1: Feline Neuro Flashcards by Madison Cogle

What portions of the neuro exam are considered unreliable in cats?

Cutaneous trunci reflex
Menace response

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Treatment for Audiogenic Reflex Seizures:

Avoiding trigger sounds eliminate seizures in 75% of patients
Keppra (Levetiracetam) is the drug of choice

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Which form of feline epilepsy is typically refractory to standard antiepileptic therapy?

Hippocampal Necrosis

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Diagnosis of feline hyperesthesia syndrome?

Diagnosis of exclusion
Apparent hallucinations +/- self mutilation with no abnormal diagnostic measures. Young cats

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What is the treatment of choice for feline hyperesthesia syndrome?

Gabapentin (works in ~2/3 patients)

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What are the treatment options for feline hyperesthesia syndrome?

Behavior modifying drugs: Gabapentin, clomipramine, amitriptyline
ASD: Phenobarbital
Pain Management: Pred/Meloxicam (usually last line of therapy)

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How does idiopathic epilepsy present in cats?

Often during resting conditions
Running fits
Status uncommon
Normal interictal

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What ASDs should you literally never give a cat according to Shinn?

DIAZEPAM and also potassium bromide is bad too

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What is the main determinant of prognosis in cats with idiopathic epilepsy?

Age; 12% increase risk of death with each year of age

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What percent of cats with idiopathic epilepsy go into remission?

40%
Can happen even without AEDs

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What percent of cats with idiopathic epilepsy respond to AEDs?

70%

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What signalment is common with audiogenic reflex seizures?

Birmans overrepresented
OLD cats- 10-19yrs; 15yo ave

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What are the current treatment options for hippocampal necrosis in cats?

AEDs- phenobarbital preferred
Prednisolone as last resort (immune suppression)

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Diagnosis of hippocampal necrosis in cats?

Clinically + Brain MRI
+/- voltage gated potassium channel-complex antibodies

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Pathophysiology of FIP:

virus replicates within macrophages resulting in immune-mediated vasculitis

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What is the most common cause of CNS disease in cats?

FIP

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What ocular signs are consistent with FIP/neurologic FIP?

Anterior chamber hemorrhage
Iris vasculitis

What are the treatment options for FIP?

Antiviral adenosine nucleoside analogue GS-441524 (legal)
Remdesivir (Kevin’s drug of choice)

What neurologic processes may be present with toxoplasmosis infection?

Encephalitis, granulomas, segmental myelitis

What signs might you see with toxoplasmosis related granulomas and encephalitis?

Seizures, vestibular signs, cerebellar signs, obtunded

What signs might you see with toxoplasmosis related segmental myelitis?

Proprioceptive ataxia, weakness, incontinence

When is CNS disease most common with toxoplasmosis?

Following reactivation of latent bradyzoites within the brain/spinal cord or skeletal muscles.
Often a sequela of some type of immunosuppression

How does neurologic toxoplasmosis present?

Often as neurologic and ocular signs in the absence of systemic signs

Treatment for toxoplasmosis:

Clindamycin
TMS & Folic acid

Where is cryptococcus typically found?

soil and pigeon feces

Clinical signs of cryptococcus?

Lethargy Behavioral changes gait abnormalities vestibular signs seizures

What are the diagnostic methods for cryptococcus?

Serology, CSF, Fungal culture (Gold standard but if you wait for results the cat will be dead)

Treatment options for Cryptococcus?

Fluconazole Prednisolone Combo tx: amphotericin B & flucytosine (remember its amphoTERRIBLE for the kidneys)

What situations cause Panleuk to cause cerebellar hypoplasia?

In utero infection Perinatal infection or vaccination of queen with live vax.

Your client wants to euthanize their kitten with cerebellar hypoplasia what do you say?

No its literally fine they adapt so well because they are babies and it will just have a cute little quirk <3

What do you see with feline ischemic encephalopathy

Typically acute blindess Good PLR (central blindness) Also depression, circling

What causes feline ischemic encephalopathy?

Cuterebra spp. migration

Characteristics of Feline Ischemic Encephalopathy:

Acute onset of signs Most common in July-September (Aug most)

Treatment of Feline Ischemic Encephalopathy:

Ivermectin Prednisolone once Premed with diphenhydramine

What is global cerebral ischemia?

When cat's mouth is open too wide and the maxillary artery is compressed and wakes up from dental dead (not dead, but about to be. Blind, obtunded, seizing)

What are the most common causes of cervical ventriflexion in cats?

Hypokalemia/ammonium chloride tox Thiamine deficiency Myasthenia gravis Hyperthyroidism Hepatic encephalopathy

What are ways that cats can end up with a thiamine deficiency?

Not on a commercial diet Consumption of raw fish that contains thiaminase Cooked foods in which thiamin have been destroyed Meats preserved with sulphite

Clinical signs of thiamine deficiency:

vestibular signs, vision loss, mydriasis without PLR, ataxia, seizures

Myasthenia gravis prognosis indicator in cats:

Is there a mediastinal mass

Meningioma in cats:

Most common brain tumor and primary brain tumor prognosis- BAD. might get 3-4 years if surgery but literally MST 18days if no sx

Most common neoplasia of the spinal cord in cats?

Lymphosarcoma

Presentation of feline neuro lymphosarc

Anything, lymphoma does what lymphoma wants Often multicentric. look for lesions elsewhere