Ischemic Myelopathy

What is ischemic myelopathy and what causes it?

Ischemic myelopathy is a condition in which the blood supply to the spinal cord is suddenly interrupted by a blood clot.  This is similar to a stroke in people, except that the spinal cord is affected as opposed to the brain.

“Ischemia" means loss of blood supply and “myelopathy" refers to disease of the spinal cord.  The ‘material’ that blocks the blood supply to the spinal cord is often fibrocartilage from the intervertebral disk, however, ischemic myelopathy can also result from heart disease, kidney disease, high blood pressure, tumor, infection and excess steroid in the body (hyperadrenocorticism).

What are the common signs of feline ischemic myelopathy?

Ischemic myelopathy in cats has a predilection for the spinal cord of the neck.  As such, most cats show signs of difficulty walking or inability to walk in all four limbs.  Signs typically come on suddenly but do not worsen after the first 24 hours.  Cats are typically not painful.  Inability to lift the head (cervical ‘ventroflexion’) is a common symptom as well.

How is feline ischemic myelopathy diagnosed?

Feline ischemic myelopathy is diagnosed by ruling out other causes of sudden onset of inability to walk, including spinal tumor, infection, slipped disk, external trauma and meningitis.

Advanced imaging is necessary in order to diagnose feline ischemic myelopathy and to rule out other conditions.  An MRI scan is the imaging technique of choice.  MRI scanning uses strong magnets and computers to create images of the body.  It provides the best detail of the soft tissues of the body including the brain, spinal cord, muscles and blood vessels.  CT scans are typically not sensitive enough to diagnose feline ischemic myelopathy, but may be useful to rule out trauma or certain types of infections and tumors.  Myelography is an older technique that is sometimes used to evaluate the spinal cord.  We typically do not perform myelograms at Southeast Veterinary Neurology due to our 24-hour access to our on-site 1.5T MRI.  Unlike myelography, MRI is completely non-invasive.

An accurate diagnosis via MRI is important, since many other conditions can mimic the symptoms of feline ischemic myelopathy.  Some of these conditions are less able to be treated, and some need a very different treatment plan.

Feline Ischemic Myelopahy - Southeast Veterinary Neurology

How can feline ischemic myelopathy be treated?

Treatment of feline ischemic myelopathy is mainly supportive.  Nursing care and physical rehabilitation are the most important aspects for a cat’s recovery.  Additionally, further tests to determine if there is an underlying cause for the stroke is warranted, including testing for heart disease, thyroid disease, kidney disease, high blood pressure, and others.

What is the likelihood of recovery for cats with ischemic myelopathy?

For most cats with ischemic myelopathy, the stroke happens in the neck region, causing weakness or inability to walk in all four limbs.  This can be very distressing for the cat and for the owner.  Despite the dramatic signs and older age, many cats can make a full recovery.  Prognosis depends on a handful of factors: first, where in the spinal cord the stroke occurred; second, how large the stroke is; third, the severity of the signs; fourth, if there is an underlying reason for the stroke such as high blood pressure or heart disease.  The last factor in prognosis is having an experienced neurologist on your cat’s team.  The MRI above was performed at another facility, but was incorrectly diagnosed/not recognized as a stroke and euthanasia was recommended.  Most cats will recover the ability to walk with time, nursing care and physical rehabilitation.

Why should I bring my cat with suspected feline ischemic myelopathy to Southeast Veterinary Neurology?

Southeast Veterinary Neurology is South Florida’s trusted name in veterinary neurology.  We are the only team of board-certified neurologists in South Florida.  Our team is available 7 days a week for your pet and we were the first neurologists in South Florida to use a high-field MRI.  Our state-of-the-art hospitals are equipped with the latest technology, most advanced techniques and a compassionate team of humble experts.