The curious case of the immobile kitty
A 6-year-old, male neutered, domestic short hair named Stanley, presents to a neurologist for a recheck exam. Stanley was originally evaluated for acute non-ambulatory paraparesis and back pain. He appeared healthy up to two weeks prior, when the owner noticed Stanley had an upper respiratory infection and a left thoracic limb injury. Stanley was taken to his primary veterinarian and treated at that time.
A day before presentation, Stanley woke up with limited mobility in his pelvic limbs and was taken to another veterinary clinic. Radiographs were performed, he was placed on multiple medications, and referred for further evaluation. On the day of initial presentation to the neurologist, Stanley was dragging himself with his thoracic limbs, but was able to move his pelvic limbs. Magnetic resonance imaging (MRI) and infectious disease testing were recommended. A trial of medications was elected, and Stanley improved at first, but when prednisolone was tapered, he stopped walking again. He also had GI upset associated with antibiotic therapy. Samples from two joints (specific joints not indicated) are submitted.
Cytologic exam reveals very high cellularity for synovial fluid, windrowing of cells (lining up), which occurs in viscous fluids (synovial, salivary), and >95% of the nucleated cellularity in both joints is neutrophils with no blood contamination. This was interpreted as marked suppurative arthritis.
Following up in the clinic, an infectious disease panel (serology) was performed and included Feline Leukemia virus, Feline Immunodeficiency virus, Feline Coronavirus, Toxoplasma and Cryptococcus. All returned negative except Feline Coronavirus 1:1600. FCoV may be repeated to determine trend and exposure versus infection. Clavamox and prednisolone (immunosuppressive dose) were started.
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