Transcript DipaNervousSystemDiseases3student

Cervical Spondylomyelopathy: Wobbler
•
Cervical spinal cord compression (__________) as a
result of caudal vertebral ______________or
misarticulation.
–
•
–
–
–
–
–
–
–
–
____________breed dogs (Great danes and Dobermans)
Signs
Progressive hind-limb ataxia (wobbly gait)
Pelvic limbs cross each other when walking
Abduct widely/tend to collapse
May drag toes (wears dorsal surface of nails)
Impaired __________________________
Signs may also be present in front limb
Crouching stance with downward flexed neck
Rigid flexion of neck; may have neck pain
Cervical Spondylomyelopathy: Wobbler
•
Dx
–
–
–
Radiographs to show malalignment and
narrowing of spinal canal
_________________ is essential to locate the
region of compression
CT and MRI if available
Cervical Spondylomyelopathy
MYELOGRAM
C6-C7
Cervical Spondylomyelopathy: Wobbler
•
Rx—without treatment, prognosis is ________
–
Medical
•
•
•
–
Anti-inflammatory doses of corticosteroids
Neck brace
Cage confinement
Surgical
•
•
Decompression of spinal cord by ___________________
Stabilize vertebral column
–
–
screws and wire dorsally
spinal fusion ventrally
Cervical Spondylomyelopathy: Wobbler
•
Client info
–
–
–
–
Prognosis is _______________________
Most likely a hereditary disease
Multiple levels of compression less favorable prognosis
than a single area of compression
Surgery is risky and costly
Degenerative Myelopathy
•
Etiology—unclear
–
–
–
•
May be __________________response to antigen in nerv sys
Degeneration of ______________ matter in ascending and descending
tracts
~ Multiple sclerosis - humans
Signs
–
–
–
–
–
–
Mainly in G Shep and Shep mixes (>5 yr)
Progressive ataxia and paresis of hind limbs (5-6 months)
Loss of proprioception is first sign
Dog “falls down” when trying to ____________________
Muscle wasting of back muscles along caudal thoracic and lumbosacral
areas
Symptoms progress until animal is unable to support weight on hind
limbs
Degenerative Myelopathy
•
Dx—
–
•
Neurologic Exam
•
↓ proprioception
•
↑ _________________________
•
Lack of pain
•
Normal sphincter tone; normal panniculus
(pin prick) reflex
•
Radiographs usually normal
Rx—none; symptoms will progress to
paralysis
Client info—
•
–
–
–
Degenerative myelopathy is a progressive, ____________ disease
Although symptoms are similar at early stages, it is a different
disease from hip dysplasia
When dog cannot support weight, quality of life should be evaluated
Degenerative Myelopathy
PERIPHERAL NERVOUS
SYSTEM
Deafness
1) Damage to auditory
pathway
– chronic otitis
– rupture of
_______________
–
damage to middle ear
(ossicles)
2) Damage to
auditory nerve
Deafness
3) Hereditary or congenital
–
Bull terriers, Dobes, Rotts, Pointers, blue-eyed white
cats, Dalmations, Aust Heelers, Aust shepherds, Eng
setters, Catahoula
4) Related to drug therapy
_________________________ (gentamicin, streptomycin,
kanamycin
– Topical polymyxin B
– Chloramphenicol
– Chlorhexidine w/ centrimide
5) Normal old age—usually due to atrophy of nerve
ganglia or cochlear hair cells (also loud rock music)
Deafness
•
Dx—
–
•
Rx—No treatment is available in most cases
–
•
Inability to rouse sleeping animal with loud
noise (e,g,. blast from air horn) is diagnostic
Hearing aids are available for animals,
but most will not tolerate something in ear canal
Client info
–
–
–
–
–
Hearing loss is ______________________________
If hereditary, do not breed
Animals can be taught to hand signals rather than words
Animals should not be off leash when outside
Hearing aids are available for dogs but are usually not tolerated;
would only be appropriate for hearing impaired
Laryngeal Paralysis
•
3 types—always be cautious of
laryngeal paralysis because of the
chance of _____________________
–
Hereditary—seen in Bouvier des Flandres and Siberian
Huskies
•
–
Acquired—can occur from lead poisoning, rabies,
trauma, inflammation of vagus nerve
•
–
Seen at 4-6 mo of age
1.5 to 13 yr of age
Idiopathic—seen in middle-age to old large- and giantbreed dogs; castrated dogs and cats have a higher
incidence than female and non-neutered males
Laryngeal Paralysis
•
•
•
•
Signs—
–
Inspiratory __________________________
–
Resp distress
–
Loss of endurance
–
Voice change
–
Dyspnea/cyanosis/complete resp collapse
Dx— ________________________ will show laryngeal abductor m.
(away from midline) dysfunction
Rx—surgical intervention including:
–
Arytenoidectomy
–
Removal of vocal folds
Client info—prognosis is guarded to good; do not breed if hereditary
Laryngeal Paralysis
Megaesophagus
•
Causes-lack of _______________________ (3 types):
–
Hereditary—a gene for the disease is identified in wire-haired fox
terriers and min schnauzers
Congenital—G Danes, G Shepherd, I Set, Newfound, Shar-Peis,
greyhounds (no gene ID’ed)
–
•
•
–
•
evident about weaning time when solid food is introduced
Due to incomplete nerve development in esophagus
Acquired—may be seen at any age; Pb tox; may be associated with
neuropathies (e.g., myasthenia gravis, tick paralysis)
Signs
–
–
–
_______________________ of undigested food
Respiratory problems (aspiration pneumonia)
Lack of growth
Megaesophagus
Dx—barium swallow
Esophagus is 3 times normal diameter
Megaesophagus
•
Rx—
–
–
–
–
•
____________________ feeding (on platform, stairs)
Liquid or soft diet high in calories
Give several small feedings daily
Gastrostomy tube (long term) is an option
Client info
–
–
–
Prognosis—guarded to poor
Treatment aim is to reduce clinical signs and prevent
__________________________________________
There is no cure
Tick Paralysis
•
Cause—female tick (Dermacenter variablis, D. andersoni) →
salivary ________________________
–
–
•
Neurotoxin interfered with Ach at neuromuscular jct
Not seen in cats; humans are affected
Signs—
–
Gradual onset of ____________ changes and hind-limb ataxia (motor
deficit) progressing to a flaccid, ascending paralysis (1-3 d)
Sensation is intact
Ticks on the dog
–
–
•
Rx
–
Remove ticks (manually or with dip)
•
–
Usually resolves in 1-3 d
Supportive care until dog recovers
•
Ventilation required for resp paralysis
Tick Paralysis
Coonhound Paralysis
(Polyradiculoneuritis )
-thought to be an immune response to an unknown etiologic factor in ________________________________
-some dogs will get it 1-2 wk after exposure, others exposed to same raccoon will not
•
Signs—(similar to tick paralysis and ____________________)
–
–
–
–
–
–
•
•
Weakness begins in hind limbs with paralysis progressing rapidly to a flaccid
tetraplegia
Alert, afebrile animal
Loss of spinal reflexes (patella tap, etc)
Loss of voice; labored breathing; inability to
lift head
May die of resp failure
May last for 2-3 mo (usually good Px)
Rx—supportive nursing care
Client info—
–
–
–
Dogs can be affected without exposure to raccoon
May require long-term nursing care
Some animals will regain total function, while more severely affected animals
may not
Idiopathic Facial Nerve Paralysis
•
•
Etiology—unknown
Occurrence
–
•
C Span, Corgis, Boxers, E Set, DLH cats
Signs—
–
–
–
–
–
–
–
Older dogs (>5 y)
________________ droop
Lip ____________________
Sialosis (drooling)
Deviation of nose
Collection of food in paralyzed side of mouth
Absence of menace and palpebral reflex
Idiopathic Facial Nerve Paralysis
•
Rx—efficacy of corticosteroids unknown
– Artificial tears to prevent___________________
– Keep oral cavity clear of food
•
Client info—
– Cause is unknown
– Complete recovery does not usually occur
– May develop ____________________________
(dry eye)
– Animals may require life-long maintenance