Feline Neurology Flashcards by Blake Thordarson

Degenerative causes of Generalized Encephalopathies in Felines

Storage diseases

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Anomylous causes of Generalized Encephalopathies in Felines

Hydrocephalus and Lyssencephaly

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Metabolic causes of Generalized Encephalopathies in Felines

Hepatic Encephalopathy, Hypoglycemia, Electrolyte Disorders, Polycythemia

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Nutritional causes of Generalized Encephalopathies in Felines

Thiamine Deficiency

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Causes of Focal Encephalopathies in Felines

Neoplastic: Primary Meningioma or Metastatic
Vascular: Feline ischemic encephalopathy

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Immune-mediated, non-infectious causes of Generalized Encephalopathies in Felines

Polioencephalomyelitis

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Infectious causes of Generalized Encephalopathies in Felines

Viral: FIP**, FeLV?, FIV?
Bacterial
Fungal: Cryptococcus, Toxoplasma

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Toxic causes of Generalized Encephalopathies in Felines

Toxins

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Traumatic causes of Generalized Encephalopathies in Felines

Hit By Car, Dog Attack

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Neoplastic causes of Focal Encephalopathy in Felines

Meningioma***

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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

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How does hydrocephalus present usually?

younger cats, 4yo is a bit old for it

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How do storage disease usually present?

more tremors and ataxia than anything

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How do hepatic encephalopathies usually present?

Seizures, head-pressing, ptyalism, disorientation, blindness, stupor/coma

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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

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What is treatment of FIP?

No effective treatment. If you catch early enough, steroids can be palliative against the inflammation.

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How does cryptococcus present?

Roman Nose. 80% will have respiratory signs. 50% will have cutaneous lesions

DX by capsular antigen test

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How do you treat cryptococcus?

Amphotericin B + Fluconazole and treat until antigen tests are negative

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Prognosis of cryptococcus?

Fair to good so keep your head up!

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Vascular causes of Focal Encephalopathy in felines

Feline ischemic encephalopathy

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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

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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