Nghiem Peter, Platt Simon, Schatzberg Scott
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA 30602, USA.
J Feline Med Surg. 2009 May;11(5):373-83. doi: 10.1016/j.jfms.2009.03.005.
Weakness is recognized somewhat infrequently in cats, but is an important manifestation of neurological disease. The clinician must perform a complete neurological examination to determine the neuroanatomic basis for the weakness. As for all species, the neuroanatomic diagnosis allows the clinician to generate an appropriate differential diagnosis, to design a diagnostic plan, to prognosticate, and ultimately to develop a treatment plan.
The cause(s) of neurological weakness in the cat may be difficult to determine without access to advanced imaging modalities, cerebrospinal fluid analysis or electrodiagnostics. However, an accurate neuroanatomic diagnosis allows the clinician to pursue preliminary anomalous (vertebral anomalies), metabolic (eg, diabetes mellitus, electrolyte abnormalities) and neoplastic differentials via blood work, vertebral column and thoracic radiography, and abdominal ultrasound. Subsequently, referral to a specialty veterinary hospital may be warranted to pursue advanced neurodiagnostics.
This review provides a framework for generating a neuroanatomic and differential diagnosis in the weak cat. It also discusses the pathogenesis and clinical signs associated with the most common neurological differentials for feline paresis. As such, it is aimed at both primary health care and specialty veterinarians.
The neurological conditions discussed in this review cause weakness in cats of all age groups.
猫的虚弱症状相对不常见,但却是神经疾病的重要表现。临床医生必须进行全面的神经学检查,以确定虚弱的神经解剖学基础。对于所有物种而言,神经解剖学诊断能使临床医生做出恰当的鉴别诊断,制定诊断计划,进行预后评估,并最终制定治疗方案。
若无法进行先进的影像学检查、脑脊液分析或电诊断,猫神经虚弱的病因可能难以确定。然而,准确的神经解剖学诊断能让临床医生通过血液检查、脊柱和胸部X光摄影以及腹部超声,排查初步的异常情况(如脊柱异常)、代谢问题(如糖尿病、电解质异常)和肿瘤性疾病。随后,可能需要转诊至专科兽医医院进行进一步的神经诊断。
本综述为虚弱猫的神经解剖学和鉴别诊断提供了一个框架。它还讨论了与猫轻瘫最常见神经学鉴别诊断相关的发病机制和临床症状。因此,它的目标受众是初级保健兽医和专科兽医。
本综述中讨论的神经疾病会导致所有年龄段的猫出现虚弱症状。