Coextensive Meningioma and Cholesterol Granuloma in the Forebrain of a Cat

A 9-year-old, female, spayed, domestic longhaired cat presented to The Ohio State University Veterinary Medical Center Oncology Service with a 6-month history of changes in behavior and weight loss. The owner reported that the cat had become abnormally unfriendly and would growl or hiss when touched. The cat also had gait changes, manifested by left hind limb weakness, difficulty walking up stairs, and occasionally losing balance and falling down stairs. The cat was examined by its regular veterinarian and had abdominal radiographs, CBC, and biochemistry profile performed, which did not detect any abnormalities. On physical examination, the cat was underweight with an estimated body condition score (BCS) of 1/5. Neurologic examination revealed a very dull mentation, severe generalized muscle atrophy, and a slow, reluctant, and crouched gait. Cranial nerve examination revealed no abnormalities. There was absence of conscious proprioception in all limbs. A forebrain lesion was suspected. The cat was examined 8 days later because of progressive signs of neurologic disease. The cat was obtunded and had a right head turn with a mild right head tilt. The gait showed proprioceptive/right vestibular ataxia with knuckling of both thoracic limbs on ambulation, a crouched posture, and a splaying outward of the left thoracic limb. There was a decreased menace response bilaterally that was worse on the left and decreased nasal sensation bilaterally. Spinal reflexes were normal in all limbs. Neurolocalization was to the right-forebrain with possible brainstem involvement. An abdominal ultrasound was then performed at the owner’s request to investigate the gastrointestinal tract as a possible explanation for the weight loss, but no abnormalities were identified.