Spinal trauma is a major cause of spinal cord injury in companion animals and may result in permanent neurological dysfunction or death depending on injury severity and location (Arias et al., 2007; Penha et al., 2011). Secondary injury mechanisms, including hemorrhage, edema, ischemia, compression and laceration of neural tissues, contribute significantly to neurological deterioration (Grasmueck and Steffen, 2006; Long et al., 2023).
       
In cats, spinal trauma commonly results from road traffic accidents, falls, high-rise syndrome, dog attacks, bite wounds and firearm injuries (Karabulut, 2018). Thoracolumbar vertebral fractures and luxations are among the most frequently reported traumatic spinal disorders (Besalti et al., 2002; Bruce et al., 2008; Bali et al., 2009; Krauss et al., 2012; Gönenci et al., 2017; Dhanalakshmi et al., 2021). Fractures may occur alone or with luxations, the latter being reported more commonly in cats than in dogs (Bali et al., 2009; Vallefuoco et al., 2014).
       
These injuries often produce severe neurological deficits requiring immediate intervention. Clinical and neurological examinations are essential for assessing injury severity and prognosis (Lee et al., 2025). Deep pain perception remains one of the most reliable prognostic indicators, with its absence generally associated with poor neurological recovery (Platt and Olby, 2004; Jeffery et al., 2022).
       
Diagnostic imaging is critical for lesion localization and treatment planning. Survey radiography serves as the primary screening tool, while myelography provides additional information regarding spinal cord compression and lesion localization (Sharp and Wheeler, 2005). Although computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly utilized, myelography remains valuable where advanced imaging is unavailable (Paithanpagare et al., 2008; Da Costa and De Decker, 2023).
       
Early diagnosis and timely treatment are essential for improving outcomes following spinal trauma (Bali et al., 2009; Dimar et al., 2010; Ayyappan, 2012; Dvorak et al., 2015). Recent advances emphasize early stabilization, decompression, neuroprotection and rehabilitation to maximize functional recovery (Olby et al., 2023; Fehlings et al., 2023; Meij and Smolders, 2024).
       
Management may be conservative or surgical depending on neurological status, imaging findings, spinal stability and clinical condition. Conservative treatment includes analgesia, anti-inflammatory therapy, nursing care, bladder management, restricted activity and rehabilitation (Bernasconi et al., 2001; Olby et al., 2023). Surgical stabilization techniques include tension-band fixation, screw-polymethylmethacrylate constructs, locking plate systems and other vertebral stabilization procedures (Koch and Montavon, 1998; Voss and Montavon, 2004; Vallefuoco et al., 2014; Karabulut, 2018; Tyagi et al., 2023; Meij and Smolders, 2024).
       
Therefore, the present study was undertaken to evaluate the clinical presentation, diagnostic findings, therapeutic outcomes and factors influencing neurological recovery in cats affected with spinal trauma.

The present study was conducted on 10 cats presented to the Department of Veterinary Surgery and Radiology and Veterinary Clinical Complex (VCC) with suspected Vertebral column/ Spinal cord affections for the duration of 9 months.
       
Detailed history was collected from the owners. Time of injury was recorded. Complete physiological, orthopedic and neurological examination was done on the day of reporting (0^th day) and on 10^th, 20^th and 30^th day post-treatment. Thorough and detailed neurological examination was done as per Wheeler (1989). After complete clinical examination, as per the neurological status, cats were scored as per Mendes and Arias (2012) (Table 1).


       
Survey and contrast radiographic (myelography) lateral and ventro-dorsal view was obtained to determine the location and type of spinal lesion (Fig 1A and B; 2A and B; 3A and B). Myelography was performed via Cerebello-medullary cistern aseptically using Iohexol @ 0.3 ml/kg body weight of the animals (Dewey, 2013).






       
Hemato-biochemical parameters were also evaluated. These parameters were obtained using different commercially available kits, UV-visible spectrophotometer, auto analyzer and Wintrobe method for ESR.
       
Cats were treated either conservatively or surgically based on the time of presenting the case, severity of the trauma as well as the consent of the owner (Table. 3). Conservatively, mannitol @ 1 gm./kg body weight intravenously for 5 days, corticosteroids (methylprednisol one sodium succinate {@ 30 mg per kg body weight intravenously within 24 hours of trauma followed by tapering dose}/dexamethasone/prednisolone), pantoprazole/ probiotics, serratiopeptidase and mecobalamine, multivitamin and minerals were prescribed. Strict cage rest on soft bedding was advised. Owners were also instructed to change the side of the patient in every 6 hours and manual evacuation of the bladder was done twice or thrice daily (Chai et al., 2008; Dhanalakshmi et al., 2021).
       
Surgically, tension band technique of vertebral stabilization was adopted (Fig 4 A to C). General anesthesia was induced using ketamine hydrochloride @ 20 mg/kg body weight. General anesthesia was maintained with isoflurane. The surgery was conducted to stabilize the vertebral instability in the cats using Kirschner wire (15 cm long and 1-1.25 mm diameter) and cerclage wires/orthopaedic wire (0.6-0.8 mm diameter). Aseptically, dorsal midline incision was done three vertebrae cranially and three vertebrae caudally to the site of affection. After dorsal facia incision, epaxial musculature was elevated from the spinous processes paying great attention to muscle attachments of articular facets. Supraspinous and interspinous ligaments were left intact. Post exposure of the luxated site, reduction and stabilization of the part was achieved with the help of double pointed bone forceps by fixing it on the dorsal spinous process of the vertebrae and with firm traction vertebrae were reduced to anatomical alignment. The K-wire then encompassed through the dorsal spinous processes of atleast two vertebrae cranially and two vertebrae caudally and then it was bend in the shape of U using bending plier. K-wire was then fixed using cerclage/orthopedic wire by passing it through the holes drilled at the base of the spinous process. The wire was tightened in the shape of 8 bilaterally (Voss and Montavon, 2004; Gönenci et al., 2017). At the end, dorsal fascia, subcutaneous tissue and the skin was sutured routinely. Post-operative radiographs were taken (Fig 1 and 2C and D) and ceftriaxone @ 20 mg per kg body weight, analgesics, serratiopeptidase and multivitamin were prescribed. The animals were observed for 30 days for neurological recovery. Removal of bullet was also done by exposing the bullet and removing it with tissue forceps as the bullet was not piercing the spinal cord. Removed bullets from each cat measured almost 0.6 cm in length (Fig 5).

The detailed clinical and neurological examination, radiographical examination findings, time of reporting and treatment followed of 10 cats with spinal trauma were shown in Table 2 and 3.




       
After complete orthopedic, neurological and radiographic evaluation, all cats were graded according to Mendes and Arias (2012). The neurological grading at presentation and at the end of the study is presented in Table 2 and 3, respectively. Improvement in neurological function observed in several cats may be attributed to the preservation of deep pain sensation and early presentation following injury. Deep pain perception remains one of the most reliable prognostic indicators in traumatic spinal cord injury. Cats retaining deep pain sensation at presentation demonstrated a greater likelihood of neurological recovery, which is consistent with previous reports by Olby et al. (2003), Eminaga et al. (2011), Dhanalakshmi et al. (2021) and Jeffery et al. (2022). Recent studies have further emphasized that preservation of nociceptive pathways is strongly associated with favorable functional recovery and long-term neurological outcome following spinal trauma in companion animals (Jeffery et al., 2022; Olby et al., 2023). In the present study, all cats graded below 5 based on neurological deficit demonstrated varying degrees of neurological recovery by the end of the observation period.
       
Survey radiography and myelography were employed for confirmatory diagnosis and lesion localization. Myelography revealed absence of contrast passage beyond the site of injury in six cats, suggesting severe spinal cord compression. Similar observations have been reported in cases involving vertebral fractures and luxations associated with marked spinal cord compromise (Voss and Montavon, 2004; Dhanalakshmi et al., 2021). Although advanced imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly used in veterinary neurology, myelography remains a valuable diagnostic technique where advanced imaging facilities are unavailable. Da Costa and De Decker (2023) highlighted the importance of advanced imaging for accurate assessment of vertebral instability, spinal cord compression and associated soft tissue injury; however, they also recognized the continuing clinical utility of myelography in resource-limited settings.
       
The majority of spinal lesions observed in the present study involved the lumbar and thoracolumbar regions. Similar anatomical distribution has been reported previously in feline spinal trauma studies (Bruce et al., 2008; Bali et al., 2009; Dhanalakshmi et al., 2021). The higher incidence of thoracolumbar injuries may be associated with the biomechanical forces generated during falls, road traffic accidents and bite injuries, which commonly affect these regions of the vertebral column.
       
Hematological parameters, including hemoglobin concentration, packed cell volume and erythrocyte sedimentation rate, remained within physiological limits and did not differ significantly throughout the study period. Similar observations have been reported by Dickomeit et al. (2011) and Abhijith (2017). Biochemical parameters including calcium, phosphorus and alkaline phosphatase concentrations also remained within normal ranges. However, serum lactate dehydrogenase (LDH) concentration was significantly elevated in affected cats. Increased LDH activity may be associated with tissue injury, cellular damage and inflammatory processes occurring secondary to spinal trauma (Fig 6). Recent studies on spinal cord injury biomarkers have demonstrated that biochemical indicators of neural tissue injury may provide valuable information regarding injury severity and prognosis (Kwon et al., 2022). Although LDH lacks tissue specificity, the significant elevation observed in the present study likely reflects ongoing tissue damage within the spinal cord and surrounding musculoskeletal structures.

In the present study, Lumbar and thoracolumbar segment of vertebral column was recorded radiographically. Patients who had deep pain sensation and was graded less than 5 after neurological examination demonstrated neurological recovery by the end of the study period. Neurological recovery was observed in 6/10 cats were observed. Prognosis of neurological recovery is highly determined by the degree of spinal cord damage. Time of reporting after spinal trauma or treatment intervention duration from the time of spinal injury is of utmost importance. Cases which reported within 48 hours of trauma demonstrated neurological recovery. Lactate dehydrogenase (LDH) concentration was found to be statistically significant at the time of reporting due to injury of spinal cord and surrounding tissues. Surgically, tension band technique of stabilization of vertebral column using K-wire and cerclage wire was adopted in the following study which provided adequate stabilization of the spine in cats. 

The present study was supported by authority of Assam Veterinary and Fishery University (AVFU), Khanapara, Assam.
 
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The views and conclusions expressed in this article are solely those of the authors and do not necessarily represent the views of their affiliated institutions. The authors are responsible for the accuracy and completeness of the information provided, but do not accept any liability for any direct or indirect losses resulting from the use of this content.
 
Informed consent
 
All animal procedures for experiments were approved by the Committee of Experimental Animal care and handling techniques were approved by the University of Animal Care Committee.

The authors declare that there are no conflicts of interest regarding the publication of this article. No funding or sponsorship influenced the design of the study, data collection, analysis, decision to publish, or preparation of the manuscript.