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Cervical Spondylomyelopathy: Wobbler

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Title: Cervical Spondylomyelopathy: Wobbler


1
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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

3
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

4
Cervical Spondylomyelopathy
MYELOGRAM C6-C7
5
Cervical Spondylomyelopathy Wobbler
  • Rxwithout 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

6
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

7
Degenerative Myelopathy
  • Etiologyunclear
  • 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 (gt5 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

8
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Degenerative Myelopathy
  • Dx
  • Neurologic Exam
  • ? proprioception
  • ? _________________________
  • Lack of pain
  • Normal sphincter tone normal panniculus
  • (pin prick) reflex
  • Radiographs usually normal
  • Rxnone 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

10
Degenerative Myelopathy
11
PERIPHERAL NERVOUS SYSTEM
12
Deafness
  • 1) Damage to auditory pathway
  • chronic otitis
  • rupture of _______________
  • damage to middle ear (ossicles)
  • 2) Damage to
  • auditory nerve

13
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 ageusually due to atrophy of nerve
    ganglia or cochlear hair cells (also loud rock
    music)

14
Deafness
  • Dx
  • Inability to rouse sleeping animal with loud
  • noise (e,g,. blast from air horn) is diagnostic
  • RxNo treatment is available in most cases
  • 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

15
Laryngeal Paralysis
  • 3 typesalways be cautious of
  • laryngeal paralysis because of the
  • chance of _____________________
  • Hereditaryseen in Bouvier des Flandres and
    Siberian Huskies
  • Seen at 4-6 mo of age
  • Acquiredcan occur from lead poisoning, rabies,
    trauma, inflammation of vagus nerve
  • 1.5 to 13 yr of age
  • Idiopathicseen in middle-age to old large- and
    giant-breed dogs castrated dogs and cats have a
    higher incidence than female and non-neutered
    males

16
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
  • Rxsurgical intervention including
  • Arytenoidectomy
  • Removal of vocal folds
  • Client infoprognosis is guarded to good do not
    breed if hereditary

17
Laryngeal Paralysis
18
Megaesophagus
  • Causes-lack of _______________________ (3
    types)
  • Hereditarya gene for the disease is identified
    in wire-haired fox terriers and min schnauzers
  • CongenitalG Danes, G Shepherd, I Set, Newfound,
    Shar-Peis, greyhounds (no gene IDed)
  • evident about weaning time when solid food is
    introduced
  • Due to incomplete nerve development in esophagus
  • Acquiredmay 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

19
Megaesophagus
Dxbarium swallow
Esophagus is 3 times normal diameter
20
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
  • Prognosisguarded to poor
  • Treatment aim is to reduce clinical signs and
    prevent __________________________________________
  • There is no cure

21
Tick Paralysis
  • Causefemale 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

22
Tick Paralysis
23
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)
  • Rxsupportive 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

24
Idiopathic Facial Nerve Paralysis
  • Etiologyunknown
  • Occurrence
  • C Span, Corgis, Boxers, E Set, DLH cats
  • Signs
  • Older dogs (gt5 y)
  • ________________ droop
  • Lip ____________________
  • Sialosis (drooling)
  • Deviation of nose
  • Collection of food in paralyzed side of mouth
  • Absence of menace and palpebral reflex

25
Idiopathic Facial Nerve Paralysis
  • Rxefficacy 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
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