Spina bifida

Spina bifida is a congenital neural tube defect that occurs when the vertebral arches fail to close properly during fetal development, leaving a portion of the spinal cord and its protective membranes exposed or inadequately covered. This developmental abnormality can affect cats at any point along the spine, though the lumbosacral region is most commonly involved. The severity of spina bifida varies tremendously, from minor defects that cause no clinical problems to severe malformations resulting in significant neurological impairment. While spina bifida can occur in any cat, it is particularly associated with certain breeds, most notably the Manx and other tailless or short-tailed breeds where the genetic mutation affecting tail development also impacts spinal formation.

The underlying cause of spina bifida involves disruption of the normal embryonic development process during which the neural tube, the precursor to the brain and spinal cord, closes and becomes enclosed by the developing vertebrae. When this closure process is incomplete, the vertebral arches remain open, creating a cleft through which spinal structures may protrude or be exposed. Genetic factors are the primary driver of spina bifida in cats, particularly in breeds selected for taillessness, though environmental factors during pregnancy may also play a role in some cases. The condition is present at birth, though mild cases may not be detected until later in life when neurological symptoms become apparent.

The impact of spina bifida on affected cats depends entirely on the location and severity of the defect. Cats with minor vertebral defects may live entirely normal lives without ever showing clinical signs, while those with more significant malformations may experience hind limb weakness, difficulty walking, urinary or fecal incontinence, and other neurological problems from birth. The quality of life for cats with spina bifida can range from excellent to severely compromised, and some kittens with very severe defects may not survive. Understanding the specific nature and extent of an individual cat's spina bifida is essential for predicting their prognosis and planning appropriate management.

While spina bifida itself cannot be cured since it represents a structural abnormality that occurred during development, many cats with this condition can live comfortable and fulfilling lives with appropriate supportive care. Management focuses on addressing the specific symptoms and challenges faced by each individual cat, which may include assistance with mobility, management of incontinence, and prevention of secondary complications. Early evaluation by a veterinarian helps establish the extent of the defect and develop a care plan tailored to the cat's needs. For prospective owners of breeds at risk for spina bifida, understanding the condition and its potential implications is an important part of responsible pet selection.

The primary cause of spina bifida is a failure of the neural tube to close properly during embryonic development, which subsequently prevents the vertebral arches from forming correctly around the developing spinal cord. In normal feline embryonic development, the neural tube closes during the first few weeks of gestation, and the mesenchymal tissue that will become the vertebrae migrates around it to form protective bony arches. When this process is disrupted, the vertebral arches remain open to varying degrees, leaving the spinal cord and its coverings vulnerable. The exact mechanisms that cause this developmental failure are complex and not fully understood, but genetic factors are clearly paramount in feline spina bifida.

Genetic and hereditary factors are the dominant cause of spina bifida in cats, with the condition most strongly associated with the genes responsible for taillessness in certain breeds. The Manx gene, which produces the characteristic absent or shortened tail of Manx cats, affects the development of the entire caudal spine, not just the tail vertebrae. This same gene can cause varying degrees of spinal abnormalities throughout the lumbosacral region, including spina bifida. The condition follows an incomplete dominant inheritance pattern, meaning that cats with two copies of the Manx gene often have severe spinal malformations incompatible with life, while those with one copy may have mild to moderate abnormalities. Other tailless or bobtail breeds may carry similar genes with similar effects on spinal development.

Environmental factors during pregnancy may contribute to the development of spina bifida in some cases, though their role is less well-established in cats than in humans or some other species. Maternal nutritional deficiencies, particularly of folic acid and other B vitamins, have been implicated in neural tube defects in various species. Exposure to certain medications, toxins, or infectious agents during the critical period of neural tube closure could theoretically disrupt normal development. High body temperature during early pregnancy has been associated with neural tube defects in some animals. However, in the majority of feline spina bifida cases, particularly those occurring in predisposed breeds, genetic factors are considered the primary cause.

Risk factors for spina bifida in cats center predominantly on breed and genetic background. Any cat from a tailless or bobtail breed, or a mixed-breed cat with ancestry from such breeds, carries an increased risk. Inbreeding, which is common in purebred cat populations, may increase the expression of recessive genetic abnormalities. The specific genetics of the parents matter significantly, as breeding two Manx cats together increases the risk of producing kittens with severe spinal malformations. Cats born to parents with known spinal abnormalities are at higher risk, as are those from breeding lines with a history of spina bifida or related conditions.

The mechanism of spina bifida development involves the failure of the dorsal portions of one or more vertebrae to fuse at the midline, leaving a cleft or opening in what should be a complete bony ring surrounding the spinal cord. In mild cases, called spina bifida occulta, only the bony arch fails to close while the spinal cord and its membranes remain in their normal position, covered by skin. In more severe forms, the meninges may bulge through the opening, creating a meningocele, or the spinal cord itself may be involved, creating a myelomeningocele. The most severe cases involve completely open spinal defects with exposure of neural tissue. The neurological consequences depend on the degree to which the spinal cord is malformed, displaced, or damaged by the defect.

Early warning signs of spina bifida are often present from birth, though they may not be immediately recognized, particularly in mild cases. Kittens with spina bifida may appear smaller or weaker than their littermates, have difficulty nursing effectively, or show subtle abnormalities in their movement patterns from the earliest days of life. A visible or palpable defect along the spine, sometimes appearing as a dimple, tuft of hair, or soft swelling, may be present over the affected area. In some cases, the opening in the spine is obvious at birth, but mild forms of spina bifida occulta may go undetected until later in life when neurological symptoms prompt diagnostic evaluation. Because kittens are naturally somewhat uncoordinated, early motor difficulties may be attributed to normal development rather than recognized as signs of a neurological problem.

Common symptoms of spina bifida reflect the neurological deficits caused by spinal cord involvement and vary based on the severity and location of the defect. Hind limb weakness is perhaps the most frequently observed sign, ranging from subtle clumsiness to complete paralysis depending on the extent of spinal cord damage. Affected cats may have an abnormal gait, with bunny-hopping movements, dragging of the hind feet, or difficulty coordinating their rear legs. Muscle wasting in the hindquarters often develops due to reduced nerve supply to these muscles. The tail is frequently affected, appearing limp, shortened, or abnormally positioned, particularly in breeds already selected for tail abnormalities.

Behavioral changes associated with spina bifida are often secondary to the physical limitations imposed by the condition. Kittens may be less playful and active than their littermates due to mobility difficulties. Litter box training may be challenging or impossible if the cat lacks normal control of elimination. Some cats adapt remarkably well to their limitations and develop compensatory behaviors that allow them to function effectively despite their disabilities. Others may show frustration or anxiety related to their inability to perform normal feline activities. Social development may be affected if the kitten is unable to engage in normal play behaviors with siblings.

Physical signs of spina bifida are often visible to observant owners and veterinarians. The defect itself may be palpable or visible as an abnormality along the spine, though this is not always the case, particularly with spina bifida occulta. Cats with more severe defects may have obvious deformities of the hindquarters, pelvis, or tail. Abnormal posture, such as a roached back or unusual positioning of the hind legs, is common. The hind feet may knuckle over or show abnormal wear patterns from dragging. Muscle atrophy affecting the hindquarters and hind legs is frequently present. Some cats develop pressure sores or skin problems in areas where they bear weight abnormally due to their disability.

Symptom progression in spina bifida varies depending on the specific nature of the defect. Because spina bifida is a structural abnormality present at birth, the underlying defect itself does not progress. However, secondary changes may occur over time. Cats with mild defects may develop worsening symptoms if degenerative changes occur around the malformed vertebrae or if tethering of the spinal cord causes progressive stretch injury to neural tissue. Muscle atrophy may worsen without physical therapy. Incontinence may become more problematic as the cat ages and the consequences of chronic bladder or bowel dysfunction accumulate. On the positive side, many cats show functional improvement over time as they learn to compensate for their limitations.

Emergency symptoms that may occur in cats with spina bifida include acute worsening of neurological function, which may indicate complications such as spinal cord tethering or compression. Signs of severe pain, sudden inability to move the hind legs, or acute urinary retention require immediate veterinary attention. Infections secondary to incontinence or skin breakdown can become serious quickly and may present with fever, lethargy, and loss of appetite. Trauma to the exposed or vulnerable spinal area, even minor bumps or falls, can cause disproportionate injury and sudden neurological deterioration. Any rapid change in a cat's neurological status warrants urgent evaluation.

Initial examination of a cat suspected of having spina bifida involves a comprehensive physical and neurological assessment to characterize the nature and extent of any deficits. The veterinarian will carefully examine the spine for palpable abnormalities, including gaps in the vertebral arches, soft tissue swellings, or skin abnormalities overlying the defect. A thorough neurological examination evaluates reflexes, muscle tone and strength, sensation, and coordination in the hind limbs and tail. Observation of gait and posture provides additional information about functional impairment. The veterinarian will also take a complete history, including information about the cat's breed, littermates, and any symptoms noticed since birth, which helps establish whether the condition is congenital as expected with spina bifida.

Diagnostic imaging is essential for confirming the diagnosis of spina bifida and determining the specific anatomy of the defect. Radiographs of the spine can reveal the characteristic appearance of incomplete vertebral arches and may show other associated bony abnormalities. However, standard radiographs do not visualize the spinal cord or soft tissues well, limiting their ability to fully characterize the defect. Advanced imaging provides much more detailed information about the extent of spinal cord involvement. Computed tomography offers excellent visualization of the bony defects and can be reconstructed to show three-dimensional anatomy. Magnetic resonance imaging is the gold standard for evaluating spina bifida, as it clearly demonstrates the spinal cord, nerve roots, and surrounding soft tissues, revealing whether the neural tissue is normal, malformed, or herniated through the vertebral defect.

Differential diagnosis for spina bifida includes other congenital and acquired conditions that can cause similar neurological signs in kittens and cats. Cerebellar hypoplasia, caused by feline panleukopenia virus infection during fetal development, causes incoordination that might be confused with spina bifida, though the characteristic tremors and head bobbing usually distinguish it. Spinal cord injury from birth trauma or later accidents can cause hind limb weakness and incontinence similar to spina bifida. Other congenital spinal abnormalities, such as hemivertebrae or spinal cord malformations, may occur independently or alongside spina bifida. Infectious or inflammatory conditions affecting the spinal cord must be considered, particularly if symptoms develop or worsen after birth rather than being present from the beginning.

Diagnosis confirmation of spina bifida relies on demonstrating the characteristic vertebral defect through imaging studies in a cat with consistent clinical signs and history. The diagnosis is typically straightforward when imaging reveals the classic appearance of incomplete vertebral arch closure, particularly when the cat is from a predisposed breed and has had symptoms since birth. The specific type and severity of spina bifida can be classified based on imaging findings, which helps with prognostication and treatment planning. In some cases, additional testing such as urodynamic studies to assess bladder function or electrodiagnostic testing to evaluate nerve function may be performed to fully characterize the functional impact of the defect.

Emergency treatment for cats with spina bifida is rarely required unless acute complications develop. Newborn kittens with exposed neural tissue require immediate protective measures to prevent infection and further injury to the delicate spinal structures. This may involve gentle cleaning of the area, application of sterile dressings, and administration of antibiotics. Surgical closure of open defects may be performed in the neonatal period if the kitten is stable enough to tolerate anesthesia. Cats with sudden worsening of neurological function require urgent evaluation to identify potentially reversible causes such as infection, trauma, or spinal cord tethering. Acute urinary retention, which can occur if bladder function is impaired, requires immediate relief through catheterization or manual expression to prevent bladder damage.

Medical management of spina bifida focuses on addressing the specific symptoms and complications experienced by each individual cat. Pain management may be necessary if the cat shows signs of discomfort, with medications selected based on the type and severity of pain present. Cats with urinary incontinence may benefit from medications that help improve bladder emptying or reduce unwanted urine leakage. Stool softeners or dietary modifications can help manage fecal incontinence. Antibiotics are used to treat urinary tract infections, which are common in cats with abnormal bladder function. Anti-inflammatory medications may help if there is ongoing irritation or inflammation around the spinal defect.

Surgical options for spina bifida in cats are limited but may be considered in specific situations. Closure of open spinal defects in neonates can protect the exposed neural tissue and reduce the risk of infection, though it does not reverse neurological damage that has already occurred. Surgery to release a tethered spinal cord, where the cord is abnormally attached to surrounding structures, may prevent progressive neurological deterioration in some cases. Rarely, procedures to address specific complications such as hydrocephalus or syringomyelia may be performed. Surgical intervention is generally reserved for cats with specific indications and must be weighed against the risks of anesthesia and surgery in often fragile patients.

Supportive care is the mainstay of management for most cats with spina bifida and encompasses numerous aspects of daily care. Assistance with bladder emptying through manual expression or intermittent catheterization may be necessary for cats unable to urinate normally on their own. Diaper use or other management strategies address urinary and fecal incontinence while protecting the skin from urine scalding. Physical therapy helps maintain muscle mass, joint flexibility, and mobility, with exercises tailored to the individual cat's abilities and limitations. Nutritional support ensures adequate intake for growth and health, with adjustments made for reduced activity levels to prevent obesity.

Alternative and complementary therapies can enhance quality of life for cats with spina bifida. Hydrotherapy provides low-impact exercise that builds strength without stressing joints, and many cats tolerate water-based therapy well. Mobility aids such as wheelchairs or carts allow cats with severe hind limb weakness to move independently, enriching their lives considerably. Acupuncture may help with pain management and possibly improve some aspects of neurological function. Massage therapy addresses muscle tension and improves circulation. Environmental enrichment ensures that cats with limited mobility still have opportunities for mental stimulation and engagement.

Treatment decisions for cats with spina bifida require careful consideration of the individual cat's quality of life, the extent of their deficits, and the resources available for their care. Mild cases may require minimal intervention beyond monitoring and basic preventive care. Moderate cases benefit from comprehensive management addressing all aspects of the cat's needs. Severe cases present difficult decisions about whether intensive management can provide an acceptable quality of life or whether euthanasia is the most humane option. These decisions should be made collaboratively between the veterinary team and the owner, with the cat's welfare as the primary consideration. Ongoing assessment and willingness to adjust the management plan as needed are essential for optimizing outcomes.

Recovery timeline considerations for cats with spina bifida differ from those for acquired conditions because spina bifida is a congenital structural abnormality rather than an injury or illness that can heal. There is no recovery from the underlying defect itself, which remains present throughout the cat's life. However, cats often show functional improvement over time as they develop compensatory strategies, build strength, and adapt to their limitations. Kittens with spina bifida may show steady improvement in their abilities during the first year of life as their nervous system matures and they learn to work with their bodies. Following any surgical intervention, recovery typically spans several weeks to months and involves gradual return to baseline function.

Post-treatment care for cats living with spina bifida is an ongoing commitment rather than a time-limited recovery period. Daily management of incontinence, including bladder expression if needed, cleaning of soiled areas, and skin care to prevent breakdown, becomes part of the routine. Physical therapy exercises should be performed regularly to maintain the gains achieved and prevent decline. Medication administration continues as needed, with periodic reassessment of what medications are providing benefit. Regular veterinary visits allow monitoring for complications and adjustment of the management plan as the cat's needs change over time.

Prognosis factors for cats with spina bifida are primarily determined by the severity and location of the defect and the degree of neurological impairment present. Cats with spina bifida occulta and minimal neurological involvement often have near-normal life expectancy and quality of life. Those with more significant defects have more guarded prognoses, with outcomes depending on the specific functional limitations present and the availability of supportive care. Incontinence is a major factor affecting quality of life and may influence whether long-term management is feasible. The development of secondary complications such as recurrent urinary infections, skin breakdown, or progressive neurological deterioration worsens the prognosis.

Long-term outlook for cats with spina bifida varies considerably based on individual circumstances. Many cats with mild to moderate defects live long, happy lives with appropriate management, bringing joy to their families for many years. Those with more severe involvement may face ongoing challenges that require intensive care, and some cats may have shortened life expectancy due to complications. Quality of life rather than quantity of life should guide decision-making, with the goal of ensuring that affected cats are comfortable, able to engage in enjoyable activities, and not suffering unduly from their condition. Regular reassessment of quality of life helps ensure that management decisions continue to serve the cat's best interests.

Primary prevention of spina bifida in cats centers on responsible breeding practices, particularly within breeds known to carry genes associated with spinal abnormalities. Breeders of Manx cats and other tailless or bobtail breeds should understand the genetics underlying their breed's characteristic features and the associated risks of spinal malformations. Avoiding breeding two tailless cats together reduces the risk of producing kittens with homozygous genetic abnormalities that cause severe spina bifida and other lethal defects. Selecting breeding cats that produce kittens with minimal spinal involvement and avoiding lines with a history of severe abnormalities gradually reduces the prevalence of spina bifida within breeding populations. Prospective buyers should seek breeders who prioritize health and transparently discuss the risks associated with the breed.

Environmental prevention during pregnancy may help reduce the risk of spina bifida, though the genetic component is predominant in cats. Ensuring pregnant cats receive optimal nutrition, including adequate folic acid and other vitamins important for neural development, supports healthy fetal development. Avoiding exposure to medications, toxins, and potential teratogens during pregnancy reduces the risk of developmental abnormalities in general. Preventing infections that could affect fetal development through appropriate vaccination and hygiene practices is prudent. While these measures cannot overcome strong genetic predisposition, they may help minimize environmental contributions to neural tube defects.

Dietary considerations for breeding cats include ensuring complete and balanced nutrition before and during pregnancy. While the role of folic acid supplementation in preventing feline neural tube defects is not as well-established as in humans, providing adequate folate through a high-quality diet or appropriate supplementation is reasonable. Avoiding nutritional deficiencies that could compromise embryonic development requires feeding a diet formulated for reproduction during pregnancy. Consulting with a veterinarian about optimal nutrition for breeding cats helps ensure that dietary factors are optimized.

Health maintenance for cats at risk of producing offspring with spina bifida includes thorough health screening before breeding. Physical and neurological examination of potential breeding cats identifies those with subtle spinal abnormalities that might be passed to offspring. Radiographic evaluation of the spine can reveal vertebral defects that might not be apparent on physical examination. Genetic testing, where available, can identify carriers of problematic genes. Working with veterinarians who understand the specific health concerns of tailless breeds ensures appropriate screening is performed.

Early intervention when spina bifida is identified in a kitten allows optimal management from the start. Kittens from at-risk breeds should be carefully evaluated for spinal abnormalities as part of their initial veterinary examination. Early identification of affected kittens allows informed decisions about their future, whether that involves intensive management by prepared owners or humane euthanasia for severely affected individuals. Monitoring kittens with mild defects as they develop ensures that any progressive problems are identified and addressed promptly. Education of new owners about the potential for spina bifida in at-risk breeds prepares them to recognize and respond to related problems.

Daily management of a cat with spina bifida requires consistency and attention to the specific needs created by the condition. For cats requiring bladder expression, this must be performed at regular intervals, typically three to four times daily, to prevent overdistension and urinary tract infection. Maintaining a clean environment is essential, which may involve frequent bedding changes, use of waterproof surfaces, and regular bathing or cleaning of soiled areas. Medication administration, if needed, should be incorporated into the daily routine to ensure consistent dosing. Physical therapy exercises help maintain muscle tone and joint flexibility, and even a few minutes of gentle stretching and range of motion activities daily can make a significant difference.

Home environment modifications significantly improve quality of life for cats with spina bifida. Non-slip flooring throughout areas the cat frequents helps them maintain traction despite mobility limitations. Low-sided litter boxes or pee pads in accessible locations accommodate cats who cannot posture normally for elimination or who need to eliminate more frequently. Ramps or steps to favorite perching spots allow continued access without the need for jumping. Soft, supportive bedding protects against pressure sores while providing comfort. Gates or barriers may be needed to prevent access to hazardous areas such as stairs or high places from which the cat could fall.

Maintaining quality of life for cats with spina bifida extends beyond managing their physical limitations to ensuring their emotional and mental wellbeing. Interactive play, adapted to the cat's abilities, provides mental stimulation and strengthens the bond with their owner. Puzzle feeders and toys encourage engagement even in cats with limited mobility. Social interaction with family members, and potentially with other gentle pets, prevents isolation. Cats with disabilities can still enjoy many normal feline pleasures, including sunny spots for napping, watching birds, and receiving affection. Focusing on what the cat can do rather than what they cannot helps maintain a positive environment.

Ongoing monitoring and care enable early detection and management of complications common in cats with spina bifida. Urinary tract infections are frequent in cats with abnormal bladder function, so watching for signs such as bloody urine, increased frequency, or straining is important. Skin condition should be checked regularly, with particular attention to areas prone to pressure sores or urine scalding. Weight monitoring ensures the cat is not becoming overweight, which would further burden their compromised mobility, or underweight, which might indicate underlying health problems. Regular veterinary check-ups allow professional assessment and adjustment of the management plan as needed.

Caregiver support is crucial for owners of cats with spina bifida, as the daily commitment of managing a special needs pet can be substantial. Connecting with online communities of owners caring for disabled cats provides emotional support, practical tips, and the reassurance that others understand the challenges and rewards involved. Building a relationship with a veterinary team experienced in managing cats with spina bifida ensures access to knowledgeable guidance. Accepting help from family or friends when available prevents caregiver burnout. Acknowledging the extra work involved while also celebrating the joy that these special cats bring helps maintain perspective. Financial planning for ongoing care helps reduce stress about treatment costs.

The Manx cat is by far the breed at highest risk for spina bifida due to the genetic mutation responsible for their characteristic taillessness, which is closely linked to abnormal development of the entire caudal spine. The severity of spinal involvement in Manx cats ranges widely, from completely normal individuals who happen to lack a tail to severely affected kittens with spina bifida, spinal cord malformations, and other abnormalities collectively termed Manx syndrome. Research indicates that the gene causing taillessness is a dominant mutation with variable expression, and cats homozygous for the gene typically die during fetal development due to severe spinal abnormalities. Even heterozygous Manx cats have elevated rates of spina bifida and related conditions compared to tailed breeds.

Other breeds with shortened or absent tails may carry similar genetic predispositions to spinal abnormalities, though the specific genes and risks vary. The Cymric, essentially a longhaired Manx, carries the same genetic mutation and similar risks for spina bifida. The Japanese Bobtail and American Bobtail have naturally shortened tails due to different genetic mutations than the Manx, and while severe spinal abnormalities appear less common in these breeds, they should still be monitored for potential issues. Various experimental or emerging tailless breeds may carry unknown risks for spinal abnormalities. Mixed-breed cats with ancestry from tailless breeds may inherit genes predisposing to spina bifida, though the risk is generally lower than in purebred tailless cats.

Screening recommendations for breeds at risk of spina bifida include thorough veterinary examination of all kittens, with careful attention to the spine and neurological function. Radiographic evaluation of the lumbosacral spine is recommended for breeding cats to identify subtle vertebral abnormalities that might be passed to offspring. Kittens should be observed closely during development for any signs of neurological problems. Breeders should maintain detailed health records and track the occurrence of spina bifida and related conditions in their lines. Pre-purchase examinations by a veterinarian can help prospective owners identify kittens with significant spinal abnormalities before commitment. Working with breeders who prioritize health and openly discuss breed-related risks is essential for anyone considering a Manx or related breed.

Spina bifida commonly co-occurs with other congenital abnormalities, particularly in breeds where the underlying genetic factors affect multiple aspects of development. Sacrocaudal dysgenesis, abnormal development of the sacrum and tail vertebrae, frequently accompanies spina bifida in Manx cats and is part of the spectrum of abnormalities known as Manx syndrome. Spinal cord malformations such as syringomyelia, the development of fluid-filled cavities within the spinal cord, may occur alongside vertebral defects. Meningocele and myelomeningocele, where meninges or spinal cord tissue herniate through vertebral defects, represent more severe forms of spina bifida. Anal atresia, absence of a normal anal opening, can occur in kittens with severe caudal abnormalities. Managing cats with multiple concurrent abnormalities requires comprehensive assessment and coordinated treatment of all conditions.

Several conditions produce symptoms similar to spina bifida and must be distinguished through careful evaluation. Spinal cord injury from trauma can cause hind limb weakness and incontinence similar to spina bifida, but the history of normal function followed by acute onset differentiates it. Cerebellar hypoplasia causes incoordination that might superficially resemble spina bifida, though the tremors, head bobbing, and involvement of all four limbs distinguish it. Intervertebral disc disease can cause similar neurological signs but typically affects older cats and may fluctuate in severity. Lumbosacral stenosis may occur secondary to vertebral abnormalities associated with spina bifida or as a separate degenerative condition. Accurate diagnosis is essential because treatment approaches differ significantly among these conditions.

Complications that may develop secondary to spina bifida include urinary tract infections, which are common in cats with neurogenic bladder dysfunction and can become recurrent or chronic if bladder management is inadequate. Skin breakdown from urine scalding or pressure sores affects cats with incontinence or limited mobility. Constipation or megacolon may develop in cats with impaired bowel function. Progressive neurological deterioration can occur if the spinal cord becomes tethered to surrounding structures, causing stretch injury as the cat grows. Arthritis may develop in joints that compensate for abnormal movement patterns. Preventing these complications through proactive management improves outcomes for affected cats.