Low complication rates are reported in cats presenting for neurological complaints and undergoing cerebrospinal fluid collection

Objective: To assess complications, outcomes, and associated risk factors of cats undergoing CSF collection. Methods: This was a single-center retrospective cohort study of client-owned cats presenting to 3 referral hospitals for CSF collection from January 2012 through December 2022. Cats were excluded for nonspecific and/or extraneural presenting complaints. If cats had multiple CSF collection presentations, only the first was included. Records were retrospectively assessed for signalment, physical examination findings, modified Glasgow coma scale, general anesthesia (GA) records, diagnostic imaging, clinical pathology results, and suspected or confirmed final diagnosis. Outcomes included complications and nonsurvival > 24 hours following CSF collection. Univariable logistic regression included breed, sex, body weight, age, modified Glasgow coma scale, evidence of herniation, evidence of intracranial hypertension (ICH) without herniation, GA protocol, GA duration, CSF analysis, collection site, inflammatory/infectious, and neoplasia diagnosis. P values were adjusted for multiple comparisons using the Benjamini-Hochberg procedure. Results: 120 cats were identified, with 2 excluded for nonspecific and/or extraneural presenting complaint, leaving 118 cats. Seven (5.9%) did not survive > 24 hours following CSF procedure, and 9 (7.6%) reported complications, including apnea, suspected iatrogenic spinal cord trauma, and Cushing reflex. After multiple-comparison correction, no variable was significantly associated with outcome. Evidence of ICH without herniation and nonsurvival reported the largest effect estimate (OR, 36.99). Estimates are imprecise and reported as hypothesis generating. Conclusions: Feline CSF collection in this cohort reported low complication rates, and the majority survived > 24 hours after CSF collection. Clinical Relevance: Imaging review for abnormalities associated with ICH is recommended prior to CSF collection.