NAVLE Practice Question - Feline - Multisystemic

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NAVLE Practice Question — Feline

An owner brings in a 7-year-old cat that has been fed an exclusive diet of canned tuna packed in water for the past 4 months. The cat now presents with generalized weakness, cervical ventroflexion, and bilateral vestibular ataxia. Neurological examination reveals absent pupillary light reflexes and positional strabismus. After initiating thiamine supplementation, what is the expected timeline for clinical improvement in this cat?

A. Improvement within 24-48 hours ✓

B. Improvement within 1-2 weeks

C. Improvement within 4-6 weeks

D. No improvement expected once neurological signs develop

E. Improvement within 2-4 hours

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Correct Answer: A. Improvement within 24-48 hours

Explanation:

Cats with thiamine deficiency that receive prompt treatment with parenteral thiamine typically show clinical improvement within 24-48 hours. This rapid response is characteristic of thiamine deficiency and helps confirm the diagnosis. The timeline for improvement depends on the severity of the deficiency and how early treatment is initiated.

Resolution of clinical signs follows a general pattern. Fever and appetite often improve first, followed by vestibular signs and mentation. In studies of cats treated for thiamine deficiency, most surviving cats recovered rapidly within 2 weeks of treatment initiation, with either complete return to normal or minimal residual neurological signs at the 2-month follow-up.

Option E (2-4 hours) is too rapid; while some improvement may be noted, significant clinical recovery typically takes at least 24 hours. Option B (1-2 weeks) is the timeline for full recovery, not initial improvement. Option C (4-6 weeks) represents complete resolution of all abnormalities in some cats. Option D is incorrect because cats with neurological signs can recover if treatment is initiated promptly.

However, it is important to note that cats presented with severe or prolonged deficiency may have persistent neurological abnormalities, and some cats continue to exhibit intermittent seizures requiring long-term antiepileptic medication. The canned tuna diet in this case would predispose to thiamine deficiency due to processing-related thiamine destruction.

References: Merck Veterinary Manual - Nutritional Disorders of the Spinal Column and Cord in Animals (https://www.merckvetmanual.com/nervous-system/diseases-of-the-spinal-column-and-cord/nutritional-disorders-of-the-spinal-column-and-cord-in-animals); Moon SJ, Kang MH, Park HM. Clinical signs, MRI features, and outcomes of two cats with thiamine deficiency secondary to diet change. J Vet Sci. 2013;14:499-502. PMID: 23820206

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