Neurology Case: Astryd

Astryd is a nearly 11-year-old domestic short haired cat. She was referred to us at Pride Veterinary Centre due to her being wobbly on her feet and shaking her head.

These symptoms began back in December and since then she has slowly become more unbalanced and disorientated. She started playing with toys less and sleeping more.

Investigations

Astryd was assessed and diagnosed by our Neurology Resident Patti and Juanjo our Neurology Clinician.

In her neurology exam Astryd showed vestibulo-ceberebellar ataxia, was swaying her head/body and collapsing on the floor but then immediately stood up. She also showed no signs of spinal pain.

It was then confirmed that she would be sent for an MRI scan of her brain.

Diagnosis

The findings of the MRI showed extra-axial neoplasia in the caudal fossa suggestive of meningioma causing marked dorsal compression of the cerebellum and medulla oblongata. Transforaminal herniation of the cerebellum as a consequence of the intracranial pressure was also observed.

Treatment

Although surgery was recommended it was very high risk due to a major vessel proximal to the area (transverse and sagittal venous sinus) and also due to the potential damage to the caudal brainsteam where important nuclei involved on breathing, heart beating, Temperature and awareness are located.

Her owner decided to move forward with surgery.

JJ and Beatrice performed the surgery on Astryd. As it was high risk and Astryd was not deteriorating rapidly the team were able to plan the procedure and ensure it was done as delicately as possible due to the risks involved, so the anaesthesia of the patient was as difficult as the surgery.

Our anaesthetist Sanne Melis assisted with the Astryd case and ensured that Astryd had an uneventful procedure.

A suboccipital approach was performed enlarging the Foramen Magnum to achieve the caudal fossa and removing the tumour. Whilst removing the original tumour the team were also able to remove a second tumour on the side of the head using a supratentorial approach to the brain.

Recovery & Progress

Astryd recovered well after the surgery and began eating and drinking fine.

Four days after her operation she was able to go home.

Whilst at home Astryd was still a little off balance however she was improving day by day.

Two weeks after the discharge, Astryd returned for a re-check. She was doing really well and showing progress and improvement. She began to go outside again and play with toys.