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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