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Neurology (SA) > Spinal disease > Flashcards

Spinal disease Flashcards

1
Q

Describe the difference between the clinical signs of a bladder with an UMN lesion compared to a LMN leson

A

UMN - tense distended bladder, difficult to express

LMN - floppy distended bladder, overflowing and dribbling

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2
Q

Name a drug that increases urethral tone

A

Phenylpropanolamine

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3
Q

Name a drug that decreases urethral tone

A

Prazosin

Diazepam

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4
Q

Name a drug that increases detrusor contraction

A

Bethanechol

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5
Q

Name a drug that decreases detrusor contraction

A

Propantheline bromide

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6
Q

What causes acute, non-compressive nucleus pulposus extrusion?

A

Trauma

exercise, RTA, fall from height

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7
Q

Is the herniated nucleus pulposus mineralised with Acute, non-compressive nucleus pulposus extrusion?

A

No mineralisation

Contusion only

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8
Q

What size and age dogs are predisposed to AA instability?

A

Toy breeds

Young dogs

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9
Q

What causes AA instability?

A

Congenital

Aplasia or hypoplasia of dens (part of axis/C2)

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10
Q

AA instability can be acute or chronic, causing waxing and waning of clinical signs. Give examples of what symptoms may be seen with this condition

A

Neck pain
Ataxia
Tetraparesis

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11
Q

How is AA instability treated?

A

Conservative Tx: splint for 6-12 weeks

Surgical: ventral stabilisation

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12
Q

What is cervical spondylomyelopathy or ‘Wobbler’s’?

A

Compression of the spinal cord and nerve roots

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13
Q

What breeds of dog are predisposed to Wobbler’s/cervical spondylomyopathy?

A

Rottweiler
Dobermann
Bassett Hound
Dalmatian

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14
Q

Wobbler’s causes paresis, ataxia, a short-stilted gait and muscle atrophy. Is it worse in the forelimbs or hindlimbs?

A

HLs

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15
Q

Wobbler’s is multifactorial. Give 2 examples of conditions that may lead to Wobbler’’s

A

Type II IVDD

Hypertrophy of spinal ligaments

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16
Q

What is the treatment for Wobbler’s cervical spondylmyelopathy?

A

Conservative: ant-inflm and rest
Treatment: surgical decompression or distraction-stabilisation

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17
Q

What is Chiari-like malformation?

A

Caudal displacement of cerebellum through foramen magnum

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18
Q

A Cavalier presents with a head tilt, scratching it’s neck, almost like an ‘air guitar’. What is your most likely diagnosis?

A

Chiari-like malformation

Syringomyelia - head tilt

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19
Q

What are the 3 types of Chiari-like malformation?

A

Hydromyelia - dilation of central canal
Syringomyelia - fluid filled cavity in spinal cord (head tilt)
Syringohydromyelia - both

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20
Q

Is surgery an option for Chiari like malformation treatment?

A

Possibly but high recurrence rate

Does not correct fluid filled cavities (syringomyelia)

21
Q

What drugs can be used for medical treatment of Chiari like malformation?

A

Analgesia - gabapentin, amantadine, paracetamol, opioids
NSAIDs or steroids
Drugs that reduce CSF production - omeprazole, furosemide

22
Q

What is degenerative myelopathy?

A

Progressive ataxia and paresis of HLs

Progresses to paralysis over 6-18 months

23
Q

Which section of the spine is usually affected by degenerative myelopathy? Is it symmetrical and painful?

A

T3-L3
Asymmetrical
Non-painful

24
Q

Degenerative myelopathy is a diagnosis of exclusion. What breeds are predisposed to degenerative myelopathy?

A

Boxer
German Shepherd
Corgi

25
Is there a treatment for degenerative myelopathy?
No | Physio and analgesia to prolong QOL
26
What is discospondylitis?
Infection of intervertebral discs and adjacent vertebrae
27
Where in the spine is discospondylitis most common?
L7-S1
28
Discospondylitis causes marked spinal pain and possible systemic signs of illness. What other infections is it associated with?
Urinary or prostate infections
29
What is the treatment for discospondylitis?
Antibiotics for 8+ weeks | Analgesia
30
What is the treatment for a fibrocartilaginous embolism and traumatic disc?
Physio, supportive care | No surgery required as nothing to remove
31
What is the prognosis for fibrocartilaginous embolisms and traumatic discs?
Depends on extent of lesion | But often ambulatory within 2 weeks, recovered in 3 months
32
How can a spinal fracture be stabilised before transporting to referral?
Splint | Or surgery
33
What are the 5 grades of IVDD?
``` Grade 1 - no deficits, just pain Grade 2 - paresis, ambulatory Grade 3 - paresis, non-ambulatory Grade 4 - paralysis Grade 5 - no pain sensatin ```
34
For what grades of IVDD is conservative treatment of 4-6 weeks recommended?
Grades 1-3
35
For what grades of IVDD is a hemilaminectomy recommended?
Grades 4 + 5
36
What are the two types of IVDD and how do they differ?
Type I - extrusion. Painful, in young chondrodystrophic breeds or older normal breeds, chondroid metamorphosis Type II - protrusion. May have pain, in older normal breeds, fibroid metamorphosis
37
Ischaemic myelopathies are peracute conditions where the blood supply to the spinal cord is interrupted. Is this condition painful? When does it typically occur?
Non-painful | Occurs at exercise usually
38
Lumbosacral degenerative stenosis is degeneration of the lumbosacral junction and which spinal nerve?
L7
39
What are the clinical signs of lumbosacral degenerative stenosis?
``` Reluctance to exercise/go up stairs Pain Proprioceptive deficits Muscle atrophy Incontinence ```
40
Lumbosacral degenerative stenosis is associated with which type of IVDD?
Type II (protrusion)
41
What are the treatment options for lumbosacral degnerative stenosis?
Conservative - rest, analgesia (gabapentin) | Surgery - dorsal laminectomy, fusion or foraminotomy
42
Meningomyelitis of unknown origin is a sub/acute, progressive condition that is painful and multifocal. What condition does it present similar to?
IVDD
43
How is meningomyelitis of unknown origin diagnosed?
CSF - pleocytosis | MRI
44
How is meningomyelitis of unknown origin treated?
Steroids or other immunosupressives
45
What is the main symptom of steroid responsive meningitis-arteritis? In which age dogs does it typically present?
Neck pain | Young dogs 6-18 months
46
What is seen on CSF analysis with steroid responsive meningitis-arteritis? (Acute and chronic)
Acute - neutrophilic pleocytosis | Chronic - mononuclear pleocytosis
47
How is steroid-responsive meningitis-arteritis treated?
Steroids/immunosuppression | For 6-9 months
48
What is spinal shock? Do animals recover?
Flaccid paralysis and loss of spinal reflexes following trauma Yes- gradually reflexes return starting with anal tone

Neurology (SA) (8 decks)

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