The neurological horse with normal mentation: ataxias

Question 1

List 5 causes of spinal ataxia in horses that have normal mentation

Answer 1

Cervical Vertebral Compressive Myelopathy (CVCM)
Equine Herpes Virus (EHV-1)
Vitamin E related ataxias
Equine protozoal myeloencephalopathy (EPM)
Cervical trauma: falls, kicks

Question 2

List the signs of spinal ataxia in horses

Answer 2

proprioceptive deficits

Question 3

List 4 signs of spinal ataxia that affects ascending pathway

Answer 3

crossing
abduction
circumduction
knuckling

Question 4

List 2 signs of spinal ataxia that affects the descending pathway

Answer 4

foot dragging
stumbling

Question 5

List the 3 types of ataxia

Answer 5

spinal ataxia
vestibular ataxia
cerebellar ataxia

Question 6

List 4 signs of vestibular ataxia

Answer 6

head tilt
leaning
falling to one side
wide base stance

Question 7

what is cerebellar ataxia

Answer 7

loss of modulatory effect of cerebellum

Question 8

what is wobblers syndrome

Answer 8

CERVICAL VERTEBRAL COMPRESSIVE MYELOPATHY

Question 9

what is the most common non-infectious neuro disease of horses

Answer 9

wobblers syndrome
cervical vertebral compressive myelopathy

Question 10

what does CERVICAL VERTEBRAL COMPRESSIVE MYELOPATHY cause

Answer 10

moderate to severe ataxia
inability to perform
unsafe to ride

Question 11

when is cervical vertebral compressive myelopathy generally diagnosed

Answer 11

early in life <4 yrs but can manifest later in life

Question 12

what causes cervical vertebral compressive myelopathy

Answer 12

is a multi-factorial disease= genetic predisposition + dietary imbalances + rapid growth rates

Question 13

List the clinical signs of cervical vertebral compressive myelopathy

Answer 13

Ataxia, weakness and spasticity
Generally symmetrical deficits, sometimes asymmetric (OA)
Truncal sway, crossing and interferences when turning, hindlimb pivoting

Question 14

Describe how to diagnose cervical vertebral compressive myelopathy (wobblers)

Answer 14

Evidence of compression on radiography, myelography or CT

Question 15

Describe how to medically treat cervical vertebral compressive myelopathy (wobblers) in young horses (<12 months)

Answer 15

NSAID +/- steriods (acute phase)
Diet restrictions

Question 16

Describe how to medically treat cervical vertebral compressive myelopathy (wobblers) in adult horses

Answer 16

NSAIDs +/- steroids
Mesotherapy and exercises
Intra-articular facet joint injection (OA)

Question 17

Describe how to surgically treat cervical vertebral compressive myelopathy

Answer 17

vertebral interbody vertebral fusion

Question 18

List the clinical signs of equine herpes virus

Answer 18

previous resp disease- 6-10 days before presentation
symmetric ataxia +/- weakness
Bladder distension/urinary incontinence
Poor annal tone
Recumbency
Inconsistent fever
Chorioretinitis

Question 19

what is chorioretinitis

Answer 19

is a type of posterior uveitis

Question 20

Describe how to diagnose equine herpes virus

Answer 20

signalment - high risk animal
Nasopharyngeal swab PCR
Whole blood PCR
Serology (Complement fixation test if unvaccinated)
CSF tap

Question 21

what do we tend to tend to see on CSF tap with equine herpes virus 1

Answer 21

often unrewarding: xanthochromia and increase protein

Question 22

Describe how to treat equine herpes virus 1

Answer 22

Quaranntine animal
Valacyclovir
low-molecular heparin SC
NSAID/ steroids
TIME

Question 23

Describe Equine degenerative myeloencephalopathy

Answer 23

diffuse degenerative disease of the equine spinal cords and caudal portion of the brainstem
Is vitamin E related

Question 24

which aged animals does Equine degenerative myeloencephalopathy tend to affect

Answer 24

primarily affects young horses (<1yo), but can take longer to dx (<5yo)

Question 25

List the clinical signs of Equine degenerative myeloencephalopathy

Answer 25

gradual onset of symmetric spasticity, ataxia, and paresis
some horse have decreased menace response, lethargy and behavioural changes
long-term poor performance in adult horses

Question 26

Describe how to prevent Equine degenerative myeloencephalopathy

Answer 26

some breed lines might be predisposed (QH?), areas with Low VitE
Supplementation last month pregnancy and nursing period

Question 27

What triggers Equine Motoneuron disease

Answer 27

vitamin E deficiency for periods longer than 18 months

Question 28

Describe Equine Motoneuron disease

Answer 28

Acquired progressive neurodegenerative disease that affects neurons in brain and spinal cord (LMD)

Question 29

what are the risk factors of Equine Motoneuron disease

Answer 29

excess copper and no access to green forage

Question 30

List the clincial signs of equine motoneuron disease

Answer 30

generalised weakness
shifting weight between limbs
generalized sweating
Neurogenic muscle atrophy: Type I fibres
Pigmentary retinopathy
Muscle fasciculations of anti-gravitatory muscles

Question 31

Describe how to diagnose equine motoneuron disease

Answer 31

low vit E in serum
confirmatory- tail biopsy
On PM

Question 32

Describe how to treat equine motoneuron disease

Answer 32

Vitamin E supplementation for 3 months

Question 33

what causes Equine protozoal myeloencephalopathy

Answer 33

Protozoa - Sarcocystis neurona and Neospora hughesi

Question 34

how do horses get affected by Equine protozoal myeloencephalopathy

Answer 34

ingestion of contaminated feed
occurs most comonly in USA/ south america

Question 35

List the clinical signs of Equine protozoal myeloencephalopathy

Answer 35

asymmetrical ataxia without CN defects
any possible neuro signs
weakness and muscle atrophy
Poor anal tone, “cauda equina syndrome”

Question 36

Decsribe how to diagnose equine protozoal myeloencephalitis

Answer 36

Challenging
generally done based on CS and in an area with opossums

Question 37

Describe how to treat equine protozoal myeloencephalitis

Answer 37

Pyrimethamine and sulfadiazine - 90 days
Diclazuril/ponazuril - 60 days
NSAIDs/Steroids acute severe stages
Long term Vitamin E supplementation?