Second exam Flashcards
(321 cards)
1
Q
What does disruption of nerve roots C6 and C7 lead to?
A
Denervation of the extensors and flexors of the shoulder
2
Q
Where does the lateral thoracic nerve to the cutaneous trunci muscles exit?
A
C8 and T1
3
Q
What will occur if the lateral thoracic nerve was lost?
A
loss of the panniculus reflex
4
Q
What does injury to T1 ventral nerve roots often lead to?
A
damage to preganglionic sympathetic nerve fibers –> Horner’s syndrome
5
Q
What is Horner’s syndrome?
A
Ptosis, enphthalmos and protrusion of the membrana nictitans
Droopy upper eye lid, backward displacement of the eyeball into orbit
6
Q
How would you treat Brachial plexus avulsion?
A
Pred.
Protect limb. Physiotherapy
Amputate if no improvement in 6 months
7
Q
What does MPNST stand for?
A
Malignant peripheral nerve sheath tumors
8
Q
What are some nerve sheath tumors?
A
Neurofibromas
Neurofibrosarcomas
Schwannomas
9
Q
Where do most nerve root or peripheral nerve neoplasia occur?
A
Caudal cervical area - brachial plexus
10
Q
What is occurring when you see chronic progressive monoparesis with neurogenic muscle atrophy, hyperesthesia and root signature?
A
Nerve root or peripheral nerve neoplasia - MPNST
11
Q
A history of a slowly progressive monoparesis with root signs is very suggestive of ________
A
Neoplasia
12
Q
How do you make a diagnosis of Nerve root or peripheral nerve neoplasia?
A
Myelograms, CT/MRI identify the site
Histopathology definitive diagnosis
13
Q
How would you treat a nerve root or peripheral nerve neoplasia?
A
Surgical resection - but high rate of recurrence
14
Q
What kind of emboli are the most common cause of spinal cord injury?
A
Fibrocartilaginous emboli
15
Q
What do fibrocartilaginous emboli cause in the cord?
A
Ischemic myelopathy
16
Q
Fibrocartilaginous emboli are most common in
A
Large breed dogs - Irish wolf hounds
and Miniature schnauzers
17
Q
Clinical signs are developing peracutely, frequently during or after vigorous exercise, its non progressive, non painful, paresis or paralysis occurs and LMN signs, whats going on?
A
Fibrocartilaginous emboli
18
Q
How would you diagnose fibrocartilaginous emboli?
A
Signalment, history, clinical signs, CSF (no inflammatory dz)
MRI
19
Q
What is albuminocytological dissociation?
A
When albumin levels are increased in the CSF but everything else is normal
20
Q
How could you treat Fibrocartilaginous emboli?
A
Acutely - Dexamethasone or methylprednisolone succinate
(to reduce edema and inflammation)
There after, supportive therapy. animals will improve on their own
If LMN - phenylpropanolamine, urecholine
If UMN - phenoxybenzamine, prazosin
21
Q
Degenerative myelopathy occurs due to
A
Degeneration of axons and their myelin sheaths in the thoracolumbar spinal cord
22
Q
T/F. Degenerative myelopathy occurs in large breed dogs mainly, aberrant immune responses can be found, its an inflammatory reaction and respond well to immunosuppressive therapy
A
False - its non inflammatory and response to immunosuppressive therapy is poor
23
Q
You see progressive paresis and ataxia, knuckling, dragging of the toes, crossing of the legs when walking/turning, dysmetria, ataxia of pelvic limbs, muscle atrophy, most commonly in large breed dogs, whats going on?
A
Degenerative myelopathy
24
Q
T/F Urinary and fecal incontinence and pain occur early on in degenerative myelopathy
A
False - they are usually spared until very late in the progression of the disease
25
how could you diagnose degenerative myelopathy?
Only possible by histopathology
26
You have a dog present to you with back leg ataxia, you do radiographs and they are normal, normal myelogram, no tumors, no inflammation, no fractures, CSF normal, and normal front legs, what is going on?
Degenerative myelopathy
27
What gene mutation has been identified and linked to degenerative myelopathy?
Superoxide dismutase 1 protein (SOD1)
28
What test could you do to evaluate degenerative myelopathy?
Myelin basic protein (MBP) in CSF. usually elevated in this disease.
29
How do you treat degenerative myelopathy?
No treatment! Good nursing and intensive physiotherapy. Euthanasia might be necessary
30
What could the instability at the L7/S1 area cause?
Spinal cord compression
Proliferation of the interarcuate ligament
Formation of osteophytes on articulation facets
Hansen type II
31
T/F Lumbosacral malarticulation- malformation causes pain and UMN signs in the sciatic and pudendal nerves, the femoral nerve is spared
False - causes LMN signs
32
You have a 7 yr large breed, working dog with lumbosacral pain, has a difficult time rising and negotiating stairs. what is going on?
Lumbosacral malarticulation-malformation
Caudal equina syndrome
Lumbosacral stenosis
Spondylolisthesis
33
How could you differentiate hip pain from lumbosacral malarticulation-malformation pain?
Hyperextension of the tail head (Tail jack) - this is specific for lumbosacral problems as opposed to hip pain.
34
Why might you see pseudohyperreflexia of the patellar reflex with lumbosacral malarticulation-malformation?
The sciatic nerve inhibits the femoral nerves actions, when the sciatic isnt working, it makes it seem as if there is hyperreflexia
35
How would you diagnose lymbosacral malarticulation malformation?
Myelography 1st - if it doesnt work (cuz the subarachnoid space ends with L6 or cranial edge of L7) do an epidurography.
MRI/CT - best, but too expensive
36
How would you treat lumbosacral malarticulation malformation (caudal equina syndrome)
Lumbosacral dorsal laminectomy, removal of ligaments and bone putting pressure on the nerves
37
T/F. Surgery (lumbosacral dorsal laminectomy) improves incontinence
False - it usually doesnt improve incontinence
38
You have a 8 yr old dog, hunched back, flaccid tail, has a hard time getting up, going up stairs, whats the likely cause?
Caudal equina syndrome
39
T/F. all vertebrae have disks between them
False - C1/C2 doesnt
40
What does a disk consist of?
Outer fibrous ring (annulus fibrosis)
| Inner gelatinous mass (nucleus pulposus)
41
Most breeds, replacement of the nucleus pulposus is with _____ as they get older, but in chondrodystrophic dogs, replacement is with ______
Fibrocartilage
| Hyaline cartilage
42
What does dorsal displacement of the nucleus pulposu result in?
stretching of the dorsal longitudinal ligaments and spinal cord damage
43
What type of displacement has an explosive extrusion of nuclear pulposus material into the spinal cord through the annulus fibrosis?
Hansen type I
44
What form of disc displacement has small tears appear in the annulus fibrosis, which causes slow protrusion of the nucleus pulposus?
Hansen Type II
45
T/F. Calcification of disks is common in cats, most often occur in the upper cervical and mid lumbar (L4/L5) areas. Mostly the condition is subclinical but there may be back pain and difficulty in walking?
True
46
There are seldom disc protrusions between T2 and T10 because of the ________ and most occur in the __________ area, between _______, giving _____ signs to the hind limbs
Intercapital ligament
Thoracolumbar area
T11-L2
UMN
47
How could you diagnose Thoracolumbar intervertebral disk disease?
Myelography
| MRI/CT
48
What grade would you give a dog that has paresis but ambulatory with intervertebral disk disease?
Grade 2
49
what will classify a dog grade 3 with intervertebral disk disease?
Paresis but non-ambulatory
50
What grade will you give a dog that is paralyzed with deep pain sensation intact that has intervertebral disk disease?
Grade 4
51
What will classify a dog with Grade 5 that has intervertebral disk disease?
Paralysis with loss of deep pain
52
How would you treat Grade 1, 2, 3 dogs with intervertebral disk disease?
Strict cage rest for 2 weeks, and 2 weeks after complete resolution of clinical signs.
NSAID/Pred/opioid
Diazepam/methocarbamol - relieve muscle spasms
53
How would you treat a dog with Grade 4 of intervertebral disk disease?
Dorsolateral hemilaminectomy
54
What does disruption of nerve roots C8 and T1 lead to?
Denervation of the extensors and flexors of the elbow and carpus
55
How do you treat Grade 5 intervertebral disk disease?
Dorsolateral hemilaminecoty or Durotomy
56
50% of dogs will recover post intervertebral disk disease surgery as long as the surgery is performed within ___ hrs of signs developing
48
57
What is diskospondylitis?
Infection of the cartilaginous endplates
58
What is spondylitis?
Vertebral osteomyelitis- infection where only the vertebrae are involved
59
What are the most common causes of diskospondylitis and how are they usually spread?
S. Intermedius, Brucella canis, Streptococcus spp.
| usually spread hematogenously (from skin, UTI, endocarditis, mouth, resp tract, orchitis (testes)
60
What are the most common sites affected with diskospondylitis?
```
Caudal Cervical (C6-C7)
Mid thoracic (T4-6)
Lumbosacral (L7/S1)
```
61
What signs will you see on an animal with diskospondylitis?
Hyperesthesia, pyrexia, depression, weight loss
| UTI, endocarditis, orchitis, epididymitis, infertility, leukocytosis
62
How would you treat a dog with diskospondylitis and minimal neurological dysfunction?
Analgesics and antibiotics (sensitivity test on blood or urine cultures. FNA/ core needle biopsies if previous two come back neg)
63
What antibiotics are often used and effecting against staphylococcus?
Cephalexin
Cephazolin
Cloxacillin
64
How long should antibiotic treatment for diskospondylitis be carried out?
until there are no radiographic sings of active infection (disappearance of the lytic focus and bridging of fusion of the vertebrae involved).
Mean duration ~ 54 weeks
65
How should you treat a dog with diskospondylitys and neurological dysfunction?
Hemi-laminectomy to decompress/stabilize
| Vertebral currettage
66
T/F. prognosis for diskospondylitis is good for both bacterial and fungal infections
False - not for fungal infections
67
Spinal neoplasms may be found:
Intramedullary / Metastatic intramedullary
Intradural-extramedullary
Extradural
68
In dogs, most tumors are ______ (50%), the rest are _____(30%) or _____ (10%)
Extradural
Intradural-extramedullary
Intramedullary
69
What are the most common tumors in dogs and cat?
```
Vertebral osteosarcoma
Chondrosarcoma
Multiple myeloma
Hemangiosarcoma
Fibrosarcoma or metastases
```
70
What is the most common primary spinal cord tumor in dogs and most frequently found in the thoracolumbar area?
Meningiomas
71
What is the most common spinal cord tumor in cats and mainly occur in the thoracolumbar area?
Extradural lymphosarcoma
72
Where do meningiomas most often occur in cats?
In the brain
73
'Root signs' with slowly progressive neurological deficits should raise a high level of suspicion for
Tumors involving the meninges and nerve roots
74
Spinal cord edema is best reduced with
20% mannitol
75
T/F. You could give mannitol IV quickly
False- give over 30 mins! vomiting and severe hemolysis may occur if given too rapidly
76
King Charles Spaniels and other small breed dogs develop _____ as a result of caudal occipital malformation syndrome (COMS)
Syringomyelia
77
What signs will you see with Syringomyelia?
Sensitivity to touch on the neck/head/shoulder and scratching at the area, vestibular signs, tetra paresis, torticollis.
78
What four general causes lead to tetraparesis/tetraplegia?
Spinal cord lesions between C1 and T2
Muscle and end plate conditions
Neuropathies
Brain conditions
79
Hansen type I cervical disk prolapse is seen most commonly in
Chondrodystrophic breeds and Poodles
| May also occur in large breed dogs
80
Where does the Hansen type I disc prolapse usually occur in chondrodystrophic breeds?
C3/C4 and between C5 and C7
81
Where does Hansen type I disc prolapse usually occur in large breed dogs?
C6/C7
82
Hansen Type II cervical disc prolapse at ____ occurs most commonly in Dobermans and Rottweilers
C6/C7
83
What is Hansen Type II cervical disc prolapse described as?
Canine wobbler syndrome
84
What clinical signs will you with cervical disc disease?
Sever neck pain, dogs hold their neck in a fixed position with head down and often yelp in pain following minor movement, may not eat unless bowl is elevated.
85
Neurological deficits due to spinal cord compression are seen in 64% of patients,_____ (less than or more than) the cases with thoracolumbar disk disease
Less than
86
How should you treat cervical disc disease?
Cage rest until 2 weeks after all signs have resolved, Pred with diazepam or methocarbamol.
Surgery if cage rest doesn't work - ventral fenestration/ventral decompression (ventral slot)
87
What is cervical spondylomyelopathy (CSM) also known as?
Caudal malformation-malarticulation syndrome
| Canine wobbler
88
What leads to cervical spondylomyelopathy aka Canine wobblers?
Congenital stenosis
Hansen type II disk protrusion
Hypertrophy of the ligament flavor
Boney proliferation of articular processes
89
Spinal cord compression occurs because of dorsal displacement of the axis by three potential mechanisms, what are they?
1) No dens (most common)
2) Dens fracture, at ossification center btw dens/C2
3) rupture of ligamentous support - dorsal atlanto-axial ligament and/or transverse ligament
90
What signs will you see with Atlanta-axial subluxation?
Vary, neck pain to tetraplegia (rare as animals die of respiratory paralysis)
91
how would you treat atlanta-axial subluxation?
Hemilaminectomy to relieve compression
| Wire/screwing vertebra together
92
T/F Myopathies are characterized by generalized weakness, exercise intolerance, fatigue, stiff plodding gait, loss of conscious proprioception, sensory function and spinal reflexes
False - Conscious proprioception, sensory function and spinal reflexes are usually normal
93
What causes myopathies?
Inflammatory - infectious and immune mediate
| Degenerative - inherited or acquired 2ndary to systemic disease
94
What causes infectious myopathies in dogs?
```
Toxoplasmosis
Neosporosis
Borrelia burgdorferi
Hepatozoonosis
Leptospirosis
```
95
What causes infectious myopathies in cats?
Toxoplasma
FeLV
FIV
96
What is the most common inflammatory myopathy in dogs?
Autoimmune polymyositis
97
What signs will you see in an animal with autoimmune polymyositis?
```
Generalized weakness
Stiff gait
Rapid fatigue
Muscle atrophy
muscle pain
Pyrexia
regurgitaion form megaesophagus
Dysphonia/dysphagia
```
98
T/F hypergammaglobulinemia is common with autoimmune polymyositis
true
99
How do you diagnose autoimmune polymyositis?
Muscle biopsie
100
How could you treat Autoimmune polymyositis?
Immunosuppressive doses of pred (long term) and Azathioprine (used concurrently for its steroid sparing effects)
101
What condition is also a common inflammatory myositis, seen mostly in larger breed dogs, under 4 yrs, with inflammation of the muscles of mastication, swollen painful muscles and pain upon opening the mouth
Masticatory muscles myositis (MMM)
102
The masticatory muscled contain type ___ fibers against which there is a humoral autoimmune response
2M
103
How would you diagnose masticatory muscle myositis?
seroloty or immunohistochemistry of muscle biopsies
104
How could you treat masticatory muscle myositis?
Prednisone with Azathioprine (for its steroid sparing effects)
105
Extraocular myositis occurs in ____ dogs especially, but also in other large breed dogs
Golden retrievers
106
Dogs with extra ocular myositis are usually ____ of age, it usually causes bilateral _____, but may also be unilateral
6-18 m of age
| Exophthalmos
107
How could you treat extra ocular myositis?
oral corticosteroid therapy for a few weeks
108
Exertional myopathy is seen in ____ and ____ dogs a day or two after a race
Greyhounds and sled dogs
109
T/F With exertional myopathy, serum CK levels are markedly elevated, which causes myonecrosis and inflammation, so treatment with fluids, bicarbonate, analgesics and rest should carried out, which has good prognosis
False - most animals die of renal failure despite treatment
110
Hypokalemic myopathy occurs in older cats with ____ and excessive ______ loss in the urine
Renal disease and excessive K loss in the urine
111
Hypokalemic myopathy could occur in cats with
```
Diets deficient in potassium
Acidifying diets
hyperthyroidism
Polyuria
Rarely with Conn's syndrome
```
112
What clinical signs will you see on a cat with hypokalemic myopathy?
persistent ventroflexion of the neck, stiff stilted gait and resistant to move
No neurological deficits
113
What is an uncommon and poorly characterized condition in cats that must be differentiated from inflammatory myopathies and hypokalemia?
Feline idiopathic inflammatory myopathy
114
How could you treat feline idiopathic inflammatory myopathy?
Prednisone - may require life long therapy
115
______ refer to myopathies that are inherited, but probably should only refer to those characterized by inherited abnormalities of the cytoskeleton - dystrophin and dystrophin asccoiated proteins
Muscular dystrophies - dystrophic myopathies
116
What is a critical cytoskeletal protein of skeletal and cardiac muscle that serves to maintain membrane integrity
Dystrophin
117
What occurs when there are dystrophin abnormalities?
Abnormal muscle contraction (weakness) and muscle cell degeneration, necrosis and fibrosis
118
What are large glycoproteins that contribute to the basement membrane of various tissues?
alpha 2 laminin deficiency
119
Congenital muscular dystrophy due to alpha 2 laminin deficiency has been described in
Domestic short haired cats
Siamese
Maine coon
Brittany springer spaniel cross
120
What are the cause of metabolic myopathies?
```
Hypothyroidism
Hyperthyroidism in cats
Hyperadrenocorticism
Various enzyme deficiencies
Exercise intolerance and collapse (EIC) of labs
```
121
What are the first signs of exercise intolerance and collapse?
ataxia, rocking horse gait before the hind limbs become weak, unable to bear weight, and are dragged behind. Forelimbs occasionally affected
122
What protein is important in sustaining neurotransmission during intense exercise with a high level of excitement
Dynamin 1- DYNM-1
123
How would you treat an animal with exercise intolerance and collapse?
Avoiding intense exercise and excitement.
animals return to normal after 5-25 mins of rest.
Phenobarbital can prevent signs
124
What condition is characterized by sustained depolarization of muscle fibers, has a characteristic sign in dimpling of a muscle after percussion, esp. the tongue, stiff and walk with difficulty
Myotonia congenita
125
What drugs may alleviate signs of myotonia congenital?
Procainamide
Phenotoin
mexiletine
126
What condition causes fainting goats?
Myotonia congenita
127
What is known as an inflammatory disease of capillary walls in skin and to a lesser extent, muscle, which causes facial dermatitis at 2-6 m followed by weakness and megaesophagus
Dermatomyositis
128
What disease may resolve by 8 m but in some the disease has a chronic waxing/waning course
Dermatomyositis
129
How could you treat dermatomyositis?
Pentoxifylline
Prednisone
Vit. E
130
What condition is seen particularly in cats5-8 yrs of age, Abyssinians, Siamese, burmese and have intermittent rippling and twitching of the dorsal skin and muscles with excessive grooming, liking, biting of area, vocalization, growling, hissing, running, aggression
Feline hyperesthesia
131
What is feline hyperesthesia thought to be?
A degenerative myopathy with secondary autoimmune response
132
T/F. Feline hyperesthesia is non progressive and prognosis is good with treatment
false - condition is progressive over one to several years and the prognosis is poor despite treatment with pred, anti-depressents, phenobarb, carnation, coenzyme Q
133
In _____ myastenia gravis, motor end plate nicotinic acetylcholine receptors (AchR) are decreased
Congenital
134
In ____ myasthenia gravis there are autoantibodies to the AchR
Acquired
135
Acquired myasthenia gravis occurs in
Medium to large breed dogs 7 yrs
136
Acquired myasthenia gravis might be focal or generalized, what occurs in focal?
No appendicular muscle weakness
Megaesophagus is major sign
Might be facial, pharyngeal or laryngeal muscle weakness
137
There are two forms of generalized myasthenia gravis, what are they?
Acute fulminating generalized MG (16%)
| Chronic generalized MG (48%)
138
T/F. with acute fulminating generalized MG, there is generalized muscle weakness and can become severe over a few days leaving the animal recumbent and in resp. distress. Resting the animal usually alleviates the weakness
False - rest does not alleviate the weakness
139
What would you consider if you see sudden onset of frequent regurgitation of large volumes of fluid due to severe megaesophagus?
Acute fulminating generalized myasthenia Gravis
140
What is a common cause of death in an animal with acute fulminating generalized myasthenia gravis
Respiratory failure caused by aspiration pneumonia and loss of strength in muscles involved with respiration
141
Animals with chronic generalized myasthenia gravis also have megaesophagus, aspiration pneumonia, facial, pharyngeal, laryngeal muscle weakness, yet how do they differ from acute MG?
In half the affected animals, muscle weakness is induced by exercise
142
T/F. Myasthenia gravis is common in cats and seem to have thymomas concurrently
False - myasthenia gravis is rare in cats and generalized weakness is most prevalent. 26% of cats have thymomas concurrently
143
How could you diagnose myasthenia gravis?
Clinica sings and by detection of AchR antibodies or immune complexes at the motor end plate
144
T/F. The tensilon test (edrophonium- an anticholinesterase agent) can be used to detect the focal form of myasthenia gravis
false - does not work with the focal form
145
The tensilon test should reverse exercise induced weakness, yet can cause diarrhea, vomiting and salivation, how could you prevent these side effects?
Give atropine before the test (blocking muscarinic receptors)
146
How could you treat myasthenia gravis?
Give anti cholinesterase drugs - prolong the action of acetylcholine PYRIDOSTIGMINE
147
What drug would you give in a dog with myasthenia gravis with megaesophagus issues?
Neostigmine injection
148
What could neostigmine injections cause and doses must be titrated to avoid these effects?
Parasympathetic effects - GI signs, bradycardia, bronchoconstriction, depolarizing blockade with resp. arrest
149
Prednisones anti inflammatory effects can improve patients survival with myasthenia gravis, but it can also
exacerbate muscle weakness and aspiration pneumonia
150
What other drugs could be considered to suppress the autoimmunity of myasthenia gravis?
Azathioprine
| Cyclosporine
151
What should you do in dogs with thymomas and not responding well to the myasthenia gravis therapy?
thymectomy
152
What toxin blocks acetylcholine release from presynaptic membranes at somatic and autonomic neuromuscular junctions?
Botulism - exotoxin from Clostridium botulinum
153
T/F. A definitive diagnosis of botulism is made by demonstrating exotoxin in feces or serum. Polyvalent antisera may help if given early. Neostigmine/physostigmine may help and the animal can develop immunity
False- No immunity, all else is true
154
What ticks commonly cause tick paralysis in dogs?
```
Dermacentor andersoni (Rocky mountain wood tick)
Dermacentor variabilis (American dog tick)
```
155
How does the Tick neurotoxin work?
Blocks conduction of impulses along distal portions of motor nerves or inhibiting presynaptic release of acetylcholine at motor end plates
156
T/F. Not all ticks produce toxins but all dogs are susceptible
False- not all dogs are susceptible
157
After the tick has been attached for ___ days, signs develop rapidly and cary from mild paresis to tetraplegia with ___ signs
5 days
| LMN signs
158
T/F. Cranial nerves, sensation and continence is also lost with tick paralysis
False - they are usually spared
159
T/F. Dogs are 300 more sensitive to tetanus than horses and people.
False - dogs are 300 times LESS sensitive
160
How does the neurotoxin from clostridium tetani growing in anaerobic wounds, which migrates within the interstitial fluid of peripheral motor neurons to the brain work?
They block the input of inhibitory interneurons on spinal motor neurons (similar to strychnine)
161
What signs might you see with tetanus?
```
Wrinkling of the skin between ears
pricking of the ears
Enophthalmos
Sardonic grin
Increased extensor tone -> saw horse stance
```
162
How could you tell the difference between tetanus and strychnine?
Strychnine has a more rapid onset, is made worse by stimulation and may be associated with seizures
163
How would you treat tetanus?
Tetanus antitoxin IV
Penicillin/Metronixazole (10 days)
Clean wounds with peroxide
Valium/ace/pentobarb to lessen muscle contractions
164
What should you be aware of when giving tetanus antitoxin?
Anaphylaxis may occur - give small amount SC first and monitor for an hr
165
How does the tetanus antitoxin work?
binds circulating neurotoxins only, which prevents further signs. Cant do anything about the toxins already in the brain
166
T/F. Cats are more susceptible to tetanus than dogs and develop generalized tetanus
False - cats are even more resistant to infection that dogs and may only develop localized tetanus after incubation period of up to 3 weeks
167
Saliva inoculated into dogs with raccoon bites is suspected to cause changes in nerve antigenicity that results in inflammation, degeneration and demyelination of the _____ nerve roots in particular, but also _____ nerves
Ventral
| Peripheral
168
What signs will you see in Coonhound paralysis?
LMN paralysis progressing to tetraplegia and hyporeflexia/hypotonia
169
T/F. Dogs with coonhound paralysis have cranial nerves affected, sensory nerves lost and are incontinent (pudendal nerve affected?
False - Cranial nerves are usually spared, as are sensory nerves and pudendal nerve (continent)
170
How is Coonhound paralysis treated?
NO definitive treatment,
Supportive therapy
Clinical signs resolve spontaneously in weeks to months
171
What causes protozoal polyradiculoneuritis?
Toxoplasmosis may be involved, but more commonly is due to Neospora caninum
172
How are neospora infections usually acquired?
Transplacentally
173
What does neospora cause?
```
Dermatitis
Trigeminal neuropathy
Pneumonia
Necrotizing cerebellitis
Encephalitis with tetraparesis/tetraplegia
```
174
How would you treat protozoal polyradiculoneuritis?
Trimethoprim-sulfadiazine and pyrimethamine
| of Clindamycin
175
Peripheral vestibular disease occurs with lesions in the vestibular portion of cranial never _____, of the vestibular sensing apparatus in the labyrinth of the ____
```
VIII
Inner ear (most common)
```
176
Where do central vestibular disease lesions occur?
In the vestibular nuclei in the medullar oblongata
177
What signs will you see with peripheral vestibular disease?
No CP deficits or paresis
NO depresssion
Facial nerve paralysis and Horner's maybe
Nystagmus - Horizontal/rotary (no change with head movement and eyes move together)
178
What signs will you see with central vestibular disease?
Tetar or hemiparesis
Depression (RAS)
Other cranial nerves affected
Nystagmus Horizontal/rotary and vertical (can be elicited by head movement and eyes move in different directions)
179
What causes peripheral vestibular disease?
Otitis media-interna
180
What causes central vestibular disease?
Neoplasia and encephalitis (distemper, FIP) mainly!
Hypothyroidism, metronidazole, aminoglycoside toxicity, RMSF, ehrlichia, cryptococcus, blastomyces, toxoplasma, neosporum, thiamine deficiency, GME, thromboembolism, etc.
181
What could a lack of inhibition of the vestibular nucleus on the side of the lesion in the cerebellum cause?
Increased extensor muscle tone on that side of the body and this causes head tilt, circling, falling to the opposite side, mimicking a vestibular lesion on the opposite side.
182
What happens in paradoxical central vestibular syndrome?
Animal has proprioceptive deficits on the side of the cerebellar lesion but vestibular signs on the opposite side
183
What does the cerebellum do?
Coordinates motor activity and helps maintain equilibrium and control posture
184
What are the major signs of cerebellar disease?
Wide base stance
Truncal ataxia (swaying)
Intention tremor
Dysmetria (inability to properly direct or limit motions)
185
What is hypermetria?
Over reaching
186
What may severe lesions in the cerebellum result in?
Decerebellate rigidity - opisthotonos
Extended thoracic limbs
Flexed pelvic limbs
187
What do midbrain lesions result in?
Decerebrate rigidity - opisthotonos
| Extension of all 4 legs
188
What does Schiff Sherrington syndrome result in?
Rigid extension of the thoracic limbs with severe spinal cord injuries between T2-L6/7
189
What causes cerebellar hypoplasia in cats?
Intrauterine infections with panleukopenia parvovirus
190
How could you treat cerebellar hypoplasia in cats?
No treatment, cats could live "normal" lives if mildly affected.
Its non progressive
191
What is responsible for cerebellar hypoplasia in dogs?
Parvo virus
192
What is abiotrophy?
The premature death of neurons due to disruption of the metabolic processes in the cells
193
What primary tumors may occur in the cerebellum?
Medullablastomas
| gliomas
194
You have a maltese dog present with tremors in all 4 limbs and head, which get worse with exercise or excitement and resolves when the animal sleeps, what is going on?
Shaker dog disease - Corticosteroid responsive tremor syndrome
195
How could you treat shaker dog disease?
Glucocorticoids
196
What is a hypertonicity syndrome caused by a deficiency of serotonin inhibitory neurotransmitter and a prostaglandin abnormality probably?
Scotty cramp - episodic muscle hypertonicity
197
You have a dog that has its thoracic legs abducted due to exercise and pelvic limbs stiff, facial muscles maybe contracted but no loss of consciousness, what is going on?
Scotty cramp - episodic muscle hypertonicity
198
Dogs with Scotty cramp recover in ___ mins or so, the condition is ______ and can be treated with _____
10 mins
Non-progressive
Ace and tryptophan
199
What syndrome is seen in Cavalier king charles spaniels which signs begin at 3-7 months after variable periods of exercise, hypertonicity in all 4 legs and consciousness is maintained?
Episodic falling
200
What condition is marked by dilatation of the ventricular system in the brain because of reduced absorption or excessive secretion of CSF?
Hydrocephalus
201
Most hydrocephalus cases are congenital and occur in toy, small, and brachycephalic breeds, what progressive signs will you see?
```
Altered metal attitude
slow learners
Seizures
Dilated pupils
Auditory impairment
Tetraparesis (circling/head pressing)
Vetrolateral strabismus
```
202
What should you be aware of when collecting CSF fluids from an animal with hydrocephalus?
May cause herniation
203
What drugs could you use to decrease CSF pressure and temporarily improve hydrocephalus signs?
```
Prednisone
Dexamethasone
Omeprazole
Acetazolamide
Furosemide
```
204
What are the most common primary brain tumors in dogs?
Gliomas
| Meningiomas
205
What breeds are predisposed to gliomas?
Brachyoceplaic breeds
206
What breeds are predisposed to meningiomas?
German Shepherds and Golden retrievers
207
T/F. Primary tumors are more common than secondary brain tumors
False - secondary brain tumors are more common
208
What are the common primary brain tumors in cats?
Meningiomas (most common)
Lymphomas
Gliomas
209
What signs might you see with cerebrocortical tumors?
Contralateral vision and postural reaction deficits
| Circling to the affected side
210
What drug may reduced edema around a mass and shrink the tumor, resulting in temporary alleviation of clinical signs?
Dexamethasone
211
What should you avoid in patients with increased intracranial pressure?
```
Volatile anesthetics (cerebral vasodilation and increase brain blood volume/pressure)
CSF tap - increase pressure gradient
```
212
What signs will you see on animal with brain herniation?
depressed/stuporous mentation, miotic
Non responsive
Slow pupillary light reflexes
213
What drug reduces brain edema and may reverse herniation?
Dexamethasone
214
Traumatic neurological dysfunction may occur with no demonstrable brain lesion, known as
Concussion
215
A traumatic neurological dysfunction with focal subpial hemorrhage and minimal malacia is known as
contusion
216
Do intra or extra cerebral hematomas result in progressive neurological dysfunction hours after the injury?
Extra cerebral
217
If you have asymmetry in the menace response, in the nostril stimulation response, or in limb proprioception without other cranial nerve deficits, what does this indicate?
Lesion in the contralateral cerebral hemisphere
218
What is Cheyne-strokes respiration?
Alternation between hyperventilation and apnea
219
Extensor rigidity is a form of ____ presentation
UMN
220
If all 4 limbs are extended and there is opisthotonus and stupor/coma, what hemisphere is involved?
both!
| Decrebrate rigidity
221
If there is no loss of consciousness and the forelimbs are extended and the rear limbs flexed, where is the lesion?
Cerebellum
| Decerebellate rigidity
222
When should increased intracranial pressure be suspected?
When pupillary light reflexes are abnormal, deterioration of consciousness, extensor rigidity, and abnormal respiratory pattern
223
Miotic pupils suggests
Thalamic lesion, this is where the sympathetic innervation begins
224
Transition from mitosis to mydriasis suggests
a progressive lesion in the brainstem
225
Bilateral unresponsive mydriasis is usually indicative of
Irreversible midbrain damage or cerebellar herniation
226
Unilateral mydriasis can be due to
Unilateral cerebellar herniation or Unilateral hemorrhage into the brain stem
227
What induces peripheral or central vestibular signs that may result in the animal rolling continuously?
Petrosal bone or internal ear injury
228
What type of fluids should you use in a patent with cranial trauma?
Crystalloids - hypertonic saline or hetastarch
229
In animals with cranial trauma, ____ and ___ must be avoided as they induce vasodilation and increases intra cranial pressure!
Hypercapnia and Hypoxia
230
If an animal continues to have CNS signs, yet no longer in shock, what can you give to decrease intracranial pressure?
Mannitol
231
What could occur is you give more than 3 doses of mannitol in 24 hrs?
acute renal failure
232
What drugs should you use to treat seizures?
Diazepam
Midazolam
Phenobarbital
233
What drugs and inhalant would you use to perform surgery on an animal with cranial trauma?
Short acting barbiturates or propofol
| Iso
234
What condition of the brain is marked by sudden recurring attacks of sleep?
Narcolepsy
235
Episodes of suddenly falling asleep and loss of muscle tone usually occur with
Excitement, especially eating
236
What causes narcolepsy?
Due to a mutation in the orexin receptor gene which stops orexin activity - keeps animals awake and stops REM sleep
237
How do you treat narcolepsy?
Amphetamines (Methylphenidate-ritalin)
| Antidepressants (Imipramine)
238
What causes feline ischemic encephalopathy?
Cuterebra larva entering the nasal passages
239
What signs will you see with feline ischemic encephalopathy?
Circling, hemiparesis, unilateral blindness, anisocoria, head tilt, behavior changes, seizures
240
How could you treat feline ischemic encephalopathy?
Ivermectin to kill parasite
Prednisone
Antihistamine to prevent anaphylactic reaction
241
What form of granulomatous meningoencephalomyelitis acts as a slowly enlarging mass causing progressive sings over months?
Focal form
242
What form of granulomatous meningoencephalomyelitis has an acute onset of multifocal signs which are progressive?
Disseminated form
243
Without treatment of granulomatous meningoencephalomyelitis, the disease is progressive and fatal after
A week (multifocal) to around 4 months (focal)
244
What drugs could you use to treat granulomatous meningoencephalomyelitis, which will extend survival times to over a year.
Cystosine arabinoside
Cyclosporin
Procarbazine**
245
Neurological signs are seen most commonly with the ___ form of FIP, which occurs in cats with humoral and partial cell mediated immunity
Dry form
246
T/F. Dry form of FIP is more common that the wet form
False - Dry form is less common
247
Anterior uveitis and chorioretinitis is common with ____ in cats
FIP
248
What does Feline leukemia virus occasionally cause?
Degenerative myelopathy
249
What is feline polio encephalomyelitis also known as?
Staggering disease
250
What does Borna virus cause?
Feline polioencephalomyelitis
251
What fatal, progressive disease of domestic and wild cats results from ingestion of infected nervous tissue form cattle infected with BSE?
Feline spongiform encephalopathy (FSE)
252
Bacterial meningitis is a rare condition in dogs and cats, it results form _____ spread of bacteria, most often ______
Hematogenous spread
| S. intermedius
253
A young dog, less than 2 yrs old has peripheral neutrophilic, CSF has increased protein and neutrophilic pleocytosis, elevated IgA in serum and CSF, what is most likely going on?
Steroid responsive meningitis arteritis
254
How do you treat meningitis arteritis?
Prednisone
| Azathioprine
255
How could you differentiate bacterial meningitis from meningitis arteritis?
Elevated IgA in serum and CSF with meningitis arteritis
256
What is protothecosis?
algal infection of the brain - very rare
257
What condition is associated with degeneration of neurons in sympathetic and parasympathetic ganglia and dysfuction of the autonomic nervous system?
Dysautonomia
258
What causes dysautonomia?
Toxicoinfection with Clostridium botulinum type C
259
What are the main clinical signs with dysautonomia?
anorexia, weight loss, obtunded, parasympathetic dysfunction, mydriasis, prolapsed third eyelid, reduced lacrimal secretions, regurgitation, constipation
260
How do you treat dysautonomia?
No specific treatment
261
What are the three types of deafness?
1) conductive
2) central
3) sensorineural
262
What type of deafness is a result from conditions such as chronic otitis externa/media which prevent sound being transmitted to the inner ear
Conductive deafness
263
What type of deafness is generally associated with brain stem lesions?
Central deafness - damage to central auditory pathways
264
What type of deafness results from congenital or acquired abnormalities of the cochlear?
Sensorineural deafness
265
Congenital sensorineural deafness occurs in 80 breeds, especially in which one?
Dalmatians
English cocker spaniel
English setter
Bull terrier
266
What is sensorineural deafness usually associated with?
Pigment associated with white, merle and piebald dogs
267
Congenital deafness is most common in
Dalmatians
268
Cats with ____ coats and ___ eyes are frequently deaf
White
| Blue
269
What drugs affect the vestibular system, which might cause deafness
Streptomycin
| Gentamicin
270
What drug has most effect on the auditory receptors
neomycin
271
What are some ototoxic antibiotics
polymyxin B
| Chloramphenical
272
What antiseptic solutions are ototoxic?
Iodine
Iodophores
Chlorhexidine
273
T/F. Chlorhexidine 0.2% is safe to use in dogs with perforated tympanic membranes
True
274
What agents used in otic preparations cause ototoxicity
Propylene glycol
Ceruminolytic agents
Detergents
275
Acquired sensorineural deafness is also associated with
normal aging - Presbycusis (atrophy of neurons of the cochlear)
276
How can you diagnose a deaf animal?
Evaluation of brainstem auditory evoked potentials (BAEP)
277
____ is a disease condition characterized by recurrent partial or generalized seizures
Epilepsy
278
What causes primary or idiopathic epilepsy?
Unknown cause
279
What cause secondary or symptomatic epilepsy?
intracranial or extracranial disease
280
What causes partial or focal seizures?
post traumatic lesions
Space occupying lesions
Cortical developmental disorders
281
What are the most common seizures that are caused by a lesion in the motor cortex resulting in brief episodes of abnormal movement in the contralateral body part - jerking of one or both limbs, chewing gum fits, flexing to one side of the body, head turning, head bobbing.
Partial motor seizures
282
T/F. Partial motor seizures, such as head bobbing, might be stopped by distracting the dog, cause of them are unknown, and diagnosis is based on MRI or CSF tap
False - Diagnosis is based on clinical signs as there are no laboratory, MRI or CSF abnormalities
283
What type of seizures are due to foci in the sensory cortex and dogs show signs of "fly-bitting" or tail chasing
Partial sensory seizures
284
T/F. You could treat partial motor seizures and partial sensory seizures with anticonvulsants
False - There is no treatment for partial motor seizures
285
What type of generalized seizures are there?
Generalized tonic-clonic seizure (Grand mal)
Tonic seizures
Clonic seizures
Atonic seizures - no muscular activity but conscious
Absence seizures - unconscious with not tonic/clonic phase
286
What are the most frequently observed seizures in vet med?
Generalized tonic-clonic seizures
287
What do generalized tonic clonic seizures often start with before the actual convulsion?
Preictal phase (aura - mins or prodromal - hrs)
288
What is the actual seizure itself phase called?
Ictal period or ictus
289
What phase follows the Ictal period?
Tonic phase
290
How is the tonic phase characterized?
Lasts for 10-30 mins, widespread sustained muscle contractions - limbs extended rigidly, opisthotonos, apnea and cyanosis
291
What follows the tonic phase?
Clonic phase
292
What occurs during the clonic phase?
Limb movement, alternating contraction and relaxation of the body musculature. Animals appear to be running/paddling/chewing gum
293
In what seizure phase will you see signs of autonomic involvement, including pupillary dilation, salivation, defecation and urination.
Clonic
294
What phase occurs after the clonic phase?
Postictal period
295
What signs will you see in the postictal period?
Gradual return to consciousness with varying degrees of depression, fatigue, fright, dazed, aimless pacing, thirst, hunger
296
T/F. the duration of postictal depression correlates with the severity or duration of seizures
false - the duration of postictal depression does not correlate with severity or duration of seizures
297
What is it called where a continuous seizure lasts for longer than 5 mins or where there are serial seizures between which there is not a full return to consciousness
status epilepticus
298
What is the probably the most important cause of seizures in general practice?
Toxicity
299
a history of neurological abnormalities - changes in personality and behavior, circling, unilateral proprioceptive defects - strongly suggests
intracranial disease
300
What tests should you run on animals presenting for seizures?
```
Physical / neurological exam
Full blood count
Biochemical profile
UA
CT/MRI
CSF
```
301
T/F.In all cases of primary or idiopathic epilepsy, CSF findings will come out abnormal
False - CSF is normal in primary epilepsy
302
If you have increased proteins and white cells in the CSF, what is that indicative of?
inflammation
303
If you have increased proteins in the CSF, what is that indicative of?
Neoplasia
304
When starting pets on anticonvulsant therapy, what should you inform the owners with?
30-40% of animals will be free of seizures
50% will have reduction in the number of seizures
Should prepare to give medications for life
305
What is the goal of anticonvulsant therapy
Reduce the frequency, duration or severity of seizures without intolerable side effects
306
What is the drug of choice for seizures?
phenobarbital
307
How does phenobarbital work?
Enhances GABA action and inhibits spread of seizures activity and elevates seizure threshold
308
When do you not want to use phenobarb?
Liver disease
309
Hyperactivity may be seen with low serum phenobarbital levels, how could you get rid of this?
increasing the dose
310
What long term side effects will you see with phenobarb?
```
Polyphagia
PU/PD
Elevated ALP/ALT
Lipemia --> pancreatitis
Decreased TT4/FT4
```
311
What does phenobarb induce? What does that mean?
cytochrome P450 - it enhances its own metabolism, so lower serum levels (may continue for 6 months)
312
How would you be able to tell if phenobarb is causing hepatotoxicity if it normally increases ALP/ALT and can't use those as indicators?
Increase in bile acids and bilirubin
Larger increase in ALT over ALP
Phenobarb levels elevated (liver not working)
313
Dogs on phenobarb have very similar clinical and laboratory signs to dogs with
Hyperadrenocorticism, but adrenal function tests are normal
314
when should you measure phenobarb levels fort the first time?
At three weeks
315
T/F. Bilirubin, albumin, cholesterol, GGT, fasting bile acid levels, liver appearance by ultrasound and histopathology, and adrenal function test should remain normal when on phenobarn
True
316
Why should you not use vacationer tubes that contain separator?
Its silicone absorbes penobarb, which leads to falsely low levels --> incorrect increase
317
What should you be aware of when giving potassium bromide?
Chloride competes with bromide for reabsorption in the kidney, so high dietary levels of chloride (salty food) will increase bromide excretion and if low salty foods, increase in bromide levels will occur
318
How could you treat Bromism toxicity?
Give high chloride diets/furosemide
319
When should you not use bromide?
renal insufficiency
320
If dogs aren't responding to phenobarb and KBr, what other drug could you use?
Imepitoin (Pexion)
321
What is the order of drugs you should use for seizures?
```
Phenobarb
Imepitoin
KBR
Levetiracetam (KEPPRA)
Zonisamide (ZONEGRAN)
```
