Botulinum toxin type A for the treatment of muscle contractures secondary to acute spinal cord injury in a young cat

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Abstract

Case Summary
A 4-month-old male entire DSH cat presented for sudden onset of right thoracic monoparesis following a fall; within 18 hours, the clinical signs progressed to non-ambulatory right hemiplegia with absent sensation in the distal right thoracic limb and left hemiparesis. MRI revealed changes consistent with a C6-C7 acute non-compressive nucleus pulposus extrusion with suspected secondary C5-7 spinal cord haemorrhage. Rehabilitation exercises were started immediately after the diagnosis of acute spinal cord trauma. Sensation in the right thoracic limb improved and, with the help of a splint applied to that limb, the cat was ambulatory on all 4 limbs. Unfortunately, clinical signs started to progress over the course of 10 days. The cat developed progressive discomfort on manipulation of the right elbow and carpus, and a hyperflexion of the right carpus. Radiographs revealed no skeletal abnormalities. Muscle contractures were suspected. Under general anaesthesia the triceps, and flexor muscles of the carpus and digits were injected with a total of 100 units of botulinum toxin type A (BTX-A). No complications were associated with the procedure and 24 hours following the injection the carpal hyperflexion resolved.
Relevance and novel information
The use of BTX-A to treat muscle contractures in human medicine is an established and growing technique. For example, in subacute stroke patients with a non-functional arm, BTX-A forearm injection appears to prevent disabling finger stiffness, likely by minimizing the development of contractures. Here we demonstrate that intramuscular BTX-A is an effective treatment for acquired muscle contractures in a cat.
Original languageEnglish
JournalJournal of Feline Medicine and Surgery Open Reports
Early online date1 Jun 2020
DOIs
Publication statusE-pub ahead of print - 1 Jun 2020

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