Cognition & Senses 2: SA Intracranial Dz

Question 1

6 POSSIBLE ETIOLOGIES for MYELITIS/ENCEPHALITIS?

Answer 1

1. VIRAL
2. BACTERIAL
3. FUNGAL
4. PROTOZOAL
5. RICKETTSIAL
6. IMMUNE-MEDIATED

Question 2

DDXs for ENCEPHALITIS in DOGS…

VIRAL? (2)

BACTERIAL? (2)

RICKETTSIAL? (2)

FUNGAL? (1)

PROTOZOAL? (2)

PARASITIC? (1)

IMMUNE-MEDIATED? (1)

Answer 2

VIRAL? (2)
1. CANINE DISTEMPER
2. RABIES

BACTERIAL? (2)
1. ASCENDING EAR INFECTION
2. HEMATOGENOUS

RICKETTSIAL? (2)
1. ROCKY MOUNTAIN SPOTTED FEVER
2. EHRLICHIA

FUNGAL? (1)
1. CRYPTOCOCCUS

PROTOZOAL? (2)
1. TOXOPLASMA
2. NEOSPORA

PARASITIC? (1)
1. CUTEBRA

IMMUNE-MEDIATED? (1)
1. MENINGOENCEPHALITIS of UNKNOWN ETIOLOGY (MUE)

Question 3

DDXs for ENCEPHALITIS in CATS…

VIRAL? (2)

BACTERIAL? (1)

FUNGAL? (1)

PROTOZOAL? (1)

PARASITIC? (1)

Answer 3

VIRAL?
1. FIP
2. RABIES

BACTERIAL?
1. HEMATOGENOUS SPREAD

FUNGAL?
1. CRYPTOCOCCUS

PROTOZOAL?
1. TOXOPLASMA

PARASITIC?
1. CUTEREBRA

Question 4

ENCEPHALITIS/MYELITIS can occur in animals of ANY AGE, but is most common in WHAT AGE?

what else about these animals makes them susceptible?

Answer 4

common in YOUNG-MIDDLE AGED animals

also often IMMUNE-SUPPRESSED

Question 5

CLINICAL SIGNS for ENCEPHALITIS/MYELITIS depends on….

signs of ____ or ____ CNS INVOLVEMENT are COMMON

asymmetrical vs. symmetrical?

PROGRESSION tends to be.. (2)

Answer 5

CLINICAL SIGNS for ENCEPHALITIS/MYELITIS depends on WHAT PART OF THE CNS IS AFFECTED

signs of MULTIFOCAL or DIFFUSE CNS INVOLVEMENT are COMMON

ASYMMETRICAL > SYMMETRICAL

PROGRESSION tends to be…
1. ACUTE
2. INSIDIOUS onset

Question 6

what 6 SA DISEASES do we tend to see with VESTIBULAR SIGNS in ENCEPHALITIS/MYELITIS?

Answer 6

1. ROCKY MOUNTAIN SPOTTED FEVER
2. CRYPTOCOCCUS
3. CANINE DISTEMPER VIRUS
4. ASCENDING BACTERIAL INFECTION from EAR
5. GRANULOMATOUS MENINGOENCEPHALITIS
6. FIP

Question 7

what DOG DZ is commonly seen with MYOCLONUS (quick jerking)?

Answer 7

CANINE DISTEMPER VIRUS

Question 8

BLINDNESS, DEAFNESS & DIARRHEA are commonly seen in WHAT DZ that causes ENCEPHALITIS/MYELITIS?

Answer 8

PROTOTHECA

Question 9

2 additional SYSTEMIC clinical signs associated with EHRLICHIA & ROCKY MOUNTAIN SPOTTED FEVER?

Answer 9

1. RETINAL HEMORRHAGE
2. PETECHIATION

Question 10

if we see PAPILLEDEMA with ENCEPHALITIS/MYELITIS, then we should suspect WHAT DZ in SA?

Answer 10

GRANULOMATOUS MENINGOENCEPHALITIS

Question 11

what DOG DZ should we suspect with HISTORY OF GI & RESPIRATORY DZ & ENCEPHALITIS/MYELITIS?

Answer 11

CANINE DISTEMPER VIRUS

Question 12

3 PREDISPOSED breeds for ENCEPHALITIS/MYELITIS?

Answer 12

1. PUGS
2. YORKIES
3. MALTESE

Question 13

CANINE DISTEMPER VIRUS…

3 descriptors?

distribution? (2)

incidence is HIGHEST in… & why?

transmission? (3)

how LONG does the virus shed?

how long does VIRUS SURVIVE IN ENVIRONMENT?

Answer 13

3 descriptors?
1. ENVELOPED
2. HELICAL
3. ssRNA

distribution?
1. ENZOOTIC
2. WORLDWIDE

incidence is HIGHEST in UNVACCINATED PUPPIES 3-6 MONTHS
–> why? = corresponds to LOSS OF MATERNAL PASSIVE IMMUNITY

transmission?
1. VIRUS shed in ALL BODY SECRETIONS & EXCRETIONS
2. AEROSOL is PRIMARY
3. TRANSPLACENTAL is RARE

virus sheds for 60-90 DAYS

LABILE in environment for 3 HOURS AT ROOM TEMP

Question 14

DISTEMPER will SPREAD TO TONSILS/____ LNs within ___ ___ of INFECTION

at 4-6 DAYS POST-INFECTION, what happens? (5)

at 8-9 DAYS, what happens? (2)

Answer 14

BRONCHIAL, 24 HOURS

at 4-6 days, virus SPREADS to…
1. SPLEEN
2. STOMACH
3. INTESTINES
4. LIVER
5. MESENTERIC LNs

at 8-9 days, virus spreads to..
1. EPITHELIAL TISSUES
2. CNS

Question 15

dogs with NORMAL IMMUNE RESPONSE can CLEAR CANINE DISTEMPER in WHAT TIME?

Answer 15

normal dogs = 9-14 DAYS

Question 16

7 main CLINICAL SIGNS for CANINE DISTEMPER?

Answer 16

1. UPPER RESPIRATORY SIGNS like COUGHING (can go from DRY to PRODUCTIVE)
2. BILATERAL SEROUS or MUCOPURULENT OCULAR DISCHARGE
3. VOMITING
4. D+
5. METAPHYSEAL OSTEOSCLEROSIS
6. PUSTULAR/VESICULAR DERMATITIS
7. NASAL/DIGITAL HYPERKERATOSIS

Question 17

what is the MOST IMPORTANT DETERMINANT of PROGNOSIS & RECOVERY for CANINE DISTEMPER?

Answer 17

presence of NEUROLOGICAL SIGNS

Question 18

6 common NEUROLOGICAL CLINICAL SIGNS of CANINE DISTEMPER

Answer 18

1. SEIZURES
2. CEREBELLAR DZ
3. VESTIBULAR DZ
4. PARESIS
5. SPINAL ATAXIA
6. MYOCLONUS

Question 19

canine distemper OFTEN PRESENTS AS ___ ____ in ___-____ ____-old ____

Answer 19

ACUTE ENCEPHALITIS in 3-6 MONTH-old PUPPIES

Question 20

what is the MOST WIDELY USED DIAGNOSTIC METHOD for CANINE DISTEMPER?

what is the HIGHEST SENSITIVITY DIAGNOSTIC? & include 3 SAMPLE types

Answer 20

MOST WIDELY USED DIAGNOSTIC METHOD for CANINE DISTEMPER? = CLINICAL PRESENTATION

HIGHEST SENSITIVITY DIAGNOSTIC? = RT-PCR with URINE, BLOOD or CSF

Question 21

TREATMENT for DISTEMPER? (4)

how is it BEST PREVENTED?

Answer 21

TREATMENT?
1. BROAD-SPECTRUM ANTIBIOTICS
2. PROCAINAMIDE for MYOCLONUS
3. COUPAGE
4. SUPPORTIVE CARE

PREVENTION via VACCINES

Question 22

FIP is the MOST COMMON CAUSE OF _____ in WHAT AGE cats?

Answer 22

FIP is the MOST COMMON CAUSE OF MENINGOENCEPHALITIS in CATS LESS THAN 3 YEARS

Question 23

BACTERIAL MENINGOENCEPHALITIS..

3 common etiological agents?

5 uncommon etiological agents?

diagnosis via… (3)

treatment? (2)

prognosis?

Answer 23

3 common etiological agents?
1. E. COLI
2. STREPTOCOCCUS
3. KLEBSIELLA

5 uncommon etiological agents?
1. BRUCELLA
2. ACTINOMYCES
3. NOCARDIA
4. BARTONELLA
5. LEPTO

diagnosis via…
1. BLOOD culture
2. URINE culture
3. MYRINGOTOMY

treatment?
1. TIME/FLUIDS
2. ANTIBIOTICS

PROGNOSIS = FAIR

Question 24

FUNGAL MENINGOENCEPHALITIS..

common etiologic agent?

diagnosis? (2)

treatment? (2, which is better?)

prognosis? (2)

Answer 24

common etiologic agent? = CRYPTOCOCCUS

diagnosis?
1. CRYPTOCOCCAL ANTIGEN (serum & CSF)
2. CULTURE of CSF

treatment? (2)
1. FLUCONAZOLE = GOOD CNS PENETRATION
2. ITRACONAZOLE = BAD CNS PENETRATION

prognosis?
1. FAIR for EARLY control
2. POOR for LONG-TERM SURVIVAL

Question 25

TICKBORNE MENINGOENCEPHALITIS

2 diseases?

diagnosis for each?

treatment for both? (3)

prognosis for both?

Answer 25

2 diseases?
1. RICKETTSIA RICKETTSII (ROCKY MOUNTAIN SPOTTED FEVER)
2. EHRLICHIA/ANAPLASMA

diagnosis?
1. R. RICKETTSII = SERUM ANTIBODY TITER
2. EHRLICHIA/ANAPLASMA = SNAP 4DX

treatment?
1. DOXYCYCLINE
2. CHLORAMPHENICOL
3. ENROFLOXACIN

PROGNOSIS = GOOD

Question 26

TOXOPLASMA

this is a ____ CNS DZ

3 clinical signs?

MOST animals have ____

common in ____ PATIENTS

diagnosis? (2, which one confirms RECENT infection?)

Answer 26

PROTOZOAL CNS DZ

3 clinical signs?
1. UVEITIS
2. RESPIRATORY DZ
3. HEPATITIS

MOST animals have ANTIBODIES for too

common in TRANSPLANTATION PATIENTS

diagnosis?
1. SERUM IgG TITERS
2. IgM CONFIRMS RECENT INFECTION

Question 27

NEOSPORA…

this is a ___ CNS DZ

clinical signs? (2)

diagnosis?

treatment? (2)

prognosis?

Answer 27

this is a PROTOZOAL CNS DZ

clinical signs?
1. NEURITIS/MYOSITIS
2. CEREBELLAR SIGNS

diagnosis? = IgG TITERS

treatment?
1. CLINDAMYCIN
2. TMS

prognosis? = FAIR

Question 28

MENINGOENCEPHALITIS of UNKNOWN ETIOLOGY (MUE)

tends to occur in WHAT SEX?

2 predisposed breeds?

what is the GOLD STANDARD IMAGING technique?

Answer 28

tends to occur in FEMALES

2 predisposed breeds?
1. TOYS
2. TERRIERS

GOLD STANDARD IMAGING technique = MRI T2

Question 29

NECROTISING ENCEPHALITIDIES (NME/NLE) is common in WHAT 2 breeds?

Answer 29

1. PUGS
2. YORKIES

Question 30

PROGNOSIS for MENINGOENCEPHALITIS of UNKNOWN ORIGIN (MUE)?

1/3 of patients….

Answer 30

PROGNOSIS for MUE is GUARDED

1/3 of patients = REMISSION
1/3 of patients = RESIDUAL NEURO DEFICITS & LIFELONG MEDS
1/3 patients = DON’T RESPOND TO Tx