Neuromuscular disorders in the cat: Clinical approach to weakness

Practical relevanceWeakness is a relatively common clinical presentation in feline medicine and can be caused by primary neuromuscular disease or by diseases of other body systems affecting the neuromuscular system secondarily. Successful work-up relies on a thorough clinical and neurological examination, and logical problem solving, based on an understanding of the underlying neuroanatomical and pathophysiological mechanisms.Clinical challengesFeline neuromuscular diseases can be a diagnostic challenge. On initial inspection, the presenting signs can mimic disorders of other body systems, particularly cardiovascular, pulmonary and orthopaedic disease, or may be confused with systemic illnesses. Additionally, because many different pathologies of the feline neuromuscular system converge to a similar clinical phenotype, further diagnostic steps such as electrodiagnostics, cerebrospinal fluid analysis, and muscle and nerve biopsies must be considered even after neuromuscular dysfunction has been identified.AudienceThis review provides a framework for the clinical approach to the weak cat and gives a practical summary of neuromuscular diseases for the general practitioner and specialist alike.Evidence baseMany diseases affecting the feline neuromuscular system have been well described in the veterinary literature, mostly based on retrospective case reports and series. The evidence base for the treatment of feline neuromuscular diseases remains very limited.