Of course spinal arachnoid diverticula (SAD) also exist in cats.....

JVIM 2025

João Miguel De Frias, Sofie F. M. Bhatti, George Nye, Rita Gonçalves, Tom Harcourt-Brown, Angela Fadda, Katia Marioni-Henry, Hannah Padley, Steven De Decker

Background
Spinal arachnoid diverticula (SAD) in cats are rare conditions characterized by subarachnoid space dilatations that cause progressive spinal cord compression. This study aimed to describe the clinical features, diagnostic imaging findings, treatment options, and outcomes for cats with SAD, addressing a gap in the veterinary literature.

Methods
A multicenter retrospective study included 21 cats diagnosed with SAD via magnetic resonance imaging (MRI). Data were gathered on signalment, clinical presentation, imaging findings, treatments (medical or surgical), and short- and long-term outcomes. Imaging studies were reviewed for specific SAD characteristics, including shape, localization, and presence of syringomyelia (SM). Treatment decisions were owner-driven, with options including medical management (e.g., controlled exercise, medication) and surgical intervention.

Results
-Most cats were Domestic Short Hair (67%) and male (63%), with ages ranging from 18 weeks to 13 years.

-The majority presented with chronic, progressive, symmetrical, nonpainful myelopathy.

-SAD was most commonly located dorsally in the thoracic region (67%) and exhibited bilateral symmetrical compression.

-SM was identified in 58% of cases.

-Short-term outcomes:
-Surgical management: 75% improved.
-Medical management: 24% improved.

-Long-term outcomes (available for 52% of cats):
-73% deteriorated regardless of treatment.
-Recurrences were noted in some surgically managed cases.

No significant differences in demographics, treatment response, or outcomes were identified between cats with primary versus acquired SAD.

Limitations
The retrospective and multicenter nature of the study introduced variability in diagnostic and treatment protocols. Limited long-term follow-up and non-standardized imaging equipment may have influenced the results. Additionally, subjective assessments (e.g., pain scoring) were noted as potential confounders.

Conclusions
SAD should be considered in cats presenting with chronic, progressive, nonlateralized myelopathy, particularly in males or those with a history of spinal disease. While surgery offers better short-term improvement, long-term prognosis remains guarded due to high deterioration rates. Further studies are needed to understand the etiology and optimize management strategies.

Sagittal T2-weighted magnetic resonance image of a 12-year-old, female neutered, Domestic Short Hair with 24-months progressive ambulatory paraparesis and fecal incontinence. Presumptive primary spinal arachnoid diverticulum from T3 to T5, with a dorsal tear-drop shape (arrow), cranial direction, and no evidence of syringomyelia. Although other intervertebral discs displayed degeneration and mild herniation, this was not considered to be clinically relevant.

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