Lecture 5: Diseases of nervous system: inflammatory/degenerative

Question 1

What is the cause of equine degenerative myelopathy/ neuroaxonal dystrophy

Answer 1

temporal vitamin E deficiency within 1st year of life

Question 2

what horses have genetic susceptibility to equine degenerative myelopathy

Answer 2

quarter horses, Morgan’s and thoroughbreds

Question 3

what are some signs of equine degenerative myelopathy

Answer 3

young horse with symmetrical ataxia, paresis, wide based stance, pacing

Question 4

how do you dx equine degenerative myelopathy

Answer 4

1. Low serum vitamin E
2. Rule out other differentials
3. Necropsy for definitive dx- central axonal degenerative projected in somatosensory tracts

Question 5

what is tx for equine degenerative myelopathy

Answer 5

natural source alpha tocopherol 5000 IU/day

Question 6

how do you prevent equine degenerative myelopathy

Answer 6

feed 1-2IU/kg vitamin E for first 3 years of life

Question 7

what is prognosis for equine degenerative myelopathy

Answer 7

poor response even if caught early

Question 8

what is etiology of equine motor neuron disease

Answer 8

disease of adults after prolonged vitamin
E deficiency that predisposes to oxidative stress or neurological system resulting in denervation of skeletal muscle

Question 9

what are some signs of equine motor neuron disease

Answer 9

feet close together, elevated tail head, low head carriage, shifting weight, walking can induce muscle fasciculations, nostril flare and sweating

No ataxia

Question 10

how do you diagnosis equine motor neuron disease

Answer 10

1. Biopsy of dorsal coccygeal muscles- sacrocaudalis dorsalis

Question 11

what is tx for equine motor neuron disease

Answer 11

natural alpha tocopherol 5000 IU/day

Question 12

What horses have genetic predisposition for cervical stenotic myelopathy (wobblers)

Answer 12

Thoroughbreds, warm bloods, Tennessee walking horses

Males over presented
Young well feed, rapidly growing horses

Question 13

what are the copper and zinc levels in wobblers

Answer 13

low copper, high zinc

Question 14

what causes wobblers

Answer 14

ataxia induced by developmental abnormality and degenerative conditions of cervical vertebrae

Question 15

what is dynamic/ type 1 wobblers

Answer 15

Unstable, affects 6-18 months old

Question 16

what is static/type 2 wobblers

Answer 16

compressive affects 3-5 year olds

Question 17

what are the most common sites affected by wobblers

Answer 17

1. C3-C4
2. C4-C5
3. C5-C6

Question 18

how do you dx wobblers

Answer 18

1. Ataxia worse behind than in forelimbs
2. Wobbler heels (scabs from hind limbs hitting front)
3. <0.5 ratio C4-C6, <0.52 ratio C7, malalignment on rads

Question 19

what is the medical tx for wobblers

Answer 19

1. Cervical facet injections
2. Slowed growth via restricted calorie diet
3. Rest, no herd mates

Question 20

what is the sx tx for wobblers

Answer 20

vertebral fusion

Question 21

what is the etiology of cervical articulate facet arthritis

Answer 21

mild cases of wobblers that worsen with age or trauma

Question 22

what are some signs of cervical articulate facet arthritis

Answer 22

+/- spinal ataxia, hind limbs worse than forelimbs, stiff neck

Question 23

how do you dx cervical articulate facet arthritis

Answer 23

rads- show enlarged facets

Question 24

middle aged horse presents with stiff neck and mild ataxia. What is problem based on rads

Answer 24

Cervical articulate facet arthritis

Facet to the right much larger than facet on left

Question 25

what is tx for cervical articulate facet arthritis

Answer 25

1. Cervical facet injection 2. NSAIDS 3. Gabapentin

Question 26

what wrong

Answer 26

C2 fracture

Question 27

what are some signs of spinal cord trauma

Answer 27

pain, reduced mobility, abnormal neck position, +/- neurological signs

Question 28

how do you dx spinal cord trauma

Answer 28

1. Localize lesion 2. Rads 3. Fracture sometimes palpable

Question 29

what is conservative tx for spinal cord trauma

Answer 29

1. Analgesia - NSAIDS, butorphanol, lidocaine or ketamine CRI 2. Anti-inflammatories 3. NSAIDS, steroids

Question 30

what is sx tx for spinal cord trauma/ fracture

Answer 30

stabilize fracture with implants and prevent large callus formation

Question 31

what is the prognosis for spinal cord trauma that resulted in immediate tetraplegia with loss of deep pain

Answer 31

grave prognosis and immediate euthanasia warranted

Question 32

what is prognosis for spinal cord trauma without neurological dysfunction

Answer 32

fair to good prognosis

Question 33

what is the prognosis for spinal luxations or fractures of vertebral body

Answer 33

guarded to poor

Question 34

what can cause osteomyelitis

Answer 34

strangles, tuberculosis, brucellosis or extension of soft tissue infection

Question 35

what are some clinical signs of osteomyelitis

Answer 35

pyrexia, stiff neck, pain, abnormal neck posture, poor appetite, weight loss

Question 36

what are some blood work findings consistent with osteomyelitis

Answer 36

leukocytosis, neutrophilia and hyperfibrinogenemia

Question 37

what is tx for osteomyelitis and prognosis

Answer 37

aggressive antimicrobial tx but guarded prognosis

Question 38

horse recently recovered from strangles, presents with stiff neck and fever. What is likely wrong based on rads and signs

Answer 38

Osteomyelitis

Question 39

what is the etiology of shivers

Answer 39

degeneration of cerebellar Purkinje cell axons

Question 40

who is most affected by shivers

Answer 40

male warm bloods, thoroughbreds and tall breeds

Question 41

what must you do in PPE to evaluate shivers and failure to do so can result in malpractice

Answer 41

back them up

Question 42

what are some clinical signs of shivers

Answer 42

hypertonic muscle contractions and protracted abduction and hyperflexion of hind limbs when walked backwards

Question 43

what is tx for shivers

Answer 43

1. Vitamin E- neuroprotectant and antioxidant 2. PT

Question 44

what is stringhalt associated with

Answer 44

weeds or trauma to sensory nerves of limbs or unknown

Question 45

stringhalt is only evident at what gait/speed

Answer 45

walk

Question 46

what other disorder is commonly seen with stringhalt

Answer 46

laryngeal paralysis

Question 47

what is tx for stringhalt

Answer 47

remove weed Lateral digital extensor tenectomy

Question 48

what causes fibrotic myopathy

Answer 48

damage and scarring or fibrosis of semi membranes is or semitendinosis muscle

Question 49

what are some signs of fibrotic myopathy

Answer 49

interrupted anterior phase of the stride “goose stepping”

Question 50

what causes upward fixation of the patella and what is the resulting sign

Answer 50

poor quadriceps tone causes the medial patellar ligament to get aught on medial trochlear ridge and maintain extension via “stay apparatus”

Question 51

what are some tx for upward fixation of patella

Answer 51

1. Conditioning 2. Tendon splitting 3. Cutting- don’t really do this

Question 52

what is the pathophysiology of polyneuritis equi

Answer 52

progressive granulomatous polradiculoneuritis involving cauda equine, cranial nerves and other spinal nerves

Question 53

cause is unknown but theorized to be ___ because of __present

Answer 53

allergic neuritis, P2 myelin protein antibodies

Question 54

what are some signs of polyneuritis equi

Answer 54

dysuria, tail rubbing, loss of skin sensation in ind end, hyperesthesia, paralysis of tail, bladder, rectum, anus, penis, fecal retention and overflow urinary incontinence, CN abnormalities

Question 55

what is the definitive dx fo polyneuritis equi

Answer 55

necropsy- nerve roots have granulomatous inflammation and mixed cell infiltrate leading to myelin/axonal degeneration and distortion of fibrous tissue

Question 56

what are some differential dx for polyneuritis equi

Answer 56

fractures of tail head/ sacrum, pelvis, EPM, EHM

Question 57

what is tx for polyneuritis equi

Answer 57

1. Supportive/ palliative 2. Fecal removal and catheterization 3. Steroids

Question 58

what is prognosis for polyneuritis equi

Answer 58

grave

Question 59

what is the promising diagnostic biomarker for neurological disorders

Answer 59

phosphorylated neurofilaments- H (Pnf-H)