Week 4- Head and Spinal Pain in Young Cats and Dogs

Question 1

What is SRMA

Answer 1

Steroid Responsive Meningitis Arteritis an immune mediated inflammatory disease of the meninges and vessels

Question 2

What dogs are commonly affected by SRMA

Answer 2

Young medium to large breed dogs especially Beagles Boxers and Bernese Mountain Dogs

Question 3

What are typical signs of acute SRMA

Answer 3

Fever neck pain lethargy and reluctance to move

Question 4

What is the cause of SRMA

Answer 4

Unknown but believed to be autoimmune with Th2 and Th17 mediated immune dysregulation

Question 5

What blood test is often elevated in SRMA

Answer 5

C Reactive Protein

Question 6

What would CSF analysis show in acute SRMA

Answer 6

Neutrophilic pleocytosis with increased protein

Question 7

How is SRMA treated

Answer 7

Prednisolone with immunosuppressive doses tapered over several months

Question 8

What are second line treatments for refractory SRMA

Answer 8

Azathioprine cytarabine and mycophenolate mofetil

Question 9

What imaging findings may be seen in SRMA

Answer 9

Meningeal enhancement paravertebral muscle changes spinal T2 hyperintensity

Question 10

What is the prognosis for SRMA

Answer 10

Good with early treatment but relapse is common especially with rapid steroid tapering

Question 11

What does MUO stand for

Answer 11

Meningoencephalitis of Unknown Origin

Question 12

What are subtypes of MUO

Answer 12

GME NME and NLE

Question 13

Which breeds are predisposed to MUO

Answer 13

Pugs Yorkshire Terriers Maltese Chihuahuas and other toy breeds

Question 14

What are clinical signs of MUO

Answer 14

Seizures ataxia cranial nerve deficits spinal pain blindness

Question 15

What is the pathophysiology of MUO

Answer 15

Immune mediated inflammation of the CNS involving T cells B cells and macrophages

Question 16

What does CSF show in MUO

Answer 16

Mononuclear or mixed pleocytosis with elevated protein

Question 17

Is CRP usually elevated in MUO

Answer 17

No CRP is often normal

Question 18

What imaging modality is preferred for MUO

Answer 18

MRI

Question 19

What MRI findings are typical in MUO

Answer 19

T2 hyperintense lesions that are patchy multifocal or ring like

Question 20

How is MUO treated

Answer 20

Prednisolone plus immunosuppressants like cytarabine cyclosporine or azathioprine

Question 21

What is the prognosis for MUO

Answer 21

Guarded with high relapse rates and variable survival beyond 100 days

Question 22

What is discospondylitis

Answer 22

Infection of the intervertebral disc and adjacent vertebral endplates

Question 23

What are common causes of discospondylitis

Answer 23

Hematogenous spread UTI foreign body or skin infection

Question 24

What breeds are predisposed to discospondylitis

Answer 24

Large breeds especially German Shepherds and Great Danes

Question 25

What are clinical signs of discospondylitis

Answer 25

Severe spinal pain fever and reluctance to move

Question 26

How is discospondylitis diagnosed

Answer 26

Radiographs MRI culture of blood urine or disc material

Question 27

What organisms are commonly involved in discospondylitis

Answer 27

Staphylococcus aureus and Brucella canis

Question 28

How is discospondylitis treated

Answer 28

Long term antibiotics and sometimes surgical stabilisation

Question 29

What is syringomyelia

Answer 29

A fluid filled cavity within the spinal cord usually secondary to CSF flow obstruction

Question 30

What is the most common cause of syringomyelia in dogs

Answer 30

Chiari malformation where the skull is too small for the brain

Question 31

Which breed is most affected by syringomyelia

Answer 31

Cavalier King Charles Spaniel

Question 32

What are signs of syringomyelia

Answer 32

Phantom scratching spinal pain ataxia weakness scoliosis

Question 33

What is phantom scratching

Answer 33

Scratching at the neck or shoulder area without making contact

Question 34

How is syringomyelia diagnosed

Answer 34

MRI showing fluid filled syrinx in the spinal cord

Question 35

How is syringomyelia treated

Answer 35

Medical management with gabapentin and omeprazole or surgical decompression

Question 36

What is CM P

Answer 36

Chiari malformation with associated pain but no syringomyelia

Question 37

What is SM S

Answer 37

Syringomyelia with spinal cord damage and neurological signs

Question 38

What is atlantoaxial instability

Answer 38

Abnormal movement between the atlas and axis causing spinal cord compression

Question 39

Which breeds are predisposed to atlantoaxial instability

Answer 39

Toy breeds especially Chihuahuas and Yorkshire Terriers

Question 40

What are the causes of AAI

Answer 40

Congenital absence of the dens trauma or ligamentous malformation

Question 41

What are clinical signs of AAI

Answer 41

Neck pain ataxia tetraparesis or sudden collapse

Question 42

How is AAI diagnosed

Answer 42

Dynamic radiographs in flexion and extension or MRI

Question 43

How is AAI treated

Answer 43

Conservative management with neck brace or surgical stabilisation

Question 44

What is type I IVDD

Answer 44

Acute extrusion of the nucleus pulposus through the annulus fibrosus

Question 45

What is type II IVDD

Answer 45

Chronic bulging of the annulus fibrosus with spinal cord compression

Question 46

Which dogs are predisposed to type I IVDD

Answer 46

Chondrodystrophic breeds like Dachshunds

Question 47

Which dogs are predisposed to type II IVDD

Answer 47

Older non chondrodystrophic breeds like Labradors

Question 48

What are signs of IVDD

Answer 48

Pain ataxia paresis or paralysis depending on severity

Question 49

How is IVDD diagnosed

Answer 49

MRI or CT for spinal cord compression and disc extrusion

Question 50

How is IVDD treated

Answer 50

Conservative rest and pain relief or surgery like hemilaminectomy

Question 51

What is the prognosis for IVDD

Answer 51

Good with early treatment especially if deep pain is present

Question 52

What is the most common site for IVDD in dogs

Answer 52

Thoracolumbar spine especially T11 to L3

Question 53

What is the difference between extrusion and protrusion

Answer 53

Extrusion is sudden nucleus herniation protrusion is chronic annular bulging