Thirteen-year-old Logan recently became the first cat in the United States to undergo a surgical spinal technique developed in Europe, and most often used in medium- and large-breed dogs.
The surgery was performed by Dr. Emma Davies, section chief of neurology at the Cornell University Hospital for Animals (CUHA), assisted by third-year neurosurgery resident Dr. Baye Williamson.
Logan’s history-making journey started with a limp.
His owner, Joe Long, noticed Logan was having trouble with stairs. A course of anti-inflammatory medication seemed to help but upset his stomach, and he resisted putting weight on one hind leg. His back right side showed increasing weakness, particularly if he tried to climb or jump.
When playing with a new kitten in the house proved too much for Logan, Long made an appointment at CUHA. The orthopedics staff determined there was a neurological delay on the back right foot.
“It’s not uncommon for an animal to first see orthopedics when it won’t bear weight on a foot,” Williamson said. “In looking at Logan’s X-rays, we saw his vertebrae didn’t line up. For this type of suspected chronic subluxation [misalignment], where there’s no history of trauma, we first prescribe rest and restricted activity to see if it will resolve itself.”
When Logan returned from a month of rest, Williamson found Logan had pain when touched in the lumbosacral (LS) area, where the left lumbar vertebrae attaches to the sacrum and pelvis. He also was unable to hold up his tail normally.
An MRI of the lumbosacral region showed compression from two directions. The intervertebral disc at the lumbosacral space was partially bulging into the area from the bottom and the ligaments were swollen on the top.
“In the LS area, a little compression usually is not a big deal because the nerve roots, and not the spinal cord, are housed there. There’s a little more space to begin with,” said Williamson. “In this case, though, it was obviously causing the animal discomfort.”
A flex-view MRI helps determine if the compression is dynamic – that is, dependent on the position of the body. In the flex position, the back legs are set forward, toward the head to see if the lumbosacral space opens up.
Logan had great decompression in the flex position, so doctors recommended a minimally invasive transilial vertebral (MTV) blocking. The procedure has a short post-op stay and a less restrictive recovery than dorsal laminectomy, a more common technique in which a portion of the vertebral bone is removed. Davies had successfully performed the procedure on several dogs after being trained by the surgeon who innovated MTV blocking.
Davies and Williamson placed Logan in the flex position and made two small incisions on either side of his pelvis. They used fluoroscopy (real-time imaging) to guide a pin through the pelvis and across the top part of the last lumbar vertebrae. The pin was fixed in place to hold the LS space in the flex position. Just one stitch was used on each side of the pelvis. Positioning and surgery took roughly three hours.
Performing this surgery on a cat for the first time presented Davies and Williamson with some minor challenges due to his size. “Logan was just one size too small for everything included in the [surgical] kit, so we had to make our own,” Williamson said.
The surgery and radiology service created a 3D reconstruction of Logan’s pelvis – a critical tool for making sure nothing has moved since the surgery. The metal pin makes it impossible to take MRI scans in the future; the team will need to rely on X-rays and CT scans.
Logan was home the following day, and Long was told he could gradually increase his activity after resting for about a week. He wore a baby onesie to keep him from grooming the stitches for the first couple of weeks.
“Every day he seems to get a little bit better. He’s become a little bit mischievous, a little more excited about life,” said Long. “He’s purring all the time now and it’s just clear that he’s very happy and I’d even say grateful. He’s much more affectionate than he was before.”
Cynthia L. McVey is a freelance writer.