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Bush Veterinary Neurology Service (BVNS)

Buttercup

Buttercup the tuxedo cat.

MEET BUTTERCUP

She was adopted as a kitten along with her “sister,” Sarahbellum, in Spring 2020. They were both adopted from a wonderful local cat rescue called Good Mews with a tentative diagnosis of cerebellar hypoplasia. On neurologic examination, Buttercup is very spastic in all four legs with exaggerated stepping movements - this is called hypermetria. Buttercup is also ataxic, meaning wobbly in all four legs and she frequently loses her balance. Buttercup also has a pronounced intention tremor which is an involuntary, rhythmic, oscillatory movement of the head; in her case, the tremors are exaggerated by goal-oriented actions (when she intends to do something such as eating, drinking, or playing with a toy).

PRESENTING COMPLAINTS

  • Hypermetria

  • Ataxia in all four limbs

  • Intermittent intention tremor

DIAGNOSTICS

  • CBC and chemistry: within normal limits

  • Brain MRI to be scheduled

  • To view videos of Buttercup's gait and intention tremors, visit bit.ly/3c2yoX5

NEUROLOCALIZATION

Buttercup's neurologic examination shows abnormalities consistent with diffuse cerebellar disease.

TENTATIVE DIAGNOSIS

Cerebellar Hypoplasia.

TREATMENT

There is no treatment for this condition.

OUTCOME

Buttercup has continued to thrive in our home alongside Sarahbellum and their three Dachshund housemates, Malcolm, Lucy Goo, and New Rock. You can see Malcolm get in on the laser pointer action in one of Buttercup’s videos. Buttercup has grown into a healthy, happy adult cat and we expect to enjoy many more years with her.

WHAT IS CEREBELLAR HYPOPLASIA?

Cerebellar hypoplasia is a disorder in which the cerebellum fails to develop properly. The cerebellum is the part of the brain that controls purposeful movement, coordination, balance (has direct input to the vestibular system), and refines our motor skills.

HOW DID BUTTERCUP GET CEREBELLAR HYPOPLASIA?

Most commonly, kittens become affected with feline panleukopenia virus during the perinatal period (in the last weeks of pregnancy and the first weeks after birth). During this period, the cerebellum is undergoing rapid growth making it susceptible to attack as the panleukopenia virus tends to damage highly active, rapidly dividing cells.

Clinical Signs

  • Cerebellar ataxia (including hypermetria) often noticed when the kitten starts walking

  • Intention tremor

  • Other neurologic signs can occasionally be seen if the virus has affected other areas of the brain

HOW DO YOU DIAGNOSE AND WHAT IS THE PROGNOSIS?

Cerebellar hypoplasia is not detected with routine laboratory tests. It is often diagnosed based on history, signalment, and examination findings. In some kittens, MRI (magnetic resonance imaging) may show a smaller than normal cerebellum. The prognosis: kittens with cerebellar hypoplasia typically have a normal life expectancy.

TAKE HOME POINTS

  • Cerebellar hypoplasia is not painful or contagious.

  • The most common cause is infection with feline panleukopenia virus. Other much less common causes include trauma, infections such as Toxoplasmosis, or other causes.

  • The vaccination of female cats against panleukopenia virus prior to pregnancy can help prevent this disease.

  • Many kittens will adapt to their cerebellar dysfunction and clinical signs may improve with time.