Muscle atrophy in a cat.

Dr. Marie replied:

Oh, it sounds like you and Sweety have been through a rough time. I won't be able to give you a diagnosis but I can give you some of my thoughts.

Have they mentioned the possibility of something called a saddle thrombus? (The medical term is aortoiliac thrombosis). Cats who have this problem can get a blood clot that interferes with the circulation to the hind legs. It is often both legs, but it is possible for just one leg to be affected. If this is the cause then you should find that the foot on the sore leg feels colder than on the other side. Sometimes you can see a difference in how pink the paw pads are (assuming that there is pink on the paw pads and not black pigment.)

If this is a saddle thrombus, unfortunately most cats do not do well. There usually is a significant problem with the heart (which is what causes the blood clot to form).

The next thought is that there is something serious going on with the nerves affecting the back leg. This can cause the severe muscle atrophy that you are describing. If this was a nerve problem I would be concerned about some type of tumor affecting the nerves to the back leg. If this was the case, the steroids would have helped temporarily but would not cure the problem. Unfortunately this type of problem is hard to diagnose. She would likely need to have a CT scan or an MRI, both of which are quite expensive.

The degree of muscle atrophy that you have described has me very concerned. I can't think of any simple conditions (i.e. easily treatable) that would cause this.

You could consider asking your vet for a referral to an internal medicine specialist if there is one in your area. These vets are used to seeing the strange cases that regular vets don't see regularly. You may be more likely to get a diagnosis that way.

I wish I had a more concrete answer for you.


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Dr. Marie replied:

A bold clot certainly could cause muscle atrophy. However, we really would expect to see that the foot is cold.

I am not completely convinced that there is no pain. If she is holding the leg up and trembling then this is often because of pain. However, if you feel that things are improving then we could continue to see a gradual improvement over the next few weeks.

I think all we can do now is keep following the vet's advice and see how things are going. If this is something serious affecting the nerves then she will get worse. Unfortunately if that is happening there is not much that. An be done. It may soon be time to make some hard decisions about her quality of life.