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Feline Meningioma: Clinical signs and treatment options

The Animal Medical Center of Seattle (AMCS) is a privately-owned emergency and specialty veterinary hospital that has been providing superior and cutting-edge veterinary medicine since 2009. AMCS offers a wide array of specialty services run by board-certified and residency trained veterinary specialists. Some of their services include neurology, dermatology, dentistry, internal medicine, interventional radiology, surgery, and oncology, with an emergency and critical care department that is always open. Their cutting-edge diagnostics include Hyperbaric Oxygen Therapy, MRI, CT, Stem Cell Therapy, and much more!

AMCS's board-certified neurologist, Beryl Swanson, DVM, DACVIM, recently joined the Animal Medical Center of Seattle family. Dr. Swanson is excited to provide pet owners of the Pacific Northwest treatment options for neurological disorders, including brain tumors called Meningiomas, which are the most common brain tumor in cats.

Meningiomas are slowly growing tumors with the vast majority considered benign (non-cancerous) but cause clinical problems because they grow within the skull and compress the brain. Malignant (cancerous) meningiomas in cats are rarely seen, and most form in the front part of the brain (forebrain). Cats tend to be older at the time of their diagnosis (12-13 years), and signs are variable and depend on where the tumor is growing. Behavioral changes are frequent and include altered mentation, circling, lack of muscle coordination, blindness, pacing, and loss of balance, but seizures may be the only clinical sign.

A diagnosis is made based on advanced imaging with an MRI, then treatment options are discussed. In general, treatment includes medical management, radiation therapy, and surgery. Chemotherapeutic options (drugs used to kill the tumor cells) are limited for brain tumorstheir effectiveness in the brain is weak because the blood vessels in the brain serve as a barrier to the entry of those drugs. The mainstay of medical management is oral steroids, which are used to reduce swelling (edema) that surrounds the tumor. This is a comfort care treatment option that often improves clinical signs in the short term but does not change the size or growth of the tumor itself.

Radiation therapy (RT) can be used in the treatment of brain tumors, including meningioma, that is not surgically accessible. A recent study evaluated the response to RT in cats that had brain tumors. The average overall survival time was 515 days for all tumor types combined. Longer survival times were seen in cats with meningioma compared to cats with other types of tumors.

Surgical removal has shown to offer the longest survival for cats with surgically accessible meningioma, and in many cases is essentially curative. A recent study examined survival times in cats who underwent surgery for meningioma, with 121 cats included. The study showed a low mortality of only 6% (cats who died during or immediately after surgery). During the study, six cats were euthanized due to confirmed regrowth of the tumor, with an additional three suspected to have regrowth based on a recurrence of clinical signs. Thus, only 16 out of 121 cats died as a direct consequence of the surgery or tumor regrowth. Cats that lived for more than one month after surgery had an average survival of over three years (38 months), with some surviving more than four and a half years. Importantly, most of these long-term survivors (45/54) did not die from tumor regrowth; many cats went on to die of age-related causes that were unrelated to the tumor. Although the average age of the cats in this study was 12 years, the survival times still exceeded three years. Thus age does not prohibit recommendation of surgery for treatment of meningiomas in cats.

Swanson strongly recommends consultation with a neurologist for cats with clinical signs that are compatible with a potential meningioma, or for cats with a confirmed meningioma. If surgery is possible, then the clinical outcomes are usually quite good. In the majority of cases, surgical complications are low, the survival times are long, and the quality of life after surgery is high. While surgical removal may represent the most definitive treatment for feline meningioma, remember that with appropriate medical management, you can achieve temporary resolution of clinical signs that allows you and your cat to have excellent quality time together. This can be very comforting to a family suddenly faced with a pet with neurological disease.

For more information on the Animal Medical Center of Seattle and the specialty services, please visit their website at https://animalmedicalspecialists.com/.

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