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74 Cards in this Set
- Front
- Back
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What are causes of non-infectious meningitis and/or encephalitis in small animals? Which is most common?
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Immune-mediated (most common)
Lymphoma maybe |
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What are common infectious causes of meningitis or encephalitis in small animals? Which look the most similar to granulomatous meningoencephalomyelitis?
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Toxoplasma, Neospora (look like GME)
Fungal infections Distemper |
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How will CSF taps look in meningitis in the following:
- Toxoplasma infection - Histoplasma infection - CNS form of distemper |
Increased protein & cell count - Toxoplasma infection
may see organisms - Histoplasma infection 100% lymphocytes - CNS form of distemper |
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How can you discern lymphoma from GME?
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PCR for antigen receptor arrangement (malignant lymphocytes have screwy receptors)
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What are the most common locations for GME? Which has the WORST prognosis?
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Cervical spinal cord
Vestibulo-cerebellar system (WORST) Optic nerve Cerebral cortex |
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What are the 3 FORMS of GME?
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Focal
Disseminated/multifocal Ocular |
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Which of the following are NOT true regarding GME?
a) unknown cause but characteristic of a type I hypersensitivity reaction b) impacts white matter c) perivascular mononuclear lymphocytic cuffing d) thoracolumbar distribution is common e) neutrophils are commonly elevated |
a) unknown cause but characteristic of a type I hypersensitivity reaction (NO; type IV delayed hypersensitivity)
d) thoracolumbar distribution is common (NO; CERVICAL) |
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What is the histopathological lesion associated with GME?
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Perivascular mononuclear lymphocytic cuffing
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If you suspect GME and find high lymphocytes on a CSF tap, what is your next step?
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Run PCR and seology for infectious disease; if negative, IMMUNOSUPPRESS
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What are the possible treatments for GME?
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Prednisone
Cytosine arabinoside Procarbazine HCl Cyclosporine A (only works when BBB is open though) |
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Which GME treatment has the following effect?
Hepatotoxicity Capsules are too potent for most dogs Doesn't normally cross blood/brain barrier Severe halitosis |
Hepatotoxicity (Pred and Cytosine arabinoside)
Capsules are too potent for most dogs (Procarbazine) Doesn't normally cross blood/brain barrier (Cyclosporine A) Severe halitosis (Cytosine arabinoside) |
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Which GME treatment has the following effect?
A safe antineoplastic drug Not good for long-term use PROFOUND immunosuppressant Conjunctivitis |
A safe antineoplastic drug (Cytosine arabinoside)
Not good for long-term use (Prednisone) PROFOUND immunosuppressant (Cyclosporine A) Conjunctivitis (Cytosine arabinoside) |
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Which drug is the BEST for the optic form of GME?
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Cytosine arabinoside
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What are some of the major differences between normal GME and Pug encephalitis?
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Pug encephalitis affects cerebrum mostly, has more necrosis, and affects gray and white matter! Poor to hopeless prognosis...
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What is the common sign of GME in the CSF?
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Mononuclear pleiocytosis!
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Which breeds have "breed-associated" GME? Which one has the worst prognosis?
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Yorkies (worst)
Maltese Chihuahua |
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Who gets steroid-responsive suppurative meningitis? What is the prognosis?
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<2 yo medium to large-breed dogs; very good to excellent prognosis with pred (maybe add cytosine arabinoside)
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Which of the following are NOT true regarding steroid-responsive suppurative meningitis?
a) non-painful b) ataxia but not seizures c) fever d) pred is often curative e) mononuclear pleiocytosis |
a) non-painful (NO - vertebral pain)
b) ataxia but not seizures (NO - neuro deficits rare) e) mononuclear pleiocytosis (NO - neutrophilic pleiocytosis) |
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Who gets necrotizing vasculitis?
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the B's (beagles, BMD, Boxers)
Also German short-haired, Irish wolfhounds |
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Which of the following are NOT associated with necrotizing vasculitis?
a) rare tetraparesis b) poor prognosis c) brainstem signs rare d) fever e) peripheral neutrophilia |
a) rare tetraparesis (NO)
c) brainstem signs rare (NO, common) |
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Choose bacterial or aseptic meningitis for the following:
- steroids are effective - brainstem/cerebral involvement more common - slower progression - more severe - high protein and high neutrophils |
BOTH - steroids are effective
Bacterial - brainstem/cerebral involvement more common Aseptic - slower progression Bacterial - more severe Both - high protein and high neutrophils |
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Which of the following cross the BBB well? Which do not cross well?
a) Cephalexin b) Fluoroquinolones c) Metronidazole d) Doxycycline e) Aminoglycosides |
c) Metronidazole (cross well)
d) Doxycycline (cross well) b) Fluoroquinolones (intermediate) a) Cephalexin (poor) e) Aminoglycosides (poor) |
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You see an older doberman with a painful neck, stiff, stilted gait in front and wobbly ataxic back legs. Where is the most likely location of the lesion?
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C5/6 or C6/7 (Cervical Spondylopathy)
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Which dogs get Wobbler's syndrome? Which are worse off?
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Young dogs
Mastiffs and Boerbels (WORST) Great danes (not as bad) |
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What are clinical signs of Wobbler's syndrome?
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Cervical hyperesthesia & neck ventroflexion
Asynchronous thoracic and pelvic gait (pelvic limbs more affected than thoracic) |
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Choose older or younger dogs with caudal cervical spinal disease for the following:
- hypertrophic ligamentum flavum - dorsolateral cord compression - DJD lesions - no disc degeneration - thickened dorsal and lateral laminae |
older - hypertrophic ligamentum flavum
young - dorsolateral cord compression older - DJD lesions young - no disc degeneration young - thickened dorsal and lateral laminae |
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How is caudal cervical instability treated in young and old dogs? What is the prognosis?
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Young (dorsal continuous laminectomy - good prognosis)
Old (ventral slot; decent prognosis) |
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Which dog breed has hypothyroidism associated with caudal cervical instability?
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Dobies
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What are the most common sites for discospondylitis?
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C6/7
Mid thoracic (T5-T8) L7-S1 |
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How is discospondylitis acquired?
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Hematogenous spread from skin or bladder infection
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What are common bacteria implicated in discospondylitis? Which is most common?
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S. intermedius (most common)
Also S. aureus, Strept, Brucella canis, E. coli |
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What are the most common signs associated with discospondylitis?
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Pain
Kyphosis Stiff-stilted gait |
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Who gets discospondylitis?
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Middle-aged large breed males!
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T or F:
Discospondylitis rarely strays from the disc space. |
True!
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Which of the following is NOT true regarding discospondylitis?
a) meningitis is often concurrent b) Urine culture isn't often positive c) Only antibiotic therapy is necessary with minimal neuro deficits d) A brucella infection is rarely cured fully e) S. intermedius is the most common and most severe cause |
a) meningitis is often concurrent (NO)
e) S. intermedius is the most common and most severe cause (NO; Strept is most severe but S. intermedius is most common) |
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Choose an antibiotic to treat discospondylitis caused by the following:
- Staph - Strept - Brucella |
Staph (cephalosporins, clindamycin, TMS)
Strept (amoxicillin, ampicillin) Brucella (tetracyclines and streptomycin) |
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How is discospondylitis treated with significant neuro signs?
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Surgical decompression + long-term abx
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Hip dysplasia is often mistakenly diagnosed for...
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...lumbosacral stenosis
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How is lumbosacral stenosis treated? What is the prognosis?
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Surgical decompression/stabilization
GREAT prognosis |
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What are common clinical signs of lumbosacral stenosis?
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Spinal pain, kyphosis, stiff-stilted gait
Sciatic nerve dysfunction Urinary/fecal incontinence and loss of tail fxn (severe) |
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What are differentials for acute generalized FLASSID tetraparesis and exercised induced weakness?
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Myasthenia gravis
Tick paralysis Botulism Coonhound paralysis (polyradiculoneuritis) Black widow envenomation |
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Which dogs get congenital myasthenia gravis? Which one has a good prognosis?
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Jack russell
Springer spaniel Wire hair fox Mini Dachshund (good prognosis - spontaneous remission) |
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Why is thymoma linked to myasthenia gravis?
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Thymocytes structurally identical to Ach receptor
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Which diseases are associated with acquired myasthenia gravis?
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Thymoma
LSA Osteosarc Anal sac adenocarcinoma Cutaneous lymphoma Addisons |
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What are common signs of myasthenia gravis?
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Focal or generalized exercise-induced neuromuscular weakness
Megaesophagus/regurg Voice change |
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How is myasthenia gravis diagnosed? How is it treated?
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Dx (anti-AchR antibodies; edrophonium response test)
Tx (elevated feeding, physostigmine) |
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What is the prognosis for myasthenia gravis in dogs? Cats?
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Dogs - BAD
Cats - GOOD (don't have megaesophagus really) |
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Which of the following diseases have megaesophagus?
a) myasthenia gravis b) tick paralysis c) coonhound paralysis d) botulism |
a) myasthenia gravis
d) botulism |
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Rapidly progressing myasthenia gravis is known as..
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...FULMINANT MG
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Which of the following diseases are characterized by hyperesthesia?
a) myasthenia gravis b) tick paralysis c) coonhound paralysis d) botulism |
c) coonhound paralysis
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Which of the following diseases has abnormal CSF?
a) coonhound paralysis b) tick paralysis c) myasthenia gravis d) polyradiculoneuritis e) botulism |
a) coonhound paralysis
d) polyradiculoneuritis (they're the same thing) |
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Which of the following diseases produces autonomic signs?
a) coonhound paralysis b) tick paralysis c) myasthenia gravis d) polyradiculoneuritis e) botulism |
e) botulism
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Which of the following diseases has hyporeflexia?
a) coonhound paralysis b) tick paralysis c) myasthenia gravis d) polyradiculoneuritis e) botulism |
a) coonhound paralysis
b) tick paralysis d) polyradiculoneuritis e) botulism |
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Which of the following diseases should self-resolve with appropriate supportive therapy?
a) coonhound paralysis b) tick paralysis c) myasthenia gravis d) polyradiculoneuritis e) botulism |
a) coonhound paralysis
d) polyradiculoneuritis e) botulism |
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Which of the following diseases resolves in 14 days?
a) coonhound paralysis b) tick paralysis c) myasthenia gravis d) polyradiculoneuritis e) botulism |
e) botulism
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How is tick paralysis diagnosed? Treated?
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Dx - clinical signs and find the tick
Tx - remove tick or use Frontline |
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Choose myopathy, neuropathy, or both:
- hypo to areflexia - acute muscle atrophy - may have CP deficits - no paresis/paralysis - muscle tremors/cramping |
Neuro - hypo to areflexia
Neuro - acute muscle atrophy Neuro - may have CP deficits Myo - no paresis/paralysis Myo - muscle tremors/cramping |
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What are some aspects of the CBC/chem panel that can help in diagnosing a myopathy or neuropathy?
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Eosinophilia
Glucose CK K T4/TSH |
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If you see an old cat with litter on its feet, what might you find in the bloodwork? What might be the cause?
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High glucose d/t diabetic neuropathy
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Facial nerve weakness is a common sign of...
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...hypothyroidism
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If you see a cat with cervical ventroflexion, what might you find in the bloodwork? What is the cause?
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Hypo-K and increased CK d/t chronic renal failure
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What chem values are high in Cushing's disease?
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High ALP, ALT, and Cholesterol
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Which two feline viruses can cause LMN dz?
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FeLV and FIV
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You see a 10 week pup with weak hind limbs progressing to rigidity. What do you think?
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Neospora!
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How can carnitine aid in diagnosing myopathies?
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High carnitine in urine and low in muscle shows a secondary carnitine issue, indicating a functional muscle disease
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Which of the following muscles are biopsied for a neuropathy?
a) triceps b) cranial tibial c) quadriceps d) extensor carpi radialis |
b) cranial tibial
d) extensor carpi radialis |
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Which of the following muscles are biopsied for a myopathy?
a) triceps b) cranial tibial c) quadriceps d) extensor carpi radialis |
a) triceps
c) quadriceps |
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What is a good nerve to biopsy?
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distal tibial nerve or ulnar nerve
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T or F:
You can put nerve biopsies in formalin but not muscle biopsies. |
True!
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T or F:
You should cut proximally first in a muscle biopsy. |
True!
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If you see massive balloons of myelin in a nerve, what might the diagnosis be? What other tests could have been done instead?
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Diabetic neuropathy
(fructosamine/glucose levels + clinical signs) |
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Choose trigeminal disorder or masticatory myositis:
- can't open jaw - can't close jaw - 2M fiber atrophy - painful - no palpebral response |
MYOSITIS - can't open jaw
TRIGEMINAL - can't close jaw MYOSITIS - 2M fiber atrophy MOSITIS - painful TRIGEMINAL - no palpebral response |
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How is masticatory myositis diagnosed?
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2M myofiber antibody assay
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Which rule-out diagnosis causes severe atrophy of peripheral muscles?
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Chronic progressive peripheral axonopathy
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