Feline Neurology Flashcards
Degenerative causes of Generalized Encephalopathies in Felines
Storage diseases
Anomylous causes of Generalized Encephalopathies in Felines
Hydrocephalus and Lyssencephaly
Metabolic causes of Generalized Encephalopathies in Felines
Hepatic Encephalopathy, Hypoglycemia, Electrolyte Disorders, Polycythemia
Nutritional causes of Generalized Encephalopathies in Felines
Thiamine Deficiency
Causes of Focal Encephalopathies in Felines
Neoplastic: Primary Meningioma or Metastatic
Vascular: Feline ischemic encephalopathy
Immune-mediated, non-infectious causes of Generalized Encephalopathies in Felines
Polioencephalomyelitis
Infectious causes of Generalized Encephalopathies in Felines
Viral: FIP**, FeLV?, FIV?
Bacterial
Fungal: Cryptococcus, Toxoplasma
Toxic causes of Generalized Encephalopathies in Felines
Toxins
Traumatic causes of Generalized Encephalopathies in Felines
Hit By Car, Dog Attack
Neoplastic causes of Focal Encephalopathy in Felines
Meningioma***
Most likely causes of Generalized Encephalopathies in a 4yo DSH
Metabolic: Hepatic Encephalopathy (head pressing and salivating), Hypoglycemia (weak)
Immune-mediated: Polioencephalomyelitis
Infectious: Viral (FIP*) or Fungal (Toxo or Crypto)
Trauma: HBC
How does hydrocephalus present usually?
younger cats, 4yo is a bit old for it
How do storage disease usually present?
more tremors and ataxia than anything
How do hepatic encephalopathies usually present?
Seizures, head-pressing, ptyalism, disorientation, blindness, stupor/coma
How does FIP usually present?
Dry form has diffuse neuro signs: dementia, ataxia and CN deficits, Wet form not so much neurologic signs.
Elevated liver enzymes (ALT and ALP), BUN and creatinine, and TP (polyclonal gammopathy)
CSF Neutrophilic pleocytosis and inc. protein
Titers and PCR are useless
What is treatment of FIP?
No effective treatment. If you catch early enough, steroids can be palliative against the inflammation.
How does cryptococcus present?
Roman Nose. 80% will have respiratory signs. 50% will have cutaneous lesions
DX by capsular antigen test
How do you treat cryptococcus?
Amphotericin B + Fluconazole and treat until antigen tests are negative
Prognosis of cryptococcus?
Fair to good so keep your head up!
Vascular causes of Focal Encephalopathy in felines
Feline ischemic encephalopathy
How do brain tumors present?
Focal encephalopathy.
DX by CT or MRI
TX Surgical removal +/- radiation, steroids, and anticonvulsants!
Steroids are great at removing peritumoral edema and reduce CSF production and lower ICP
Median survival time in Cats with meningioma on palliative TX
2 months
Median survival time in Cats with meningioma on surgical TX
26 months – very responsive to surgery and quite an easy procedure too
How does FIE present?
non-progressive, acute and in the summer most often (possibly associated with cuterebra migration)
DX with CT or MRI
TX Anticonvulsants, if going to use steroids combine with Ivermectin + antihistamines as cuterebra has been implicated
Degenerative causes of Feline Spinal Cord Disease
Degenerative myelopathy (progressive, non-painful) IVDD* Type 1 more than Type 2
Anomalous causes of Feline Spinal Cord Disease
Hemivertebrae, Block vertebrae, Butterfly vertebrae, Spinal Dysraphism (spina bifida)
Nutritional causes of Feline Spinal Cord Disease
Hypervitaminosis A in cats on high liver or liver only diet
Neoplastic causes of Feline Spinal Cord Disease
lymphosarcoma or bone tumors
Immune-mediated, non-infectious causes of Feline Spinal Cord Disease
polioencephalomyelitis
Infectious causes of Feline Spinal Cord Disease
FIP
Meningoencephalitis
Diskospondylitis
Traumatic causes of Feline Spinal Cord Disease
HBC and others
Toxic causes of Feline Spinal Cord Disease
Chronic organophosphate toxicity
Vascular causes of Feline Spinal Cord Disease
Aortic thromboembolism, FCE
How does IVDD usually present?
Type 1 acute, painful
How does degenerative myelopathy usually present?
chronic, non-painful
How does diskospondylitis usually present?
chronic, progressive, back pain and paraparesis
vertebral endplate lysis*
How does spinal neoplasia usually present?
osteosarcoma and chondrosarcoma more commonly affect the spine than lymphosarcoma
How do FCE usually present?
acute, initially painful then non-progressive and non-painful. is a non-compressive lesion
How does spina bifida (and other anomalous) usually present?
Paraparesis, urinary and fecal intcontinence most common.
How do you treat spinal cord trauma?
high dose methylprednisone followed by lower dose then surgical repair. tail base fractures can be hard to repair
How does hypervitaminosis A present?
upright sitting posture
Anomalous causes of peripheral nerve disease in felines
lots: Inherited Neuropathy in Birman Cats Hyperchylomicronemia Hyperoxaluria Type II GM2 Gangliosidosis Globoid Cell Leukodystrophy Neiman-Pick Disease Gylcogen Storage Type II Muscular Dystrophy
Metabolic cause of peripheral nerve disease in cats
Diabetic neuropathy from hypoglycemia
Neoplastic cause of peripheral nerve disease in cats
lymphosarcoma
nerve sheath tumor
Infectious cause of peripheral nerve disease in cats
toxoplasma
Immune cause of peripheral nerve disease in cats
Myasthenia gravis
Chronic remitting and relapsing neuropathy
Vascular cause of peripheral nerve disease in cats
Saddle Thrombus
How does diabetic neuropathy present?
Plantigrade stance*
Pelvic limb weakness
muscle wasting and decreased reflexes
Improved with diabetic management
How does chronic remitting and relapsing neuropathy present?
Generalized, progressive, remitting and relapsing, clinical signs appear acutely and often asymmetric. Diffuse muscle atrophy
Inflammatory infiltrates in peripheral nerves
TX with steroids and taper off at about 6-8 months
How does myasthenia gravis present?
Generalized weakness that presents worse with exercise and resolves with rest
Megaesophagus and CN deficits common
DX with response to edrophonium chloride and finding Ach antibodies
TX with acytelcholinesterase inhibitors, immunosuppression and thymectomy if thymoma present
How does saddle thrombus usually present?
Acute, painful on palpation of pelvic limbs, paraparesis and cold limbs that may fail to bleed if cut. Heart disease often concurrent (HCM)
TX: treat heart disease, warm the limbs, Acepromazine for vascular dilation, heparin to prevent thrombus and Butorphanol for pain control
Differentials for cats with myopathies
Anomalous: Muscular Dystrophy
Metabolic: Hypokalemic myopathy
Infectious: Toxo
Immune-mediated: Polymyositis
How does muscular dystrophy usually present?
congenital, progressive, non-inflammatory
No treatments.
How does hypokalemic myopathy usually present?
marked ventroflexion of the head and neck
all ages and breeds can be affected
Generalized weakness, with
TX with potassium oral supplementation. Response to therapy in 2-3 days.
PX excellent
