Dysautonomia is a disease characterised by degeneration of autonomic neurons. Previous retrospective case series have been small, single centre and indicate a grave prognosis. The aim of this study was to perform a retrospective, multicentre review of clinical data relating to dogs and cats diagnosed with dysautonomia and to evaluate the outcome in those patients. Cats and dogs with clinical signs consistent with dysautonomia were included in this retrospective study. A total of 34 cats and 19 dogs were included. Reported clinical signs included oesophageal, gastric and intestinal dysmotility and distension, urinary retention and dysuria, reduced or absent tear production, third eyelid protrusion and inappropriate mydriasis. Vomiting and regurgitation were commonly reported in both species (cats n=29/34, dogs n=17/19), while signs consistent with urinary retention were primarily reported in dogs (n=14/19) and third eyelid protrusion was more frequently reported in cats (n=20/34). Diagnostic imaging findings included aspiration pneumonia, megaoesophagus, gastrointestinal dilation with either fluid or gas and bladder distension. Oesophageal dilation was the most often identified diagnostic imaging finding in cats (n=20/34), while in dogs gastrointestinal distension was most commonly identified (n=5/19). Regularly instituted treatments included gastrointestinal prokinetics such as cisapride and metoclopramide, feeding tube placement (oesophageal and percutaneous endoscopic gastrostomy tubes) and medications to treat urinary retention such as bethanechol. The overall survival to discharge was 36%. The mortality rate prior to discharge was 71% in cats and 53% in dogs. Longer term survival (greater than two years) was seen in three dogs and six cats. In this retrospective study clinical signs, diagnostic imaging findings, treatment and prognosis were all similar to previous retrospective publications. This paper has illustrated that some individuals are able to survive this disease and can have a good long-term prognosis. Prospective studies are required to identify risk factors that indicate whether a patient is likely to survive and thus if it is worth embarking upon treatment.

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