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Identifying Feline Hippocampal Necrosis

Clinician's Brief (Capsule)


May 2015

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A 7-year-old cat was presented for a 3-day history of behavioral changes (excessive vocalization, facial territorial marking, inappropriate urination) followed by salivation and focal seizures. At examination, the cat was agitated and pyrexic. It was also hypersalivating and exhibited anisocoria. Treatment with cooling, IV fluids, and anticonvulsants was initiated, but the cat continued to deteriorate. MRI findings were compatible with hippocampal necrosis. Over the next day, the cat began to show improvement; however, it then experienced an episode of vomiting and aspiration of ingesta followed by cyanosis and cardiorespiratory arrest. Initial resuscitation was successful, but the owner declined continued care, and the cat died. Necropsy was grossly unremarkable except for pallor of the hepatic tissues. Histologic changes in the brain showed subacute degenerative encephalopathy involving the hippocampus. The cause of this disease in cats remains unknown.


The hippocampus is an area of the brain thought to be involved in processing sensory information and forming memories. Feline hippocampal necrosis (FHN) is infrequently reported and carries a poor prognosis. Until MRI abnormalities were defined in 2008, most FHN diagnoses were made at postmortem examination of brain tissue from cats that died or were euthanized. In 2011, Pakozdy and others1 reported antemortem diagnosis via MRI and survival in a small number of cats with FHN. The case presented in this report had normalization of neurological examination findings preceding death because of an acute aspiration event. Perhaps now, with better antemortem diagnostic criteria, we are more likely to identify less severe cases and advance knowledge of this condition.—Julie Walker, DVM, DACVECC


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