A 1-year-old castrated male Maine Coon cat was referred because of a 1-week history of progressive
spastic non-ambulatory
paraparesis. An MRI examination of the thoracolumbar spine showed multiple lytic lesions, with the most aggressive one centred on the adjacent endplates of L1-L2 and its associated disc. Ventral new bone formation, L1 vertebral body shortening and mild dorsal displacement of the caudal aspect of L1 were noted. Contrast enhancement of both paravertebral soft tissue and extradural lesion was present. These findings were compatible with L1-L2 discospondylitis (DS), spinal epidural
empyema (SEE), with secondary L1 pathological vertebral fracture, subluxation and
spinal cord compression. CT of the thoracolumbar spine, abdomen and thorax confirmed these findings. The patient deteriorated to
paraplegia with absent nociception, despite initial medical
therapy. A right-sided L1-L2 hemilaminectomy and spinal
decompression were then performed, followed by application of a unilateral construct comprising four smooth
arthrodesis wires and
polymethylmethacrylate (
PMMA). Staphylococcus aureus was isolated from both epidural material, intraoperatively sampled and blood culture.
Antibiotic therapy was continued for 6 weeks, based on susceptibility results. The outcome was excellent, with a gradual improvement and complete neurological recovery at the 8-week postoperative check. Repeated spinal radiographs showed an intact apparatus and marked signs of vertebral fusion. At the 14-month follow-up examination, the cat remained free of clinical signs.
Relevance and novel information: To the authors' knowledge, this is the first case report of SEE and DS in a cat that required surgical stabilisation. The outcome was still optimal, despite the rapid neurological deterioration.