Re: Cat with forelimb neuro issues

Laurence Webb — Tue, 27 Oct 2009 14:54:02 GMT

If cost is a big issue then you could put it onto clindamycin for toxoplasmosis. Probably won't be, but worth a shot!

Re: Cat with forelimb neuro issues

Utlendigur — Tue, 27 Oct 2009 14:37:59 GMT

May be worth a chest xray to check for an anterior mediastinal mass. I have a feeling that a cat I saw several years ago with a thymoma presented with similar symptoms but I haven't been able to find any references linking thymoma and neuro signs other than mysathenia which would probably be more generalised.

Re: Cat with forelimb neuro issues

Hannah Wynne Richards — Tue, 27 Oct 2009 11:12:25 GMT

Something neuro is as far as I would be prepared to go-and would probably use the opportunity to advise insurence on any other or future animals, as I would definitely like to refer that one

Wynne

Re: Cat with forelimb neuro issues

Clive Ansell — Tue, 27 Oct 2009 08:05:13 GMT

Bit of a brain teaser for a Tuesday morning. A progessive and bilateral loss of both sensory and motor function affecting only forelimbs; I think my first thoughts would be along the line of a spinal cord or cns lesion; as you say a bilateral brachial plexus lesion or injury would be unlikely, and with a generalised disease or neuropathy one would expect to affect hindlimbs too. That's as far as my thinking takes me at the moment. I suppose nerve conduction studies and MRI in an ideal world would be useful. have any routine bloods been done?

I had a similar case several years ago in an 8 year old Yorkshire Terrier that showed a progressive and bilateral loss of forelimb proprioception, motor function and hindlimbs were unaffected, and the dog was otherwise well. Referral to a specialist and MRI showed Arnold Chiari syndrome with severely enlarged cerebral ventricles and the loss of about 50% diameter of the cervical spinal cord with a grossly dilated central canal. The surgical option of placing a stent was declined, and the dog was managed and did fine for a while on low doses of prednisolne and frusemide.