Neuro 2 Flashcards
You have a large breed dog presenting for acute ataxia with no head involvement. Only 1 hindlimb is involved. It is not progressive and has been going on since last night. What is your diagnosis? How do you double check? what is your treatment?
fibrocartilaginous embolism (FCE).
rads/MRI/CT
supportive care and time! (mobility support, fecal/urinary support, cleaning), physiotherapy
improvement in 2 weeks, may be ongoing for 3-4 mo
You have a 9 yo GSD presenting for non-head involved ataxia. It has been progressive for the past couple months. Only the hindlmbs are involved and there is no pain. What do yo think is going on? how do you treat?
degenerative myelopathy (but remember, this is a diagnosis of exclusion)
supportive care, mobility support, physiotherapy, maintain healthy weight
You have a dog presenting for non-head involved ataxia. Only the hindlimb are involved and there is pain. You take rads and this is what you see. What do you think it is? What is the treatment?
discospondylitis
8+ weeks Abx or antifungals (week 1 IV if neuro deficits), pain relief, cage rest
You have a dog that comes in with non-head involved ataxia. Both himdlimbs are involved and there is a lot of pain. You take rads and this is what you find. What is going on? How do you treat?
fracture
euthanasia, pain mgmt, stabilization, REFERRAL
You have a dog presenting with hindlimb ataxia. It has been progressive over the past few months. You take rads and this is what you find. What is going on? How do you treat?
neoplasia
euthanasia, palliative, REFERRAL
You have a dog diagnosed with idiopathic epilepsy. Tell me about treatment. What are your options? What are the best ones? What monitoring should you do? When should you consider an anti epileptic?
Phenobarbital > phenobarbital & KBr > levetiracetam (keppra) or gabapentin or zonisamide
Consider anti-epileptic if:
- 2+ seizures in a mo
- seizure longer than 5 min
- clusters of seizures (2+ in 24h)
- keep a seizure log
therapeutic blood level check 2-4 weeks after starting, 3mo out, and then every 6 mo
the most common cause of seizures in cats is…?
infectious neuro
ex. rickettsial, parasitic, protozoal, bacterial, fungal, viral
hepatic encephalopathy is worse when? how do you diagnose? how do you treat?
worse after a high protein meal
liver function (bile acids) and imaging
non-absorbable disaccharides (ex. lactulose), Abx (metronidazole), dietary changes, go for sx
What are some non-infectious inflammatory causes of seizures? how do you treat?
eosinophilic meningoencephalitis (young), encephalitis (young, pug, Maltese, yorkie), GME (old dog), periventricular encephalitis, non-suppurative meningoencephalitis (cats)
anticonvulsants, supportive care, corticosteroids, chemo drugs, euthanasia
how do you treat the pre-ganglionic causes of Horner’s syndrome?
- idiopathic = none
- traumatic, iatrogenic = supportive care
- neoplasia = sx, chemo, radiation
- infection = doxycycline (from ticks)
how do you treat the post-ganglionic causes of Horner’s syndrome?
- otitis media/intenra = tx infection
- post-op TECA-BO = supportive care
- idiopathic = none
- neoplasia = sx, chemo, radiation
Horner’s syndrome in dogs is mainly _____. tx? breed disposition?
idiopathic
goldens and cocker spaniels
tx: most resolve spontaneously, some are permanent. either way, no tx
You have a yorkie presenting with hindlimb ataxia. there is pain involved and an acute onset. you take rads and see this. what is happening? how do you treat it?
atlantoaxial subluxation
young toy breed:
any age/breed: trauma
neck pain > ataxia > weakness > paralysis
tx: conservative (rest, neck brace, pain meds), sx
px is good for young dog, acute onset with mild C/S
What are the C/S of trigeminal neuritis? What is the typical signalment?
acute onset flaccid jaw paralysis
older Goldens
Horner’s syndrome, facial paresis, decreased facial sensitization also possible
cause = unknown
you have a 9yo golden retriever presenting with this main complaint. what is the diagnosis? how do you confirm the dx? how do you tx?
trigeminal neuritis
CSF analysis: mild to mod elevations in TP, nucleated cell count
tx: supportive feeding care bc can’t close jaw
recovery in 1-9 weeks, mean 3 weeks
