Neuromuscular

Introduction to the Course Structure

• Welcome and overview of the course format.

• This session will focus on team-based learning (TBL).

• Content will be shorter than previous lectures, focusing on existing materials available in PDFs and videos.

• Access to videos and materials should be confirmed to be functioning.

Course Materials

• Learning Resources:

  • Approximately 8 videos covering neuro and muscle diseases.

  • PDF documents available for self-study.

• Individual Readiness Assessment Test (IRAT):

  • Consists of 9 questions with a time limit of 15 minutes.

  • Designed to be straightforward.

Group Formation

• Students are encouraged to form groups today to streamline activities on Friday.

• Suggested structure: 5-6 groups of 4-5 people each.

Learning Format on Fridays

1. IRAT Review:

   • Brief discussion on answers and clarifications for any unclear content.

2. Case Studies:

   • Focus on neuro cases primarily, with some muscle cases interspersed.

   • Utilize videos or pictures of cases not covered in lectures.

   • Questions will gauge recognition of diseases and potential treatment management.

Neuro Diseases Overview

• Common Issues in Horses:

  • Brain diseases are rare; focus on conditions like seizures, abscesses, or infections (e.g., West Nile).

  • Familiarize with working up brain diseases vs. spinal cord diseases.

• Spinal Cord Issues:

  • Cervical Vertebral Stenotic Myelopathy (CVSM) is prominent, especially in regions lacking opossums for EPM (Equine Protozoal Myeloencephalitis).

  • Understand EPM diagnostics and its commonality in misdiagnosis/treatment costs.

  • Herpes/Neuro myeloencephalopathy is another critical disease needing attention.

• Cranial Nerve Diseases:

  • Most common deficits involve cranial nerves VII (facial nerve) and VIII; related to trauma or guttural pouch disease.

  • Exploration of potential causes, prognosis varies based on severity and regenerative capacity.

Vaccination and Preventative Measures

• Protective vaccines against neurologic diseases significantly reduce clinical cases.

• Compare pathology of Tetanus vs. Botulism:

  • Tetanus: spastic paralysis due to spinal cord disease localization.

  • Botulism: flaccid paralysis stemming from nerve end-plate involvement.

Movement Disorders in Horses

• Common Disorders:

  • Stringhalt: Affects forward movement, can be unilateral or bilateral.

  • Shivers: More pronounced when the horse backs up; prevalent in draft horses.

Muscle Diseases

• Rhabdomyolysis:

  • Can arise from sporadic causes, usually following exertion without prior training.

  • Considerations for horses not accustomed to trailering and high-stress activities (e.g., emergency transport).

  • Underlying myopathies yield varied severities of symptoms. Recognize indicators like reluctance to exert.

• Diagnostic Considerations:

  • Muscle biopsies should be performed post-recovery from rhabdomyolysis.

  • Key muscle enzymes include Creatine Kinase (CK) and Astrocytic Transaminase (AST), with specific interpretations during recovery

Key Takeaways on Diagnosis and Management

• Levels of CK can indicate severity of muscle breakdown; values exceeding 2000 prompt further investigation into underlying conditions.

• Elevated AST levels inform recovery time, aiding in patient management decisions post-episode.

• Awareness of conditions like PSSM (Polysaccharide Storage Myopathy) and importance of genetic testing in Quarter Horses and specific breeds.

Individual Questions and Group Collaboration

• Encourage open communication for any inquiries, particularly regarding study materials or group dynamics leading into case discussions.

• Reminders to integrate knowledge from previous lectures and focus on the diagnostic processes discussed.