An 8-year-old neutered domestic shorthaired cat presented for tetraparalysis 12 hours after a fall. The cat had been experiencing difficulty in ambulation for 3 months prior, was indoor only, and was exclusively fed a home-made diet based on raw beef liver and giblets.
Physical examination confirmed tetraparalysis; no reflexes or deep pain sensation were present in the limbs, and there was osseous crepitation with severe pain evident on manipulation of the cervical and thoracic spine. Radiographic evaluation of the cervical and thoracic vertebrae revealed exostosis and fusion of all vertebrae from C1-T7, with fracture and deviation of the spinal axis at the level of C1 and C2. The animal was euthanized and gross pathology confirmed radiographic findings. High levels of vitamin A in the liver were measured, and histopathology revealed severe hepatic fibrosis and stellate cell lipidosis. Liver injury in cases of vitamin A toxicity is likely caused by excessive accumulation of vitamin A in the liver, leading to fatty accumulation and liposomal storage disease. Although the exact mechanism of injury in cats is unknown, these changes ultimately can lead to varying degrees of fibrosis and, ultimately, cirrhosis.