Term
| What is the common name for Cervical Veterbral Stenotic Myelopathy? |
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Definition
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Term
| What are the two general manifestations of cervical vertebral stenotic myelopathy? |
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Definition
-Cervical VErtebral Instability (CVI)
-Cervical Static Stenosis (CSS) |
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Term
| Derscribe the cervical vertebral instability manifestation of wobblers. |
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Definition
-dynamic condition
-intermittent compression
-C3-4, C4-5 |
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Term
| Describe the cervical static stenosis of wobblers. |
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Definition
-static condition
-C5-6, C6-7 |
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Term
| What are the two broad classes of horses affected by wobblers? |
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Definition
-Young,male thoroughbreds
-old: any breed |
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Term
| What are some predisposing factors of wobblers? |
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Definition
-young, rapidly growing
-males
-TB
-high carb diet
-zinc excess
-copper deficiency |
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Term
| What are the CS of Wobblers? |
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Definition
-dysfunction of UMN & GP in all four limbs
-SYMMETRIC
-PL worse |
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Term
| What CP deficits do we see w/ wobblers? |
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Definition
-stumbling
-toe dragging
-circumduction of hind limbs
-truncal sway |
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Term
| What developmental orthopedic dz tend to occur w/ wobblers in young animals? |
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Definition
-OCD
-joint effusion
-physeal enlargement of long bones
-flexural limb deformities |
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Term
| What do we see when wobblers animals are walked in a straight line? |
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Definition
-warying stride lengths
-hypometria: floating of hooves
-dragging of hooves
-outward or inward swaying of limbs in motion
-unsteady movement of trunk and pelvis
-may worsen w/ head elevation |
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Term
| What do wobblers horses do when walking up and down a curb? |
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Definition
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Term
| What do wobblers horses do when walked in tight circles? |
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Definition
-pivot on hind lim
-circumduct outside limb
-scuff hooves
-step on themselves, strike inside of their own limbs |
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Term
| What are is the most sensitive clinical test of UMN & GP function? |
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Definition
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Term
| What does a Wobblers horse do when backing up? On tail pull? |
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Definition
-backing: difficult, drag limbs, can fall backward
-easy to pull in motion |
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Term
| What are some differentials for Wobblers (symmetrical spinal ataxia)? |
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Definition
-EHV-1
-WNV
-EDM
-trauma
-vertebral fracture, abscess |
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Term
| What do we see on rads w/ wobblers? |
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Definition
-subluxation
-physeal enlargement & dorsal projection of the caudal epiphysis
-degen changes of articular processes
-osteochondrotic changes |
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Term
| What direction is the compression w/ Wobblers? |
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Definition
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Term
| Which vertebrae are affected by vertebral malformation w/ vertebral subluxation that occurs during flexion? Extension? |
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Definition
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Term
| How do we definitively diagnose wobblers? |
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Definition
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Term
| What can we see on CSF w/ wobblers? |
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Definition
-typically normal
-can see slight inc in protein, xanthochromia, erythrophagocytosis |
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Term
| How do we surgically fix Wobblers? |
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Definition
-basket: stabilize, decompress
-dorsal laminectomy
-rehab = 6-12m |
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Term
| What is the prognosis of Wobblers? |
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Definition
-fair w/ some surgical techniques
-guarded to poor w/ dietary restriction
-poor w/ no tx |
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Term
| How do we work to prevent Wobblers? |
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Definition
-most important is avoiding rapid growth
-avoid over-feeding |
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Term
| Describe Equine Degenerative Myeloencephalopathy. |
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Definition
-noncompressive
-diffuse, symmetric
-degenerative dz |
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Term
| Describe the clinical characteristics of Equine Degenerative Myeloencephalopathy. |
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Definition
-ataxia
-weakness
-spasticity |
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Term
| Describe the signalment of Equine Degenerative Myeloencephalopathy. |
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Definition
-YOUNG, both sexes <6m
-Arabians, TB, Paso Finos, Appaloosas, Standardbreds
-MORE COMMON IN NE USA
-Vit E deficiency plays a role |
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Term
| What are the clinical signs of Equine Degenerative Myeloencephalopathy? |
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Definition
-dysmetric gait, stab around w/ limbs
-hind limb interference, drag toes
-resist backing, can fall and dog sit
-abnormal postural placement
-circumduct & pivot when circled
-NO CN INVOLVEMENT, M ATROPHY, SKIN SENSATION CHANGES, TAIL TONE ABNORMALITY
-potential hyporeflexia of neck & trunk |
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Term
| What are some risk factors that lead to Equine Degenerative Myeloencephalopathy? |
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Definition
-use of insecticides
-exposure to wood preservatives
-FREQUENT TIME IN A DIRT LOT
-dam w/ previous foal diagnosed w/ EDM |
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Term
| What is a protective factor that lead to Equine Degenerative Myeloencephalopathy? |
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Definition
| -time spent on green pastures |
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Term
| How do we definitively diagnose Equine Degenerative Myeloencephalopathy? |
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Definition
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Term
| What are some major differentials of Equine Degenerative Myeloencephalopathy? |
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Definition
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Term
| How do we treat/prevent Equine Degenerative Myeloencephalopathy? |
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Definition
-oral vit E supplementation
-IM vit E tx
-monitor serum vitamin E concentrations
-exposure to fresh, green forage
-prophylactic vit E supplementation |
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Term
| What is the prognosis of Equine Degenerative Myeloencephalopathy? |
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Definition
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Term
| What is the typical history of Equine Protozoal Myeloencephalitis? |
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Definition
| -only one horse is affected |
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Term
| What is the typical signalment of Equine Protozoal Myeloencephalitis? |
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Definition
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Term
| What is the major concern w/ diagnosis EPM? |
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Definition
| -way, way over-diagnosed dz |
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Term
| What are the CS seen w/ EPM? |
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Definition
-highly variable b/c organism can affect many different areas of CNS
-may observe muscle atrophy: most common in quadriceps & gluteals
-CS: asymmteric ataxia, gait can mimic Sweeney, brainstem involvement |
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Term
| What do we find on neuro exam w/ EPM? |
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Definition
-frequent complaint of obscure lmeness that progresses to ataxia, spasticity, incoordination
-worse when head is elevated or when waking on incline
-findings can be focal or extensive: seizures, blindness, head shaking, severe vestibular signs |
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Term
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Definition
-SAG 2/3/4 w/ CSF index or IFAT
-CSF & blood |
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Term
| What are the major differentials for EOM? |
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Definition
-CVSM
-SNV
-EHV
-trauma
-EEE,WEE
-EDM
-verminous myeloencephalitis
-rabies |
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Term
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Definition
-TMS + pyrimethamine: blocks foalte met in protozoan
-Diclazuril
-Ponazuril
-Decoquinate/Levamisole
-Anti-inflamm meds: Flunixin meglumine
-supportive care: padded helmets, slings, deeply bedded, supportive fluids & nutrition if needed |
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Term
| What is our caution w/ using TMS + Pyrimethamine to treat EPM? |
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Definition
| -block folate metabolism for sperm & in pregnant mares |
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Term
| What is the prognosis of TMS + Pyrimethamine? |
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Definition
-60-75% improve 1 grade
-<25% return to normal activity |
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Term
| How do we work to prevent EPM? |
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Definition
-vx
-prevent wildlife access to feed
-keep premises clear of dead cats, armadillos, skunks, racoons
-dec exposure of horses to opossums |
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Term
| Describe Equine Herpes Myeloencephlopathy. |
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Definition
-diffuse, multifocal CNS lesions
-vasculitis, hemorrhage, thrombosis, ischemic neuronal injury |
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Term
| What virus is most commonly associated w/ Equine Herpes Myeloencephalopathy? |
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Definition
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Term
| What are the typical clinical features of Equine Herpes Myeloencephalopathy? |
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Definition
-ataxia
-paresis
-urinary incontinence
-recent hx of fever, resp dz, or abortion on farm |
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Term
| Which vx is best for Equine Herpes Myeloencephalopathy? |
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Definition
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Term
| Describe the epidemiology of Equine Herpes Myeloencephalopathy. |
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Definition
-majority of horses have been exposed
-most horses infected via resp route in first yr of life
-majority of horses remain latently infected for life |
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Term
| What is the incubation period of Equine Herpes Myeloencephalopathy? |
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Definition
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Term
| Describe natural infection w/ Equine Herpes Myeloencephalopathy. |
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Definition
-inhalation or ingestion of aerosolized virus
-direct contact w/ abortion fluids/tissues, nasal or ocular discharge or salive of infected horses
-EHV1 can remain infective in the environemnet for up to 14d and on horse hair for 35-42d |
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Term
| Describe the seasonality of Equine Herpes Myeloencephalopathy. |
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Definition
| -late winter, spring, early summer |
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Term
| When during pregnancy must a mare be infected w/ Equine Herpes Myeloencephalopathy for the neuro form to occur? Abortive form? |
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Definition
-neuro form: infected during first two trimesters
-abortive form: infected during last trimester |
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Term
| When do neuro signs develop in relation to Equine Herpes Myeloencephalopathy? |
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Definition
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Term
| Neuro signs may be preceded (2w) or accompanied by what other signs w/ EHM? |
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Definition
-upper resp signs
-fever
-inappetance
-hind limb edema |
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Term
| What neuro signs occur w/ Equine Herpes Myeloencephalopathy? |
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Definition
+/- fever
-acute onset of neuro signs
-predominant spinal white matter: ataxia, paresis of limbs, hypotonia of tail & anus, urinary incontinence
-typically symmetric but can be asymmetric
-hind limbs affected earlier and more severely |
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Term
| What CP deficits occur w/ mild Equine Herpes Myeloencephalopathy cases? |
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Definition
-reluctance to move
-clunsiness
-toe dragging
-knuckling
-stumbling
-pivoting
-circumduction on circling |
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Term
| What deficits occur w/ severe cases of Equine Herpes Myeloencephalopathy? |
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Definition
-profound limb weakness
-swaying of hind quarters
-paralysis of affected limbs
-dog sitting
-complete recumbency
-tetraplegia: urinary incontinence |
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Term
| Why are Equine Herpes Myeloencephalopathy cases difficult for euthanasia? |
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Definition
| -horses typically remain alert and appetant |
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Term
| What are your differentials for Equine Herpes Myeloencephalopathy? |
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Definition
-WNV, EEE, WEE
-CVSM
-EPM
-trauma
-rabies
-verminous myeloencephalitis
-botulism |
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Term
| How do we diagnose Equine Herpes Myeloencephalopathy? |
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Definition
-CSF: xanthochromia, inc protein, WBC=WNL
-virus isolation: may be negative
-PCR
-serologic titers |
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Term
| How do we treat Equine Herpes Myeloencephalopathy? |
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Definition
-prompt isolation
-supportive nursing and nutritional care
-reduce CNS inflammation |
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Term
| What kind of supportive care do we use for Equine Herpes Myeloencephalopathy? |
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Definition
-protection from self-inflicted trauma
-make food and water easly accessible
-recumbent patients
-maintain hydration
-laxative diet to avoid impactions
-appropriate caloric intake
-urinary bladder catheterization
-anti-inflamms
-ANTI-VIRAL MEDS: Valacyclovir, Gancyclovir |
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Term
| What is the prognosis of Equine Herpes Myeloencephalopathy? |
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Definition
-good if they remain standing
-poor if they become recumbent |
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Term
| What control measures do we use for Equine Herpes Myeloencephalopathy? |
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Definition
-minimize contact: aerosol, direct contact, fomites
-minimize stress
-isolate suspect animals immediately
-isolate exposed animals for 30d, pregnant mares until they foal
-fetuses and membranes bagged and disposed of for necropsy
-clean infected stalls
-clean fomites
-vx of unexposed animals
-new farm arrivals isolated
-minimize stress
-broodmare separate from rest of farm population |
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