Polyneuropathies are a group of diseases that affect multiple nerves in any combination. They may be inherited or acquired later in life.
Inherited Causes of Polyneuropathy in Cats
Spinal muscular atrophy, which is shrinkage of the muscles of the spine
Demyelination, which is destruction of the covering of the nerves
Lysosomal storage diseases are inherited deficiencies of particular enzymes creating an inability to perform normal metabolic functions
Acquired Causes of Polyneuropathy in Cats
Immune-mediated or associated with a hyperactive immune system
Systemic lupus erythematosus, which is a multi-organ immune disease
Polymyositis, or inflammation of the muscles
Polyarthritis, or inflammation of the joints
Glomerulonephritis, or inflammation of a part of the kidneys
Infectious Causes of Polyneuropathy in Cats
Metabolic Causes of Polyneuropathy in Cats
Paraneoplastic syndrome is a collective term for disorders arising from metabolic effects of cancer on tissues remote from the tumor. Some of these include:
Mast cell tumors
Toxic or Drugs Causes
Heavy metals (thallium, mercury lead, copper, zinc)
Chemicals (organophosphates, carbon tetrachloride, lindane)
Chemotherapy (vincristine, vinblastine, cisplatin)
Various breeds of cats may be affected. Specific breeds are associated with specific inherited neuropathies.
Inherited polyneuropathies generally begin by the age of 6 months, while acquired neuropathies, depending on the specific disorder, may be seen in all ages.
What to Watch For
Signs associated with inherited polyneuropathies are generally slow and progressive.
Muscle tremors (shaking)
Muscle atrophy (shrinkage)
Ataxia (unsteady gait)
Signs associated with acquired polyneuropathies may progress rapidly or slowly, depending on the particular illness.
A stiff-stilted gait often progressive to paralysis or paresis (incomplete paralysis)
Diagnosis of Polyneuropathy in Cats
Baseline tests to include a complete blood count (CBC), biochemical profile, and urinalysis are recommended in all patients and may be within normal limits. They may indicate underlying metabolic or neoplastic (cancer) disorder.
Serum antinuclear antibody titer (ANA) may be positive, suggesting immune disease
Titers or other blood tests screening for infectious organisms (N. caninum)
Radiographs (X-rays) of the chest may be normal, although they may support the findings of a dilated esophagus or underlying cancer.
Electrophysiology, advanced, specialized testing, is the cornerstone for diagnosis. This includes electromyographic evaluation (EMG), motor and sensory nerve conduction and action potential amplitudes. These tests help differentiate myositis from polyneuropathy as the cause of weakness
Muscle biopsy confirms evidence of denervation or loss of nerve function
Nerve biopsy further delineates disease process
Treatment of Polyneuropathy in Cats
Most patients are treated on an outpatient basis. Supportive care may be required to prevent wounds and decubital ulcers (bed sores) in severely affected patients who cannot walk.
Fluid and electrolyte therapy, as well as nutritional support, may be necessary in some patients, as some have a malfunctioning esophagus and cannot support themselves.
In cases where an underlying disorder has been identified, specific therapy for that disorder should be instituted. Remove/discontinue any drugs/toxins that may be causative.
Inherited polyneuropathies are generally untreatable.
Immunosuppressive drugs are medications that suppresses the immune system, such as corticosteroids and azathioprine (Imuran). These are recommended in cases of immune mediated polyneuropathies.
Administer all medication and diet as directed by your veterinarian. If any change is noted in your pet’s condition, notify your veterinarian. In particular, if coughing or difficulty breathing is observed, contact your veterinarian at once, as this may signal aspiration pneumonia secondary to a malfunctioning esophagus.
Depending on the underlying cause, life long therapy may be necessary in these patients. It is important to realize that although in some cases where an underlying disorder has been identified and treated the associated polyneuropathy will resolve, in others, despite treatment, it may not.
Avoid breeding patients with inherited disease.