Suspected Cerebral Salt Wasting Syndrome with Cervical Spinal Lesion in a Domestic Shorthair Cat

• Published in: Veterinary sciences Vol. 10; no. 6; p. 385
• Main Authors: Kim, Minkun, Song, Woo-Jin, Park, Jongjin, Lee, Saeyoung, Choen, Sangkyung, Kim, Myung-Chul, Yun, Youngmin
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.06.2023; MDPI
• Subjects: Animals; Anorexia; Case Report; cat; Cats; Central nervous system diseases; cerebral salt wasting syndrome; Dehydration; Dehydration (Physiology); Differential diagnosis; Drug dosages; Electrolytes; females; Fludrocortisone; fluid therapy; Hyponatremia; Intravenous administration; intravenous injection; Ischemia; ischemic myelopathy; Kidneys; Laboratories; Lesions; Magnetic resonance imaging; magnetism; Nervous system; Osmosis; Parietal lobe; Pathogenesis; Patients; Plasma; Potassium; prognosis; Quality of life; Salt; Sodium; Spinal cord; Substantia alba; Substantia grisea; Urine; Veterinary medicine; Veterinary services; Wasting syndrome; South Korea; cerebral salt wasting syndrome; ischemic myelopathy; hyponatremia; cat; fludrocortisone
• ISSN: 2306-7381; 2306-7381
• DOI: 10.3390/vetsci10060385

A 12-year-old spayed female domestic short cat was presented with tetraplegia. The cat also showed signs of hyponatremia and dehydration, which were rapidly corrected by intravenous fluid infusion. Based on thorough physical and neurological examinations, the patient was suspected of having an intracranial disease. MRI revealed a high-signal T2 image of the bilateral parietal cerebral cortical gray matter junction, which is associated with fast electrolyte calibration, and a high-signal T2 image of the C2 spinal cord ventral area, which is associated with ischemic myelopathy. The cat reappeared three days later due to anorexia. Laboratory examinations revealed that the cat was clinically dehydrated and exhibited hyponatremia. Other causes of hyponatremia were excluded through history-taking, laboratory examination, imaging, and therapeutic response to fluid therapy, except for cerebral salt-wasting syndrome (CSWS). The cat was discharged 3 days after the start of fludrocortisone therapy with electrolytes within the normal range. Magnetic resonance imaging (MRI) was performed again 1 month after hospitalization, and the cerebral lesion disappeared, but the spinal cord lesion worsened compared to the previous image. The patient was euthanized due to the progression of the spinal lesion, with a poor prognosis and poor quality of life. This is the first case of suspected CSWS with a cervical spinal lesion in a cat.