Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism

Case summary A 16-year-old spayed female domestic shorthair cat with methimazole-treated hyperthyroidism presented with a chronic progressive history of a stiff gait progressing to recumbency. A neurological examination revealed continuous excessive muscle tone with myokymia, which exacerbated with...

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Main Authors: Koen M Santifort, An Vanhaesebrouck, James Bashford, Iris Van Soens
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Journal of Feline Medicine and Surgery Open Reports
Online Access:https://doi.org/10.1177/20551169241297768
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author Koen M Santifort
An Vanhaesebrouck
James Bashford
Iris Van Soens
author_facet Koen M Santifort
An Vanhaesebrouck
James Bashford
Iris Van Soens
author_sort Koen M Santifort
collection DOAJ
description Case summary A 16-year-old spayed female domestic shorthair cat with methimazole-treated hyperthyroidism presented with a chronic progressive history of a stiff gait progressing to recumbency. A neurological examination revealed continuous excessive muscle tone with myokymia, which exacerbated with exercise and persisted during general anaesthesia. An electromyographic study revealed myokymic discharges in all tested muscles, as well as complex repetitive discharges, fibrillation potentials and positive sharp waves. Blood tests, urinalysis and abdominal ultrasound did not reveal significant abnormalities. A histological examination of a muscle biopsy showed no specific abnormalities. A clinical diagnosis of acquired neuromyotonia with myokymia was formulated. Phenytoin treatment resulted in temporary improvement, but excessive muscle tone recurred resulting in episodes of dyspnoea. Euthanasia was elected 3 weeks after presentation. Relevance and novel information To the best of the authors’ knowledge, this is the second report of an acquired neuromyotonia in a cat. In contrast with the previous report, treatment with phenytoin resulted in only partial and temporary improvement of signs. Subsequent progression of the disease, including signs of dyspnoea and dysuria, led to the decision to euthanase the cat. In humans, acquired neuromyotonia (Isaacs syndrome) is usually due to an autoimmune response to proteins associated with voltage-gated potassium channels. More rarely, it has also been described in humans with thyroid disorders. A link with methimazole treatment or hyperthyroidism in the cat reported here could not be excluded.
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spelling doaj-art-5551e048c5d14e56a665fbed2a6f016c2025-08-20T02:21:03ZengSAGE PublishingJournal of Feline Medicine and Surgery Open Reports2055-11692024-12-011010.1177/20551169241297768Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidismKoen M Santifort0An Vanhaesebrouck1James Bashford2Iris Van Soens3IVC Evidensia Small Animal Referral Hospital Hart van Brabant, Waalwijk, The NetherlandsVeterinary Department, Cambridge University, Cambridge, UKKing’s College Hospital NHS Foundation Trust, Denmark Hill, London, UKIVC Evidensia Small Animal Referral Hospital Hart van Brabant, Waalwijk, The NetherlandsCase summary A 16-year-old spayed female domestic shorthair cat with methimazole-treated hyperthyroidism presented with a chronic progressive history of a stiff gait progressing to recumbency. A neurological examination revealed continuous excessive muscle tone with myokymia, which exacerbated with exercise and persisted during general anaesthesia. An electromyographic study revealed myokymic discharges in all tested muscles, as well as complex repetitive discharges, fibrillation potentials and positive sharp waves. Blood tests, urinalysis and abdominal ultrasound did not reveal significant abnormalities. A histological examination of a muscle biopsy showed no specific abnormalities. A clinical diagnosis of acquired neuromyotonia with myokymia was formulated. Phenytoin treatment resulted in temporary improvement, but excessive muscle tone recurred resulting in episodes of dyspnoea. Euthanasia was elected 3 weeks after presentation. Relevance and novel information To the best of the authors’ knowledge, this is the second report of an acquired neuromyotonia in a cat. In contrast with the previous report, treatment with phenytoin resulted in only partial and temporary improvement of signs. Subsequent progression of the disease, including signs of dyspnoea and dysuria, led to the decision to euthanase the cat. In humans, acquired neuromyotonia (Isaacs syndrome) is usually due to an autoimmune response to proteins associated with voltage-gated potassium channels. More rarely, it has also been described in humans with thyroid disorders. A link with methimazole treatment or hyperthyroidism in the cat reported here could not be excluded.https://doi.org/10.1177/20551169241297768
spellingShingle Koen M Santifort
An Vanhaesebrouck
James Bashford
Iris Van Soens
Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism
Journal of Feline Medicine and Surgery Open Reports
title Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism
title_full Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism
title_fullStr Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism
title_full_unstemmed Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism
title_short Presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism
title_sort presumed acquired neuromyotonia of unknown cause in a cat with hyperthyroidism
url https://doi.org/10.1177/20551169241297768
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AT jamesbashford presumedacquiredneuromyotoniaofunknowncauseinacatwithhyperthyroidism
AT irisvansoens presumedacquiredneuromyotoniaofunknowncauseinacatwithhyperthyroidism