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Equine > Neuro > Flashcards

Neuro Flashcards

1
Q

Clinical signs of kissing spines

A
  • Pain on palpation
  • Poor muscling
  • Abnormal dynamic response
  • Resentment of ridden exercise
  • Poor canter
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2
Q

Signs of dorsal spinous process impingement on Xray

A

Kissing spins
Withers have narrow/no spaces in between them
Override==> coalesce and bony remodelling too

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3
Q

DSPs management

A
  • Local injection of corticosteroids + rehabilitation programme (strengthen core, water treadmill, equiband)
  • Interspinous ligament desmotomy (can be back in work quickly (good for young TBs who can’t afford to have time off)
  • Subtotal (cranial wedge) ostectomy. Invasive but better outcomes
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4
Q

what other structure might be involved in DSP? and how to manage

A

Articular joint processes (only in cervical region)

Manage: Corticosteroid injections

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5
Q

signs of sacroiliac disease

A
  • Can buck under saddle
  • Becomes disunited at canter
  • Has poor hind limb engagement
  • Occasionally has overt lameness
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6
Q

how to block scare iliac joint

A
  • Inject local into the sacroiliac joint bilaterally
  • Observe the horse ridden before and after blocking

Risks:
- SIJ close to important structures
- Inadvertent block of the cranial gluteal nerve  recumbent for 3-4 hours

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7
Q

tx for sacro iliac disease

A

Regional medications
The joint: About the size of a 50p with ~3ml of synovial fluid = tiny

Injection technique:
- Needles are 12-20cm long
- Injectate is 10-20mls on each side… very rarely injecting the actual joint, more the region

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8
Q

how does Nuclear Scintigraphy (Bone scan) work

A
  • Technetium-99 bonded to methylene diphosphate
  • MDP binds to hydroxyapatite crystals during osteoblastic activity in bones
  • TC emits radiation as it decays
    o The of uptake determined by bone turnover
    o Damage areas of the skeleton or areas trying to heal will take up more MDP and emit more radiation
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9
Q

what To do to a horse before and after bone scan

A

delivered in led tube by special courier just before
Exercised + rugged just prior = vasodilation MDP goes to extremities.
Secreted in urine so cover legs to prevent splashing

isolate for 36-48 hours as excreted in urine

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10
Q

4 examination steps for poor performance

A

Observe ridden
Palpation: of neck and epaxial muscles and sacroiliac region
- Assess muscle mass, tone, symmetry and look for pain
- Pressure either side of tail base = should be no response
Baited stretches
Sternal lift (sustained pressure = should see dorsal flexion)

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11
Q

why can poor performance localise to the tarsal region be a bother

A
  • Suspensory ligament and tarsometatarsal joint usually cause of lameness here
  • Image to differentiate (Suspensory inserts just below tarsus)
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12
Q

3 manifestations of cervical spine disease

A
  1. Neck pain/dysfunction
    o Reduced range of motion with baited stretches
    o Changes in posture
    o Reduced muscle mass
  2. Forelimb lameness
    o Outside limb lameness when circling. Either
    o 1: Muscle dysfunction: loss of muscle I the area involved in forelimb protraction (Brachiocephalicus particularly)
    o 2: Radiculopathy: Neuropathic pain causing lameness due to compression of nerve roots (joint narrows to compress intervertebral foramen)
  3. Ataxia – cervical stenotic myelopathy (compression of the whole cord)
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13
Q

signs of the 3 main ataxia presentations

A

Spinal ataxia: Proprioceptive deficits
- Crossing, abduction, circumduction, knuckling (ascending pathways)
- Foot dragging, stumbling (descending pathways)

Vestibular ataxia: Head tilt, leaning, falling to one side, wide base stance

Cerebellar ataxia:
- Loss of modulatory effect of cerebellum
- Wide base stance
- No proprioceptive deficits
- No weakness

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14
Q

mayhem scale of ataxia grading

A
  • Grade 1 – abnormalities are not consistent, present in only one part of the neurological examination
  • Grade 2 – abnormalities are consistent in all parts of the neurological examination but are mild
  • Grade 3 – abnormalities are consistent and moderate in all parts of the neurological exam
  • Grade 4 – Truncal sway is evident when the horse is stood still, signs at walk are likely severe
  • Grade 5 – The horse is recumbent
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15
Q

causes of ataxia with normal mentation

A
  • Spinal ataxia (CVCM, EHV, EPM, vitamin E related)
  • Head shaking
  • Sleep-deprivation
  • Shivers
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16
Q

causes of abnormal mentation

A

will have cerebral dysfunction and forebrain disease

Viral encephalitides EEE/WEE/VE/WNV/ Borna virus/ RAbies
head trauma
Hepatic encephalaopathy
Leukoencephalomalacia (or however you try pronounce it)

17
Q

cause and signs of Cervical Vertebral Compressive Myelopathy (CVCM)

= Wobbler’s syndrome

A

Malformation of spine causing compression on spinal cord
- Developmental condition in well-fed foals and young horses (rapid growth, dietary imbalance, genetic)

Signs:
- Ataxia - Moderate to severe
- Weakness
- Generally symmetrical deficits
- Pelvic limbs more effected
- Truncal sway, crossing and interferences when circling
- Normal cranial nerves

18
Q

dx and tx of Wobblers

A

Radiographs show compression of cord

Tx:
Young horses <12months
- NSAIDs ± Steroids (acute phase)
- Diet: Limit overnutrition (protein and/or starch)

Adult horses
- NSAIDs ± Steroids
- Mesotherapy and exercises
- Intra-articular facet joint injection (OA)
- Surgical - Ventral interbody vertebral fusion

19
Q

patho and signs of EHV1 myeloencephalopathy

A
  • Vasculitis of blood vessels in CNS ==> neuro signs

signs:
- previous respiratory disease
- fever
- symmetrical ataxia and weakness
- Also incontinence, poor anal tone

20
Q

dx and tx of EHV1

A

PCR: NP swab or blood
Serology: Paired or complement fixation if unvaccinated

Tx:
- supportive care (anti-inflammatory, IVFT)
- Prevent spread (isolate, movement restrictions)
- Valacyclovir
- steroids to treat brain inflammation

21
Q

patho and signs of Equine protozoal myeloencephalopathy

A
  • Sarcocystis neurona and Neospora hughesi
  • Migration of schizonts and merozoites to CNS = direct neurone damage
  • USA and South America
  • Ingestion of contaminated feed: concs/hay/ grass

signs:
- Any possible neurological sign
- Asymmetric ataxia with/without cranial nerve deficits (VIII, VII, X)
- Weakness (mostly pelvic limbs) and muscle atrophy (gluteus, biceps femoris, epaxial musculature)

22
Q

Dx and Tx of Equine protozoal myeloencephalopathy

A

Challening
clinical signs and area with opossums

Tx:
Pyrimethamine and sulfadiazine - 90 days treatment

Diclazuril/ponazuril - 60 days treatment

23
Q

What are the two vitamin E related ataxias

A

Equine degenerative myeloencephalopathy
- inherited in young horses
- insidious onset of symmetrical ataxia and paresis

Equine motor neurone disease
- acquired and progressive. triggered by VE deficiency (need green forage!)
- Generalised weakness, muscle fascinations, sweating, muscle atrophy

24
Q

Dx and Tx of the vitamin e ones

A

Low vit E in blood!
Also for motor neurone: confirmatory is tailed muscle biopsy to see atrophy of fibres

Supplementation! especially in dams during pregnancy

25
Q

Head shaking patho

A
  • Persistent = Trigeminal mediated idiopathic: Spontaneous activity of neurones of CN V
    See sharp and vertical head shaking
  • Symptomatic= Identify pain/irritation: Photic, allergic, sinusitis, otitis, structural (skull fractures, dental disease, TMJ), bit/bridle
26
Q

Tx for trigeminal head shaking

A

Symptomatic = identify trigger and treat

trigeminal =
- Cyproheptadine PO BID
- Carbamazepine

27
Q

What is shivers

A
  • Progressive NMSK disease
  • Around 5 years of age
  • Performance limiting
  • Unknown cause

See gait abnormalities and shivers when backing up

28
Q

What 4 agents can cause viral encephalitides

A

Eastern/Western/ Venezuelan (most found in America)
West Nile virus (outbreaks in Europe)

29
Q

Signs and Tx of the different ones

A

E/WV = fever and head tilt in Autumn/winter
- High mortality
- Can to IgM titre

WMN
- Mostly no symptoms but can have ataxia
- Hx of travel and IgM ELISA
- Vaccinate

30
Q

What other viruses cause viral encephalitides

A

Borna and rabies

Borna = white toothed shrew urine
CS: forebrain dz, fever, central blindness, high mortality

31
Q

Overall treatment for all 6 of the viral encephalitides

A

VACCINATION:
- Most effective way: annual (q 2 years) in endemic areas
- Borna virus: no vaccine available

VECTOR CONTROL:
- Time-operating insecticide spray system in the barn
- Mosquitos feed from dusk to dawn: stable at night with fly-screen windows
- Stall window fans (20 inches)> midges are poor fliers
- Apply permethrin pour-on (++) or any other fly repellent
- Rodent control in feeding rooms (borna)

32
Q

Signs of Hepatic encpalopathy

A
  • Depression
  • Sedation
  • Obtundation
  • Head pressing
  • Compulsive walking
  • Ataxia
  • Seizures

Liver enzymes elevation:
- SDH, GDH, GGT, AST, bile acids

Severe cases:
- hyperammonaemia
- Low BUN
- Prolonged clotting times (PT, APTT)

33
Q

what is Leuko-encephalo-malacia

A
  • Fatal intoxication of mycotoxins
  • Ingestion of fumononisin toxins on corn or corn by-products but not exclusively
  • Fusarium moniliforme fungus toxins (Fumonisin B1)

acute onset and death

34
Q

acute vs longterm seizure management

A

Acute phase
- Midazolam or diazepam (3 doses)
- Phenobarbital 5mg/kg q 12h

Maintenance (Foals = 3 months then tapered, adults = 6 months seizure free, then tapered)
- Phenobarbital
- K-bromide can be added for additional control
- Levetiracetam (32mg/kg q 24h)

35
Q

Signs and tx of tetanus

A

Tight jaw and facial expression
dysphagia
sweating
fixed extended neck

TX; vaccinate. tetanus anti-toxin
magnesium sulphate can block neuromuscular transmission
- Muscle relaxants: Dantrolene, methocarbamol, acepromazine

36
Q

sighs and tx of botulism

A
  • Mydriasis
  • Slow pupillary light reflexes
  • Tongue hypotonia
  • Dysphagia
  • Weakness

support. poorer prognosis

37
Q

signs of stringhalt

A

Sudden exaggerate flexion during walking
weird movement
often due to ingestion of toxic plants or mechanical damage to specific muscles

38
Q

Rye grass staggers

A

mycotoxins from rye-grass
- Dry summer/autumn after very wet spring

  • Coarse muscle tremors, thoracic limbs, muzzle> cerebellar damage
  • Jerky hindlimb movement, base wide stance, exaggerated truncal sway

Equine (11 decks)

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