Agatha, an ataxic kitten

Case Presentation

Agatha, a European long-haired cat, was brought in for consultation by her owner, a human neurology specialist, due to a progressive deterioration of her general condition. Over several days, she exhibited progressive paraparesis, marked ataxia, and spinal hyperesthesia. Her appetite was reduced, she suffered from dyschezia secondary to constipation, and displayed signs of general malaise.

FIP was suspected.

Clinical Examination and Differential Diagnosis

The attending veterinarian, Andrii, based in Sweden, conducted a clinical examination. He identified:

• Marked proprioceptive deficits in the hind limbs,

• Progressive spastic paresis,

• Pronounced hyperesthesia upon thoracolumbar spinal palpation,

• Mild hyperthermia.

Given the rapid progression and the absence of major systemic signs, Andrii suspected an inflammatory or infectious meningoencephalomyelitis.

Collaboration with the Specialist

Aware of the complexity of the case, Andrii sought the opinion of Nicolas, a European College-certified veterinary neurologist based in France, through The Digital Clinic platform. One major challenge was that Andrii and Nicolas did not speak the same language. However, thanks to the platform’s integrated communication tools, this language barrier was effectively overcome, enabling a smooth and efficient exchange of medical expertise.

Thanks to this collaboration, Andrii received Nicolas' initial recommendations just 20 minutes after creating the case on the platform. This swift response facilitated an optimized diagnostic approach, guided complementary testing, and reduced therapeutic uncertainty, thereby improving case management.

Complementary Tests and Diagnostic Confirmation

Nicolas recommended:

• A comprehensive hematology and biochemistry panel,

• A quantitative FCoV serology test.

The findings reinforced the suspicion of neurological FIP with medullary involvement:

• Significant hyperproteinemia in cerebrospinal fluid,

• Moderate pleocytosis,

• Marked increase in serum globulins,

• Confirmation of feline coronavirus via high-titer serology.

Treatment and Clinical Evolution

An antiviral treatment based on GS-441524 was initiated immediately, combined with a multimodal approach, including neuropathic pain management and tailored nutritional support. The treatment effects were evident within the first few days:

• Appetite restoration,

• Rapid improvement of ataxia,

• Gradual recovery of locomotor function.

Within a week, Agatha had regained near-complete neurological function, allowing her to return to an optimal quality of life.

Importance of Generalist-Specialist Collaboration

This case highlights the importance of a multidisciplinary approach in veterinary neurology. With Nicolas' expertise, Andrii was able to refine his differential diagnosis, optimize complementary testing, and implement an appropriate therapeutic protocol, thereby reducing cognitive and decision-making burdens associated with managing complex neurological conditions.

Tele-expertise via The Digital Clinic has proven to be a strategic asset in managing infectious and inflammatory central nervous system diseases, providing practitioners with rapid access to specialized guidance, ultimately enhancing diagnostic accuracy and therapeutic efficacy, while also breaking language barriers to ensure seamless international collaboration.