Presentation
Presents with lethargy, inappetance, and generalized ataxia and weakness for two weeks.
Patient Data
Axial and sagittal images through the brain were obtained in T1 and T2 weighted and FLAIR sequences. The ventricular system is markedly dilated. On FLAIR sequences, the CSF is hyperintense. Extending from the lining of the lateral ventricles, are bilaterally symmetric lobular structures that are isointense to brain on both T1 and T2 sequences and are enlarged choroid plexuses.The ependyma of the ventricular system is thickened and markedly contrast enhancing. The choroid plexuses are also contrast enhancing.
Impressions: Severe ependymitis and hydrocephalus, likely due to infectious inflammatory disease.
Case Discussion
The CSF in the ventricles had a high cell count as well as high protein content. This caused it not to suppress during the FLAIR sequance, giving a clue to the underlying abnormality. The hydrocephalus and enlarged choroid plexus were likely secondary to inflammatory infiltrate and debris impeding drainage. Feline Infectious Peritonitis (FIP) was diagnosed considering the high protein and neutrophilic inflammation in the CSF, as well as chorioretinitis.
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