4 - Encephalopathies I

Question 1

Cognitive Dysfunction Syndrome

Answer 1

Dog - best animal model for human Alzheimer’s
Accumulation of neurotoxic beta-amyloid protein in the aged canine and feline brain
Other structural abN
–Cerebral atrophy
–Ventricular enlargement
–Blood vessel wall fibrosis
–Amyloid deposition
–Microhemorrhages, infarcts
–Axonal degeneration w/ myelin loss, atroglial hypertrophy and hyperplasia, and intraneuronal accumulation of several substances

Question 2

CDS - what happens

Answer 2

Age-associated decline in brain NT levels of ach, dopamine, NE and GABA
–cholinergic dysfunction appears to have the highest and most consistent correlation w/ age-related cognitive impairment
Also see increased achesterases, increased monoamine oxidase B, elevated CSF levels of lactate, pyruvate, potassium

Question 3

3 Categories of CDS

Answer 3

1. Successful gaining
2. Mild cognitive impairment
3. Severe cognitive impairment (dementia)

Question 4

CDS Drug Therapies

Answer 4

1. Selegilene
2. Phenserine
3. Anti-IFM
4. Complementary Therarpies

Question 5

Tx of CDS: Selegilene

Answer 5

Effect on cognitive dysfunction owner reported
May produce non-specific low-level hyperactivity by increasing brain catecholamine levels so response observed by owners may not truly be representative of improved cognitive ability

Question 6

Tx of CDS: Phenserine

Answer 6

ACHesterase inhibitor

Improve cognitive dysfunction

Question 7

Tx of CDS: gabapentin

Answer 7

Gabanergic drugs can alleviate some of the behavior changes seen w/ CDS

Question 8

Tx CDS: Anti-IFM

Answer 8

Because inflammatory changes identified in the brain

Question 9

Tx of CDS: complimentary therapies

Answer 9

Efficacy entirely anecdotal

Calm P, reduce anxiety, and normalize sleep/wake cycle

Question 10

Tx of CDS: nutritional

Answer 10

Diet fortified w/ antioxidants, mitochondrial cofactors, and essential FA improves cognitive function and delays cognitive decline
–Ex: Hill’s b/d

Question 11

Phosphatidyl serine, SAMe

Answer 11

Beneficial antioxidant properties in the tx of CDS

Other naturally-occuring photochemicals that exhibit anti-amyloidogenic, antioxidative and anti-IFM properties = reseveratrol, curcumin, catechins

Question 12

Categories of CM Tx

Answer 12

1. Analgesic drugs (implies relief of dysesthesia, paresthesia
2. Drugs that decrease CSF production
3. CS Therapy

Question 13

Most useful drug for tx’ing CLM?

Answer 13

Gabapetin! *or pregabalin

Question 14

CLM Tx: Drugs aimed at reducing CSF production

Answer 14

(All anecdotal)
Omeprazole (PPI)
Acetazolamide (CAI)
Furosemide (loop diuretic)

Question 15

CLM Tx: Opioids

Answer 15

Pain - usually combined with other drugs

Question 16

CLM Tx: CS

Answer 16

Anti-IFM
Decreased CSF production
Decreased substance P (nociceptive NT)