Term
| Describe the typical history of Fibrocartilagenous Embolic Ischemic Myelopathy (FCE)? |
|
Definition
-large to giant breeds mainly
-peracute onset: mins to hrs
-no history of trauma
-not progressive |
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Term
|
Definition
-type I disc herniation
-trauma
-gunshot wound
-other vascular dz |
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Term
| What differentials do we run to diagnose FCE? |
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Definition
-rads: rule out trauma
-myelogram: rule out a compressive lesion
-dx is made by ruling out other causes of cord damage |
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Term
| What is the prognosis of FCE? |
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Definition
-hemiparetic and monoparetic dogs have a better chance for recovery than paraparetic or tetraparetic dogs
=LMN damage worse than UMN
-loss of deep pain = worse
-improvement should be seen w/in 2-3w if recovery is going to occur
-nursing care is problematic |
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Term
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Definition
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Term
| How do we initially eval trauma to the spinal cord? |
|
Definition
-spinal reflexes
-voluntary movement
-anal sphincter
-tail function
-pain perception |
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Term
| How do we medically manage trauma to the spinal cord? |
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Definition
-avoid further damage to cord, give rigid support
-steroids: caution beginning steroids 8h post injury |
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Term
| What is the prognosis of spinal cord trauma? |
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Definition
-LMN damage worse prognosis
-retention of voluntary movement is positive sign
-loss of deep pain perception is vry poorsign
-rad findings do not always equate w/ severity |
|
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Term
| Which dog breeds are most commonly affected by cervical vertebral instability (wobbler dz)? |
|
Definition
-Doberman pinschers
-infrequently in the GReat Dane too |
|
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Term
| What is the basic defect behind Wobblers? |
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Definition
-malformation of the cervical vertebrae resulting in a narrowed canal in the Great Dane and instability of the vertebrae in the Doberman
-this results in changes in the ligamentum flavum, dorsal longitudinal ligament, and dorsal annulus |
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Term
| Which animals are most commonly affected by atlanto-axial disorders? |
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Definition
-toy breeds
-onset of signs usually prior to 18m |
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Term
| What are the common complaints from owners about atlanto-axial disorders? |
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Definition
-animal cries out in pain w/out being touched
-reluctant to look up
-cries when petted on the head
-holds neck rigidly
-episodes of motor weakness |
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Term
| What are the clinical findings of atlanto-axial disorders? |
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Definition
-animal holds neck rigidly
-reluctance to move head
-neck mm may be tense
-animal resists neck flexion: BE CAREFUL
-pain may be intense
-can see all degrees of weakness |
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Term
| How do we diagnose atlanto-axial disorders? |
|
Definition
|
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Term
| How do we treat atlanto-axial disorders? |
|
Definition
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Term
| What are some examples of brainstem diseases that cause tetraparesis? |
|
Definition
-GME
=FIP
-neoplasia
-distemper
-mycotic dz
-toxoplasmosis
-neuroaxonal dystrophy |
|
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Term
| Once it has been established that brain dz exists which tests are used? |
|
Definition
-CSF w/ titers
-imaging: MRI, CAT scan
-skull rads |
|
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Term
| What is granulomatous meningoencephalitis (GME)? |
|
Definition
| -proliferation of elements of the RE system occurs w/in the CNSn due to inflammation |
|
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Term
| What is the typical signalment of GME? |
|
Definition
-small breed problem
-middle-aged animal |
|
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Term
| What neuro findings do we see w/ GME? |
|
Definition
-central vestibular signs very common
-motor deficits
-seizures
-mentation changes |
|
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Term
| Why is there a variety of signs due to BME? |
|
Definition
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Term
| What diagnostics do we see w/ GME? |
|
Definition
-CSF analysis
-MRI
-brain biopsy
-necropsy |
|
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Term
| What do we see on CSF analysis w/ GME? |
|
Definition
-inc protein
-inc WBCs
-lymphocytes, macrophages |
|
|
Term
|
Definition
-Glucocorticoids
-therapy is required for duration of life
-Leflunomide, cyclosporine, cytosine arabinoside, probarbazine |
|
|
Term
| What is the prognosis of GME? |
|
Definition
| -poor for long term but they will survive for a few months |
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Term
| What are some examples of generalized muscle dz? |
|
Definition
-lab retriever myopathy
-golden retriever myopathy
-polymyositis
-hypokalemic polymyopathy in cats
-tetanus |
|
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Term
| What diagnostics do we run for generalized muscle dz? |
|
Definition
-serum muscle enzymes
-serum electrolytes
-EMG: electromyogram
-muscle biopsy |
|
|
Term
| What is the typical histry + signalment of lab retriever myopathy? |
|
Definition
-black and yellow labs, not chocolate
-signs begin w/ 3-5m of age
-pup as difficulty holding head up
-progresses to severe exercise intolerance
-cold, excitement aggravae problem |
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Term
| What are our clinical findings of lab retirever myopathy? |
|
Definition
-stiff, stilted gait
-tires on exercise w/in 5 min
-no muscle pain
-poor patellar tendon reflexes |
|
|
Term
| How do we diagnose lab retriever myopathy? |
|
Definition
-hx, breed, exam
-muscle biopsy: type 2 fiber deficiency
-DNA test: autosomal recessive |
|
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Term
| What is the prognosis for lab retriever myopathy? |
|
Definition
| -good for life, bad for Strenuous activity |
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|
Term
| What is the etiology behind tetanus? |
|
Definition
| -exotoxin of C. tetani introduced bia deep puncture wounds/surgical wounds |
|
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Term
| Is the dog or horse more resistant to tetanus? |
|
Definition
| -dog is approx 300X more resistant than horse |
|
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Term
| What is the typical history of a dog w/ tetanus? |
|
Definition
-signs usually 5-8 d after intro of organism
-owner complains dog has stiff gait (funny look to eyes)
-some think that head is swollen due to abnormal ear carriage |
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Term
| What are the typical clinical signs of tetanus? |
|
Definition
-generalized muscle hyperexcitability
-pathognomonic facial expression: eyes asian, ears standing up, lips pulled back
-protrustion of 3rd eyelid
-FOCAL TETANUS TO MUSCLE GROUPS
-opisthotonus in severe cases
-diarrhea |
|
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Term
| How do you treat tetanus? |
|
Definition
-Antitoxin
-Abx: penicillin, metronidazole, Clindamycin
-sedation, quiet, dark environment
-excise any apparent necrotic tissue |
|
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Term
| What is the prognosis of tetanus? |
|
Definition
-mild signs don't usually progress
-if dog is still alive after 5 d, usually recover
-opisthotonus is a grave sign |
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Term
| In which way are coondog and tick paralysis similar? |
|
Definition
| -both disorders cause a generalized LMN problem: beneralized weakness may progress to paralysis w/ poor-absent tendon reflexes in all four lims |
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Term
| How do we differentiate coondog and tick paralysis? |
|
Definition
-hx
-response to tx
-recovery time |
|
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Term
| Describe coondog paralysis. |
|
Definition
-disorder causes an inflammatory response in ventral roots of entire spinal cord
-allergic rxn to raccoon saliva Ag |
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Term
| What is the typical hx of coondog paralysis? |
|
Definition
-access to raccoon 7-14d prior to signs
-initial signs = rear limb weakness
-w/in 48h TL affected
-may be nonambulatory
-at worse 7-10 d
-change in pitch of bark |
|
|
Term
| What are the clinical signs of coondog paralysis? |
|
Definition
-alert adn a febrile
-all degrees of weakness: symmetric in all 4 limbs
-hypo to a reflexia
-hypotonia
-painful when tension put on spine or abdomen
-severe m atrophy in 10-14d |
|
|
Term
| How do you differentiate m dz and generalized LMN dz? |
|
Definition
| -reflexes remain intact w/ muscle dz |
|
|
Term
| How do we treat coondog paralysis? |
|
Definition
-good nusring care!!
-keep warm
-turn animal 4-6 times a day
-help them eat and drink
-prevent decubital ulcers
-bladder function is fine
-TAKE WEEKS TO RECOVER (tick paralysis is better w/in 24h) |
|
|
Term
| What is the prognosis of coondog paralysis? |
|
Definition
-95% recovery rate
-no evidence of immunity |
|
|
Term
| What causes tick paralysis? |
|
Definition
-toxic releasd from an engorged female tick that inh ACh synth
-spp: Ixodes + Dermacentor |
|
|
Term
| What is the hx of tick paralysisi? |
|
Definition
-signs begin 5-7 after tick attachment
-very acute onset of posterior weakness to front limbs that progresses w/ 24-48h |
|
|
Term
| What are the clinical findings of tick paralysis? |
|
Definition
-symetric posterior weakness to tetraparesis
-tenden refles are hypo to areflexia
-pain perception remains intact BUT NO PAIN ON TENSION OF ABDOMEN
-find tick? |
|
|
Term
| How do we treat tick paralysis? |
|
Definition
-direct removal of tick
-insectiside, acaricide |
|
|
Term
| What is the prognosis of tick paralysis? |
|
Definition
-excellent, almost all should recover
-w/in 24-48h: should be close to normal
-more severe form in Australia |
|
|
Term
| What is myasthenia gravis? |
|
Definition
| -autoimmune dz against ACh rc |
|
|
Term
| What is the typical hx of myasthenia gravis? |
|
Definition
-exercise intolerance
-cannot swallow
-regurgitation
-excessive salivation
-coughing secondary to pneumonia
-Breed predisposition: Goldens GSD, G shorthair pointer |
|
|
Term
| What are the clinical findings of myasthenia gravis? |
|
Definition
-may be normal in exam room
-varying degrees of weakness
-exercise intolerance
-excessive salivation
-coughing/resp crackles
-tendon reflexes normal |
|
|
Term
| How do we diagnose myasthenia gravis? |
|
Definition
-Tensilon test: edrophonium chloride
-serum ACh rc AB test
-chest rads: megaesophagus +/- asp pneumonia
-tendon reflexes normal |
|
|
Term
| How do we treat myasthenia gravis? |
|
Definition
-ACh inh: mestinon syrup or sustained release mestinon tablets
-glucocorticoids
-immunosuppressive agents: Cyclosporine, mycophenolate |
|
|
Term
| What is the prognosis of myasthenia gravis? |
|
Definition
-guarded for long term
-megaesophagus & pneumonia = worse |
|
|
Term
| What is the typical history/signalment of steroid responsive meningitis? |
|
Definition
-large breed problem
-acute onset of neck pain
-reluctance to walk
-poor appetite
-usually young dog
-reluctant to look up |
|
|
Term
| What diagnostics do we use for steroid responsive meningitis? |
|
Definition
-CSF analysis
-neutrophilic cytolosy
-CSF culture neg |
|
|
Term
| What are the clinical signs of steroid responsive meningitis? |
|
Definition
-fever
-cervical rigidity
-vertebral column pain |
|
|
Term
| HOw do we treat steroid responsive meningitis? |
|
Definition
-signs not responsive to Abx
-Pred for 6-10w |
|
|
Term
| What is the prognosis for steroid responsive meningitis? |
|
Definition
-usually excellent response in 24-48h
-prognosis excellent |
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