(B) Canine and Feline Neurological Disorders

Brain + Spinal Cord + Peripheral Nervous System + Neurological Emergencies

head trauma is always — onset

acute

what causes head trauma (5)

1. HBC

2. falls

3. gunshot wounds

4. animal bites

5. malicious human behaviour

clinical signs of head trauma (12)

1. History of trauma to the head

2. Seizures

3. Blood in the ear

4. blood in the nose

5. blood in the oral cavity

6. Ocular hemorrhage

7. Loss of consciousness

8. decreased responsiveness

9. Signs of shock

10. arrhythmias

11. changes in ventilation

12. coma

13. anisicoria

what is the ABCD’s of head injuty assessment

1. Airway

2. Breathing

3. Cardiovascular

4. Disability assessment

hemorrhage may indicate …

skull fracture

hemorrhages are entry for —

bacteria

define anisicoria

pupils are diff sizes

when looking at Disability or Level of Consciousness in head trauma, what mental status signs are we looking for

1. Alert

2. Depressed

3. Delirious

4. Stuporous

5. Comatose

define Depressed

subdued attitude

define Delirious

altered perception of reality, may be frantic/hallucinating, unusual responses to stimuli

define Stuporous

state of sleep unless aroused by strong stimuli

define Comatose

deep unconsciousness, can’t be stimulated

the pupil size is considered

normal

the pupil reactivity would be

normal

the prognosis based on these pupils sizes is

good

the pupil size is considered

bilateral miosis

the pupil reactivity would be

poor to none

the prognosis based on these pupils sizes is

guarded

the pupil size is considered

unilateral mydriasis

the pupil reactivity would be

poor to none on mydriatic side

the prognosis based on these pupils sizes is

guarded to poor

the pupil size is considered

unilateral mydriasis with ventrolateral strabismus

the pupil reactivity would be

poor to non on mydriatic side

the prognosis based on these pupils sizes is

guarded to poor

the pupil size is considered

normal

the pupil reactivity would be

non-responsive

the prognosis based on these pupils sizes is

poor to grave

the pupil size is considered

bilateral mydriasis

the pupil reactivity would be

poor to non-responsive

the prognosis based on these pupils sizes is

poor to grave

the pupil size is considered

normal

the pupil reactivity would be

miosis, ptosis and third eyelid protrusion

how to diagnose head trauma (5)

1. Rads

2. CT scan

3. MRI

4. history

5. Serum chem

how to treat head trauma (10)

1. Protect brain from ongoing damage

2. decrease edema

3. decrease ischemia

4. decrease pressure

5. Correct metabolic abnormalities

6. Provide oxygen

7. Elevate the head

8. Administer osmotic agents to decrease cerebral edema

9. Administer antiseizure medication if required

10. Administer corticosteroids

brain damage — reversible

isn’t

Animals in a coma for greater than 48 hours often will — survive

likely not

define primary head trauma

injury to the brain directly from trauma that causes injury to the nervous tissues

define secondary head trauma

from events that that worsen the neurological damage and produce systemic derangements

what are the classifications of head trauma (4)

1. concussion

2. contusion

3. coup-contrcoup

4. coma

what is under concussion (3)

1. Brief loss of consciousness

2. short period of confusion

3. no significant parenchymal damage

what is under contusion (3)

1. Injury where skin remains intact

2. usually due to blow to head

3. physical damage to brain parenchyma

what is under Coup-contrecoup (3)

1. Impact to head brain floating

2. brain hits opposite side of brain case

3. damage occurs to both sides of brain

comas are based on the assessment of (3)

1. motor activity

2. brain stem reflexes

3. level of consciousness

what is the common sequence of events for head trauma (8)

1. Trauma

2. brain hemorrhage

3. edema

4. increased intracranial pressure

5. cerebral ischemia

6. CO2 up

7. O2 down

8. oxygen free radical induced brain injury

define seizure

Abnormal electrical activity in brain

define Hydrocephalus (3)

1. caused by a blockage, or obstruction, of normal CSF drainage from around the brain

2. decreased CSF absorption

3. excessive CSF production that builds up faster than it can drain

what are the different types of intracranial seizures (6)

1. Congenital

2. Neoplasia

3. Inflammatory Diseases

4. Vascular Disease

5. acquired epilepsy

6. Metabolic Storage Disease

define Infarct

area of necrosis in tissue or an organ due to a thrombus disrupting blood flow

define Metabolic Storage Disease (2)

1. A metabolic enzyme deficiency

2. occurs when a dog's body fails to produce a sufficient amount of an enzyme necessary to metabolize, or break down, a specific substance.

A metabolic enzyme deficiency aka

metabolic storage disorder

what are the different types of extracranial seizures (2)

1. Toxins

2. Metabolic Disease

what are metabolic diseases that can cause extracranial seizures (5)

1. Liver ds

2. Hypocalcemia

3. Electrolyte abnormalities

4. Hypoglycemia

5. Ketosis

how to diagnose seizures (6)

1. CBC

2. Chemistry

3. UA

4. Radiographs

5. MRI

6. CSF

how to treat seizures (4)

1. Treat the underlying issue

2. Phenobarb

3. KBr

4. Levetiracetam

what are the different types of seizures (7)

1. Reactive Seizure

2. Epileptic seizure

3. Grand mal seizure

4. Petite mal seizure

5. Partial seizure

6. Idiopathic Epilepsy

7. Status Epilepticus

define reactive seizures (2)

1. Occurring as a natural response from the brain to a transient disturbance

2. Reversible when the cause is rectified

define Epileptic seizure (3)

1. Excessive synchronous usually self limiting epileptic activity of neurons in the brain

2. Short episodes with convulsions or focal motor, autonomic, or behavioral features

3. Having at least two unprovoked greater than 24 hours apart

define Grand mal seizure (3)

1. Whole brain affected

2. Unconscious

3. Generalized motor activity

define Petite mal seizure (2)

1. Mild generalized seizure

2. Momentary loss of consciousness

define Partial seizure

Localized to one area of brain

define Pre-ictal

clingy behavior in dogs

define Ictal

actual seizure

define Post-ictal

lethargy while the brain resets itself

define tonic

increase in muscle contraction lasting seconds to minutes, stiffening

define clonic

involves the same muscle groups, contractions every 2-3 secs, twitching/jerking

define Tonic-clonic

sequence of a seizure where the tonic phase is followed by the clonic phase

define Prodromal

change in disposition leading up to the preictal period

when should an epileptic patient be rush to the hospital

status epilepticus

what is some pre-hospital advice (4)

1. Do not restrain patient

2. Move if animal is at risk of injury

3. Book appointment for exam

4. Keep a journal of seizures

define Idiopathic Epilepsy

Characterized by repeated episodes of seizures without cause

what age does Idiopathic Epilepsy effect (range)

1 - 3 yrs

idiopathic epilepsy is typically seen in what breeds (9)

1. German shepherds

2. Miniature poodles

3. Toy poodles

4. St. Bernards

5. Cocker spaniels

6. Beagles

7. Irish setters

8. Golden retrievers

9. mixed breeds

clinical signs of idopathic epilepsy (2)

1. Seizures, often occurring at regular intervals

2. Normal behavior between seizures

how to diagnose idopathic epilepsy (5)

1. CBC

2. serum chem

3. Radiography

4. CT

5. MRI

how to treat idiopathic epilepsy (2)

1. Control seizure activity with phenobarbital

2. add potassium bromide with food if (1) not enough

define Status Epilepticus

Continual seizures for a prolonged period of time

what is considered a prolonged period of time for seizures (range)

5 - 10 mins

what causes status epilepticus (3)

1. Severe uncontrolled epilepsy

2. toxins

3. metabolic disease

clinical signs of status epilepticus(1)

Prolonged, uninterrupted seizure activity

how to treat status epilepticus (general) (3)

1. Control seizures

2. Begin fluid therapy

3. May need treatment for cerebral edema

how to give immediate treatment status epilepticus (10)

1. Diazepam

2. Propofol

3. sodium pentobarbital IV to effect

4. Establish an airway

5. give oxygen

6. start fluids

7. Check blood glucose and calcium concentrations

8. Monitor body temperature.

9. mannitol IV

10. prednisolone sodium succinate

how to give Maintenance treatment status epilepticus (2)

1. Phenobarbital

2. Levetiracetam

Epilepsy— a curable disease.

isn’t

Idiopathic Vestibular Disease aka

Old Dog Vestibular Disease

what is the Central vestibular system responsible for (4ish)

balance and coordination of … in relation to the movement of the head.

1. the eyes

2. body

3. limbs

what causes central vestibular disease (4)

1. Trauma

2. Infection

3. Neoplasia

4. Infarct

what causes peripheral vestibular disease (7)

1. Otitis media/interna

2. Middle ear tumors

3. Feline nasopharyngeal polyps

4. Trauma

5. Medication

6. Geriatric canine vestibular ds

7. Feline idiopathic vestibular ds

clinical signs of vestibular disease (6)

1. Incapacitating loss of balance

2. Nystagmus

3. Disorientation

4. Ataxia

5. Vomiting

6. Anorexia

how to diagnose vestibular disease (4)

1. History

2. CT

3. MRI

4. BAER - hearing test

how to treat vestibular disease (4)

1. antiemetic

2. spontaneous recovery

3. Supportive therapy and force-feeding should be implemented

4. Confine the animal to prevent injury from falling

what does MG stand for

Myasthenia Gravis

Myasthenia Gravis is a — receptor problem

Acetylcholine

Myasthenia Gravis is often — mediated

immune

what breed (group) is prone to Myasthenia Gravis

terrier breeds

what causes Flaccid paralysis (4ish)

Diseases affecting the

1. Peripheral nerves

2. spinal cord

3. neuromuscular junctions

Functional Zones of Spinal Cord (5)

1. Proprioceptive layer

2. Purposeful movement

3. Bladder/bowel function

4. Superficial pain

5. Deep pain

define Proprioceptive layer

allows animal to know where limbs are in space

define Purposeful movement

controls conscious ability to move limbs

define Bladder/bowel function

conscious and subconscious control of bladder and bowels

define Superficial pain

ability to feel light stimuli to skin and superficial tissues