EXPRESS: Surgical treatment of feline meningioma: a single institution survival analysis

Case series summary The aim of this study was to evaluate survival time (MST), disease-free interval (DFI), and post-operative complications of surgical resection of feline intracranial meningiomas, providing evidence for prognostic counselling for general practitioners. A retrospective review of medical records (2012–2025) identified 17 cats undergoing craniotomy or craniectomy for histologically confirmed meningiomas. Data included patient characteristics, clinical signs, imaging findings, surgical approach, complications, histopathology, recurrence and survival. MRI or CT imaging was used for diagnosis and post-operative monitoring when available. Survival analysis employed Kaplan-Meier and competing risk models; DFI was based on clinical signs or follow-up imaging. Seventeen cats (median age 11.6 years; 82.4% Domestic Shorthair) underwent surgery. Rostrotentorial approach was most common (65%), with minor intraoperative complications in three cases. Post-operative mortality within 4 weeks after surgery was 17.6% (3/17). Fourteen cats survived to discharge. Median follow-up was 622 days. Estimated median survival time was 1674 days (95% CI: 1395-NE (not estimable)), with one-, two-, three-, and four-year survival rates of 82%, 82%, 82%, and 72%, respectively. Median DFI was 377 days (855 days for cats surviving to discharge). Histopathology predominantly included meningothelial and transitional subtypes. Recurrence was detected on MRI in 3/6 cases undergoing follow-up imaging. Relevance and Novel Information Surgical resection of feline meningiomas is a feasible treatment option with excellent outcomes for cats surviving the immediate post-operative period. The study demonstrates a high median survival time and low recurrence rate among treated cats, with surgery being curative in many cases. These results enable the veterinary general practitioner to more accurately assess the risks and benefits of surgical treatment of feline intra-cranial meningioma and discuss treatment with owners.