Neurology and ophthalmology Flashcards
What structure of the eye is a thin transparent/pink mucous membrane that starts at the limbus and forms a continuous sheet over eyelids, third eyelid and globe?
The conjunctival surfaces
What breed is mucinosis common in?
Shar Pei
What clinical signs are associated with acute conjunctivitis?
Hyperaemia, chemosis, swelling/thickening, discharge, mild irritation/blepharospasm, pruritus
What are the clinical signs of chronic conjunctivitis?
Thickening squamous metaplasia of epithelium, hyperpigmentation, follicular hyperplasia.
What are the four types of ocular discharge?
- Purulent
- Thick/tenacious
- Serous
- Haemorrhagic
What are some non-infectious causes of conjunctivitis?
FBs, irritants, allergic, adnexal disease
What is entropion?
Inversion of the eyelid margin
How do you treat entropion?
Hotz-celcius surgery involving the removal of elliptical piece of skin
What is distichiasis?
Extra eyelashes emerge from meibomian gland orifices
What are ectopic cilia?
Lashes that arise from the follicle inside/near the meibomian gland. They emerge through the conjunctiva at right angles to the cornea.
What does KCS stand for?
Keratoconjunctivitis sicca - dry eye
What breeds are pre-disposed to KCS?
WHWT, Pug, Shih Tzu, CKCS, English cocker
What are the clinical signs of dry eye?
Recurrent conjunctivitis that improves with any topical treatment, tacky mucoid-mucopurulent discharge stuck to the ocular surface.
Blepharospasm +/- corneal ulceration
What additional clinical signs are seen with chronic KCS?
Corneal vascularisation, fibrosis and pigmentation, reduced vision
What is considered a normal Schirmer tear test?
15-25 mm/min
What is epiphora?
Tear overflow due to poor teat drainage
What conditions can a red eye be a sign of?
Uveitis, glaucoma and scleritis/episcleritis
What topical antibiotics can be used in ophthalmology treatment?
Fusidic acid (Isathal)
Chloramphenicol drops/ointment
Other antibiotics based on C+S
What infectious pathogens can cause feline conjunctivitis?
Chlamydophila felis
Feline herpesvirus-1
Feline calicivirus
Mycoplasma felis
Bordetella bronchiseptica
What are the clinical signs of Chlamydophila felis?
Conjunctivitis
Chemosis
Hyperaemia
Absent or mild upper respiratory disease
How do you treat Chlamydophila felis?
Systemic treatment - doxycycline
Amoxiclav in pregnant queens and kittens
What is the definition of a corneal ulcer?
Break in continuity or corneal epithelium with exposure of underlying stroma
Which type of corneal ulcer is more painful? Superficial or deep?
Superficial
What does SCCEDs stand for?
Spontaneous chronic corneal epithelial defects
What clinical signs can be seen with a painful eye?
Increased lacrimation, blepharospasm, photophobia
Conjunctival hyperaemia, discharge, corneal oedema, reflex uveitis
What breed is commonly affected by spontaneous chronic corneal epithelial defects?
Boxers
What are the characteristics of SCEEDs?
Epithelium loss only with no stroma involvement.
Lip of loose epithelium.
Variable inflammatory response
How can you identify a descemetocele?
Acute or chronic with complete stromal loss. Walls or ulcer/crater. Wall strain positive but the Descemet’s membrane does not strain.
How do melting corneal ulcers present?
Acute and painful.
Lots of gelatinous ‘gloopy’ discharge. Ill defined, rounded, soft edges.
Marked corneal oedema and anterior uveitis.
How do you treat superficial ulcers?
Prevent secondary infections, systemic NSAIDs, single drop atropine, recheck in 3-5 days
What does a head tilt indicate?
Peripheral or central vestibular syndrome
What are the clinical signs of idiopathic vestibular disease?
Sudden onset, head tilt, stumbling, circling, nystagmus, nausea
Sometimes accompanied by Horner’s syndrome
What is the prognosis for idiopathic vestibular disease?
Good to excellent
What are the clinical signs of otitis interna?
Head tilt, spontaneous horizontal or rotary nystagmus, circling
What are the most common bacteria involved in otitis interna?
Pseudomonas spp and staphylococcus spp
What radiographic views can be used to view the tympanic bullae and to check for fluid?
Oblique skyline and lateral oblique
What drugs are of highest concern for ototoxicity?
Aminoglycosides, cisplatin, metronidazole
Where do inflammatory polyps typically develop in the feline ear?
Middle ear and Eustachian tubes
What are the clinical signs of inflammatory polyps in the middle ear?
Abnormal balance, changes in pupil sizes, head tilt, nystagmus
What are the clinical signs of trigeminal neuritis?
Inability to close jaw, difficulty taking food into mouth, may have difficulty swallowing
Can be accompanied by Horner’s syndrome and/or sensory disturbances
What are the clinical signa of trigeminal nerve sheath tumours?
Facial asymmetry, reduced facial sensation, absent palpebral reflex with normal menace response.
Reduced unilateral corneal sensation and enophthalmos.
Horner’s syndrome
What is the definition of globe prolapse?
Globe is acutely displaced forwards beyond the plane of the eyelids
What is exophthalmos?
A degree of forward displacement of the globe with the eyelids remaining in the normal anatomical position
What is the pathophysiology of a globe prolapse?
Immediate oedema exacerbated by the eyelid spasm.
Traction of the optic nerve likely resulting in permanent blindness.
Desiccation of the ocular surface and rupture of extraocular muscles
What is a retrobulbar abscess?
Abscess or cellulitis behind the globe
What are the clinical signs of a retrobulbar abscess?
Acute onset, unilateral, exophthalmos, pain, third eyelid protrusion, discharge, pyrexia, lethargy
What are the clinical signs of acute glaucoma?
Ocular pain, head shy, yelping, dull/quiet, vision loss, change in appearance
Corneal oedema, episcleral vessel congestion, fixed and dilated pupil
What is the common presentation of anterior lens luxation?
Acutely painful eye, glaucoma, focal corneal oedema, lens outline may be visible in anterior chamber
What are classed as corneal emergencies?
Chemical injury, foreign bodies, melting ulcers, severe lacerations
What are the differential diagnoses for sudden onset blindness?
Acute glaucoma, acute uveitis, intraocular haemorrhage, retinal detachment, optic neuritis, SARD, toxicity, intracranial lesion
What does IVDD stand for?
Intervertebral disc disease
What are the two types of IVDD?
Extrusion and protrusion
What is extrusion IVDD?
When the disc erupts and disc material escapes and compresses the spinal cord.
What is protrusion IVDD?
Disc gets compressed and changes shape, compressing the spinal cord
What breed is predisposed to IVDD?
Dachshunds
What is a fibrocartilaginous embolism?
Microscopic blood clot in the spinal column
What are the clinical signs of fibrocartilaginous embolsim?
Acute onset, not painful, unilateral or bilateral paralysis
When is neospora infection transmitted to puppies?
In utero
When does a neospora infection normally start showing signs?
From 4 weeks
What are the clinical signs of a neospora infection?
Hindlimb extensor rigidity, inability to walk, difficult to demonstrate reflexes, resents limb flexion
What does the dry form of feline infectious peritonitis form?
Granulomas
What are the clinical signs of dry feline infectious peritonitis in relation to granuloma formation in the spinal cord?
Paraparesis with increased tone, discomfort on spinal palpation, reflexes and pain sensation, absent tail movement
What is the presentation of atlantoaxial subluxation?
Cervical pain with non-ambulatory tetraparesis
What is the breed pre-disposition for atlantoaxial subluxation?
Toy breeds - chihuahuas and Yorkshire terriers
What are the clinical signs of bacterial meningitis?
Neck or back pain. Pyrexia.
What is the breed pre-disposition of bacterial meningitis?
GSD - Rickettsia spp
American cocker spaniel - cryptococcosis meningitis
What is discospondylitis?
Abscess/infection of an intervertebral disc
How can you confirm diagnosis of steroid responsive meningitis arteritis?
Give an immunosuppressive course of prednisolone after a CSF spinal tap showing high levels of neutrophils.
What are the clinical signs of steroid responsive meningitis arteritis?
Pyrexia, pain, rigidity of the neck, lethargic, Inappetant
What does MUO stand for?
Meningitis of unknown origin
What are the clinical signs of localised tetanus?
Muscle rigidity in the limb or muscles closest to the wound. Can have muscel tremors.
What are the clinical signs of generalised tetanus?
Stiff gait with the tail held up or extended out behind them.
Form a sawhorse stance with all limbs in rigid extension.
Facial muscles affected
How soon after tetanus infection do symptoms develop?
5 to 10 days after initial wound.
Can be 3 days to 3 weeks.
What is the treatment for tetanus infection?
Tetanus antitoxin, antibiotics (penicillin, metronidazole), IVFT, feeding tube, kept in a dark quiet area
When does botulism usually occur?
After eating dead animals or raw contaminated meat
How does botulism present?
Initial weakness in the rear legs. Progresses to front legs and facial muscles within 24 hours.
What is the treatment for botulism?
Botulism antitoxin, supportive care, bladder expression, antibiotics for secondary infection
What is syringomyelia?
CSD in the spinal cord due to expansion of the central canal
What is the breed predisposition of syringomyelia?
Cavalier king Charles spaniel
What is the definition of spastic?
Abnormal increased muscle tone or stiffness of muscles
What is the definition of ataxia?
Uncoordinated movement, can’t position legs underneath body
What is the definition of weakness?
Not strong enough to pull legs underneath the body and push to stand up
