Feline Neurology Flashcards
You’re performing a neuro exam on a cat and are struggling to observe a cutaneous trunci reflex and menace response. Is this abnormal?
No, 1/3 of cats will not show a cutaneous trunci reflex. As for the menace, cats are harder to elicit this with, you may need to do a sneak attack or lay them on their back.
Briefly describe feline hyperesthesia syndrome. What happens in severe cases?
Typically cats are ~ year old and seemingly have hallucinations, twitching with head involvement and in severe cases will self mutilate their tail. Their labs will come back normal, making us think its caused by vaculolar myopathy or a seizure. GABAPENTIN is a good starting point for 2/3 of patients
Briefly describe idiopathic epilepsy in cats.
Idiopathic epilepsy can occur at any age but typically affects cats over 7 years old. The seizures occur during resting conditions with rapid running being common during and then the cat will be normal during interictal states. These cats should be treated with phenobarbital or levetiracetam.
In healthy cats with no hx of liver dz that have idiopathic epilepsy __ is the most appropriate choice
Phenobarbital
What 2 drugs should not be used to treat idiopathic epilepsy in cats?
Potassium bromide and diazepam
Idiopathic epilepsy has a __ prognosis for older patients but a __ response rate to anti seizure drugs and a __ complete remission of seizures
Poor, 70%, 40%
Audiogenic Reflex Seizures is in __ cats and associated with ___ sounds. Avoiding these sounds can eliminate seizures in __ of cases while __ is the go to drug
Older Birman, high pitched, 75%, Keppra
The drug of choice for idiopathic epilepsy is __ while the drug of choice for audiogenic reflex seizures is __
Phenobarbital , Keppra (levitiracetam)
Hippocampal Necrosis is __ and cats will have what clinical signs? What treatment is used
Hippocampal necrosis is focal and cats will show aggressive behavior, hyper salivation, vocalization, and facial twitching. What’s interesting about this condition is the animals don’t response to conventional treatment so a combo therapy of pheno + Keppra with prednisolone is used
Name 6 common CNS infections in cats
FIP
Toxoplasmosis
Cryptococcus
FeLV
FIV
Panleukopenia
What is the most common diagnosis of cats with CNS inflammation/infection?
FIP
What are exam findings of a cat with FIP? What is pathopneumonic?
Anterior chamber hemorrhage and Iris vasculitis because this is a CNS disease and the optic nerve is an extension of the brain. On MRI, we should see ventricular dilation and periventricular contrast enhancement which is pathopneumonic for FIP
FIP is diagnosed by high ___ titers and treated with ___ which has a ___ response to treatment. The virus will come back eventually but you can retreat, however developing resistance is possible.
CSF coronavirus, remdesevir, 80-85%
Toxoplasmosis causes CNS disease when __ become __ and is more common in __ animals.
Bradyzoites become tachyzoites and immunocompromised
How do you DX toxoplasmosis?
IgG positive -> exposure
IgG neg, IgM positive -> more likely recent exposure
PCR may be helpful
The more definitive diagnoses is doing a CSF tap and seeing the Protozoal cysts with inflammation
Toxoplasmosis treatment
Clindamycin, or TMS
Prognosis is good if caught early
Cryptococcus is the most common fungus causing __ signs in cats and is more common with abundant __ in the environment. The gold standard of dx is __ while serology and CSF may also be helpful.
Cryptococcus is the most common fungus causing neurological signs in cats and is more common with abundant bird feces in the environment. The gold standard of dx is fungal culture while serology and CSF may also be helpful.
How would you treat cryptococcus? Prognosis?
Fluconazole for life
Prednisolone for 3-5 days
Amphotericin B and flucytosine combo
Prognosis is good so long as patient is not obtunded
FeLV has a predisposition to other __ infections and __
CNS, lymphoma
FIV is a __ virus that on cytology will show __ and __ but CNS signs are only reported in ___ of cases
Neurotropic, perivascular cuffing, glial nodules, 1-5%
Feline Panleukopenia Virus causes ___ when infected in utero, perinatally or by a __ vaccine in a pregnant queen. It is a non-progressive disorder with no inflammatory changes within the brain
Feline Panleukopenia Virus causes cerebellar hypoplasia when infected in utero, perinatally or by a live vaccine in a pregnant queen. It is a non-progressive disorder with no inflammatory changes within the brain
A cat comes into your clinic acutely blind but with a normal ocular exam in august, what is your top differential?
Feline ischemic encephalopathy
Feline ischemic encephalopathy treatment
Ivermectin (effective against cuterebra) , Prednisolone once, and Premed with diphenhydramine may work but Shinn recommends a craniotomy
briefly describe global cerebral ischemia
The maxillary artery supplies the brain cerebellum and forebrain but can be occluded if the cats jaw is open for an extended period of time (ex. Dental). This results in the cat waking up with blindness and seizures that are irreversible. They can be treated with anti seizure meds but prognosis is poor.
Cervical ventroflexion is most commonly caused by __ and is more common in cats because of the lack of a __. __ and __ are also common causes
Hypokalemia, nuchal ligament, thiamine deficiency and myasthenia gravis
Cervical ventroflexion is most commonly caused by __ and is more common in cats because of the lack of a __. __ and __ are also common causes
Hypokalemia, nuchal ligament, thiamine deficiency and myasthenia gravis
Brief description of Thiamine Deficiency
In cats this vitamin is needed for carb metabolism so a lack of it would cause vestibular signs, vision loss, mydriasis without pupil light reflexes, ataxia and seizures. Some signs may persist once you catch it but it can be ok if you catch it
Meningiomas account for __ of primary brain tumors. What are the clinical signs? MST?
57%
Behavioral change, seizures, ataxia, visual impairment
18 day MST with medical therapy but 37 months with surgery
What is the most common neoplasm affecting the spinal cord and second most common intracranial tumor in cats?
Lymphosarcoma
