Neurological Disorders

Question 1

Vestibular System

Answer 1

• Responsible for balance, posture & orientation of the body in space
• Can be caused by; hypothyroidism, perforated ear drum, ear infection, trauma, tumours

CLINICAL SIGNS: Head tilt, Ataxia, Circling, Nystagmus, Rolling or falling over, Vomiting, Lethargy

TREATMENT & NURSING CARE: Safe, padded environment, Meds, Assisted walking/toileting

Question 1

Status Epilepticus

Answer 1

• Continuous seizure lasting more than 5 series or multiple seizures without full recovery between episodes

EMERGENCY - can lead to permanent brain damage, hypoglycaemia, hyperthermia

TRIAGE: General health, Signalment, Trauma, Medication, Toxic ingestion?? Is this the 1st seizure?? Details of seizure

TREATMENT & NURSING CARE: Appropriate environment, Constant monitoring: TPR, mentation, neuro exam (likely to be hyperthermic), IV access, Blood sample, Blood glucose monitoring, Medication, O2 therapy

LONG TERM CARE OF EPILEPTIC PATIENT: Commitment to regular medication - life long treatment required - Medication aims to raise seizure threshold - Regular blood tests needed - Side effects common (drowsiness, ataxia etc)

Question 2

E-Cuniculi

Answer 2

Protozoal infection seen in rabbits
Targets the brain & kidneys
Licensed treatment & prevention available
Shed in the urine

CLINICAL SIGNS: Head tilt, Hind limb paresis / paralysis, Tremors, Convulsions, Urinary incontinence, Cataracts

Question 3

Senile Cognitive Dysfunction

Answer 3

• Has been linked to Alzheimers or dementia in humans

CLINICAL SIGNS: DISHA (disorientated, interact less, sleep pattern disturbed, house training lost, altered activity level)
Vocalise more, appear restless

MANAGEMENT: Meds = Propentofylline (vivtonin), Selegiline (Selgain), Aktivait
Diet = high in antioxidants
Environmental enrichment ‘use it or lose it’ (puzzle games etc)
VNs play a vital role in supporting clients

Question 4

Invertebrate Disc Disease

Answer 4

• Pressure on the spinal cord results in either complete or partial loss of voluntary movement
• Type 1 - disc extrusion = nucleus pulposus herniates due to a change to the gelatinous consistency
• Common in chondrodystrophic disease like bassets, but common in beagles & GS etc
  Acute cause
• Type 2 - disc protrusion = whale disc becomes more fibrous and moves into spinal cord space
• Common in older dogs, Due to degeneration, Seen in non-chondrodystrophic breeds

CLINICAL SIGNS: Pain (hunched back, shivering, panting, unwillingness to move, stiff), Proprioceptive deficits (e.g. knuckling, urine/faecal incontinence), Loss of skin sensation, Loss of deep pain, Reflexes absent, Urinary/faecal incontinence

Limit movement until diagnosis is made

CONSERVATIVE TREATMENT: Suitable for dogs with a low grade. Strict cage rest, Analgesia, Physiotherapy, Nursing care (turning to prevent pressure sores etc), Manual expression of the bladder

If these don’t work then surgery is recommended

Question 5

Canine Degenerative Myelopathy

Answer 5

• Progressive loss of nerve function
• A genetic component lading to a reduction in antioxidants
• Due to degeneration of axons and demyelination
• Affects dog older than 5 but commonly seen in dogs over 8 years old

CLINICAL SIGNS: Ataxia, Paresis, Paralysis of hind limbs, Loss of control of urination / defecation

MANAGEMENT: No treatment, just management (assisted walking, slings, physio/hydrotherapy), QOL assessment tools

NURSING CARE OF THE SPINAL PATIENT: Urinary faecal management, Barrier creams , Regular washing and drying, Deep absorbent bedding, turning regular to prevent hypostatic pneumonia, Support to walk (sling), Analgesia ,Regular pain scoring, Delivering physio, Accurate records of patients movements, Eating well - appropriate nutrition, Stress free environment, TLC, Regular monitoring (TPR etc)