Exam 2 Flashcards
1
Q
Reflex where we Pinch the Web of the Patients Toe to see if a Superficial Pain Senstation is Created
A
Flexor Withdrawal
*If No Senstation- The lesion could be in the Peripheral Nerve, the Spinal Cord or Brain. Loss of Sensation does not help to Localize the Lesion
*If we Pinch the Toe, and there is No Sensation (Dog doesn’t Look) and No Withdrawal Reflex, that Indicates there is a Peripheral Nerve Problem
*If we Pinch the Toe and get a Normal Reflex Withdrawal, however the Dog isn’t Feeling anything (No Sensation)- Sensory Nerve Cranial to L3 is Damaged, leaving the Reflex Arc Intact
2
Q
True/False: There are No Drugs that will Kill Heartworm from the Age of 30 Days up until 120 Days of Age
A
True
*Susceptibility Gap- Difilaria Immitis between 30-120 Days of Age
*We put patients on Prophylaxis for about 3 months (90days) followed by Malarsomine for Adulticide Therapy. This will make sure that even Heartworm in the Suseptibility Gap will be killed by the end of Treatment
2
Q
Space Occupying Lesion in the Brain that leads to Decrease CSF Outflow and a Buildup of Intracranial Pressure
A
Brain Herniation
*Volatile Anesthetics and CSF Taps may Precipitate Hernation
3
Q
Treatment for Acute Canine Polyradiculoneuritis
A
Supportive Therapy- Physiotherapy, Massages, Turning the Patient
*Spontaneous Recovery- Weeks/Months
*Steroids DO NOT help these patients because the Inflammatory Phase if very short
4
Q
Heart Worm occurs in Animals older than ____ Months of Age, and is more Common in Male, Middle Aged, Large Breed Canines
A
> 6 Months
*Dirofilaria Life Cycle is 6 Months- If dog is Bitten by Mosquito and Infected on the day it was born, we won’t see clinical Signs until 6 Months of Age when the Adults are Developed. Heartworm Cannot be Transferred from Mother to Baby In Utero
4
Q
Treatment for Lumbosacral Malarticulation-Malformation
A
Dorsal Laminectomy + Stabilization (80% Success)
*Cage Rest Helps to Subside Symptoms but as soon as the Patient Exercises Again the Clinical SIgns will Return
4
Q
4 General Causes for Tetraparesis/Tetraplegia
A
5
Q
Tumors that Easily Metastasize to the Vertebrae and Spinal Cord and make up 50% of Vertebral and Spinal Neoplasias in Dogs
A
Osteosarcoma/Chonsdrosarcoma
6
Q
True/False: Melarsomine is the Treatment of Choice for Heartworms in Felines
A
False
*Melarsomine is only 36% Effective in Felines- Melarsomine is not used for Heartworm Treatment in Felines
*Heartworms are an Untreatable Disease in Cats!- No Treatment, send Owner home with Prophylaxis so the Cat does not get more Heartworms
8
Q
Large Numbers of Heartworms within the Pulmonary Artery can Back up into the Right Ventricle leading to _____ Malfunction and Acute Onset of Heart Failure and Cardiogenic Shock, known as Caval Syndrome
A
Tricuspid Valve
8
Q
Upper Motor Neuron Signs in the Hind Limb means the Lesion is Cranial to _____, while Lower Motor Neuron Signs in the Hind Limb means the Lesion in Caudal to ___
A
L3
9
Q
Treatment for Post-Caval Syndrome
A
Jugular Venotomy- Remove Worms
*Followed by Chemotherapy
10
Q
Stretching of Nerve Roots Results in Lameness from _____
A
Hyperpathia
*Hyperpathia- Excessive Response to Pain
11
Q
Condition caused by a Toxin that Grows in Anaerobic Wounds that is Characterized Stiff Front and Hind Legs (Saw Horse Stance) and Sardonic Facial Expression
A
Tetanus
*Tetanus gets inocculated into a wound and grows in the wounds and produces the tetanus toxin which goes into the spinal cord and knocks out Upper Motor Neurons, therefore the Lower motor Neurons take over and we get Stiff Legs in these Animals
11
Q
In all Patients with Seizures, a Neurological Exam is Essential. Abnormal Findings on the Neurological Exam are Diagnostic for _____ Seizures
A
Type 2 Symptomatic Seizures/Epilepsy
12
Q
Treatment for Felines with Heartworm
A
(No Treatment!!!)
Prophylaxis- Prevent Future Infection
Supportive/Symptomatic Therapy- Prednisone as Needed- Treats Inflammation
*If Feline has Severe Respiratory Signs as a Result of a Dead Worm- Furosemide for Pulmonary Edema, Oxygen, and Dex/Pred IV for Inflammation
12
Q
True/False: Myelograms are the Best Way to Diagnose Fibrocartilagenous Emboli
A
False
*CT or MRI is Best- Myelograms are Typically Normal in these Patients
12
Q
If a Patient has Lower Motor Neuron Signs in the Right Front Limb and Upper Motor Neuron Signs in the Right Hind Limb, where is the Lesion?
A
C8-T2
*On the Right Hand Side
12
Q
Common Problem in Cats that is Related to Chronic Renal Failure and Hyperthryoidism that leads to Muscle Weakness (Myopathy)
A
Hypokalemia
*Treatment- Supplementation with Oral Potassium
12
Q
True/False: We Treat Seizures if:
Seizures are Occuring Less than Every 6-8 Weeks
Clusters/Prolonged/Status Epilepticus
Untreatable CNS Disease
Owner Insists
A
True
*Untreatable CNS Disease- Ex. Brain Tumor. You can’t Remove the Tumor, but you can Treat for the Seizures to Help the Patient
13
Q
True/False: Only 30% of Dogs get appropriate Prophylaxis (Heart Worm Preventative)
A
True
*Most common Prophylactic used as Heartworm Prevention- Ivermectin (Macrocyclic Lactone)
13
Q
____ Disk Disease Occurs Between C1-T2 and Commonly Causes Tetraparesis/Tetraplegia
A
Cervical
*Question He May Ask on Exam- Compare Signs of Cervial Lesions to Thoracolumbar Lesions:
Cervical Disk Disease- Tetraparesis (64%)- Not as Many Patients Develop Motor Deficiencies but Patients have Extereme Neck Pain
Thoracolumbar Disk Disease- Paraparesis (90%)- More Associated with Motor Deficiencies
13
Q
Treatment for Cervical Spondylomyelopathy
A
Medical Therapy (Cage Rest, Turning, Physiotherapy)- 40% Get Better, 30% stay the Same, 20% Get Worse
Surgery (Slanted Slot)- 80% Get Better, However 30-40% Recurrence Rate. Recovery takes 3-4 Months
*Best to give Cage Rest a Chance, unless the Dog has Severe Tetraparesis/Tetraplegia
13
Q
Cranial Trauma that Results in Focal Hemorrhage and Edema and can cause:
More Confusion and Ataxia
Conscious Proprioception Deficits
Unconscious for Longer Period of Time
A
Contusion
14
**Nerve Root Tumors** that are Commonly found in the _Brachial Plexus_ that can cause Monoparesis/Monoplagia
**Malignant Peripheral Nerve Sheath Tumors** (MPNST)
\*80% Are Found in the _Brachial Plexus_- Grow from the Peripheral Nerve and Towards the Spinal Cord
15
_Connection between the Sensory Nerves and the Motor Nerves_ take place at Spinal Segments \_\_\_\_\_\_
**C6-T2**
**\***A Lesion in the Spinal Cord in this area will Damage this Connection and Give _Lower Motor Neuron Signs_ to the Front Limb
16
Clincal Signs of ______ Include:
Neck Pain (90%)
Tetraparesis (64%)
Acute Onset (45%)
**Cervical Disc Disease**
**\***Most Predominant Clinical Sign- Neck Pain
\*Most Cases will be _Acute (Type I)-_ Dog was Fine and All of a Sudden the Disk Erupted and Now Patient has Neck Pain
\*Tetraparesis in 64%- 1/3rd of Patients will Only have Neck Pain with no Motor Abnormalities
17
A Lesion between Spinal Nerves _____ will Result in _Normal Front Limbs and **Paraparesis** of the Hind Limbs_
**T2-L3**
_\*Paraparesis- Decreased Motor Fuction in the Hind Limbs_
_Paraplegia- No Motor Function (Paralysis) in the Hind Limbs_
18
Treatment for **Masticatory Muscle Myositis**
**Predisolone**
19
Treatment for Patients with _Grade 1, 2, and 3_ **Intervertebral Disk Disease**
**Cage Rest (2 Week Minimum)**
**Prednisolone (Pain)**
Sometimes Diazepam (Muscle Relaxation)
_**\***80-100% Will Recover with Cage Rest_
_\*_Prednisolone works very well in these Patients- However use Small Doses Infrequently to Reduce the Risk of Side Effects- PU/PD and GI Bleeding
19
Autoimmune Disease of _Large Breed Dogs_ that causes an **Inflammatory Myopathy with Necrosis and Phagocytosis of Muscle Fibers** that Leads to Acute or Chronic _Weakness, Stiff Gait, Rapid Fatigue and Atrophy_
**Canine Idiopathic Polymyositis**
_\*Treamtent- Immuno Suppressive Dose of Prednisolone_
\*Photo- Necrosis and Phagocytosis of Muscle Fibers (Autoimmune)
20
**Myopathy** that is Common in Racing Greyhounds, Post Exercise where there isn't enough Oxygen Perfusion to Muscles and Muscles begin to Break down and Release Myoglobin _leading to Renal Failure_
**Exertional Myopathy**
\*Myoglobin Blocks up the Kidneys- _Most Die from Renal Failure_
21
Two **Primary Tumors** found in the _Brain_
**Gliomas** (20%)- Tumor of Glial Cells
**Meningiomas** (45%)- Most common Primary Brain Neoplasia in the Dog and the Cat
\*Secondary (Metastases) Brain Neoplasia- Mainly _Hemangiosarcomas- Very common Metastases to the Brain_
22
True/False: There is No Single Test to Diagnose Heart Worm in **Felines** and Diagnosis is Based on **Composite of Signs**
**True**
**\***_Antibody Tests_ are more useful in Felines for Diagnosis of Heartworm, however result in 30-40% False Positive Results
\*_Antigen Test-_ Good chance with 2-4 Adult Worms that there will not be Females Present leading to False Negatives 20% of the Time
22
Review of Motor Signs
**\*Will be Exam Question from This**
_\*Lower Motor Neuron Signs- Areflexia, Severe Muscle Atrophy, Decreased/Absent Muscle Tone, Paralysis/Paresis_
_Upper Motor Neuron Signs- Hyperreflexia (Exagerated Reflexes), Paralysis/Paresis, Normal/Increased Muscle Tone_
_\*_Upper Motor Neuron comes from the Brain and connects to the Lower Motor Neuron. _Upper Motor Neurons "Calm Down" Primitive Reflexes, therefore if we loose the Upper Motor Neuron = Hyperreflexia_
23
**Reflex** that Tests:
_All Limb Joints (Hock, Knee, Hip)_
_Strength_
_Sensation_
**Flexor Withdrawal Reflex**
\*Tested in Both the Front and Hind Limb
\*When the Toe is Pinched, all Joints should Flex
\*_Weak Strength = Myopathy_
24
\_\_\_\_\_ Examination Includes:
Observation of Mental Status/Gait/Posture
Palpation of Muscular and Skeletal System
Evaluate Postural Reactions
Evaluate Cranial Nerves
Evaluate Spinal Nerves (C6-T2, L3-S3)
Evaluate Sensation
**Neurological**
**\***Testing _Cranial Nerves will tell us if there is a Brain Lesion_
24
Patients with a Droopy Ear, Eye and Lip have a Lesion on what **Cranial Nerve?**
**Facial Nerve**
25
Which **Cranial Nerve** has a Lesion in this Patient?
**Trigeminal**
**\***Severe Muscle Atrophy with loss of Motor Supply to Muscles
_\*Trigeminal Nerve Supplies Jaw Tone- Lack of Jaw tone (Mouth Open) Means there is Damage to the Trigeminal Nerve_
25
Clinical Signs of _____ Disease:
_**Head Tilt** Towards the Affected Side_
_**Circling/Falling** Towards the Affected Side_
_**Nystagmus** Towards the Affected Side_
**Vestibular**
**\***Infections in the ear affect the Vestibular System
25
\_\_\_\_\_ **Vestibular** Disease is the _Most Common_ and Occurs due to Infections within the Ear. _____ **Vestibular** Disease occurs due to a Lesion in the Brain Stem leading to Other Cranial Nerve Abnormalities and Conscious Proprioception Deficits (Tetraparesis)
**Peripheral**
**Central**
\*Central- If the Lesion is in the Brainstem, _Other Cranial Nerves will be Affected_ as well (Ex. Facial or Trigeminal). Motor Neurons travel through the Brainstem so with a Central Lesion they will also have _Tetra or Hemiparesis- Conscious Proprioception Deficits_
_\*Nystagmus Going Horizontally Indicates an Ear Problem- Peripheral_
_\*Vertical Nystagmus Indicates a Lesion in the Brain Stem- Central_
26
Most of the Pathology in **Seizuring Felines** is Related to _____ Disease, such as _Neoplasia_
**Intracranial Pathology**
_**\***Most common Seizures seen in General Practice for Dogs and Cats- **Reactive Seizures in response to Toxicities- KNOW THIS**_
27
True/False: Patients with **Intervertebral Disk Disease** that are On Prednisolone should ALWAYS be Cage Rested
**True**
**\***Prednisolone will take away the Patients Pain. If the Patients is Not cage Rested they will be Running Around pain free and will make the Disk Prolapse worse
\*_Prednisolone without Cage Rest is Always Contraindicated!!_
28
Clinical Signs associated with **Cranial Trauma** in the \_\_\_\_\_\_
**Brain Stem**
29
True/False: Aspirin is Recommended as a good Post Adulticide Treatment for Heartworm
**False**
**\***Aspirin is NOT Recommeneded and may actually make the Patients worse
29
Reflex that we Test by _Pinching the Patient with Forceps along its Back_ and Look for the Skin to Twitch that gives a Rough Approximation of Lesion Location
**Panniculus Reflex**
**\***The Further Caudal we Pinch on the Patients Back, the Less Effective the Panniculus Reflex is- Spinal Cord Shortens and we cannot Localize the Lesion as well
30
Most commonly used Laboratory test to Diagnose Heart Worm that Detects a Specific _Glycoprotein_ that is Produced by Female Heart Worms
**Antigen Test**
\*AKA- Snap Test
\*Most Sensitive Test that exists currently- 90% Sensitivity
30
_Old Dog Disease_ that is Common in Terriers and Larger Breed Dogs that can be seen in One or Both Hind Limbs Especially when Standing, Sitting, or Lying but _Disappears with Movement_
**Old Dog Hind Limb Tremors**
**\***Older Dogs that are weak on their hind limbs- Treatment Not Needed
30
Treatment for **Caudal Occipital Malformation Syndrome** in King Charles Caveliers
**Foramen Magnum Decompression**
**\***70% Successful and 20-40% Recurrence
31
A Lesion between **L3-S3** Spinal Nerves will Result in ____ Motor Neuron Signs to the Hind Limbs
**Lower**
31
Treatment of **Myasthenia Gravis**
**Pyridostigmine +/-** Prednisolone
\*Supportive Therapy- _Gastrostomy- Placing a Feeding Tube to Prevent Aspiration Pneumonia in Patients with Megaesophagus_
\*After 6 Months of Treatment 90% of Patients got Better
32
Patients with ______ Abnormalities commonly Present with:
_Behavoiral Changes_
_Forgotten Owners_
_Aimless Pacing_
_Head Pressing_
**Cerebral Cortical (Brain)**
**\*AKA Thalamocortex**
32
Condition that Occurs after a Dog has been _Biten by a Racoon_ that causes **Inflammation and Demyelination of the Ventral Nerve Roots** that leads to _LMN Flaccid Paralysis and Tetraplegia_
**Acute Canine Polyradiculoneuritis**
**\***Three Differentials for a Dog that comes in with Flaccid Paralysis:
_Acute Canine Polyradiculoneuritis, Tick Paralysis, and Botulsim_
34
Drug that is used to Kill Adult Heartworm _over 120 Days_ of Age
**Melarsomine**
35
What **Nerve** is Injured in this Cat?
**Radial Nerve**
35
Tools for Diagnosing **Myasthenia Gravis**
**Tensilon Test** - Only Picks up 25% of Cases
## Footnote
**AchR Antibody Test**
36
Condition seen in **Scottish Terriers** where they _Stiffen with Excercise/Excitment_ that is caused by a Serotonin Deficiency
**Scotty Cramp**
37
Which Nerves Operate the:
1. Knee Joint
2. Hock Joint
3. Hip Joint
**1. Sciatic Nerve- Knee Joint**
**2. Sciatic Nerve- Hock Joint**
**3. Femoral Nerve- Hip Joint**
**\***If you Pinch the Patients Toe and he Just flexes his Hip and leaves his Hock Extended, it Indicates a Sciatic Nerve Problem- All Joints should Flex when the Toe is Pinched
38
Treatment for Patients with Grade 5 **Intervertebral Disk Disease**
**Surgery (Success rate only 50%)**
**Intensive Nursing and Physiotherapy (Months)**
\*No Deep Pain = Bad Prognosis
39
The _Menace Reflex_ tests What **Two Cranial Nerves**?
**Optic**
**Facial**
_**\***Optic (Sensory) Nerve Travels to the Brainstem and Stimulates the Facial (Motor) Nerve back to the Eye causing a Blink_
40
Prophylaxis, such as _Macrocyclic Lactones_, will Kill Dirofilaria Immitis in the L4 stage up to ____ Days of Age
**30**
**\***The _Macrocyclic Lactones_ will Kill any Dirofilaria Immitis (L1, L2, L3 and L4) up until L4 Stage and 30 Days of Age. Beyond L4 and 30 Days of age, the Effectivness of Macrocyclic Lactones Decreases
\*We put patients on _Prophylaxis for about 3 months (90days) followed by Malarsomine_ for Adulticide Therapy. This will make sure that even Heartworm in the Suseptibility Gap will be killed by the end of Treatment
40
Clinical Signs of **Brain Neoplasia** in the \_\_\_\_\_:
_Behavioral Changes- Head Pressing_
_Seizures_
_Circling Towards Effected Side_
_Locomotion Problems (Paresis) on the Opposite Side of Tumo_r
_Abnormal/Absent Menace Reflex_
**Cortex**
**\***_Cerebal Cortex lesions lead to Crossover- Ex. Cerebral Neoplasia on the Right Side will cause Locomotion problems on the Patients Left Side_
_\*What Cranial Nerves will Have a Problem if the Cerebral Cortex is involved? Menace Reflex (Facial Nerve) does not Work_
41
**Ivermectin** (Macrocyclic Lactone) Kills all the L3 and L4 Difilaria Immitis up to ____ of Age
**1 Month** (30 Days)
\*A Single Dose of Ivermectin will Kill all Microfilaria up to 1 Month of Age. Once the Difilaria are over 1 month of age, Chronic Administration of Ivermectin Monthly (Over a Year) will "Reachback" and kill around 98% of the Microfilaria (Reachback/Safety Net Effect)
42
Contradindication for **Potassium Bromide** Therapy
**Renal Insufficiency**
**\***Potassium Bromide is excreted by the Kidneys- Contraindicated in patients with Renal Disease
43
End-Plate Condition Caused by a _Toxin_ that **Blocks Acetylcholine Release** leading to Tetraparalysis and Hyporeflexia in the Cranial Nerves
**Botulism**
**\***Patients will Slowely Improve over 2-3 Weeks of Intenstive Care- Turn them a Couple Times a Day with Physiotherapy
_\*Botulism Grows in a Carcas that an Animal Eats- Ex. Hunting Dogs catching Duck Carcasses with Botulin Toxin_
44
Syndrome that is Common in **3-6 Year Old King Charles Caveliers** that is a Malformation of the Caudal Occipital Bone leading to Crowding in Caudal Fossa where the Patients _Scratch at the Neck, Show Vestibular Signs, Spinal Hyperesthesia, and Concious Proprioception Deficits_
**Caudal Occipital Malformation Syndrome (COMS)**
**(aka Chiari 1 Malformation Syndrome)**
\*Occipital Bone doesn't form properly at the back of the head and the Cerrebulum prolapses out through the Foramen Magnum that Affects the Flow of the CSF
44
Spinal Cord Compression due to **Dorsal Displacement of the Axis**
**Atlanto-Axial Subluxation**
**\***Toy Breed Dogs- Dens doesn't Develop, C1 and C2 are not attached well and Pinch the Spinal Cord causing Damage and Pain
\*Fracture of the Dens- C1 Moves Independent of C2 and the Spinal Cord gets crushed
44
\_\_\_\_\_ Vestibular Disease is Caused by **Otitis Media-Interna**
**Peripheral**
_**\***Treatment of Peripheral Vestibular Disease- Antibiotics and Keep the Ear Clean_
45
Condition seen in Cats where the Cerebellum does not Develop Properly due to **In-Utero Infections of Panleukopenia Virus,** where the Cats develop _Broad Based Stance, Head Bobbing, and Truncal Ataxia (Swaying)_
**Cerebellar Hypoplasia**
**\***The Cat is Infected in Utero and the Panleukopenia Virus can get into the Fetus and prevents the Cerebellum from developing properly
_\*If Cerebellar Hypoplasia is seen in Dogs it is caused by Parvovirus_ (Rare)
47
Drug used as a **Heartworm Adulticide** that is Administered as Either:
2 Intramuscular Injections at 24 Hours
or
_1 Intramuscular Injection now, then 2 a Month Later_
**Melarsomine**
**\***Normal Canine_/No Clinical or Radiographic Signs- Give 2 IM Injections at 24 Hours (Rapid Kill)_
\*_Canine with Severe Clinical Signs- Give 1 IM Injection now and a Month Later give 2 More Injections (Slow Kill)_
\* The Second (Slow Kill) Method is now Recommended for all Dogs by the AVMA
49
True/False: Antibody Assays and Microfilaria Tests are used for Diagnosis of **Heartworm**
**False**
**\***_Antigen_ Assays and Microfilaria Tests are used for Diagnosis of Heartworm
_\*We take Radiographs to look for Lung Severity and Ultrasound to check for Heart Severity_
49
Placing our Finger in the back of the Patients Throat Causing a **Gag Reflex**, Tests which **Two Cranial Nerves**?
**Glossopharyngeal**
**Vagus**
50
Clinical Signs associated with **Cranial Trauma** in the _____ of the Brain
**Cortex**
**\***Contralateral Locomotion Problems
52
Reflex that Tests the **Pudendal Nerve (S1,2)**
**Perineal Reflex**
**\***Stimulate around the Anus and should see it contract and the Tail Twitch Downwards
_\*Spinal Cord is shorter in Dogs. Ex. S3 Nerve Portion of the Spinal Cord, will sit around the L6 Area_
_\*_Perineal Reflex is good for Spotting _Lower Motor Neuron Signs_
_If the Pudendal Nerve is Damaged, the Animal will be Incontinent_
53
Signs of ______ Include:
_Monoparesis/Monoplagia_
_Muscle Atrophy_
_Hyperpathia with Limb Palpation/Manipulation_
**Malignant Peripheral Nerve Sheath Tumors**
\*Hyperpathia- Excessive Pain Response
54
Syndrome seen in Young Purebreed Cats characterized by **Intermittent Twitching along the Back**, Excessive Grooming, Running and Aggression
**Feline Hyperesthesia Syndrome**
**\***Can be caused by Allergies, Spinal Cord Lesions, Seizure Activity, and _Inclusion Body Myopathy_
55
Treatment for **Status Epilepticus** in a Patient that is _Currently Seizuring_
**Diazepam-** Suppress Seizures
Followed by **Phenobarbital**- **Slow IV Loading Dose**
56
Patients with Grade 4 **Intervertebral Disk Disease** will have ___ Motor Neuron Bladders
**Upper**
\*Grade 1-3 Disk Disease Patients are Continent
Grade 4 and 5 Disk Disease Patients are Incontinent
_\*Express the Bladder every 4-6 Hours and Administer Prazosin_
_\*20% of Dogs with Grade 4 will get Urinary Tract Infections_
57
\_\_\_\_\_ Deafness is the **Most Commonly seen in Canines** characterized by Large amounts of Wax, Bacteria and Pus within the Ear Canal
**Conductive**
\*Mainly seen in _Canines with Floppy Ears_
_\*Treatment- Clean Ears/Antibiotics_
58
A _Brachial Plexus Avulsion_ that Damages the Region of **T1** Ventral Nerve Roots can block Sympathetic Innervation of the Eye Leading to Horners Syndrome, where the Pupil is ____ than Normal
**Smaller (Miosis)**
**\***Horners Syndrome- Pupil is _Smaller_ than it should be because Parasympathetic Innervation is taking over since the Sympathetic Innervation is Blocked
\*_Horners Syndrome_- _Small Pupil, Prolapsing Third Eyelid, Enopthalmus (Sunken Eye), and Drooping Eyelid_
59
\_\_\_\_\_ Vertebrae Are Common in Patients with **Lumbosacral Malarticulation Malformation**
**Transitional**
**\***_Transitional Vertebrae are a Predisposing Factor to Lumbosacral Malarticulation-Malformation_
60
Condition Common in Large/Giant Breed Dogs and Miniature Schnauzers that is:
_Non-Progressive_
_Not Associated with Trauma_
_Causes Tetraparesis/Tetraplegia_
_Lower Motor Neuron Signs- Forelimbs_
_Upper Motor Neuron Signs- Hindlimbs_
**Fibrocartilaginous Emboli**
\*Fibrocartilaginous Emboli in the **Brachial Plexus leads to Tetraparesis**- _Lower Motor Neuron Signs in Front Limbs and Upper Motor Neuron Signs in Hind Limbs_
\*Fibrocartilaginous Emboli in the _Pelvic Plexus leads to LMN Signs in the Hind Limbs- Paraparesis/Paraplegia_
_\*Not Associated with Trauma- 60% Occur Post/During EXERCISE_
60
The _____ **Fine Tunes Motor Activity** and Maintains Equilibrium
**Cerebellum**
**\***Smooth Fluid Motions
61
Treatment for **Shaker Dog Disease**
**Prednisolone**
62
True/False: **Malignant Peripheral Nerve Sheath Tumors** are Best Diagnosed by Myelograms, CT, and MRI
**True**
**\***Photo- _Myelogram_- Contrast is Injected into the Subarachnoid Space that will Outline the Tumor- "Golf Tee" Sign (Arrows are Pointint at Golf Tee Sign)
64
How is Heartworm, Dirofilaria Immitis, Transmitted?
**Mosquitos**
**\***Keep Dogs away from Mosquitoes!
65
Congenital Condition Common in **6-18 Month Old Toy/Mini Breeds** that Leads to Neck Pain and Tetraplegia (Respiratory Paralysis)
**Atlanto-Axial Subluxation**
65
Treatment for **Altanto-Axial Subluxation** in Toy/Mini Breed Dogs
**Hemilaminectomy + Wiring/Screwing**
**\***30% Failure Rate- Hard to do these Surgeries on Small Breed Dogs
66
True/False: _Peripheral Nerve Injuries_ Result in **Decreased Reflexes** and **Hyp/Anesthesia**
**True**
**\***Decreased Reflexes/Tone- Lower Motor Neuron Signs
_Hyp/anesthesia- Decreased or Complete Lack of Sensation_
67
Degeneration of Axons and Myelin in the _Thoracolumbar Spinal Cord_ Leading to **Paraparesis/Paraplegia** that is Very common in German Shepards
**Degeneration Myelopathy**
**\***Very Common in _German Shepards-_ Genetic
68
Main Clinical Signs associated with **Myopathies**
**Weakness**
\*Myopathy- Disease of Muscle Tissue
\*Patients with Myopathies May or May Not have Pain and Elevated CPK. If there is No Pain and CPK is Not Elevated you can't rule out Myopathy
69
A Lesion between Spinal Nerves \_\_\_\_\_, will Result in _Tetraparesis/Tetraplagia_, where **All Four Limbs** will be Affected
**C6-T2**
**\***_Paresis- Decreased Voluntary Motor Activity_
_Plegia- No Voluntary Motor Activity_
70
Condition in _King Charles Caveliers_ characterized by **Hypertonicity with Exercise**
**Episodic Falling**
_**\***Treatment- Clonazepam_
70
In _Felines_ with **Inflammtory Brain Disease**, Half of them will have \_\_\_\_\_
**FIP**
_**\***Underlying Cause for 50% of Cats with Ecephalopathy_
**_\*FIP- Very important cause of Multifocal Neurological Signs in Cats_**
\*If you see Cats under 2 Years of Age with CNS signs always have FIP high on the Differential List
71
Treatment for **Cranial Trauma**
**Treat Shock First:** **Hetastarch Fluids-** Increase Cerebral Perfusion and Decrease Intracranial Pressure
**Once Patient is Stable-** _Elevate Body on a Slanted Board (30 Degrees) to Facilitate CSF Ouflow from the Skull_
**Mannitol (Once Stable)**- Increases Brain Perfusion/Decrease Brain Edema and Intracranial Pressure
**Diazepam** _-Treats Seizures_
\*Want to Prevent Hypercapnia (Increased PaCO2) and Hypoxia- Increase Intracranial Pressure
72
Reflex that will be Abnormal in Patients with **Myopathies**
**Flexor Withdrawal Reflex**
**\***The Flexor Withdrawal Reflex will be Weakend in Patients with Myopathies
73
Cluster of Seizures where the Dog **DOES NOT regain full consciousness** before Digressing into another Seizure
**Status Epilepticus**
74
Cranial Trauma that results in **No Morphological Lesion** and causes:
_Transient Unconsciousness_
_Confusion/Ataxia for a Few Days_
**Concussion**
75
Animals with **Lumbosacral Malarticulation-Malformation** show ____ Motor Neuron Signs in the Hind Limbs
**Lower**
**\***_Hyporeflexia_ of the Crianial Tibial Reflex
77
True/False: **Felines** are _Incidental Hosts_ to Heartworm with a Low Prevalence. Only 10% of L3 Microfilaria become Adults in Felines (2-4 Adult Worms in Felines)
**True**
\*_Heartworms don't like living in Cats_
78
Type of **Disk Disease/Prolapse** that is Associated with Disks that Undergo _Hyaline Degeneration_ (Chondrodystrophic Breeds) where the Calcified Disk Explosively Extrudes through the Annulus Fibrosis and leads to _Spinal Cord Compression and Tearing of Dorsal Longitudinal Ligaments_
**Hansen Type I**
\*By the Time a Dauchshund gets to be 3 years of age, almost all of them have Calcified Disks (Hyaline Cartilage can Calcify)
\*Hansen Type I Disc Disease can lead to _Dorsal Longitudinal Ligament Tears **(Painful)** and Spinal Cord Compression_
_\*Hansen Type I- More Common in Small Breeds (Dauchshunds)_
80
Only Two Possible Lesions that will Create Conditions in **One Limb**
**Peripheral Nerve Lesion (On Any Limb)**
**Unilateral Spinal Lesion between L3-S3**
80
Treatment for **Hydrocephalus**
**Shunts**
_**\***Plastic Tube that travels from the CSF to the Abdomen- Excess Fluid that forms in the CSF will drain into the Abdomen, which will release the pressure in the brain_
81
Inflammatory Condition that occurs in Middle Aged Small Breed Dogs that Presents as **Disseminated or Focal Neurological Disease** characterized by _Progressive Seizures_ and Other Multifocal Problems throughout the Brain (Facial Nerve Paralysis, Vestibular Signs, Sore Neck)
**Granulomatous Meningoencephalomyelitis (GME)**
**\***Disseminated Form- Rapidly Progressive and Fatal
_\*Diagnosis- Based on CSF Tap_
\*Prognosis- If the patient is just having Seizures with the Focal form they may Live for up to a Year. If Patient has the Focal or Disseminated form with Many Problems they will only Live 1 Week -3 Months
82
Best Diagnostic Tool in Patients with **Cervical Spondylomyelopathy**
**MRI**
82
**Degenerative/Developmental Myopathy** where a Whole Litter of Puppies will be Affected around 6 weeks old with Strange Gaits and Muscle Atrophy and Damage, Where Muscle is Broken down and Replaced by Fibrinous Tissue
**Dystrophinopathies**
**\***Muscle cells begin to Die with Time
83
Treatment for **Diskospondylitis**
**Minimal Dysfunction- Antibiotics (Parenteral 5 days + Oral 54 weeks)**
**Neurological Sign- Hemilaminectomy**
**\***Use a Culture to Determine the Bacteria Present
\*_It is Difficult for Antibiotics to Penetrate Bone- Need to Give for Extended periods of Time = Parenteral 5 Days and Oral for 54 Weeks. Can Take up to 1 Year of Treatment for Patient to Completely Recover_
83
Most Common Cause of **Vertebral Fractures/Luxations** in Felines that Leads to _Tail Paralysis and Incontinence_
**Tail Tugs**
**\***Ex. Dog tugs on Cats Tail or Tail gets stuck in the Door
_The Spinal Cord will get tugged and the Cauda Equina will Stretch and become Damaged. Damage to the Caudal Nerve will Cause the Tail to be Paralyzed and Damage to the Pudendal Nerve will make the Cat Incontinent with a **Lower Motor Neuron Bladder- Rapidly Fatal Disease in Felines**_
85
When Forceps are Placed up a Patients Nose, Which **Two Cranial Nerves** are we Testing
**Trigeminal**
**Facial**
\*Sensory of the Trigeminal to the Spinal Cord and Facial Nerve Traveling from the Spinal Cord back to the Nose for a Motor Response
86
Clinical Signs associated with ______ Include:
_Mental Depression_
_Learning Deficits (Never Learns Name)_
_Seizures/Blindness/Deafness_
_Tetraparesis (Clumsy, Uncoordinated)_
_Domed Skull_
**Hydrocephalus**
88
Laboratory Test that can be used to Diagnose Heartworm that Concentrates the Microfilaria in the Blood for Examination under a Microscope. This Laboratory Technique is not used much anymore because it Produces 10-67% _False Negative Results_
**Concentration Test**
**\***There are a lot of Dogs that have Adult Heartworms but do not have Circulating Microfilaria- False Negatives
88
Treatment for **Brain Herniation**
**Dexamethasone**- Reduces Brain Edema and may Reverse the Herniation
## Footnote
**Remove the Underlying Cause**
88
Condition Transmitted by **Cuterebra** that Migrate into the Brain leading to Non-Progressive signs of _Behavoir Changes, Seizures, Unilateral Blindness, Circling and Hemiparesis_
**Feline Ischemic Encephalopathy**
\*Usually Recover, Seizures may persist
89
Clinical Signs of Heartworms in _____ Include:
Asymptomatic (25%)
Respiratory Signs (60%)
Vomiting (38%)
Sudden Death (10-23%)- 1 Worm
**Felines**
\*Respiratory Signs- 50% are Similar to Dogs ( Weight Loss, Cough, Lethargy) but the Other **50% Develop Acute Respiratory Illness**
**\***_1/4 of Cats will Die Suddenly with Heart Worm- One Dead worm is enough to Kill a Cat_
89
True/False: For Most Neurological/Spinal Cord Conditions a **Definitive Diagnosis** will be Made by _Myelogram or MRI_
**True**
89
Clinical Signs of _____ in **Swimming/Hunting Dogs**:
_Mydriasis (Dilated Pupils)_
_Crusty Noses/Eyes_
_Distended Bladder_
_Dry Mucous Membranes_
_Weight Loss_
_Absent Pupillary Light Response_
**Dysautonomia**
_\*Associated with Clostridium Botulinum_
\*Distended Bladder- Lost the Parasympathetic supply to the Bladder
90
Patients with **Seizures** that are Treated with \_\_\_\_\_, _40% of Patients will have no More Seizures_, while _50% of Patients just Experience a Reduction in the Number of Seizures_
**Phenobarbitol**
92
Reflex that Tests the **Femoral Nerve (L4,5)**
**Patellar Reflex**
**\***Hyperreflexia = _Upper Motor Neuron Sign_. **Clonus**- Knee Straightens and then slowely Relaxes. Ex. Lesion at L3, T1 and a Lesion in the Brain Stem would all lead to Upper Motor Neuron Signs
\*Lesion at L5 will Result in _Lower Motor Neuron Signs_- Hyporeflexia and Hypotonus
92
Which Condition that Causes _Tetraparesis/Tetraplegia_ is Common in **3-18 Month old Great Danes and 5-8 Year Old Dobermans**
**Cervical Spondylomyelopathy (Canine Wobblers)**
93
26% Of _Cats_ with **Myesthenia Gravis** have a \_\_\_\_\_
**Thymoma**
**\***If you Remove the Thymus in the Cat, they will get Better
95
True/False: A **Brain Lesion** on the Right Hand Side will Affect the Motor Nerves on the Left Side of the Patients Body
**True**
**\***_The Cerebral Cortex on the Right operates the Left Side of the Body and Vice Versa_
_\*The Brain Stem on the Left Side operates the Left Side of the Body_
_\*There is a Crossover Cranial to the Brainstem- Ex. A **Brain** Lesion, will lead to a Locomotor Issue on the Opposite side of the Body. Ex. A **Brainstem** Lesion will lead to Locomotor issues on the Same Side of the Patient_
95
**Hydrocephalus** is most Commonly **\_\_\_\_\_\_** in Toy Breeds and Brachycephalic Dogs where the Pressure within the Brain is Progressive and will destroy More and More Neurons with Time
**Congenital**
97
Three Pathologies that Cause **Lumbosacral Malarticulation-Malformation**
**Disk Pertrusion** (Annulus Fibrosis)
**Thickened Interarcuate Ligament** (Pressure on Cauda Equina)
**Osteophytes** (Pressure on Sciatic Nerve)
99
Decreased or Absent Motor Activity in **Both Hind Limbs**
**Paraparesis/Paraplegia**
100
**Treatment** for Heartworm
**Prophylaxis** (Microcylic Lactones)- Stop New infections
\*Killing the Heartworms will cause severe Inflammatory reaction in the Lungs so we want the Lungs in the best shape before we Attempt to Kill the Adult Heartworms- We want to Treat the Clinical Signs in the Lungs and Heart Prior to Treating the Adult Heartworm and Microfilaria
101
What Three Things can be Detected on a _Radiograph_ of a Canine with **Heartworm**
**Right Heart Enlargment**
**Prominant Pulmonary Artery**
**Pulmonary Edema**
\*_Radiographs are Very Helpful in Diagnosing Heartworms-_ Radiographs tell us how bad the Pathology is within the **Lungs**
_**\***Heart Worms cause Large Dilated Right Hearts with Pulmonary Hypertension_
101
Disease of Small dogs where they Dog develops **Tremors in the Head and Limbs** that gets worse with Exercise/Excitment but Disappears when the Dog Sleeps
**Shaker Dog Disease**
102
Intervertebral **Disks** occur between the Vertebral Bodies of all Vertebrae except which One?
**C1-C2**
**\***Dens is Located between C1-C2
103
**Extracerebral Hemorrhage** Occurs in the _____ of the Brain, while **Intracerebral Hemorrhage** occurs in the \_\_\_\_\_.
**Extracerebral- Cortex**
**Intracerebral- Brainstem**
103
True/False: When a Patient has been **seizure-free for a year**, you can Slowely Withdraw them from Treatment
**True**
**\***Must Tapper the Dose, cannot just Completely Remove the Drug
104
True/False: With **Cerebellar Signs**, Conscious Proprioception and Reflexes are Okay
**True**
106
True/False: A **Blood Donor** Canine has Dirofilaria Immitis _Microfilaremia_ (Microfilaria within the Blood Stream). The Recipient of the Blood Donation will now have Heartworm
**False**
\*The L1 (Microfilaria) cannot go anywhere unless it goes through a Mosquito
**\*The L3 is the Infective Stage-** A Dog cannot be Infected by the L1 or L2 Stages of Dirofilaria Immitis
107
Best Tools for Diagnosing **Vertebral and Spinal Cord Neoplasia**
**CT/MRI (Best)**
**\***Sometimes can Pick up Tumor Cells within the CSF
109
How Often should Patients on Prophylaxis Preventative be Checked for Heartworm?
**0.5 - 1 Yearly Checks**
110
_Hematogenous Bacterial Infection (Staph. Intermedius) of the Cartilagenous Endplates and Disk_, Destroying the Disk and the Cartlage leading to an Increased Bone Density (Sclerosis) around the site of the Infection
**Diskospondylitis**
**\***Usually Caused by _Staph. Intermedius_
Radiograph- Lysis, Sclerosis (Increased Density) and Spondylosis (Bridging at the Top)
112
In Cases of **Paraparesis/Paraplegia**, where Both Hind Limbs are Affected, the Lesion must be Caudal to \_\_\_\_
**T2**
**\***Front Legs will be Normal
113
In Patients being treated for **Seizures** with _Phenobarbitol or Potassium Bromide_, you have to Measure the Patients \_\_\_\_\_
**Blood Levels**
**\***Autoinduction- The Longer the Animal is on Phenobarbitol, the Faster the Body will be able to break down Phenobarbitol
114
Treatment for **Vertebral and Spinal Cord Tumors**
**Meningiomas/Malignant Peripheral Nerve Sheath Tumors**- Remove the Tumor. Give the Patient 6 Months- These Tumors tend to Regrow
**Vertebral Tumors** (Ex. Osteosarcomas)- Remove for the Time, but Will Regrow after 6-7 Months
**Lymphoma (FeLV**)- Chemotherapy- Patient may live 7 Months
_\*Vertebral and Spinal Cord Tumors occur Rarely, but Prognosis is Poor in Most Cases_
114
Which One of these Conditions can Cause **Tetraparesis/Tetraplegia?**
A. Diskospondylitis
B. Spinal Cord Neoplasia
C. Neck Fractures
D. Luxations
E. Fibrocartilagenous Emboli (FCE)
**All of the Above**
115
Treatment for **Fibrocartilagenous Emboli**
**Supportive Therapy-** Rest, Physical Therapy, Clean (Incontinent)
\*Have to Wait for the Body to Send in Neutrophils and Macrophages to Eat Away the Embolism and Restore the Blood Circulation
\*_These Patients may have Upper or Lower Motor Neuron Bladders-_ Phenoxybenzamine/Prazosin to Treat UMN Bladder
Phenylpropanolamine to Treat LMN Bladder
116
Prognosis for **Cranial Trauma**
117
Decreased or Absent Motor Activity in **One Limb**
**Monoparesis/Monoplagia**
118
End-Plate Condition that is Congential in _Jack Russells and Fox Terriers_, where these Patients **Lack Acetylcholine Receptors at their Motor End Plates** leading to Flaccid Paralysis
**Myasthenia Gravis**
_\*With Exercise these Patients will get Weaker and Weaker until they Collapse_
\*1/3 Of all the Cases have _Focal_ Myasthenia Gravis that Doesn't effect the Skeletal muscles- Mainly leading to **_Megaesophagus- Aspiration Pneumonia_**
120
True/False: **Postural Reactions** help to Localize (Narrow Down) the Location of a Lesion
**False**
**\***Postural Reactions just tell us "yes or no" to an Abnormality, they DO NOT Localize Lesions
121
Treatment for **Tail Tugs in Cats (Vertebral Fractures/Luxations)**
**Give Time for the Cauda Equina to Heal**
**Tail Amputation**
**Phenylpropanolamine (PPE)**-- Lower Motor Neuron Bladder
\*_Generally These Cats have a Poor Prognosis_
123
Reflex that Tests the **Radial Nerve (C7,8)**
**Extensor Carpi Radialis Reflex**
123
\_\_\_\_\_ Signs Include:
_Wide Based Stance_
_Truncal Ataxia (Swaying)_
_Hypermetria (Over Stepping)_
_Intention Tremor (Head Bob)_
**Cerebellar Signs**
**\***Truncal Ataxia- These Animals Sway from Side to Side
124
Condition when **Partial Seizures** cause Abnormal Behavoir such as _Salivation, Agression, Licking/Chewing, and Running/Vocalizing and Trembling_
**Psychomotor Seizures**
**\***May be associated with Hallucinations
125
Condition common in _Beagles_, characterized by **Meningeal Arteritis, Hemorrhage and Inflammation in the Cervical Area** leading to Fever and Neck Pain
**Steroid Responsive Meningitis-Arteritis**
_\*Two Differentials in a Dog with Fever and Neck Pain with Neutrophilia of the CSF: Bacterial Meningioecephalitis and Steroid Responsive Meningitis-Arteritis. **If IgA levels are High then its Steroid Responsive Meningitis Arteritis. If IgA levels are Normal/Low then its Bacterial Meningioecephalitis**_
_\*Treat Bacterial Meningioecephalitis with Antibiotics and we Treat Steroid Responsive Meningitis-Areteritis with Prednisone_
126
Treatment for **Protozoal Polyradiculoneurititis**
**Clindamycin**
128
True/False: In Heartworm Positive Patients treated with **Melarsomine**, _5% of Class I and II (Healthy)_ and _20% of Class III (Critically Ill)_ Patients will Die
**True**
129
If there is a **Spinal Cord Lesion** within the **C6-T2** Area causing _Lower Motor Signs to the Front Limb_, What will be Happening in the Hind Limbs?
**Upper Motor Neuron Signs**
**\***Exaggerated Reflexes
_\*Tetraparesis_- Will not be Able to Walk on the Front or Back Legs
\*Side Note- If there was a Peripheral Lesion (Ex. Fractured Humerus) causing Lower Motor Neuron Signs in the Front Limb, we will have Normal Motor Neuron Signs on the Hind Limb
\*_How you Differentiate if the Lesion is at C6-T2 Spinal Cord or within the Periphery_
129
Drug used for Treatment of **Seizures** in Patients where Phenobarbital Fails or Patients with Liver Disease. This Drug works by acting on **Chloride Channels** and _Increases the Seizure Threshold_
**Potassium Bromide**
**\***The Amount of Chloride in the Diet is going to Affect your Bromide- _Patients on High Salt (Chloride) Diets will require more Potassium Bromide_
**_\*Commonly Potassium Bromide is used as an Add on with Phenobarbitol-_** _we use them together when Phenobarbital isn't working properly_
130
Two Clinical signs that can be seen with **Partial Sensory Seizures,** that occur in the Sensory Cortex of the Brain
**Fly-Biting**
**Tail Chasing**
131
Condition characterized by **Chloride Channelopathy**, where animals can Depolarize their Muscles but not Repolaize them Quickly leading to Prolonged Muscle Contractions. This Condition is Seen in "Fainting Goats"
**Myotonia**
132
Test used during Physical Exam to Diagnose **Lumbosacral Malarticulation-Malformation,** where the Tail is Lifted to see if the Patient is Painful in the **L7-S1** Junction
**Tail Jack**
134
Treatment for **Thoracolumbar Intervertebral Disk Disease** is Dependent on the Grade of Disease. What are the Different Grades?
Grade 1- Only have Back Pain (Minor)
Grade 3- Cannot Walk on Hind Legs but as they drag their back legs you will see the legs making an attempt to walk
135
\_\_\_\_\_ Motor Neuron **Bladder** is Created by a Lesion **Caudal to L3**, and is Characterized by:
_Markedly Dilated Bladder_
_Atonic_
_Easy to Express_
**Lower**
**\***_The Nerves that operate the Bladder come off Caudal to L3_
_**\***Sphincters are Open_
136
**Spinal Cord Tumors** that Create a "Golf-Tee" Sign
**Intradural-Extramedullary**
138
Which Drug works to Decrease the Size of the Bladder in Patients with **Lower Motor Neuron Bladder?**
**Bethanicol**
\*Gives Tone to the Bladder- Making it Easier to Find and Empty
\*Urecholine- Tenses up Detrusor Muscle
**Phenylpropanolamine (PPE)**- Tightens up the Sphincter
139
Clinical Signs associated with \_\_\_\_\_\_:
_Depressed Mentation_
_Non-Responsive Pupillary Light Reflex_
_Cranial Nerve Deficits_
_Tetraparesis_
_Coma_
_Respiratory Depression/Arrest_
**Brain Herniation**
\*Cranial Nerve Deficits- Ex. Facial Nerve Dysfunction, Weak Jaw tone
140
Dobermans with **Cervical Spondylomyelopathy** will have signs of ____ Motor Neuron Bladders
**Upper**
**\***Treatment- _Phenoxybenzamine or Prazosin_
140
\_\_\_\_ Cranial Trauma occurs to the _Brain Parenchyma and Blood Vessels resulting in Edema and Hemorrhage_. ____ Cranial Trauma occurs as a Result of Hypotension and Hypoxemia that _Result in Free Radicals which damage Neuronal Membranes_
**Primary**
**Secondary**
142
A Heatworm Patient has been Treated with **Melarsomine**. Adult Worms die at 3-21 days Post Treatment and can cause Serious Complications at 2-3 Weeks. The Patient is brought into the Clinic with Dyspnea, Cough and Fever. What are the _Two_ most Important Post Adulticide Drugs for Treatment?
**Prednisone (Steroid**)- Stop Inflammation
**Furosemide**- Treats Pulmonary Edema
144
Condition Common in _Large/Giant Breed Dogs and Miniature Schnauzers_ that occurs Most commonly in the Brachial Plexus leading to Ischemic Myelopathy
**Fibrocartilagenous Emboli**
**\***Ischemic Myelopathy- Cuts off Blood Supply to a Portion of the Spinal Cord
145
Treatment for Patients with _Grade 4_ **Intervertebral Disk Disease**
**Surgery (Dorsolateral-Hemilaminectomy)**
**\***90% of These Patients will Recover with Surgery
146
_Match_ Pathological Changes caused by **Traumatic Nerve Injuries:**
A. Cut off Blood Supply to Nerve 1. Neurotmesis
B. Damage to Nerve Axon 2. Neuropraxia
C. Damage to Nerve Axon and Myelin Sheath 3. Axonotmesis
**Cut Off Blood Supply to Nerve (Minor)- Neuropraxia**
**Damage to the Nerve Axon** (Loss of Function but Function will Return when the Axon Regrows)- **Axonotmesis**
**Damage to Axon and Myelin Sheath** (Nerve does not Regrow)- **Neurotmesis**
**\***Traumatic Nerve Injuries, Normally Result a Mixture of all Three
147
Treatment for **Status Epilepticus** if the patient is _NOT Seizuring_ and the Liver is Okay
**Phenobarbital- IV Loading Dose**
**\***Phenobarbital takes 30 Minutes to kick in- Use Diazepam to control Seizures while you wait for Phenobarbital to take Effect
_\*Supportive Therapy- Manitol for Brain Edema_
148
Rapidly _Recurring Convulsions with no Complete Recovery in Between_ or if _Seizures Persist for Longer than 5 Minutes_
**Status Epilepticus**
150
**Fibrocartilage** Blocking Blood Vessels within the Spinal Cord leading to Ischemic Myelopathy
**Fibrocartilaginous Emboli**
\*No Blood will Enter the Spinal Cord in that Particular Area
_\*60% Occur Post/During Exercise- No History of Trauma in these Animals_
151
Treatment for **Vertebral Fractures/Luxations**
_Treat **Shock** First_- **Colloid Fluids**
Pain Treatment- **Opiods**
Spinal Edema Treatment (Once Stable)- **20% Mannitol**
**Surgial Decompression/Stabilization-** Large Dogs (\>20kg) get External Coaptation while Small Dogs get Hemilaminectomy with Plates and Pins
152
Sudden Attack of Sleep when Animals are Stimulated/Excited that is caused by Autonomic Imbalances where the Patients have a **Classic Sleep EEG**
**Narcolepsy**
153
_Flexion of the Hind Limbs and Extension of the Front Limbs_ is a Sign of \_\_\_\_\_\_\_
**Decerebellate Rigidity**
_\*Loss of Cerebellum Completely- Severe Lesion in the Cerebellum_
154
We Begin to Treat animals with **Seizures,** when the Seizures are Occuring Less than Every _______ Weeks
**6-8 Weeks**
**\***Antiseizure Drugs are Dangerous. Its best to Wait until the Patient is having more Frequent Seizures before placing the Dog on Medication. If a Patient Only has a Seizure Once a Year, its not worth putting them on dangerous medication to Prevent One seizure a Year
155
When **_L5_** Microfilaria arrive in the Lungs of \_\_\_\_\_, it causes a Massive **Eosinophilic Pneumonitis** leading to Respiratory Dyspnea and Coughing
**Felines**
\*_Most L5 Microfilaria Die in the Lungs_
_\*In Felines, Dead Worms set off a massive inflammatory Reaction- Just One Dead Worm is enough to kill a cat- Anaphylaxis, Lung Edema, and Localized Arteritis_
157
Treatment for **Degenerative Myelopathy**
**No Treatment**
**\***Only thing that Helps is _Good Nursing Care, Physiotherapy, and Keeping Weight Down._ Eventually the Patient will Develop Paraplegia in the Hind Legs and Normally will be Euthanized
158
\_\_\_\_\_ Deafness is caused by Congenital **Degneration of the Cochlear** that is common in _Cats with a White Coat and Blue Eyes and Dalmations_
**Sensorineural**
\*Congenital- These animals are Born Deaf
\*If the Cat has only one Blue eye- Likely the Cat is Unilaterally Deaf on the side of the Blue Eye
\*22% of Dalmations are Unliaterally Deaf and 8% of Dalmations are Bilaterally Deaf. Dalmations that are Bilaterally Deaf are normally Euthanized
159
When you Treat Adult Heartworms (Post-Adulticide), that Dog must be _Cage Rested_ for at Least _____ Thereafter
**1 Month**
**\***No Excitment/No Excersize to Decrease Blood Flow through the Lungs
\*_After Injection of Malarsomine, Worms die 3-21 Days Later- Cage Rest must be for 1 Month_
160
Reflex used to Test the **Sciatic Nerve (L6,7, S1)**
**Cranial Tibial**
161
Treatment for **Status Epilepticus** if _Diazepam and Phenobarbital Don't Work_
**IV Pentobarbital (Barbiturate Coma)**
**\***Keep them In Anesthetized state Until No Seizures occur on Recovery
162
True/False: In **Heartworm** Disease, The Amount of Damage that happens in the Lungs depends on the amount of Blood flowing through the Lungs
**True**
**\***Dog is more Likely to Die Post Adulticide if Running Around- _Cage Rest is Essential to Recovery_
163
\_\_\_\_\_ Motor Neuron **Bladder** is Created by a Lesion **Cranial to L3**, Characterized by:
_Small Bladder_
_Incomplete Emptying_
_Difficult to Express_
**Upper**
_\*Bladder Sphincter will be Very Tight- Bladder will not Empty Well_
164
In a Patient with Normal Front Legs and Upper Motor Signs in the Hind Limbs (Hyperreflexia), where is the lesion Located?
**T2-L3**
**\***Side Note- If this Patient was a German Shephard and you Performed an X Ray and Myelogram or MRI and they were all Normal as well as the CSF, what would be your Diagnosis? _Degenerative Myelopathy_
165
Patients with **Lumbosacral Malarticulation-Malformation** may Display ______ of the Patellar Reflex
**Pseudo-Hyperreflexia**
**\***Patellar Reflex can Sometimes have Pseudo-Hyperreflexia
166
**Macrocyclic Lactone** that is a Good Microfilaricide and kills 99% of Microfilaria in _1 Day_
**Milbemycin**
**\***Gets rid of Microfilaria Quickly
167
Treatment for **Narcolepsy**
**Amphetamines (Ritalin)**
\*Avoid the Triggers
169
Large Breed Dog Collapses Immediately After **Exercise** with No Signs of Pain or Trauma. What is your top Differential?
**Fibrocartilagenous Emboli**
**\***Use MRI or CT for Diagnosis
170
True/False: _Prophylaxis for 2-3 Months Pre-Adulticide (Marlarsomine_) will Result in a Better Kill Rate of **Heartworm**
**True**
171
75% of **Thoracolumbar Intervertebral Disk Diseases** Occur between \_\_\_\_\_
**T11-L2**
**\***Right in the Middle of the Back
_\*Dauchshund will come into the Clinic with Paraparesis/Paraplegia with Upper Motor Signs in the Hind Legs and Upper Motor Neuron Bladder_
172
Treatment for **Brachial Plexus Avulsion**
**No Treatment**
**\***Protect Leg with Bandages, Physiotherapy to Regain Muscle Strength, and Massaging
_\*Nerves take about 6 Months to Heal- If Motor Activity does Not Return in 6 Months, then Amputate_
173
Three Levels of **Altered Mental Status**
**Depression-** Not Interested in External Environment
**Stupor-** Have to Apply Painful Stimulus to get Attention
**Coma-** Cannot get the Animals Attention even with Painful Stimulus
174
Treatment for **Steroid Responsive Meningitis-Arteritis**
**Prednisone**
175
Clinical Signs of ______ Include:
_Decreased Flexia (Reflexes)_
_Decreased Muscle Tonicity_
_Muscle Atrophy_
_Monoparesis/Monoplegia_
**Peripheral Nerve Injuries**
**\*_Lower Motor Neuron Signs_**
176
Common **Viruses** that Lead to _Cerebellar Infections_
**Distemper**
**FIP**
178
Clinical Signs associated with _____ Include:
_Hyperesthesia (Back Pain)_
_Fever_
_Depression_
_Weight Loss_
**Diskospondylitis**
**\***Main clinical signs- _Painful Back and a Fever!_
**\***If left Untreated can lead to Proliferation, Spinal Cord Compression and Neurological Signs
\*_CSF will be Normal_ in these Patients
179
Treatment for **Brain Neoplasia**
_Benign/Superficial Meningiomas_- **Surgical Removal**
**Dexmathazone/Mannitol**- _Decrease Cerebral Edema_
\*Gliomas are Normally Deep in the Brain and cannot be Removed Surgically- Poorer Prognosis
180
_Emergency Home Treatment_ for Animals with **Cluster History of Seizures**
**Diazepam Gel (Rectally)**
182
**4 Possibilities** of Which Condition?
_Ventral Canal Stenosis_
_Osteophytes from Malformed Articular Processes_
_Hansen Type II Disk Prolapses_
_Interarcuate Ligament Tear_
**Cervical Spondylomyelopathy**
\*Osteophytes can Grow Inwardly and put pressure on the Spinal Cord, resulting in Neck Pain and Tetraparesis
\*Hansen Type II Disk Prolapses- Particularly Bad in Dobermans
183
Patients with a _____ Abnormality will have:
_Head Tilt to One Side_
_Falling to One Side_
_Patient Walking in Circles_
_Nystagmus (_Eye Twitches)
**Vestibular Disease**
184
Autoimmune Myopathy against the **Masticatory Muscles** where the Patients Present with _Painful Swollen Head Muscles and Refusal to Eat or Open their Mouths (Pseudotrismus)_
**Masticatory Muscle Myositis**
**\***Pseudotrismus- Inability to Completely Open the Mouth
185
**Brainstem Lesions** cause _____ Motor Neuron Signs within the _Cranial Nerves_ on the Side of the Lesion
**Lower**
186
Treatment for **Peripheral Nerve Injuries**
**Glucocorticoids**- Decrease Inflammation
_\*No Actual Treatmen_t- Nerves need time to Heal
\*Decompress/Bandages and _Physical Therapy (Physiotherapy) and Massage_ to Regain Muscle Strength
187
Clinical Signs of Which Condition of **Dobermans and Great Danes**:
_Guarded Neck (Keep Neck Straight)_
_Hind Limb Paresis/Wobbling (Swaying)_
_Scuff Back Limbs (Ulcers)_
_Dysmetria in Front Limbs_
_Upper Motor Neuron Signs in All Four Limbs_
**Cervical Spondylomyelopathy**
\*Guarded Neck- Neck Pain so they keep their necks straight!
_\*Lesions in the Neck tend to make the hind limbs worse than the front limbs_
Dysmetria- Short Choppy Gait- Lack of Coordination of Movement
_15% of these Dogs will only present with Neck Pain_
188
Which Condition has these Characteristics:
_**Progressive** Paresis and Ataxia of the Hind Limbs ( Over 6-36 Months)_
_Common in German Shepards \> 8 Years Old_
_Knucking/Dragging of Hind Limbs_
_Ataxia_
**_Continent_**
**_Normal Pain Response_**
**Degenerative Myelopathy**
\*Erosions on the Dorsal Digits from Dragging Feet
_\*Even Though These Patients are moving Poorly on their Hind Limbs, Continence is Spared until Very Late in the Disease. These Patients also have Normal Pain Sensation_
190
True/False: **Ivermectin** used for Heartworm Prevention is Safe for use in Collies
**True**
**\***Heartworm Preventative Only contains 1/10th of the Toxic Dose for Collies- _Heartworm Prevention is Safe for Collies_
192
Canines that are Heartworm Positive and present with _Congestive Heart Failure_. What Drugs do we Use to Treat Clinical Signs?
**Furosemide-** Diuretic
## Footnote
**ACE Inhibitors**
**Low Sodium**
193
Rare Condition where **Staph. Intermedius Infects the Brain** via the Hematogenous Route causing Fever, Neck Pain, Rigidity, and Seizures
**Bacterial Meningioencephalitis**
**\***Definitive Diagnosis- Culture CSF to determine the Type of Bacteria and treat it with the most appropriate Antibiotic- Poor Prognosis even on Antibiotics
195
Drug Family that are Powerful Preventatives for **Heartworm**
**Macrocylic Lactones**
\*Ex. Ivermectin
_\*70% of Dogs in the US are Unprotected for Heartworms- Not on Macrocylic Lactone Preventatives_
197
Clinical Signs of ______ Include:
Weight Loss
**Non-Productive** Cough
Dyspnea
Exercise Intolerance
Right Sided-Congestive Heart Failure
**Heart Worm**
**\***Dog must have severe Pathology in their Lungs before Right Sided Congestive Heart failure will occur
198
Touching the Patients Eye, tests which **Two Cranial Nerves?**
**Facial**
**Trigeminal**
\*Trigeminal Nerve (Sensory) Travels to the Brainstem and the Facial Nerve (Motor) Travels back to the Eye causing a Blink
199
Treatment for **Tetanus**
**Acepromazine-** Muscle Relaxation
_\*After a Week the Tetanus will wear off the patient will be Okay_
\*Antitoxin IV is also available but can cause Anaphalaxis Reactions
\*If these Patients don't relax enough they may not be getting enough Nutrition and a Feeding tube can be used to Feed the Patient
200
Widespread Seizure where on EEG Abnormal Activity can be seen over the _Entire Cortex_
**Generalized Seizures**
**\***These animals will be _Unconscious_
_\*Most Common Generalized Seizures- **Tonic Clonic Seizures** = Contraction of the Muscles and the Animals will be Unconscious_
202
On Physical Exam, Canines with **Heart Worm** will Present with:
_Decreased_ Weight
_Increased_ Respiratory Rate
Split ____ Heart Sound
Tracheal Sensivity
Normal Respiratory Sounds/Crackles
**S2**
**\***If the Patient is in Right Sided Congestive Heart Failure, they may present with Ascites + Hepatosplenomegaly
203
**Cranial Nerve** that Creates _Tongue Tone_
**Hypoglossal Nerve**
**\***No Tongue Tone = Damage to Hypoglossal Nerve
204
Which of the Following is _Incorrect_ for a Patient with a Lesion in the Spinal Segments **C1-C3 (Neck):**
A. Good Mental Status- Ex. Knows Name
B. Conscious Proprioception is Intact
C. Tetraparesis/Tetraplegia
D. Normal Cranial Nerves
E. Upper Motor Neuron Signs in Front Limbs
F. Lower Motor Neuron Signs in Hind Limbs
**F.**
**\***Upper Motor Neuron Signs will be Present in the Hind and Front Limbs
206
If you see a Feline with a Spinal Cord problem that is **Less than Two years of Age** you should think \_\_\_\_. In Felines with Spinal Cord Problems that ar**e Between 2-8 Years Old** you should be thinking \_\_\_\_\_. In Felines with a Spinal Cord Problem that are **Over the Age of 8** you should be thinking \_\_\_\_\_
\< 2 Years- **FIP**
2-8 Years- **Lymphoma/Feline Leukemia**
\> 8 Years- **Other Tumors (**Ex. Osteosarcomas)
207
Animals with **Lumbosacral Malarticulation-Malformation**, will Have What Response to the Flexor Withdrawal Reflex?
**Only Withdraws Hip**
**\***Will Not Withdraw the Hock or Stifle due to Sciatic Nerve Damage
208
Dirofilaria Immitis (Heart Worm) has a Synergistic Relationship with which **Bacteria**?
**Wolbachia Spp.**
**\***Lives in Symbiosis with the Dirofilaria and Helps the Dirofilaria. Wolbachia adds to the Lung Inflammation seen with Dirofilaria Immitis
\*_Surface Proteins and Endotoxins of the Organisms promote Neutrophil Chemokinesis and Cytokine Production_
210
Most Dauchshunds with **Intervertebral Disk Disease** will come into the Clinic with Paraparesis/Paraplegia with Upper Motor Signs in the Hind Legs and ___ Motor Neuron Bladder
**Upper**
211
Syndrome in Young dogs with a Massive Infection of Heart Worm (70-150), where the Worms back up from the Pulmonary Artery into the Right Atrium causing **Tricuspid Insufficiency**. Tricuspid Insuficiency leads to _Acute Right Sided Heart Failure_ with Hepatic Congestion, Ascites, Hemolysis, DIC ect.
**Post-Caval Syndrome**
\*Occurs in Dogs that are not on Prophylaxis
\*Dog Normally presents with _Acute Collapse and Shock_
213
\_\_\_\_\_ Paralysis occurs in Dogs due to the **Toxins of Dermacentor and Ixodes** leading to _Blocked Nerve Conductions and Blocked Acetylcholine_ Causing Tetraparesis/Tetraplegia and Lower motor neuron Signs
**Tick**
\*58 Species of Ticks are associated with Tick Paralysis
_\*Tick Paralysis- Leads to Tetraparesis and Lower Motor Neuron signs, however the Cranial Nerves are Spared_
\*Patients Recovery Quickly after the Ticks are removed
214
**Drug of Choice** for Treatment (70-80%) of Seizure Patients that _Enhances GABA and Increases the Seizure Threshold_
**Phenobarbital**
**\***Metabolized in the Liver- Don't use in Patients with Liver Disease
_\*Hepatopathy- Patients on Phenobarbital can develop Liver Cirrhosis_
_\*All Patients taking Phenobarbital will have an Increase in ALP and ALT Levels!- KNOW THIS_
216
A **Unilateral** Spinal Cord Lesion **Caudal to L3** will lead to _Monoparesis/Monoplagia_ in the corresponding Hind Limb, while a **Unilateral** Spinal Cord Lesion Between **C6-T2** will lead to \_\_\_\_
**Hemiparesis/Hemiplagia**
_\*Monoparesis- Decreased Motor Function involving One Limb_
_Hemiparesis- Decreased Motor Function involving a Front and Hind Limb on the Same Side of the Animal_
\*A Unilateral Lesion from C6-T2 = Hemiparesis- Lower Motor Neuron Signs in the Front Limb and Upper Motor Neuron Signs in the Hind Limb _on the Side of the Lesion_
218
True/False: **Fibrocartilaginous Emboli** can Cause Monoplaresis/Monoplegia or Paraparesis/Paraplegia if the Lesion is _Caudal to T2_
**True**
220
Autoimmune Myopathy that Causes _Inflammation of the Extraocular Muscles_ where the Patients Present with Exopthalmus (Bulging Eyes)
**Extraocular Myositis**
221
**Peripheral Nerve Injury** where the _Forelimb is Abducted Caudally or Cranially_, Stretching and Tearing the Nerve Roots (C6-T2) which can Cause Monoparesis/Monoplagia
**Brachial Plexus Avulsion**
**\***Tearing of the Nerve Roots of the Brachial Plexus- Common in Dogs Hit by Car (HBC)
_No Motor Activity going to the Limb- Decreased Tone and Muscle Atrophy **(Lower Motor Neuron Signs)**_
222
Gene Mutation that is Homozygous in Patients with **Degenerative Myelopathy**
**Superoxide Dismutase 1 Protein**
**\***While all dogs with Degenerative Myelopathy have this Gene Mutation, there are Some Dogs without Degenerative Myelopathy that Also are Homozygous for the Gene Mutation
**\***Etiology of Degenerative Myelopathy is Unknown, However is Most Likely Genetic in Nature
223
Condition caused by **Neospora Caninum** that Damages the Muscles and Lower Motor Neurons Particularly on the Hind Legs
**Protozoal Polyradiculoneuritis**
224
Dirofilaria Immitis, the Parasite Responsible for **Heartworm**, is a Parasite of the \_\_\_\_\_\_
**Pulmonary Artery**
**\***Mainly see Heartworm in _Canine_ Species (Normally 15 Worms)
225
\_\_\_\_\_ Reactions, such as _Hopping, Placing, Wheelbarrowing, Extensor Postural Thrust and Hemi-Walking_, that are used to Determine if an animal has a Neurological Issue
**Postural Reactions**
**\***No Point in testing Postural Reactions in Patients that Present with Abnormalities- Only test Postural Reactions to see if the Patient is Abnormal
_\*In order for the Patient to Perform Postural Reactions, such as Wheelbarrowing and Hemiwalking, everything must be Intact. Postural Reactions DO NOT help to Localize a lesion, it just tells us whether or not there is an Abnormality/Lesion_
226
3 Phases of **Generalized Tonic Seizures**
**Preictal Phase**- _Subtle Behavoiral Changes Prior to Seizure (Aura/Prodromal Phase)- Ex. Clingy, Anxious, Hiding_
**Ictal Phase-** _Unconscious, Falls, Tonic Phase (Stiff Muscles) followed by Clonic Phase (Running/Paddling Motions)_
**Postictal Phase-** _Recovered Consciouness, Depression, Fatigue, Pacing, Neuro Deficits (Patient can be abnromal for 5 Hours after a seizure)_
227
These are all Pathogenesis for \_\_\_\_\_\_:
1. Damaged Pulmonary Artery Endothelium
2. Dyspnea/Cough
3. Platelets Adhering- Myointimal Thickening
4. _Eccentric Hypertrophy_ of Right Heart
5. Potential Right Heart Failure
6. Vasconstriction/Bronchoconstriction
**Heart Worm**
\*Dyspnea- Damage to the Endothelium in the Pulmonary Artery will allow Fluid to Travel through the Pulmonary Artery into the Lungs. Causes _Difficulty Breathing and Coughing_
_\*_Basement Membrane of Pulmonary Artery will be exposed- Platelets will attach and form Thrombi. The smooth Muscle walls of the Arteries will get Bigger (Myointimal Thickening) which closes off the Diameter of the Pulmonary Artery and Pressure Overload in the Right Ventricle- Eccentric Hypertrophy
\*Worm Release Vasoconstrictors and Bronchoconstrictors
228
True/False: **Urinary Tract Infections** are Very Common in Patients with Upper Motor Neuron and Lower Motor Neuron Bladders
**True**
**\***If the Bladder is not being Emptied Regularly, it will Result in Infections that can lead to Pyelonephritis
229
Clinical Signs for **Brain Neoplasia** in the \_\_\_\_\_
_Depression (Sleepy)_
_Absent Menace Reflex (Cranial Nerves)_
_Absent Blink Reflex (Cranial Nerves)_
_Absent Nose/Ear Twitch Reflex (Cranial Nerves)_
_Paresis on the Same Side of the Lesion_
**Brain Stem**
_**\***Intelligence is intact but the animal will be Depressed_
\*_Brain Stem Lesion- Depression and Cranial Nerve Abnormalities_ (All Cranial Nerves run through the Brain stem)
\*Paresis- Motor Nerves in the Brainstem are not Functioning. _Paresis on the Same Side of the Lesion because Cross over Does not Occur in the Brainstem_
230
What are the **Best Macrocyclic Lactones** to Kill Heartworm _Microfilaria_
**Moxidectin- Best**
**Ivermectin- 2nd Best**
**\***If you are going to use Ivermectin, put Doxycyline on at the Same Time- Combination of _Ivermectin and Doxycyline kills Microfilaria Quickly_
\*Milbemycin is Good, but only used Off-Label because it is not Registered as a Microfilaricidal Drug
231
In All cases of **Type 1 Idiopathic Seizures**, the CSF should be \_\_\_\_\_
**Normal**
232
Clinical Signs for ______ Include:
_Wounds/History of Trauma_
_Paraparesis/Paraplegia_
_Neurogenic Shock_
_Spinal Hyperesthesia (Pain)_
_Spinal Edema_
_Shiff-Sherrington Syndrome_
**Vertebral Fractures/Luxations**
\*Vertebral Fractures/Luxation most Commonly are Caused by **Trauma (HBC)** to the _Sacroiliac or Thoracolumbar Region_
_**Shiff-Sherington Sydrome**- Fracture in the **Thoracolumbar Area**. Neurons going from the Back Legs to the Front Legs that are Inhibitory. If these Nerves get Damaged then the Back Leg Neurons aren't Inhibitng the Front Legs leading to a Dog with **Stiff Front Legs**_
234
Condition Common in **Dobermans** Characterized by Spinal Cord Compression at the Base of the Neck, Especially around **C5-C6** that is also known as Canine Wobblers. **_There will be Stenosis (Narrowing) of the Vertebral Canal_** in the Neck leading to Tetraparesis/Tetraplegia
**Cervical Spondylomyelopathy**
**\***Particularly seen in Dobermans and Giant Breed Dogs- _Tetraparesis_
_\*Marked Stenosis of the Spinal Cord Putting Pressure and Damaging those Nerves. All Dobermans tend to have some Degree of Stenosis_
235
True/False: It is NOT the Number of Heartworms, but Rather the Amount of Blood Flowing past the Heartworms that Dictates the Pathology in the Lungs
**True**
**\***_The MORE Active the Animal- The WORSE the Pathology. Small Numbers of Worms in Dogs which Exercise regularly cause more severe Pathology than Large Numbers of Worms in Dogs that are Sedentary_
_\*Most Sedentary Dogs are Asymptomatic_
236
Seizures that **Disrupt Function in the Area of Cerebrum where they occur**
**Partial Seizures**
**\***Clinical Signs depend on the location of the Focus in the Brain
\*If the Focus is in the _Motor Cortex_- Chewing Gum Seizures, Contralateral Limb Jerking, Head Turning to one Side
237
\_\_\_\_% of Large Breed Dogs and \_\_\_\_% of Miniature Schnauzers Do Not Recover from **Fibrocartilagenous Emboli**
**65%- Large Breed**
**22%- Miniature Schnauzers**
238
Treatment for **Malignant Peripheral Nerve Sheath Tumors**
**Surgical Resection**
**\***Normally Involves Removing a Nerve- Decreased Motor Function
\*Chemotherapy and Radiation do not Work Well Against MPNST
240
Condition also known as "Canine Wobblers" that is a Big Problem in Working Dogs where there is Disk Protrusion in the **L7-S1** Area of the Spine that puts Pressure on the Cauda Equina (Nerve Endings) that Damages the _Sciatic Nerve, Pudendal Nerve, and Caudal Nerve_
**Lumbosacral Malarticulation-Malformation**
241
Length of the Dirofilaria Immitis (Heart Worm) Life Cycle
**App. 6-8 Months**
242
Canines that are Heartworm Positive and present with _Moderate/Severe_ Signs (Weight Loss, Cough, Exercise Intolerance). What Drug do we Use to Treat Clinical Signs in the **Lungs**?
**Prednisolone**
**\***Give Prednisolone over a 2-5 Day Period- Sorts out the Lung Changes
243
Main Drug for **Anticonvulsant** Therapy in Cats
**Phenobarbital**
_\*Potassium Bromide in Cats- 50% will develope Eosiniphilic Pneumonitis (Feline Asthma) and Renal Insufficiency- Don't use Potassium Bromide in Cats_
245
Type of **Cervical Disc Disease** that Occurs 75% in Chrondrodystrophics and Poodles and 25% in Large Breed Dogs (Labs, German Shepards, Rotties)
**Type 1**
**\***_Calcified Hyaline Cartilage in Chondrodystrophic Breeds_
246
Life Stages of Dirofilaria Immitis (Heartworm)
**L1 = Microfilaria**
_Microfilaria circulates in Body for up to 3 Years_
\*L1 may be Taken in by a Mosquito- Can Develop inside a Mosquito from an L1 to an L2 or L3 within the Mouth Parts of the Mosquito. When the Mosquito bites another dog, the L3 then can Infect another Dog
\*L3 Can move into the Bite Wound from the Mosquito and establish an Infection in the Dog. _8-10 L3 (Heartworm) can be Injected at the Site._
_\*_L3 hang around at the Bite site for 3-4 Days, then Molt into L4 and migrate through the subcutaneous tissues. L4's Molt into L5's. When they Become L5's, L5's Burrow through smooth Muscle and Lodges in the Distal Pulmonary Artery. Once in the Pulmonary Artery, the L5's Molt into Adults (20cm) and start producing L1's and the Lifecycle begins again
247
**Macrocyclic Lactone** that is a _Registered Microfilaricide_ that kills the L3 and L4 Larvae up to 1 Month of Age
**Moxidectin**
248
Placing Foreceps into the Ear of a Patient and Seeing the Ear Twich is Testing which **Cranial Nerve**?
**Trigeminal**
_**\***Trigeminal Nerve Travels down to the Brainstem and the Facial Nerve travels back to the Ear causing the Twitch_
249
True/False: If we Pinch the Toe of the Hind Right Limb, the Left Hind Limb should Extend _in a Standing Dog_
**True**
**\*Cross Extensor Reflex**- Only occurs if the Dog is Standing
\*If the Patient is laying down, the Cross Extensor Reflex should not Occur
\***If you see the Cross Extensor Reflex while the Animal is Lying down- Upper Motor Neuron Problem**
250
Decreased/Absent Voluntary Motor Activity in **All Four Limbs**
**Tetraparesis/Tetraplegia**
**\***Caused by Lesions in: _Brain, Neck, C6-T2, Peripheral Nerves, and Muscles_
251
50% of Seizures in **Felines** are \_\_\_\_\_, mainly Mild Generalized or Partial Seizures
**Non-Convulsive**
**\***Do not commonly have Tonic/Clonic seizures in Cats
_\*Seizure Signs in Cats are more variable_
_\*50% of Seizures in cats are Idiopathic (Type 1) and 50% are Symptomatic (Type 2)_
252
\_\_\_\_\_\_\_ Seizures/Epilepsy commonly occur in **1-5 Year Old Dogs** with a **Genetic Basis** in Golden labs, Border Collies, and German Shephards
**Idiopathic**
_**\***Epilepsy/Seizures in any Dog_
_\*Epilepsy/Seizures in any Dog \> 5 Years Old- Think Neoplasia or Metabolic Disease_
\*Dobermans DO NOT commonly have Idiopathic Seizures- Need to Work Dobermans up if they come to the clinic Seizuring
254
Which Drug is Given to Patients with **Upper Motor Neuron Bladder** to Help Open up the Sphincter?
**Prazosin or Phenoxybenzamine**
255
**Degenerative Myelopathy** leads to ____ Motor Neuron Signs in the Hind Limbs
**Upper**
_**\***Hyperreflexia, Normal Pain Sensation_
_\***Non Painful** Degeneration of the Spinal Cord Axons_
256
Potential Causes of ____ **Vestibular Disease**:
_Neoplasia_
_Infections- Distemper/FIP_
_Hypothyroidism_
_Trauma_
_Strokes_
**Central**
_\*In the Brainstem_
258
\_\_\_\_\_\_\_ Stimulate a _Powerful Inflammatory Reaction_ within the Lungs leading to:
Coughing/Dyspnea
Proliferation of Smooth Muscle
_Granulomas_ in Vessel Walls
_Thrombus_ Formation
_Acute Right Sided Congestive Heart Failure_
**Dead Heart Worms**
**\***Most of these Dogs will Die Suddenly (CHF) due to the Increased Inflammatory Response to the Dead Worms
259
Treatment for **Cervical Disk Disease**
No Neurological Deficits- **Cage Rest + Prednisolone (Pain)**
Neurological Deficits- **Surgery-Ventral Decompression (Slanted Slot)**
260
Generalized **Tonic-Clonic seizures** in clinically normal puppies _up to 4 months of Age_
**Juvenile Epilepsy**
**\***Laboratory results are normal
_\*Treatment- Phenobarbital- Wean off if seizure free after 6 months_
261
In Large Breed Dogs, the Nulceus Pulposus of the Intervertebral **Disk** will undergo Degeneration into Fibrocartilage. In Small Breed Dogs (Ex. Dauchshunds) the Nucleus Pulposus Degenerates into \_\_\_\_\_\_
**Hyaline Cartilage**
**\***Hyaline Cartilage Formation occurs when Small Dogs are about 1 Year of Age
\* _70% of Thoracolumbar Intervertebral Disk Disease Cases will be Dauchshunds_
262
Type of **Disk Disease/Protrusion** that is Common in Large Breed Dogs where Fibrocartilagenous Disks Slowly Protrude leading to Thickening of the Annulus Fibrosis causing Spinal Cord Compression and Ruputure of Dorsal Longitudenal Ligaments
**Hansen Type 2**
**\***Hansen Type 2- Very Slow Protrusion
Hansen Type 1- Very Fast (Bullet Like)
263
What **Nerve** is Injured in these Felines?
**Sciatic Nerve**
**\***Dropped Hock
264
Which Drug can be given in Conjuction with _Ivermectin (Prophylaxis)_ to Significantly Decrease Microfilaria Counts
**Doxycycline**
**\***Wolbachia, which are living inside the Heartworms, can be Killed with Doxycycline. _Doxycycline Coupled with Ivermectin really Knock down the Number of Microfilaria_
**_\*_Best Treatment for Heartworm- Ivermectin with Doxycycline, followed by Melarsomine**
265
**Protocol** for _Status Epilepticus_
**1. Stop Seizures- Phenobarbital**
**2. Sample- FBC (Full blood count), Biochemistry, Urine**
**3. Stabilize**
266
Condition when a Focus of Neurons in the **Cerebral Cortex** start Firing Rapidly
**Seizures**
**\***If the Firing Neurons stay in the Focus- _Partial Seizure_
\*If the FIring Neurons Spread throughout the Brain- _Generalized Seizure_
_\*Most Common Type of Seizures are PROVOKED seizures- Ex. Animal that gets into the Rat Poison. These Seizures are only Temporary_
267
Intervertebral **Disks** work as _Shock Absorbers_ and Allow Movement of the Vertebral Bodies. What are the Two Parts that Make up a Disk?
**Annulus Fibrosis**
**Nucleus Pulposus**
\*Annulus Fibrosis- Fibrous Connective Tissue Ring that makes up the Outside of the Disk
\*Nucleus Pulposus- Gel-Like Substance located in the Middle of the Disk. _Overtime the Nucleus Pulposus Degenerates and forms Fibrocartilage in Large breed Dogs_
268
Type of **Cervical Disc Disease** that Occurs Mainly in Dobermans and Rottweilers (Large Breed Dogs) at **C6/7**
**Type II**
**\***_Most Typical Type in Large Breed Dogs_- Canine Wobblers
269
Condition caused by **Degeneration of Sympathetic and Parasymphathetic Ganglia** mainly seen in Felines that was Contributed to _Clostridium Botulinum_
**Dysautonomia**
\*Only 30% Survive- _Mainly Knocks out the Parasymphathetic System_
270
Condition with **Recurrent Partial or Generalized Seizures**
**Epilepsy**
**Type 1 Idiopathic Epilepsy**- We cannot make these animals better because we don't know whats wrong with them- _Put on Antiseizure Drugs_
**Type 2 Symptomatic Epilepsy**- Ex. Brain Tumor- Treatment = _Treat the Underlying Cause of the Seizures_
271
Condition Common in Older _Working Breed Dogs_ that causes:
_Hunched Stance_
_Flaccid Tail_
_Incontinent_
_Sunken Hock_
_Absent Cranial Tibial Reflex_
_Decreased Pudendal Reflex_
**Lumbosacral Malarticulation-Malformation**
\*Flaccid Tail- Damage to the Caudal Nerve
\*Incontinent- Damage to the Pudendal Nerve
\*Absent Cranial Tibial Reflex- Damage to Sciatic Nerve
272
Cranial ____ happens more Often in Cats because they have Less Masticatory Muscle Mass and a Thinner Calvarium than Dogs
**Trauma**
273
A Lesion between **T2-L3** Spinal Nerves will Result in ___ Motor Neuron Signs to the Hind Limb
**Upper**
274
Condition of **Dilated Ventricles of the Brain** caused by _Decreased CSF Flow_ that is commonly Congenital or due to Neoplasia
**Hydrocephalus**
_\*Increased Pressure from CSF Fluid destroys the neurons around the fluid and Destroys the Cerebral Cortex- Intellegance, Behavoir_
