A Return to Sass: Surgical Treatment of an Intracranial Meningioma in a Cat
Health Tips
Patient: Mr. Cat Marsh
Species/Breed: Feline, Domestic Shorthair
Referring Veterinarian: Dr. Repeta, The Cat Hospital at Park Street
Neurology Hospital: SCAN Clearwater
Neurologist: Jenna Lind, DVM, DACVIM (Neurology)
When Subtle Changes Signal Something More
In the early fall of 2024, Mr. Cat Marsh’s family began noticing subtle but concerning changes in his behavior. Increased vocalization, visual deficits, and episodes of staring at walls slowly progressed over several months. Despite a thorough extracranial workup, including bloodwork, radiographs, and abdominal ultrasound, no abnormalities were identified.
As these neurologic signs worsened, Mr. Cat was referred to SCAN Clearwater for further evaluation.
Neurologic Examination and Advanced Imaging
Mr. Cat first presented to SCAN on April 21, 2025. On neurologic examination, he was dull but responsive. He walked over and through objects, bumped into walls, and displayed wide circling in both directions, more frequently to the right. His pupils were dilated in both eyes, though pupillary light reflexes were intact. Menace responses were absent bilaterally, and visual tracking was inconsistent.
Given these findings, an MRI of the brain was recommended.
MRI Results revealed a strongly contrast-enhancing, symmetrical, mid-falx extra-axial mass, consistent with an intracranial meningioma. The mass caused severe compression and distortion of the lateral ventricles, midline shift, and even cerebellar herniation, findings that explained the progressive neurologic signs seen at home.
Initial Medical Management
Mr. Cat was started on an anti-inflammatory dose of prednisolone to help reduce peritumoral inflammation and intracranial pressure while definitive treatment options were discussed.
Surgical Intervention: A Complex but Rewarding Procedure
On May 12, 2025, Mr. Cat underwent surgical debulking of the mass via a bilateral rostrotentorial craniectomy with cranioplasty using titanium mesh.
Because the tumor was located along the midline, a bilateral approach was required to safely access and toggle the mass. This type of surgery demands meticulous planning and execution:
The dorsal sagittal sinus, normally present in this region, had been obliterated by the mass due to chronic compression.
The tumor’s proximity to the frontal sinus increased the risk of infection.
Meningiomas are highly vascular, requiring careful hemostasis throughout the procedure.
Tumor removal can lead to acute brain swelling and increased intracranial pressure, necessitating close intra- and post-operative monitoring.
Despite these challenges, the procedure was successful.
Post-Operative Care and Recovery
Following surgery, Mr. Cat was closely monitored:
12 hours overnight at VEG Clearwater
Two additional nights at SCAN Clearwater
He was discharged with a comprehensive medication plan including prednisolone, antibiotics, pain control, and prophylactic anti-seizure therapy.
Even at discharge, it was clear that Mr. Cat was feeling better; he had returned to his “sassy self” and firmly limited handling privileges to his owner only.
A Remarkable Outcome
Two-week recheck: Mr. Cat was more coordinated, jumping, and acting like himself again.
Three-month recheck and follow-up MRI: He was neurologically normal, off all medications, and enjoying an excellent quality of life.
While microscopic disease often remains after meningioma surgery, debulking alone can dramatically reduce clinical signs and significantly extend survival time.
Key Takeaways
Meningiomas are the most common intracranial tumors in older cats.
These tumors are typically benign and slow-growing, which explains the gradual onset of clinical signs.
Surgical resection offers a favorable prognosis, with many cats living three years or longer after surgery alone.
When anatomically accessible, surgery is often the treatment of choice and can result in a profound improvement in quality of life.
