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Advances in Veterinary Neurology, An Issue of Veterinary Clinics of North America: Small Animal Practice, E-Book

Advances in Veterinary Neurology, An Issue of Veterinary Clinics of North America: Small Animal Practice, E-Book

Natasha J. Olby


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Book Details


This issue highlights the advances in neurological treatments for dogs and cats. Articles include: New Treatment Modalities for Brain Tumors in Dogs and Cats, Altered Mental Status in Dogs and Cats: Stupor and Coma, Steroid Use in Veterinary Neurology, Hereditary Ataxia and Paroxysmal Movement Disorders in Dogs and Cats, Paroxysmal Movement Disorders in Dogs and Cats, Cluster Seizures and Status Epilepticus, Aging in the canine and feline brain, Acute Spinal Cord Injury: Tetraparesis and Paraparesis, Meningoencephalitis of Unknown Etiology, and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Advances in Veterinary Neurology\r i
Copyright\r ii
Contributors iii
Contents v
Veterinary Clinics Of North America: Small Animal Practice\r ix
Preface\r xi
New Treatment Modalities for Brain Tumors in Dogs and Cats 1013
Key points 1013
Introduction 1013
Current Therapeutic Options 1014
Stereotactic radiosurgery 1015
Introduction and History 1015
Technical Aspects of Stereotactic Radiosurgery 1015
Linear accelerator stereotactic radiosurgery 1016
Gamma Knife stereotactic radiosurgery 1016
Cyberknife stereotactic radiosurgery 1017
Radiobiological Considerations 1018
Stereotactic Radiosurgery for Canine and Feline Brain Tumors 1019
Convection-enhanced delivery 1020
The Convection-enhanced Delivery Procedure 1021
Technical Factors Governing Infusate Distributions in the Brain 1022
Convection-enhanced Delivery Infusion Techniques 1024
Convection-enhanced Delivery for Treatment of Canine Brain Tumors 1026
Immunotherapy 1026
History of and Rationale for Brain Tumor Immunotherapy 1027
Basic Immunotherapeutic Strategies 1027
Passive immunotherapy: cytokine immunomodulation 1027
Passive immunotherapy: monoclonal antibodies 1027
Passive immunotherapy: adoptive immunotherapy 1028
Active immunotherapy 1029
Future Directions of Immunotherapy 1030
References 1031
Altered States of Consciousness in Small Animals 1039
Key points 1039
Introduction 1039
States of normal and impaired consciousness 1040
Neuro-anatomical basis of consciousness 1041
Neurologic evaluation of the animal with impaired consciousness 1043
Using the Modified Glasgow Coma Scoring System 1043
Levels of consciousness 1043
Limb movements, posture, and reflexes 1043
Neuro-ophthalmologic examination 1045
Pupillary responses 1045
Dazzle reflex 1046
Ocular mobility 1048
Diagnostic approach to the animal with impaired consciousness 1049
Laboratory and Ancillary Investigations 1049
Neuroimaging 1049
Electrodiagnostic Evaluation 1051
Immediate emergency therapy of impaired consciousness 1052
General Care 1052
Specific Care 1052
Management of oxygen and carbon dioxide 1052
Fluid therapy 1054
Diuretics 1055
Prognosis 1056
Coma scales in the future 1056
Summary 1056
References 1057
Corticosteroid Use in Small Animal Neurology 1059
Key points 1059
Introduction 1059
Mechanisms of corticosteroid activity 1060
Activity via Nuclear Effects 1060
Activity via Nongenomic Effects 1061
Therapeutic Effects of GC 1061
Metabolic Effects 1061
Gluconeogenic effects 1061
Effects on blood pressure 1062
Reduction in cerebrospinal fluid production 1062
Effects on the Immune System 1062
Immunosuppression, anti-inflammatory effect, and cytotoxicity versus lymphocytes 1062
Reduction of CNS edema in association with tumors 1062
Direct effect of GC on tumors 1063
Role of glucocorticoid treatment of specific conditions 1063
Conditions for Which GC Are Definitely Indicated 1063
Immune-mediated disease 1063
Corticosteroid-responsive meningitis 1063
Meningoencephalomyelitis of unknown origin 1064
Immune-mediated myositis 1064
Conditions for Which GC May Be Helpful 1065
CNS neoplasia 1065
Conditions for Which GC Have Dubious Value 1065
Polyradiculoneuritis and myasthenia gravis 1065
Infectious disease 1066
Use for pain control or other nonspecific purposes 1066
Pain 1066
Nonspecific use 1067
Conditions for Which GC Are Not Indicated 1067
CNS trauma 1067
Detrimental effects of corticosteroid therapy 1068
Immunosuppression 1068
Gut Ulceration, Vomiting, Diarrhea 1068
Delay and Obstruction in Making a Definitive Diagnosis 1068
Muscle Wasting 1068
Summary 1069
References 1069
Canine Hereditary Ataxia 1075
Key points 1075
Introduction 1075
Classification 1076
Clinical approach to hereditary ataxia 1077
Cerebellar cortical degeneration 1081
SEL1 1082
RAB24 1083
SPTBN2 1083
Mapped diseases 1083
Spinocerebellar degeneration 1083
Ataxias without neurodegeneration 1085
Canine multiple system degeneration (CMSD) 1085
Episodic ataxia 1086
Summary 1086
References 1086
Canine Paroxysmal Movement Disorders 1091
Key points 1091
Introduction 1091
Inherited diseases 1093
Episodic Falling in Cavalier King Charles Spaniels 1093
PNKD in Chinooks 1095
Scottie Cramp in Scottish Terriers 1095
Canine Epileptoid Cramping in Border Terriers 1098
Episodic Head Tremor Syndrome 1098
Sporadic reports 1099
Paroxysmal Dyskinesia in a Bichon Frise 1099
Paroxysmal Dyskinesia in the Boxer 1099
Paroxysmal Dyskinesia Reported in Other Breeds 1099
Phenobarbital-Responsive Paroxysmal Dyskinesia 1099
Phenobarbital-Induced Dyskinesia 1100
Other involuntary movement disorders 1100
Summary 1100
References 1101
Status Epilepticus and Cluster Seizures 1103
Key points 1103
Definitions 1103
Status Epilepticus 1103
Generalized Seizure 1103
Focal Seizure 1104
Convulsive Status Epilepticus 1104
Nonconvulsive SE 1104
Acute Repetitive Seizures and Cluster Seizures 1104
Refractory SE 1104
Super RSE (SRSE) 1104
Introduction 1104
Therapy of SE 1105
General Considerations for SE Care for Companion Animals 1105
Current and historical drug therapy for SE 1106
Human SE 1106
Canine SE 1107
General Standard of Practice for Companion Animal SE (Box 2) 1107
Feline SE 1107
Recent Prospective Studies of SE in Dogs 1108
Levetiracetam 1108
Fosphenytoin 1109
CS Recommendations 1109
Open Question—Single-Agent Versus Combined Therapy for Initial Treatment of SE? 1109
Future possibilities 1110
Final summary 1110
References 1110
Aging in the Canine and Feline Brain 1113
Key points 1113
Introduction 1113
Neurobiology of aging in the dog 1114
Brain Atrophy 1114
Selective Neuron Loss 1115
Senile Plaques (β-Amyloid) in Dogs 1115
Vascular Disorders, Cerebrovascular Amyloid Angiopathy 1116
Tau Neuropathology 1117
Oxidative Damage and Mitochondrial Dysfunction 1118
Correlates of Brain Aging Found in Lysosomal Storage Diseases 1118
Neurobiology of aging in the cat 1119
Neuron Loss and Atrophy 1119
Tau Phosphorylation 1120
Neuronal Loss in Feline Niemann-Pick Type C Disease and Similarities to AD 1120
Clinical implications of brain aging in dogs and cats 1121
Summary 1122
Acknowledgments 1122
References 1122
Acute Spinal Cord Injury 1131
Key points 1131
Etiology of spinal cord injury 1132
Clinical evaluation of the patient following severe spinal cord injury 1133
Normal Locomotion 1133
Sequential Appearance of Neurologic Deficits After Spinal Cord Damage 1133
UMN Versus LMN 1134
Spinal Shock and Schiff-Sherrington Syndrome 1134
Sensory Dysfunction Following Spinal Cord Injury 1135
Urinary Dysfunction Following Spinal Cord Injury 1136
Do Blood Pressure Abnormalities Occur Following Spinal Cord Injury in Dogs? 1137
Respiratory Dysfunction Following Spinal Cord Injury 1137
Ancillary methods used to assess spinal cord function 1138
Clinical Scoring 1138
Kinematics 1139
Advances in Magnetic Resonance Imaging 1139
Utility of Electrophysiologic Measures 1141
Standard of care and treatment advances for spinal cord injury 1142
Prospects for New Pharmacologic Interventions for the Acute Phase of Spinal Cord Injury 1142
What Is the Evidence for Cell Transplantation in the Acute Phase of Spinal Cord Injury? 1142
Cell Transplantation in Experimental Canine Models of Spinal Cord Injury 1144
Cell Transplantation in Experimental Feline Models of Spinal Cord Injury 1144
Cell Transplantation in Clinical Cases with Spinal Cord Injury 1145
Standard of Care for Urinary Retention Management 1145
Is There a Role for Early Rehabilitation Following Spinal Cord Injury? 1146
Spinal walking, motor relearning, and postural rehabilitation 1146
Neuromuscular electrical stimulation 1146
Prognosis following spinal cord injury 1147
Presence or Absence of Detectable Pain Sensation 1147
Value of the Cutaneous Trunci Muscle Reflex 1147
Effect of Age on Prognosis 1147
Prognosis in Cats with Intervertebral Disc Disease 1147
Biomarkers 1148
Use of MRI for Prognostication 1148
Summary 1148
Supplementary data 1148
References 1149
Perspectives on Meningoencephalomyelitis of Unknown Origin 1157
Key points 1157
Introduction 1157
Categorization of Noninfectious Inflammatory Disease of the CNS 1158
An overview of neuroinflammation 1159
Immune-Mediated CNS Disease 1159
T-cell responses 1160
Microglial responses 1161
Histopathology of Neuroinflammation 1161
Neuroinflammation in MUO 1161
Signalment, neurologic signs, and histopathologic features 1163
Granulomatous Meningoencephalomyelitis 1163
Necrotizing Encephalitis 1166
Necrotizing meningoencephalitis 1167
Necrotizing leukoencephalitis 1168
Diagnostic evaluation 1168
Cross-Sectional Imaging 1169
Cerebrospinal Fluid Analysis 1171
Brain Biopsy 1171
Infectious Disease Testing 1171
Genetic Testing 1172
Treatment 1172
Prognosis 1175
References 1176
Biomarkers for Neural Injury and Infection in Small Animals 1187
Key points 1187
Neural injury markers 1187
Introduction 1187
Diagnostic Testing 1188
Limitations of Biomarkers 1188
Neuron-specific enolase 1190
Myelin basic protein 1190
Glial fibrillary acidic protein 1190
Cleaved tau 1191
Phosphorylated neurofilament heavy chain 1191
MMPs 1192
Growth factors 1192
Summary 1192
Infectious disease testing 1193
Introduction 1193
Polymerase Chain Reaction–based Techniques 1193
Limitations of PCR 1194
Microbial Agents 1194
Bacteria 1194
Virus 1195
Protozoa 1195
Rickettsia 1196
Fungus 1196
References 1196
Acute Lower Motor Neuron Tetraparesis 1201
Key points 1201
Introduction 1201
Acute idiopathic polyradiculoneuritis (coonhound paralysis) 1202
Pathophysiology 1203
Clinical Signs 1203
Diagnosis 1204
Treatment and Prognosis 1205
Botulism 1208
Pathophysiology 1210
Clinical Signs 1211
Diagnosis 1212
Treatment and Prognosis 1212
Prevention 1213
Tick paralysis 1213
Pathophysiology 1214
Clinical Signs 1214
Diagnosis 1215
Treatment and Prognosis 1215
Prevention 1216
Acquired acute fulminating myasthenia gravis 1216
Clinical Signs 1216
Diagnosis 1217
Treatment and Prognosis 1217
References 1218
Inherited Neurologic Disorders in the Dog 1223
Key points 1223
Broad characteristics of inherited disease—when should a veterinarian suspect a disease is inherited? 1223
Sources of Data Regarding Inherited Diseases in Domestic Animals 1224
Identifying the underlying cause of an inherited disorder 1224
Methodology of Mutation Identification 1225
Genetic Markers 1225
Genetic Linkage Analysis 1226
Example 1226
Genomewide Association Studies 1226
Neuronavigation in Small Animals 1235
Key points 1235
The need for neuronavigation 1235
Development of Neuronavigation Devices 1236
Frameless systems 1239
Struggles in veterinary stereotaxy 1239
Pointer-based frameless neuronavigation technique 1240
Tomographic Data Set 1240
Identifiable Fiducial Markers 1241
Creation of Image Space 1242
The Subject Tracker 1242
Tracker systems 1242
The Image Tracker 1243
Summary of Frameless Stereotactic Technique 1243
Sources of error 1243
Veterinary applications 1244
Other uses for neuronavigation 1245
References 1246
Index 1249