Study finds low CSF collection complication rates in cats

A new American Journal of Veterinary Research study suggests CSF collection in cats with neurological complaints may be safer than many clinicians fear, at least in referral practice. In a retrospective review of 120 cats undergoing CSF collection across three referral hospitals, investigators found an 8.3% complication rate and an 89.2% survival-to-discharge rate, with most discharged cats surviving beyond 12 months. The paper was published October 13, 2026, and addresses a procedure that remains diagnostically valuable but clinically sensitive in feline neurology. (vetlit.org)

That question matters because CSF sampling sits at the center of many feline neurology workups, especially when clinicians are trying to distinguish inflammatory, infectious, neoplastic, or other central nervous system disease. At the same time, standard references and feline infectious peritonitis guidance have long warned about risks including hemorrhage, iatrogenic trauma, and brain herniation, particularly with cisternal taps in cats with increased intracranial pressure. (pmc.ncbi.nlm.nih.gov)

The new study, led by Gemma J. Spinoglio, Rachel M. Korman, and Ann L. Thompson, reviewed first-time CSF collection presentations from January 2012 through December 2022 at three referral centers. According to the study summary, 10 of 120 cats experienced complications, including apnea, vital sign deviations such as Cushing's reflex, and suspected iatrogenic spinal cord trauma. Thirteen cats did not survive to discharge, including nine euthanized within 0 to 5 days post-procedure, three that died within 1 to 2 days, and one that failed to recover spontaneous ventilation and was euthanized. (pmc.ncbi.nlm.nih.gov)

The risk-factor analysis is where the paper becomes most useful clinically. Non-survival to discharge was significantly associated on univariate analysis with lower body weight, evidence of herniation, and pleocytosis. A combined endpoint of complication or non-survival to discharge was significantly associated on multivariate analysis with evidence of herniation and a non-isoflurane general anesthesia protocol. The authors also reported that too few cats fell into some outcome categories for full multivariate modeling of every endpoint, an important reminder that the findings are directional rather than definitive. (pmc.ncbi.nlm.nih.gov)

There wasn't much direct outside commentary on this paper at the time of writing, but adjacent literature helps frame the findings. A 2024 study of cats undergoing brain MRI found perianesthetic complications were common in that population, and that intracranial lesions and abnormal mentation increased risk of severe anesthetic events. That doesn't directly measure CSF tap safety, but it does support the broader point that the neurologic patient, not just the procedure, drives risk. Similarly, a 2023 prospective study in dogs found CSF collection complications were uncommon, suggesting the veterinary field may be moving toward a more evidence-based, less anecdote-driven view of tap-related risk. (journals.sagepub.com)

Why it matters: For veterinary professionals, the study offers a practical middle ground. It doesn't argue that CSF collection is benign in every cat, and it doesn't erase the need for advanced imaging review, anesthetic planning, or close recovery monitoring. What it does suggest is that, when cases are selected appropriately, CSF collection can remain a justifiable diagnostic step rather than a last-resort procedure avoided out of disproportionate concern. The strongest caution signal in the data was herniation, which reinforces the importance of imaging-based screening before sampling, especially in cats with suspected intracranial disease. (pmc.ncbi.nlm.nih.gov)

For general practitioners and referral teams, the body-weight and pleocytosis findings may also influence how risk is discussed with pet parents and how post-procedure observation is structured. Smaller cats may warrant extra care in anesthetic dosing, airway planning, and recovery support. Cats with pleocytosis may not be at higher risk because of the tap itself so much as because they may have more severe underlying disease, but the practical takeaway is the same: these are not routine anesthesia patients. That interpretation is an inference from the study's reported associations and the broader anesthesia literature in feline neurologic cases. (pmc.ncbi.nlm.nih.gov)

What to watch: The full paper should help clinicians judge how much these findings depend on referral-hospital case mix, tap location, and anesthesia protocol details, and whether the results lead to changes in pre-tap imaging thresholds or monitoring recommendations in feline neurology services. (vetlit.org)