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57 Cards in this Set
- Front
- Back
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Seizures
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‘A period of disorganised brain activity, where there is overstimulation of the central nervous system and random involuntary muscle spasms’
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Causes of seizures
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Toxins, electrolyte imbalances, hypoglycaemia, hypocalcaemia, physical brain trauma, epilepsy, meningitis, neoplasia
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Idiopathic epilepsy
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Cause is unknown - possibly genetic? First fit usually between 1yrs-3yrs Controlled with drugs that lower the ability of neurons to transmit impulses (management not cure) It is usual that lifelong treatment is needed |
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Pre-ictal
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Time before onset of seizure Abnormal behaviours are usually seen |
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Ictus
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seizure, which can be: Partial - localised area of the brain behaviours seen such as – facial twitiching, neck/shoulder/limb muscle involvement/impaired consciousness/bizarre behaviour/ fly-biting, howling, salivation, salivation Generalised - can be further divided depending on nature of seizure – tonic-clonic (stiffening then jerking), clonic (alternating between relx/contract of muscles - jerking), urination, defecation Cluster - 2 or more in 24 hrs Status epilepticus - continuous > 5 mins or repeated seizures lasting 20-30 minutes or more – needs immediate treatment – emergency, extended fits can lead to permanent brain damage and other issues related to hypoglycaemia, hyperthermia etc. |
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Post-ictal
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time after the seizure may see: restlessness Disorientation Polydipsea - excessive thirst Polyphagia - excessive eating |
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What advice should we give owners whose animal is having a seizure at home?
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Time seizure and keep record in diary over time to record regularity Stay with animal but just monitor from a distance as may bite/lash out Ensure animal can not hurt themselves – move objects out of the way etc. Darken and quieten room.Should only last a few minutes – explain how the animal will be afterwards – may want food/water, reassurance Arrange to see a vet for check over esp if has happened a few times. No rush on appointment unless is having regular clusters or is in SE. IF SE THEN SEE IMMEDIATELY!! |
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SE emergency What questions do we need to ask the owner? |
Patient signalment Any previous seizures? Potential toxin ingestion Trauma? Current medical status/current meds Recent behavioural changes? Details of seizure what happened |
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SE - Nursing care and treatment
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Continuous monitoring – TPR, neurological exam Appropriate environment - Dim lights, reduce noise and ensure kennel is well padded IV access required Measure blood parameters prior to medicating and on-going Vets may use phenobarbital, diazepam, propofol infusions to sedate/anaesthetise animal Oxygen therapy Good records of medication and care Care of anaesthetised animal - monitoring, temperature management, urine management (catheter?), physiotherapy for recumbency and lubricate the eyes monitor temperature - likely to be hyperthermic |
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Long term care for epileptics
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Commitment to regular medication Side effects to medication – drowsiness, PU/PD, polyphagia, ataxia and others Altered behaviours dependant on control Regular monitoring Progressive disorder – with each seizure further damage to the brain making seizures more likely |
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what is the vestibular system?
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Receptor organ (Inner ear) - peripheral Central: Balance control centre in the brain Vestibular nerve Can be a problem in any of these areas to result in the clinical signs of vestibular disease. |
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Clinical signs of vestibule disease
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Head tilt Falling Rolling Leaning Circling Nystagmus- involuntary eye movement Positional strabismus-abnormal positioning of the eye Ataxia - loss of co-ordination and balance Vomiting |
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Idiopathic Vestibular Syndrome
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Common in geriatric animals Cause is unclear No treatment has been evidenced as beneficial Many improve over time but head tilt may remain Reoccurrence is possible |
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Vestibular Disease - Nursing care
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Medication as prescribed – anti-emetics, steroids, antibiotics etc. , poss iv fluids, vivitonin Monitoring Padded environment Help going out to toilet Safe environment – consider water bowls, feeding bowls May need assisted feeding TLC and reassurance Physiotherapy? Owner support if sent home |
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E. Cuniculi in rabbits
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Protozoal infection Estimated 50% of pet rabbits are infected sub-clinically Reason for clinical signs developing in some is not fully understood Licensed treatment & preventative available Treatment is not always successful |
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Intervertebral disc disease
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Pressure of the spinal cord results in either complete or partial loss of voluntary movement Normal disc is squashy nucleus surround by fibrous ring, compress with spinal stress/cushioning effect. IVDD can occur due degenerative changes to the discs or due to injury Type I – Disc extrusion where nucleus pulposus herniates due to change from gelatinous to cartilage consistency – more common in breeds such as dachshunds. Think doughnut, where the jam squirts out. Type II – Disc Protrusion – whole disc becomes more fibrous and moves into spinal cord space – more common in older dogs (degeneration)Can be cervical/throraco-lumbar which will affect clinical signs shown |
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paresis
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weakness of a limb
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paralysis
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loss of movement or inability to move a limb
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hemiplegia
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paralysis affecting one side of the body
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paraplegia
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Paralysis affecting the back limbs only
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quadriplegia/ tetraplegia
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paralysis of all four limbs
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Clinical signs of IVDD
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Pain Proprioceptive deficits Loss of skin sensation Loss of deep pain Reflexes absent Urinary/faecal incontinence Limit movement until diagnosis is made Signs shown will depend on the individual the area of the disc injury and the degree of compression etc. |
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Treatment of IVDD
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Conservative or surgical
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Nursing considerations for IVDD
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Analgesia & pain scoring Care of the recumbent patient – turning (prevent hypostatic pneumonia/pressure sores), urinary/faecal management, assisted feeding Neurological monitoring Physiotherapy (under direction of vet) – talk about more next week but PROM, massage to relax, prevent stiffness of musculoskeletal tissues, assisted walking (sling), supported standing, therapeutic exercise (sit to stand, caveletti, dancing) |
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Canine Degenerative Myelopathy
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Progressive loss of nerve functiondue to degeneration of axons and demyelination
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Clinical signs of CDM
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Ataxia Paresis Paralysis of hind limbs Loss of control of urination/defecation |
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treatment of CDM
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Genetic disease – common in GSD Condition is managed not treated May lead to requirement for euthanasia Managed - assisted walking slings/carts, physio, hydro |
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Senile Changes (Cognitive Dysfunction Syndrome)
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Been likened to Alzheimer's/Dementia in humans. Build up of fibrous proteins in brain interfering with nerve conduction. Fewer antioxidants produced by body as it ages so free radicals able to cause more damage Signs – DISHA Disorientation, Interacts less, Sleep pattern disturbed, House training lost, Altered activity level Diagnosis – owners may perceive changes as normal for old age |
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Management of congnitive dysfunction syndrome
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Medication – Propentofylline (vivtonin) improves cerebral perfusion – more blood to brain, better oxygenation, Selegiline (selgian) Antioxidant, deactivate damaging free radicals , Aktivaitantioxidant medications/ supplements should be implemented asap in presence of clinical signs Diet – High in antioxidants Environmental enrichment – ‘use it or lose it’ |
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Metaphyseal osteopathy (Hypertrophic osteodystrophy) |
Unknown cause Large breed dogs whose growth plates are still open Distal growth plates of long bones most commonly affected e.g. radius/ulnar just above carpus Area of inflammation develops, invaded by neutrophils just above the growth plate Unknown cause – could be linked to dietary component low vit C, high calcium etc., prior infection, distemper virus, vaccination |
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Diagnosis of metaphyseal osteopathy
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Diagnosis based on clinical signs, xray and breed/age Evident on radiographs as radiolucent line At later stages new bone growth can be seen around the growth plate |
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Clinical signs of mestphyseal osteopathy
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pain can cause anorexia shifting lameness swelling and heat at site pyrexia anorexia |
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Treatment and Nursing care
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Analgesia & Antibiotics IV fluids if required Encourage eating – balanced diet Physio – cryotherapy, range of motion TLC – positive experience of vets at an early age |
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Panosteitis
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Cause unknown Common in GSDs, seen in other large breeds also Medullary cavity is invaded by fibrous tissue which then converts to new bone Self-limiting condition, but common to see it reoccur in another limb Supportive care needed during bouts of pain & lameness No long term effect |
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Clinincal signs of panosteitis
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Lameness Pain Pyrexia |
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Elbow Dysplasia
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Three distinct syndromes: Fragmented medial coronoid process (FCP) United anconeal process (UAP) Osteochondritis dissecans (OCD) Pathogenesis is not fully understoodas it could be caused by genetics, nutrition, trauma, asynchronous growth of radius and ulna common in larger/giant breed dogs. |
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Clinical signs of elbow dysplasia
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Occurs in growing dogs LamenessJoint swelling and pain Atrophy of muscles As progresses – reduced ROM, crepitus, thickening of the joint |
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Diagnosis and treatment of elbow dysplasia
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Radiography Arthroscopy Treatment: Surgery may be an option Management Will be predisposed to OA |
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Hip Dysplasia
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Animals born ‘normal’ but changes to joint ball and socket occur during development. As mature musculature surrounding the joint may support it so clinical signs less evident depending on severity of dysplasia but will be predisposed to arthritic changes. Conservative management and surgical options available – rehabilitation is essential in both cases.Breeding schemes to reduce occurrence due to genetic involvement.
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Hip dysplasia clinical signs
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Lameness hip laxity/instability signs of OA atrophy of muscles bunny hopping pain on hip extension weakness |
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Arthritis
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degenerative - osteoarthritis immune-mediated inflammatory |
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inflammatory arthritis
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Septicaemia can lead to joint infections in young animals Diagnosis is confirmed with joint fluid samples being analysed, radiography and presenting signs Clinical signs: Joint swelling Pain Lameness Pyrexia |
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immune mediated arthritis
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May be produced by a reaction to a viral infection or drug administrationImmune complexes lodge in the synovial membrane and cause marked inflammation in multiple joints, along with pyrexia Diagnosed by joint fluid analysis, but it can still be hard to distinguish it from the infectious cause. Steroids are the treatment of choice in this condition Clinical signs: Pyrexia Inappetance Multiple joint involvement Other signs of systemic disease |
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Osteoarthritis
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Causes (multi-factoral) Abnormal forces on normal cartilage Normal forces on abnormal cartilage Progressive changes which are often self-perpetuating 20% of dogs are affected Abnormal forces – injury/instability of joint, obesity Abnormal cartilage – OCD, age related changes to cartilage weaken it making it more susceptible to damage |
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Clinical signs of osteoarthritis
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Gradual onset Stiff on rising Improvement seen once up and moving Pain Lameness |
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management of osteoarthritis
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Weight loss Aid the animal getting up stairs, into cars etc. Soft bedding Heat Gentle regular exercise; short walks often Pain relief Prescription diets Physiotherapy, complementary therapies |
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Cruciate disease
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Cranial (or anterior), Caudal (posterior) Due to gradual weakening and then eventual rupture, or sudden rupture due to trauma In some cases will happen when young and likely to happen in both stifles Predisposed breeds- labs, golden ret, rottie, bosers, newfoundland, westie, but can affect any breed and any age. Instability of the joint can lead to: Meniscal damage Osteoarthritic changes |
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Clinical signs of cruciate disease
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lameness stiffness instability of joint – cranial drawer joint swelling and muscle atrophy sit with leg straight |
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Treatment of cruciate disease
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Surgical vs conservative Surgical: TPLO TTA post op rehabilitation is essential can be treated with medication such as Yumove appropriate analgesia as required |
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Patella Luxation
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If this presents while the bones are still growing then the abnormal position affects the pull of the quadriceps muscle on the tibia and growth deformities of the bone can occur
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Clinical signs of patella luxation
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treatment of patella luxation
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pain relief rest rehabilitation with be important during recovery surgery to make he grove deeper. |
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Perthes disease
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Small breeds. Avascular necrosis of the femoral head – fails to form properly and crumbles, leading to lameness. Treatment is femoral head excision. Muscles maintain stability and false joint functions very well.
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Neoplasia
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osteosarcoma chrondrosarcoma fibrosarcoma |
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Osteosarcoma
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Malignant tumour commonly affecting the long bones Present with swelling, pain, lameness, poss pathological fracture Radiography – sun burst effect Treatment – amputation, prognosis depend on staging at time of diagnosis and treatment, poor if metastases present |
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Chrondrosarcoma
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malignant tumour commonly affecting bones such as ribs and the nasal cavity
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Fibrosarcoma
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malignant tumour usually affecting the bones of the axial skeleton, including the skull and the mandible
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