Peripheral neuropathy is a recognized debilitating complication of feline diabetes mellitus. Diabetes mellitus is a common endocrinopathy in the cat, with an incidence of 1 in 400 animals. Diabetes usually affects older cats with no definitive breed predisposition. In poorly controlled diabetic cats, a distal symmetrical peripheral neuropathy may develop with progressive paraparesis and a plantigrade gait {Fig. 1 and Go to video clip, video provided courtesy of Dr Susan Wagner}. Clinical signs may progress to also involve the thoracic limbs. The reported clinical incidence of neurologic signs is 8% although the true incidence may be much higher. Strict glycemic control reverses the clinical signs of neuropathy in some cats, although many cats continue to show degrees of clinical weakness even with specific therapy including oral hypoglycemic agents or insulin.  Acetyl-l-carnitine has been shown to be of benefit in experimental models of diabetes and has been used in a few cats with persistent clinical signs of neuropathy with subjectively good results (Shelton, unpublished).

  Fig 1 Diabetic cat with polyneuropathy and plantigrade stance (arrow)

References

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Munana KA. Long-term complications of diabetes mellitus, Part I: Retinopathy, nephropathy, neuropathy. Vet Clin North Am Small Anim Pract 1995;25:715.

Mizisin AP, Shelton GD, Wagner S et al. Myelin splitting, Schwann cell inuury and demyelination in feline diabetic neuropathy. Acta Neuropath 1998;95:171.

Mizisin AP, Shelton GD, Burgers ML et al. Neurological complications associated with spontaneously occurring feline diabetes mellitus. J Neuropath Exp Neurol 2002;61:892.

Peterson ME. Endocrine diseases. In: Sherding RG (ed): The Cat, Diseases, and Clinical Management, ed 2. New York, Churchill Livingstone 1994, p1465.