Aim of the study was to establish reference values for total protein (TP), albumin-quotient (AQ) and IgG index in cerebrospinal fluid (CSF) in the cat. Furthermore, diagnostic value of these parameters for detection of subclinical inflammation of the central nervous system (CNS) or dysfunction of the blood brain barrier (BBB) was to be evaluated for the cat.
Corresponding CSF and serum samples of 72 cats were evaluated. In detail, 37 neurologically healthy cats (group I, reference group), 23 cats with neurological diseases (group II), including eight cats with intracranial neoplasia (group II a) and 15 cats with CNS manifestation of FIP (group II b) and 12 cats with an exclusively extraneural FIP infection were included in the study. Classification into separate groups was based on results of histopathologic examination of the CNS in each cat.
All measurements were done with the Behring Nephelometer 100. TP in CSF was determined after precipitation with trichloroacetic acid; albumin and IgG were measured in CSF and serum (S) by immunonephelometriy using species specific anti-albumin and anti-IgG antibodies. Human CSF-protein, standard cat albumin and standard cat IgG served as controls. Albumin quotient (AQ) and IgG index were calculated utilizing the following formulas:
AQ = CSF-albumin / S-albumin; IgG index = (CSF-IgG/S-IgG) / (CSF-albumin/S-albumin). The AQ was used as an indicator for the integrity of the BBB; the IgG index described the intrathecally produced IgG fraction.
For the reference group (group I) total protein in CSF was 0,06 - 0,36 g/l (0,15 ± 0,1), albumin quotient was 0,0006 - 0,0057 (0,0024 ± 0,0012), and IgG index was 0,3 - 0,6 (0,43 ± 0,16), respectively.
In cats with extra neural FIP (group III) there was no difference in TP, AQ and IgG index compared with the reference group (group I). All measurements were within the reference range.
In cats with intracranial neoplasia (group II a) most animals with abnormal CSF protein profile exhibited intrathekal IgG synthesis (n = 5; 62.5 %) and two of these showed a concurrent disturbance of the BBB. An exclusive disturbance of the BBB was only detected in two cats (25 %). In two other cats (25 %) the CSF protein profile was unremarkable.
In cats with CNS manifestation of FIP (group II b) 33.3 % (n = 5) demonstrated an increased IgG index, two of these patients also revealed a concurrent disturbance of the BBB. Within this group two cats (13.3 %) had an isolated disruption of the BBB. The protein profile was normal in eight (53.3 %) of the cats.
In 21.7 % of all cats with neurological diseases an abnormal protein profile could only be detected by measurement of AQ or IgG index. This equals 29.4 % of the neurologically diseased cats with a normal CSF total protein.
In cats with neurological disease, which do not show abnormalities in routine CSF examination, the measurement of the AQ and the IgG index provides a reasonable diagnostic feature. However, the theory postulated in human medicine that tumours are mainly characterised by a change of BBB, and that inflammation is characterised by intrathecal IgG production could not be proven for the cat considering the results of this study.
In cats with extra neural FIP AQ and IgG index helped to confirm that no subclinical involvement of the CNS was present in the disease process.