Clinical reasoning in feline non-ambulatory tetraparesis or tetraplegia: Which combination of clinical information is useful?

Age, onset acuity, neurological exam findings guide diagnosis of feline tetraparesis.

This retrospective study analyzed 81 cats with non-ambulatory tetraparesis or tetraplegia presented to a referral center between 2010-2023 to identify clinical variables useful for differential diagnosis. The six most common diagnoses accounted for 82.7% of cases: polyneuropathy (n=26), ischaemic myelopathy (n=15), spinal cord neoplasia (n=8), feline infectious peritonitis (n=7), intracranial neoplasia (n=6), and spinal cord contusion (n=5). Multivariable analysis revealed that polyneuropathy was associated with age <3 years, progressive presentation, normal mentation, reduced thoracic limb reflexes, and normal blood work. Ischaemic myelopathy correlated with age 6-9 years or >9 years and peracute clinical onset. The authors conclude that attention to neurological examination findings and readily identifiable clinical features can effectively guide diagnostic planning in general practice. However, limitations include the retrospective design, limited multivariable analysis for certain diagnostic categories, and inclusion of only referral cases, which may not represent the general feline population encountered by primary care practitioners.

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