CAL: Forebrain Dz

Question 1

Ddx for a R forebrain predominant (+- L) and brainstem lesion, acute onset progressive, asymmetrical and non-painful ni a 9yo MN DSH?

Answer 1

> infectious (focal so abscess/granuloma)
- fungal granuloma/meningioma?
- FIP dry?
Neoplasia (can presnt as acute onset d/t blockage of CSF/vasculature)
- meningioma/lymphoma, glioma (astrocytoma or oligodendroglioma)
- choroid plexus tumour
- ependymomas
- pituitary tumours
vascular maybe (usually peracute onset)
- feline ischameic encephalopathy
- haemorrhage 2* to coagulopathy
inflam maybe
- immune mediated encephalitides (eosinophilic/polioencaphalomyelitis)
nutritional maybe
- thiamine deficiency (brainstem vestibualr signs mostly)
trauma maybe (but progessive deterioration usually hours w/ trauma rather than days)

Question 2

What effects can a SOL in the brain have?

Answer 2

> mass effect

• midline shift
• 2* meningioencaphalitis
• ^ ICP -> caudal transtentorial and caudal cerebellar herniation

Question 3

Tx of brain abscess 2* to bite injury in cats. What type of infection are these commonly?

Answer 3

> commonly polymicrobial, aerobic bacteria
Tx
- BS abx while await C+S with good penetration (amoxicillin, clindamycin, ampicillin, 3rd gen cephalosporins, TMPS, enrofloxacin, metronidazole)
- GCs (usually CI with infection but need to v brain inflammation greater than evidence against using them!)
- mannitol (v ICP and oedema, limit oxidative injury)
- SURGERY within 3d referral (rostral tentorial craniectomy to remove septic focus eg. tooth fragment)

Question 4

Top 3 ddx in a young dog, acute onset episodic tonic clonic seizures.

Answer 4

• idiopathic
• 2* to infection
• 2* to hepatic disease

Question 5

Top 3 Dddx for an older dog, seizurs first onset @9yo, postural signs and some cranial n. signs lacking inter-ictally, acute onset progressive

Answer 5

• Neoplasia 1/2

- INfection/inflam

Question 6

DO animals circle away or owards a forebrain lesion?

Answer 6

TOWARDS