Many of you have mentioned enjoying reading the last few postings, and how informative they have been. So it is with that in mind that we will share with you a few thoughts we are currently pondering, and will be discussing further with Moki's neurologist.
1. The normal growth pattern of a skull (cranium) depends on the structures contained within it, i.e., the brain and cerebellum. This being the case, if the brain or cerebellum do not fully develop, then the shape and size of the cranium will grow only as large as the under developed brain or cerebellum. (For more information on cranial anatomy click here and scroll down to the section that says, "Review of Cranial Anatomy.")
So what does that mean? Well in the case of Cerebellar Hypoplasia, the cranial growth would be based upon the actual size of the under developed cerebellum. In other words, in a cat with Cerebellar Hypoplasia, one would not expect to see fluid filled spaces surrounding the cerebellum, the kind that we are seeing on Moki's MRI images, since the cranium would have only grown to match the actual size of the under developed cerebellum. Now with that said, since Moki does have "fluid filled spaces" surrounding his cerebellum, it would appear more likely that Moki did have a fully developed cerebellum from birth (meaning that he couldn't have had even a slight case of Cerebellar Hypoplasia) which later became under developed for whatever (at this time still unknown) reason. This brings us to our next point.
2. Since feline Cerebellar Hypoplasia is a disease which causes the cerebellum to never fully develop, signs of this condition are either present at birth, i.e., head tremors, shaking, and so forth, or become present/noticeable as soon as the feline starts to walk. The very nature of a cerebellum under developing from birth, means that the condition is present throughout a felines life. In other words, if the cerebellum under develops to the point that it causes interference with a cats ability to run, walk, jump and so forth, it would have caused this kind of interference with the cats nervous system starting with the day that the cat was born, and signs/symptoms would have manifested themselves then, or when the cat first began to walk. With that said, if Moki had a even slight case of Cerebellar Hypoplasia, and his cerebellum was under developed from birth, then the current neurological signs we are seeing in Moki should have been present from the moment Moki first started to walk. If Cerebellar Hypoplasia was in fact the culprit, even with only a slight case, Moki never would have been able to run, walk and jump like a normal cat, prior to getting sick a few months after he was born...
3. Cerebellar Hypoplasia only causes coordination, and movement problems. It does not cause other symptoms which are commonly associated with viruses, i.e., lethargy, depression, refusal to eat, decreased white blood cell count, dehydration, and so forth. With that said, Panleukopenia a highly contiguous virus, does cause such symptoms, and can cause Cerebellar Hypoplasia as we discussed in eariler posts. Could Moki have been exposed to Panleukopenia? It's possible, but doesn't quite add up. For starters if Moki's mother had Panleukopenia and Moki was exposed to the virus from his mother after birth, then one would assume that his sister, who entered the shelter with Moki, would have been exposed to the virus as well, if not from the mother than from Moki. That being said, Moki and his sister showed no signs of the virus upon entering the shelter and where temporarily housed with four other kittens, who would have all been exposed to the virus as well. No one, not Moki's sister, or any of the other four kittens, ever showed having any signs of the virus, despite sharing food bowls and litter boxes (a common way known for the virus to spread) and all remain healthy to this day. It doesn't quite fit what is known about Panleukopenia. Add to this the fact that Moki did not show any symptoms until a couple of weeks after we brought him home to live with us, and that none of our other six cats got sick, and it begins to appear as though whatever Moki had was not contiguous.
When Moki did get sick, at the height of his illness, the night we had him transferred to an ER vet, we did suspect Panleukopenia. Because Moki's symptoms at that time appeared to have matched what was known about Panleukopenia, we had a parvo snap test done (this was the only test that was available to detect Panleukopenia at that time, and while the test was intended to detect the Parvo virus in dogs, the canine Parvo virus, is very similar to the feline Panleukopenia virus as I have mentioned in an eariler post, so it is given to felines suspected of having Panleukopenia.) The results of the Parvo test, well, they came back negative. In other words it is highly unlikely that Moki had Panleukopenia, while some of the symptoms matched those known of Panleukopenia, this wasn't spreading, as you would expect to see in the case of Panleukopenia or showing up as such on the Parvo test.
4. With all of that said, I think you can begin to see how the answer to all of this, just isn't that simple. Feeling that things didn't quite add up, we asked Nearly Dr. Ferox, for her opinion, I wanted someones take on all of this who was located outside the U.S. Now Nearly Dr. Ferox is still a student, and she has never actually seen Moki in person, but she had what we feel is some valuable information to share. She too felt that Cerebellar Hypoplasia and Panleukopenia, where not the best possible answers/comparisons in Moki's particular case. Nearly Dr. Ferox, was the one who helped enlighten us about our very first point, and after looking into it, we couldn't agree more. She also told us about a disease called Cerebellar Abiotrophy. The onset of this disease, and the way it affects the cerebellum, do in fact appear to be a better fit with the way Moki's neurological symptoms progressed. It doesn't however explain the other symptoms that where present, the low white blood cell count, dehydration, refusing to eat, lethargy and so forth...Now with that said, one could say that Cerebellar Abiotrophy is extremely rare in cats, even more so that Cerebellar Hypoplasia. Very few cases of this happening in a cat are ever recorded as is evidence by this article published in the Journal of American Animal Hospital Association. This is something that definitely warrants further looking into and we can't thank Nearly Dr. Ferox enough for bringing it to our attention. With that said, we will leave you for now to take in and ponder some of these things. We will definitely be following up with Moki's neurologist on all of them, and will be sure to share with all of you what we hear back in return!
On a different note, we do have some awards and memes which we hope to have posted for you all to enjoy tomorrow! (After all this medical talk, we figure you could all use a break.)
1. The normal growth pattern of a skull (cranium) depends on the structures contained within it, i.e., the brain and cerebellum. This being the case, if the brain or cerebellum do not fully develop, then the shape and size of the cranium will grow only as large as the under developed brain or cerebellum. (For more information on cranial anatomy click here and scroll down to the section that says, "Review of Cranial Anatomy.")
So what does that mean? Well in the case of Cerebellar Hypoplasia, the cranial growth would be based upon the actual size of the under developed cerebellum. In other words, in a cat with Cerebellar Hypoplasia, one would not expect to see fluid filled spaces surrounding the cerebellum, the kind that we are seeing on Moki's MRI images, since the cranium would have only grown to match the actual size of the under developed cerebellum. Now with that said, since Moki does have "fluid filled spaces" surrounding his cerebellum, it would appear more likely that Moki did have a fully developed cerebellum from birth (meaning that he couldn't have had even a slight case of Cerebellar Hypoplasia) which later became under developed for whatever (at this time still unknown) reason. This brings us to our next point.
2. Since feline Cerebellar Hypoplasia is a disease which causes the cerebellum to never fully develop, signs of this condition are either present at birth, i.e., head tremors, shaking, and so forth, or become present/noticeable as soon as the feline starts to walk. The very nature of a cerebellum under developing from birth, means that the condition is present throughout a felines life. In other words, if the cerebellum under develops to the point that it causes interference with a cats ability to run, walk, jump and so forth, it would have caused this kind of interference with the cats nervous system starting with the day that the cat was born, and signs/symptoms would have manifested themselves then, or when the cat first began to walk. With that said, if Moki had a even slight case of Cerebellar Hypoplasia, and his cerebellum was under developed from birth, then the current neurological signs we are seeing in Moki should have been present from the moment Moki first started to walk. If Cerebellar Hypoplasia was in fact the culprit, even with only a slight case, Moki never would have been able to run, walk and jump like a normal cat, prior to getting sick a few months after he was born...
3. Cerebellar Hypoplasia only causes coordination, and movement problems. It does not cause other symptoms which are commonly associated with viruses, i.e., lethargy, depression, refusal to eat, decreased white blood cell count, dehydration, and so forth. With that said, Panleukopenia a highly contiguous virus, does cause such symptoms, and can cause Cerebellar Hypoplasia as we discussed in eariler posts. Could Moki have been exposed to Panleukopenia? It's possible, but doesn't quite add up. For starters if Moki's mother had Panleukopenia and Moki was exposed to the virus from his mother after birth, then one would assume that his sister, who entered the shelter with Moki, would have been exposed to the virus as well, if not from the mother than from Moki. That being said, Moki and his sister showed no signs of the virus upon entering the shelter and where temporarily housed with four other kittens, who would have all been exposed to the virus as well. No one, not Moki's sister, or any of the other four kittens, ever showed having any signs of the virus, despite sharing food bowls and litter boxes (a common way known for the virus to spread) and all remain healthy to this day. It doesn't quite fit what is known about Panleukopenia. Add to this the fact that Moki did not show any symptoms until a couple of weeks after we brought him home to live with us, and that none of our other six cats got sick, and it begins to appear as though whatever Moki had was not contiguous.
When Moki did get sick, at the height of his illness, the night we had him transferred to an ER vet, we did suspect Panleukopenia. Because Moki's symptoms at that time appeared to have matched what was known about Panleukopenia, we had a parvo snap test done (this was the only test that was available to detect Panleukopenia at that time, and while the test was intended to detect the Parvo virus in dogs, the canine Parvo virus, is very similar to the feline Panleukopenia virus as I have mentioned in an eariler post, so it is given to felines suspected of having Panleukopenia.) The results of the Parvo test, well, they came back negative. In other words it is highly unlikely that Moki had Panleukopenia, while some of the symptoms matched those known of Panleukopenia, this wasn't spreading, as you would expect to see in the case of Panleukopenia or showing up as such on the Parvo test.
4. With all of that said, I think you can begin to see how the answer to all of this, just isn't that simple. Feeling that things didn't quite add up, we asked Nearly Dr. Ferox, for her opinion, I wanted someones take on all of this who was located outside the U.S. Now Nearly Dr. Ferox is still a student, and she has never actually seen Moki in person, but she had what we feel is some valuable information to share. She too felt that Cerebellar Hypoplasia and Panleukopenia, where not the best possible answers/comparisons in Moki's particular case. Nearly Dr. Ferox, was the one who helped enlighten us about our very first point, and after looking into it, we couldn't agree more. She also told us about a disease called Cerebellar Abiotrophy. The onset of this disease, and the way it affects the cerebellum, do in fact appear to be a better fit with the way Moki's neurological symptoms progressed. It doesn't however explain the other symptoms that where present, the low white blood cell count, dehydration, refusing to eat, lethargy and so forth...Now with that said, one could say that Cerebellar Abiotrophy is extremely rare in cats, even more so that Cerebellar Hypoplasia. Very few cases of this happening in a cat are ever recorded as is evidence by this article published in the Journal of American Animal Hospital Association. This is something that definitely warrants further looking into and we can't thank Nearly Dr. Ferox enough for bringing it to our attention. With that said, we will leave you for now to take in and ponder some of these things. We will definitely be following up with Moki's neurologist on all of them, and will be sure to share with all of you what we hear back in return!
On a different note, we do have some awards and memes which we hope to have posted for you all to enjoy tomorrow! (After all this medical talk, we figure you could all use a break.)