What to Expect if you were to bring a Pet to our Hospital
with Signs of Neural Disease
(Of course, other vets may do things differently)
History: We want to know what unusual behavior your pet is showing, whether or not there is any circling, stumbling, seizures, quivering, drooling etc. We need to know, as best you can remember, the duration and frequency of any symptoms. Has there been any exposure you know of to poisons, mushrooms, insect bites, fumes, or extreme activity. Has there been any recent illness, Injury, pregnancy, heat, diet change, or medication?
Exam and History: A head to toe exam is critical for a couple of reasons;
1. so many different injuries and diseases can conceivably cause neural signs, and
2. often there are multiple things going on that we would miss if we stopped as soon as we found something wrong. The brain and the rest of the nervous system is quite sensitive to changes in pressure, temperature, sugar, urea, electrolytes, oxygen, and hormone levels as well as to various poisons, endotoxins, and medications. With this many factors as possible causes, we need to take the time for a very careful exam and history. This will include looking closely at the responses of the eye and at the ear drum. One of the more interesting things you will see your vet do that you might not notice on a more routine exam is the checking of reflexes...to include the famous knee jerk...
trying to pinpoint where the problem is.
Diagnostics: If the cause of the neural signs isn't obvious trauma such as being hit by a car (or in the new age language; vehicular trauma), or an obvious tooth or ear infection, then it's important to do radiographs and blood work early in hopes of getting an accurate diagnostic picture early enough in the disease process to choose an appropriate treatment
Initial tests at our clinic would include:
CBC (complete blood count) looking for signs of anemia, bleeding disorders, and various types of infection.
Blood Chemistry; clues about possible kidney, liver, pancreas, diabetic, and electrolyte problems...all of which might be causes of neural signs ... or be affected by whatever disease process is causing the neural symptoms.
Thyroid Testing; especially in older cats but not a bad idea in all neural cases. Thyroid hormone affects practically everything.
Antifreeze Poisoning Test; This test is expensive and has a short shelf life, so a lot of vets don't have this test available, but your vet might recommend it in some situations...and possibly save your pet's life because of an early diagnosis...critical with antifreeze.
Microscopic Fecal Tests for parasites; especially in puppies and poorly cared for pets where whip or hook worms might be the cause of anemia and/or endotoxin absorption.
Urinalysis; more clues about possible diabetes, protein loosing diseases, ketone producing diseases, and kidney disease.
Titers or test kits; for distemper, lymes disease, feline leukemia, feline AIDS and other infectious diseases if suspected
Radiographs; Skull or spinal radiographs would be appropriate if the exam revealed pain or abnormalities on spinal palpation or neck manipulation. Or if we suspect a possible mass or other problem in the head.
Other Tests that might be done by a specialist or possibly your veterinarian:
Spinal Fluid Tap; testing for pressure, infection, cancer, and inflammation
Special Radiographs of the spinal cord using dyes to highlight subtle lesions
And while not common at most community veterinary clinics, cat scans, mri's, ultra sound imaging, and other newer imaging techniques are now commonly available at referral practices and veterinary colleges.
A comment about testing: the availability of all these tests in human and veterinary medicine would be considered amazing not long ago and as a result, we are saving a lot more lives, but be prepared for the possibility of not getting an easy answer. The nervous system is extremely complex. And the interpretation of lab results is not always straight forward either.
Treatment:
Treatment of the various neural problems ranges a great deal depending on the cause
but will always/usually include;
1. Control of the symptoms if possible, whatever they might be, such as vomiting, seizures, anxiety, and pain.
2. Supportive care to maintain hydration, temperature, nutrition, voiding, and electrolyte balance.
3. Control of infection and inflammation.
4. Repair, if needed and possible, of damaged bones, vertebrae, and tissue. In other words; surgery
5. And the very likely possibility of referral to the heavy metal drummers of our profession (specialists) in serious cases or those cases not yet diagnosed or responding to initial treatment.
Website Directory
"What To Expect When You Go To The Vet"
if your pet should have a problem with ...
To include Femoral Head Removal, Hip Dysplasia, Anterior Cruciate Ligament Injuries, Panosteitis, Radiographic Demonstrations, Disc Disease, and Bone Surgery
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Cardiology Heart disease in Cats, Cardiac Hypertrophy, Valvular disease, Cardiac Insufficiency, Congestive Heart Failure, Heartworm Disease, and a little history about the milestones in treating heart disease
Cats: general information page and directory of diseases and problems specific to cats including vaccine recommendations, leukemia, feline viral infections, feline upper respiratory disease and cats that just aren't feeling well.
Dermatology: Skin problems including allergies, rashes, bacterial infections, and itching. Hair Loss, Yeast Infections, Hormonal Problems
Heart disease; Cardiac diseases, vascular diseases, stroke, & heartworms
Hormone Diseases: Diabetes, Thyroid Disease, Cushing's Disease or Hypercortisolism, Addison's disease or Hypocortisolism, Pancreatitis, obesity as a disease
Infectious Diseases Colds, Distemper, Parvo, Leptospirosis, Bruceellosis, Panleukopenia, Feline AIDS, Leukemia, Hepatitis, Kennel Cough, Ringworm, Rabies, FIP, Canine Herpes, Toxic Shock Syndrome, & More
Intestinal problems: diarrhea, constipation, torsion, indigestion, and gas. Also pancreatitis, vomiting, esophagitis, colitis, parvo and other types of dysentery
Metabolic Diseases: Diabetes, Thyroid Disease, Cushing's Disease or Hypercortisolism, Addison's disease or Hypocortisolism, Pancreatitis, obesity as a disease
Parasite Problems Fleas, Ticks, Heartworms, Intestinal Worms, Mosquitos, Lice, Mites, and other welfare recipients
Poisons Snakes, Insects, household chemicals, plants, and foods that might poison your pet
Skeletal-Muscular Problems Arthritis, Fractures, ACL, Ligament Injuries, Disc Disease, Pannus, and many other problems of the bones, muscles, tendons, and ligaments
Skin Problems: allergies, rashes, bacterial infections, and itching. Hair Loss, Yeast Infections, Hormonal Problems
Surgery: Spays, Castrations, Testicle Recipes, Soft Tissue Surgery, Hard Tissue Surgery (Bones), C- Sections, Declawing, Tumor Removal and Cancer Surgery
Other Topics on This Site
Zoonotics: Diseases, worms, and parasites people get from pets.
Includes information about Prescription diets used to treat disease, and a discussion about the pet food industry
Includes information about feline and canine heat or estrus, breeding, C-Sections, pyometra or Infected Uterus, dystocia, no milk, mastitis, & brucellosis
Also newborn care, undescended testicles, and alternative to spaying and castration
WildLife Page: Taking care of baby bunnies, squirrels, and birds. A very funny story about beavers, and other misc information
Our Dog Page: a directory of problems of concern in dogs including parvovirus, distemper, canine herpes, and other diseases
Dysautonomia
... also known as "Grass Sickness"
by Roger Ross, DVM
I'd be surprised if you need to know about this rare disease, but if you happen to be on this page for another reason, I thought you might find this disease kind of interesting.
As I mentioned, it's a rare disease. Rare, that is, unless you happen to live in Missouri. Or Kansas.
Symptoms:
Dilated pupils, poor pupil constriction, and raised 3rd lids
Possible vomiting or upchucking
Irregular heart rate
Dry mucous membranes
Weakness
Difficulty Urinating
These are all symptoms of a poorly functioning autonomic system. Dysautonomia is a degenerative disease of the autonomic nervous system. Unfortunately, this disease is often fatal, and so far, incurable. Most patients are euthanized to give them relief from their misery.
Grass Sickness. This degenerative disease of the autonomic nervous system was first written about in Britain about horses in the early 1900's. You may recall that horses were of supreme importance in that era. The disease was called Grass Sickness and in equine circles it's still called that.
Horses afflicted with dysautonomia typically die of colic or other GI problems. That's because the autonomic nervous system controls the motility and secretions of the intestinal system.
The disease was next detected in cats. But not until 1982! Again, this was in Great Britain. Soon after that, the problem was detected in hundreds of cats across Europe.
Apparently it was a sort of epidemic somewhat similar to mad cow disease, because after those first hundreds of cases, the number of cats affected went way down.
In cats, the symptoms are similar to dogs (dilated pupils, raised 3rd eyelid, poor tear production, and GI signs caused by poor motility such as constipation, and dry mouth.)
In 1983, the same disease was discovered in dogs. Again it was the British who first documented the disease. The disease has since been detected in dogs throughout Europe and the U.S. but for some reason the disease seems to be now concentrated in Missouri and Kansas.
Roy Berghaus, DVM, wrote an article about the disease. He compared 174 dogs examined at the University of Missouri-42 dogs diagnosed with dysautonomia and 132 control dogs examined for other issues. His findings were published in the April 15, 2001, edition of the Journal of the American Veterinary Medical Association.
Basically he found that rural dogs were more likely to get the disease. Perhaps because
they were more likely to have access to pasture land, farm ponds, and cattle. And more likely to have eaten carrion and wildlife. Other findings were that most of the dogs were fairly young and that the diseased occurred almost always in the early Spring of the year.
Researchers are busy trying to figure out the cause of the disease. Maybe soon.
Oh, by the way, when I compared this disease to being somewhat like Mad Cow disease, I forgot to tell you that it doesn't seem to affect humans.
For more information:
A few comments about pets with neural signs
If you take the time to read about some of the different neural diseases on these pages, you will appreciate how many of them have similar symptoms.
Basically, anything that affects the brain can cause depression, hypersensitivity, seizures, paralysis of different degrees, increased salivation, pain, fever, and the drunken like staggering we call ataxia.
While an experienced veterinarian can often guess what disease is likely, or even successfully treat your pet without knowing exactly which neural disease it has, don't expect a definitive diagnosis without a fair amount of expensive testing.
And don't be surprised if your vet doesn't get the correct diagnois right off the bat...we often have to rule out a few things we suspect before the mystery is solved.
Also, many times the neural signs are the result of disease in other organs. Diabetes, liver disease, endocarditis, and bacterial invasion through unhealthy gut or gums are examples.
And lastly, be realistic about the prognosis; brain and spinal cord disease is very serious.
