Feline polyneuropathy affects a cat’s peripheral nerves (those outside the brain and spinal cord). While its causes can vary, the clinical picture is usually the same, starting with weakness due to inflamed, infected, and/or diseased nerves.
An affected cat may have a slightly wobbly gait, muscle/head tremors, or have trouble jumping up on things or climbing stairs. In severe cases, the cat may appear to be paralyzed. Some cats may suffer from seizures or blindness.
Symptoms can be progressive, developing over years in some cases, or acute (sudden onset). Since muscles and nerves work hand-in-hand, what may first appear as a muscle problem may have an underlying neurological cause.
Inherited Problems
Many inherited polyneuropathy problems show up in middle aged or older cats. These cats generally don’t have good treatment options. Some genetic polyneuropathies do have a better prognosis, however.
Juvenile motor neuropathies may be seen in Snowshoe, Siberian, Abyssinian, and Bengal cats. The affected kittens tend to be under a year old. Signs may wax and wane or be progressive. Some kittens show partial paralysis early on. Others just have a plantigrade stance or walk, characterized by their hocks being on the ground when they stand or walk.
Treatment generally consists of robenacoxib or prednisolone. Most young cats respond, but many will have relapses requiring repeat treatment.
A recent study of four Siberian kittens suggests an autosomal recessive form of inheritance.
In Bengals, affected cats tend to show multiple nerves affected, including those involved in pain perception, and they may demonstrate hyperesthesia (extreme sensitivity to touch and temperature) and muscle atrophy as well as motor (movement) problems.
In Snowshoes cats, many cases also show involvement of the central nervous system (including vestibular signs like balance problems). Cats with vestibular signs may circle, have a head tilt, or walk with a wobbly gait.
Special diagnostic techniques may be required to separate out muscle and nerve conditions, including electromyography and motor nerve conduction.
With juvenile polyneuropathies, most kittens/cats respond to treatment. Some will go into long-term remission, while others may have periodic relapses and require repeated treatment. Any cat who has had a case of juvenile polyneuropathy should not be bred.
Known Causes
Cats with diabetes that is untreated or poorly controlled may show weakness in their rear legs, with a plantigrade stance or gait. They often develop muscle atrophy and may develop paresis (partial paralysis). Proper management of diabetes often leads to resolution of these clinical signs.
Certain drugs and heavy-metal poisonings can cause temporary polyneuropathies. Chemotherapy drugs such as cisplatin and vincristine are two. For heavy metal poisonings, mercury, lead, and thallium are all potential culprits. These temporary conditions usually clear up when the offending drug is discontinued or the exposure to toxins is addressed.
Trauma may damage a group of nerves, leading to neuromuscular defects. An example is brachial plexus avulsion, with which the nerves innervating the forelimb are over stretched during a traumatic incident. These cats can develop paralysis of the affected limb, and while many affected cats heal with time and regain function in the affected limb, some end up requiring amputation of the limb. It’s important to note that, while making the decision to amputate a limb is a difficult one, cats can do quite well after limb amputation.
Acute idiopathic polyradiculoneuritis, also known as “coonhound paralysis,” is a rare polyneuropathy in cats. This usually starts with rear limb weakness and progresses to all four limbs, often in just a day or so. Muscle wasting tends to be severe, but affected cats generally can control elimination, still feel pain, and can eat and drink. Improvement is slow, with the first signs of hope usually seen within three weeks, but it can take up to six months for a cat to recover fully.
Treatment
Unfortunately, no treatment seems to be particularly effective in reducing symptoms or speeding up recovery. Corticosteroids, robenacoxib, and gabapentin may help reduce clinical signs and keep cats comfortable. If your cat has a known cause for his neurologic problems, treatment should be addressed specifically to that disease, such as a cat with diabetes.
Treating a cat with a neurologic problem requires patience. Nerve damage can take months to show improvement. During these months, an owner’s care often makes the difference between a cat who improves and a cat who stagnates or regresses clinically.
The first line of care is basic life necessities. While many neurologic cats can eat and drink, affected cats may require assistance to reach their food and water and may need to be held up while they eat and drink. Their appetite may be off, so “smelly” foods and/or slightly warmed up foods may be necessary to entice them to eat. They may have to be hand fed, and in some cases, placement of a feeding tube may be recommended. While a feeding tube may seem drastic, it is often a stress-free way to get food, water, and medications into your cat.
Many cats with neurologic problems remain continent and can urinate and defecate on their own. If, however, your cat can’t move, you must keep her clean. Gentle wipes made for babies or a warm, damp washcloth work well.
Don’t forget to carefully dry the cleaned areas as well to prevent skin irritation. Keeping your cat on a mesh bed may help reduce soiling.
If your cat is incontinent, it’s a bigger job. Your veterinary staff can show you how to gently express your cat’s bladder. This will need to be done multiple times per day, followed by cleaning to maintain hygiene. Bowel movements are more problematic, but use of warm water enemas may help.
With partial or full paralysis, your cat will not be able to groom. A slicker brush mimics your cat’s rough tongue and can help to keep her feeling better and prevent mats.
Bed Sores
Bed sores are a bane of bedridden people, and it is no different for a cat who can’t move about. Your cat will require a very soft and “giving” bed to lie on. She should be able to get by with a couple of soft pillows and possibly a blanket or two. A diaper cover is important if your cat is incontinent.
Along with plenty of padding, you will need to turn your cat every four to six hours, which reduces pressure on any side or bony area. Foam cutouts can help with areas that start to look inflamed.
A consultation with a certified rehabilitation clinic is recommended to help with muscle atrophy and joints freezing from inactivity. The veterinarian or technician you work with can give you a wide range of exercises and activities to help maintain muscle strength and “remind” the nerves to heal so they can function again.
Laser therapy, medical massage, and acupuncture are potential adjunctive rehabilitation techniques that may be recommended. As your cat slowly gains strength, some more active rehab work may be suggested. Your cat might benefit from a sling to hold her with her paws just touching the ground and being gently “walked along.” Once she is up on her feet, a dry or underwater treadmill may help. These can be done with your cat “free walking” or with the help of a sling.
If your cat walks on a harness, using equipment such as fitness pillows and wobble boards can all add exercises to help restore full muscle and nerve capabilities.
The important thing is to remember that progress tends to be slow with nerve injuries. Younger cats and kittens will recover faster than adult cats. Some cats may never return to normal function, but if your cat is comfortable and enjoying life, that is your most important consideration.
Bianca Grueneberg | iStock
Your cat climbed up there, but now she’s hesitant to jump down. Could this be an early warning of polyneuropathy?
