Term
| What is the purpose of the neuro exam? |
|
Definition
| -to localize w/in the CNS |
|
|
Term
| What diagnostics follow the neuro exam? |
|
Definition
-plain spinal films: look for osseus changes
-CSF analysis
-Myelogram
-MRI, CAT scan
-surgery based upon imaging |
|
|
Term
| Are cats that are presented for acute onset of paraparesis/ plegia more likely to have cardiac dz or CNS dz? |
|
Definition
-cardiac
-dogs with the same presentation are more likely to have CNS dz |
|
|
Term
| What is the typical history of degenerative myelopathy? |
|
Definition
-very slow insidious onset
-rear limb problem only
-back legs don't follow the front
-not a painful problem
-seen primarily in the older dog
-no improvement seen in course of dz |
|
|
Term
| Which dog breeds have an increased risk of degenerative myelopathy? |
|
Definition
-German Shepherd***
-Standard poodle
-Retrievers
-Rhodesian ridgeback
-Boxers
-Retrievers
-Pembroke/Cardigan corgis |
|
|
Term
| What do we see on neuroexam of degen myelopathy? |
|
Definition
-starts with mild ataxia in read limbs
-UMN paraparesis
-hyperreflexia of rear limb reflexes
-crouched posture
-deep pain always present
-limbs often crossed
-front limbs are fine
-if femoral reflex is present, then ahead of L4 |
|
|
Term
| How do we treat degen myelopathy? |
|
Definition
-none specific
-Vitamin E
-aminocaproic acid
-supportive care
-glucocorticoids
-exercise: swimming
-N-acetylcystine |
|
|
Term
| What is the prognosis of degen myelopathy? |
|
Definition
-pretty much hopeless
-most dogs are nonambulatory in 12-18m |
|
|
Term
| What are some common causes of the lumbosacral syndrome in practice? |
|
Definition
-lumbar vertebral fractures in L5-L7
-fibrocartilagenous emboli
-degen disc dz
-discospondylitis
-cord neoplasia
-vertebral neoplasia
-congenital vertebral malformations, myelodysplasias |
|
|
Term
| What are some common causes of thoracolumbar syndrome in practice? |
|
Definition
-Degen myelopathy
-distemper myelitis
-myelomalacia |
|
|
Term
| What are the six major locations which can cause tetraparesis/ataxia of all four limbs? |
|
Definition
-multifocal/diffuse spinal cord dz
-focal cervical spinal cord
-Brainstem dz
-diffuse peripheral nerve dz (polyneuropathy)
0generalized muscle dz
-diffuse neuromuscular junction dz |
|
|
Term
| When tetraparesis is unaccompanied by signs of dz above the foramen magnus then what are our options? |
|
Definition
-focal cervical cord lesion
-diffuse cord dz
-diffuse muscle or nerve dz
-neuromuscular dz |
|
|
Term
| Assuming a focal spinal lesion, where is it with tetraparesis w/ LMN signs? |
|
Definition
|
|
Term
| Assuming a focal spinal lesion, where is it with tetraparesis w/ sympathetic signs? |
|
Definition
|
|
Term
| What are the common etiologies of multifocal/diffuse cord dz? |
|
Definition
-canine distemper
-toxo
-FIP in cats
-systemic mycoses
-GME: inflammatory dz |
|
|
Term
| What diagnostics do we run to diagnose multifocal/diffuse cord dz? |
|
Definition
-CSF +/- culture
-CSF titers
-serum titers
-FAtesting |
|
|
Term
| What are the possibilities of focal cervical spinal cord dz? |
|
Definition
-disc dz
-discospondylitis
-neoplasia
-fibrocartilagenous infarct
-vertebral malformations
-trauma
-wobblers
-A-A luxations
-GME |
|
|
Term
| Which of the possibilities of focal cervical spinal cord dz will show on spinal rads? |
|
Definition
-disc dz
-discospondulitis
-malformations
-trauma
-wobblers
-A-A luxations |
|
|
Term
| Which of the possibilities of focal cervical spinal cord dz will show on CSF analysis? |
|
Definition
-GME
-neoplasia
-infectious/inflamm |
|
|
Term
| Which of the possibilities of focal cervical spinal cord dz will show on myelogram/MRI/CT? |
|
Definition
-disc dz
-neoplasia
-wobblers
-other compressive lesions |
|
|
Term
| What is discospondylitis? |
|
Definition
-a discrete infection of the disc and the adjacent vertebral end-plates
-most commonly the result of a bacterial infection: Staph aureas> B. canis> MIscell |
|
|
Term
| What are the clinical signs of discospondylitis? |
|
Definition
-large breed + male
-painful at disc site
-pyrexia uncommonly
-poor appetitie, et loss
-crouched posture
-persistent erection if lumbosacral dz
-cautious to sit
-if behind L7: anus, bladder, etc will be screwy |
|
|
Term
| How do we diagnose discospondylitis? |
|
Definition
-rads: lysis of adjacent vertebral end-plates
-B. canis screening
-surgery: bone biopsy/culture
-special imaging |
|
|
Term
| What meds do we use to treat discospondylitis? |
|
Definition
-can choose an antibiotic based on cultures
-but can also use: Enrofloxacin, TMP-S, Clavamox, Cephalosporins
-tx lasts for at least 30d, but should do for 60-90d |
|
|
Term
| What is the prognosis for discospondylitis? |
|
Definition
-with aggressive antibiotic therapy we should be good for about 65-70%
-B. canis positive dogs must use Enrofloxacin or Doxy
-can be a recurrent problem in dogs |
|
|
