Exam 1 - Interrelation of Behavioral & Medical Problems Flashcards
T/F: all medical problems will have some effect on animal behavior
true
non-specific anxiety in dogs has been linked to what medical issue?
heart base tumors
why have we seen recent reports of splenic tumors associated with anxiety in companion animals?
anxiety not responsive to fluoxetine
abundance of sequestered immune cells (WBCs) in the spleen relays a message to the brain leading to behavior changes
‘________ ___________’ secondary to allergies in dogs is common
phantom licking
T/F: all behavior problems have some effect on the animal’s biology
true
how does stress in an animal affect its biology?
stress increases cortisol & alters WBC distribution in the body
WBC go to the spleen which sends a message to the brain
circulation of ‘killer cells’ increases
how do drugs alter an animals biology in regards to behavior?
can cause ataxia, seizures, depression, sound/light hypersensitivity, & vomiting
how does depression alter an animals biology in regards to behavior?
look at dexamethasone tests & thyroid levels
what are signs of pain related to behavior in dogs & cats?
difficulty jumping, withdrawn/hiding, absence of grooming, playing less, general activity decrease, general mood, temperament changes, avoiding bright areas, etc
what are some characteristics seen in animals with behavioral problems that suggest a medical etiology?
very young or senior animal
abrupt onset or change in character
pre-existing medical conditions
breed predispositions
inconsistent or unidentifiable triggers
what should be included in the work up of behavioral & medical patients?
signalment, history, physical exam, direct observation of behavior, problem list, differential diagnosis, diagnostic tests, diagnosis, treatment plan, & reevaluating poor treatment responses
what are the presenting signs of an animal with house soiling (urine) problems that interrelate with behavioral/medical issues?
dog or cat that is urinating around the house
what are the general characteristics of a cat with idiopathic cystitis?
hypervigilance/hypersensitivity, stress increases sympathetic activation (increased ACTH & reduced glucocorticoids) which results in pain, increased stress, & increased pain
what are some systemic characteristics of a cat with idiopathic cystitis?
pollakiuria, stranguria, pain, & irritated bladder wall
variable to extensive inappropriate urination that waxes & wanes over time
what is polyuria?
production of abnormally large volumes of dilute urine
what is oliguria?
the production of abnormally small amounts of urine
what is pollakiuria?
increased frequency of urination
what are some medical differentials for a dog or cat that is house soiling (urine)?
urinary calculi
bacterial infection
idiopathic interstitial cystitis in cats
what are some skin & gi signs of idiopathic interstitial cystitis in cats?
skin - barbering of the abdomen because upper motor neurons of the pelvic cavity synapse in same areas as neurons of the abdominal skin
gi - vomiting, diarrhea, & constipation
what are some behavioral differentials for a dog or cat that is house soiling (urine)?
marking behavior, improper house training, poor litter box management, & poor access to acceptable areas
what is the treatment for idiopathic interstitial cystitis in cats?
lower their environmental stress
buprenorphine to control pain
+/- antianxiety medication
what are some medical differentials for a dog or cat that is house soiling (urine)?
bladder irritation - UTI, calculi, idiopathic interstitial cystitis in cats
kidney disease
polydipsia
incontinence
neurologic disease
what is the typical presenting signs of a dog or cat that is house soiling feces?
dog defecating inside the house & cat defecating outside of the litter box
what are some behavioral differentials for a dog or cat that is house soiling (feces)?
improper house training
poor litter box management
separation anxiety
poor access to acceptable areas
painful defecation - especially cats
what are some medical differentials for a dog or cat that is house soiling (feces)?
parasites
IBD/colitis
neoplasia
megacolon
metabolic/endocrine disease
drugs
neurologic disease
what are the presenting medical signs of an animal with a portosystemic shunt?
seizures, poor growth, apparent blindness
what are the presenting behavioral signs of an animal with a portosystemic shunt?
poor learning ability, aggression, stereotypies, & lethargic or hyper behavior
what are some differentials for a portosystemic shunt?
liver disease, distemper, hypoglycemia, toxicities, epilepsy, & hydrocephalus
what dogs are commonly affected by portosystemic shunts?
small breed dogs usually less than 10 lbs
what large breed dogs has hydrocephalus been reported in?
st. bernards, rottweilers, & bull terriers
T/F: presenting signs of hydrocephalus depends on the areas of the brain that are affected
true
what dogs are commonly predisposed to hydrocephalus?
small breed dogs
what are the presenting behavioral signs of an animal with hydrocephalus?
stereotypies including circling
aggression
poor learning ability
hyper behavior
lethargy
what are the presenting medical signs of an animal with hydrocephalus?
seizures!!!!
what are some differentials for hydrocephalus?
congenital hydrocephalus - portosystemic shunt
secondary obstructive hydrocephalus - neoplasia, trauma, inflammatory CNS disease, & other seizure disorders
what are the presenting behavioral signs of an animal with hypothyroidism?
aggression, hyper behavior, lethargy, & senility
what are the presenting medical signs of an animal with hypothyroidism?
bilateral hair loss, non-pruritic alopecia, hyperpigmentation, & poor muscle tone
what are some drugs that may lower thyroid levels causing a misinterpretation of test results? what else may cause a secondarily lower level?
anti-seizure drugs, furosemide, glucocorticoids, & sulfonamides
illness
what are some drugs that may elevate thyroid levels causing a misinterpretation of test results? what else may cause a secondarily higher level?
estrogen & progesterone
normal fluctuations, recovery from an illness, diestrus, & auto-antibodies
what are some differentials for hypothyroidism?
iatrogenic hypothyroidism - post hyperthyroid treatment in cats
misinterpretation of test results
different types of aggression
what are the presenting medical signs of an animal with seizures?
generalized seizures
focal seizures - ‘chewing gum’ fits
what are the presenting behavioral signs of an animal with seizures?
aggression - Dr. Jeckell Mr. Hyde personality
stereotypy including circling
star gazing
air snapping
restlessness
what are some behavioral differentials for seizures? what are some medical differentials for seizures?
behavioral - different types of aggression, stress, & learned behavior
medical - idiopathic, toxicities, hydrocephalus, & portosystemic shunts
what are the presenting signs of an animal with excessive licking?
history of licking an inanimate object excessively
what are some behavioral differentials for excessive licking? what are some medical differentials for excessive licking?
behavioral - spilled food/liquid, stereotypy or OCD, separation anxiety, & stress
medical - gi issues & allergies
what may trigger feline hyperesthesia syndrome?
tactile stimulation
what medical & behavioral signs are seen in self-directed aggression?
medical - focal like seizure activity
behavioral - unexplained running, screaming, tail chasing, aggression, & rippling skin (rolling skin syndrome)
what special studies have been done for feline hyperesthesia syndrome?
spontaneous EMG activity in TL epaxial muscles
vacuoles in biopsied muscles similar to inclusion body myositis/myopathy in humans
how is feline hyperesthesia syndrome treated?
fluoxetine & pain medications
what are the presenting signs of an animal with floating limb syndrome?
attacks are directed towards a hind limb, often mild pre-attack signs, & may or may not be able to disrupt the animal
what are some differentials for floating limb syndrome?
seizures, encephalitis, myositis/myopathy, idiopathic, & associated with self-biting in primates
how is floating limb syndrome treated?
treatments are empirical based on whether they help or not
seizure meds, fluoxetine, & pain meds
what are the presenting signs of an animal with self-biting behavior?
physical damage done to the rear parts of the body
what are some differentials for self-biting behavior?
cauda equina syndrome, dermatitis, neuropathy, seizures, myositis/myopathy, & idiopathic
how is self-biting behavior treated?
wound care - antibiotics +/- pain meds
fluoxetine
gabapentin
what is cognitive dysfunction?
age-related or senior onset behavior changes that are not attributable to another general medical condition
what are the main presenting signs of cognitive dysfunction in companion animals?
disorientation - 49% of dogs & 22% of cats
loss of house training - 27% of affected cats
abnormal sleep/wake cycles - 57% of affected dogs
decreased greetings/responsiveness to family members - 51% of affected dogs
increased vocalizations - 61% of affected cats & most of them do this at night
generalized/separation anxiety
reduced sensory ability - excessive sniffing
what is the relationship to animal age in regards to cognitive dysfunction?
dog age with at least 1 impairment -
11-12 = 28%
14 = 48%
16 = 68%
cats with at least 1 impairment -
7-11 = 36%
12-15 = 60%
16-19 = 88%
what are some neuropathological changes seen in animals with cognitive dysfunction?
increased production of free radicals & decreased clearance
beta amyloid plaques with the amount of oxidative damage correlating with severity of clinical signs
ventricular dilation, reduced cerebral perfusion
what are some neurotransmitter changes seen in animals with cognitive dysfunction?
decrease in ACh which affects motor impulses to skeletal muscle
decreased serotonin - reduces appetite, sleep, memory, & affects mood/social behavior
increase in monoamine oxidase-b levels which decreases dopamine & reduces cognition
where should you start with treatments for a patient with cognitive dysfunction?
rule out & treat medical conditions (ortho problems very common in cats, deafness, vision problems)
rule out & treat behavioral problems with similar presentations
how is environmental enrichment used to treat cognitive dysfunction?
stimulate mental activity
night light, white noise at night, exercise during the day, & schedule physical/social activities
how is dietary management & supplements used to treat cognitive dysfunction?
supplements - melatonin, nutriceuticals, & senilife
dietary - antioxidants (hills b/d, vitamins C, E, B6, beta carotine, selenium, flavonoids, & carotenoids)
medium chain fatty acids - purina bright mind or purina neuro care
what pharmacologic therapies are used to treat cognitive dysfunction?
selegiline - carries significant concern when using with other drugs
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