Contents 8
Contributers 17
Preface to the English edition 22
Preface to the second German edition 23
Preface to the first German edition 24
Abbreviations 25
1 Neurological Examination of Small Animals 28
1.1 Signalment 28
1.2 Anamnesis 28
1.3 General examination 29
1.4 Neurological status 29
1.4.1 Neurological examination methods 29
1.4.2 The sequence of the neurological examination 29
1.4.3 The main aspects of the examination 29
1.4.4 Postural reactions 35
1.4.5 Investigation of the cranial nerves 39
1.4.6 Spinal reflexes 50
1.4.7 Sensory system 54
1.4.8 Localisation 56
1.5 Ophthalmological examination 61
1.5.1 Examination of vision 61
1.5.2 Examination of the pupillary light reflex and the size of the pupils 62
1.5.3 Palpebral reflex 62
1.5.4 Corneal reflex 63
1.5.5 Tear production 63
1.5.6 Eyeball position 63
1.5.7 Normal vestibular nystagmus 63
1.5.8 Electrophysiological examinations 63
2 Principles of Neuropathology 66
2.1 General neuropathology 66
2.1.1 Histopathology 66
2.1.2 Disturbances in development/malformations 70
2.1.3 Mechanical and physical disturbances 71
2.1.4 Metabolic disturbances 72
2.2 Classification of neurological diseases: VITAMIN D 75
2.2.1 V = Vascular disease 75
2.2.2 I = Inflammatory and infectious diseases 76
2.2.3 T = Toxic diseases 77
2.2.4 A = Anomalies 77
2.2.5 M = Metabolic diseases 78
2.2.6 N = Neoplasia 79
2.2.7 D = Degenerative diseases 79
2.3 Investigation of the cerebrospinal fluid (CSF) 80
3 Genetic Neurological Siseases and Breed Predisposition 84
3.1 Genetic defects 84
3.2 Inheritance 85
3.3 Demonstrating the mode of inheritance 85
3.4 Testing for potential genetic carriers 87
3.5 Breeding methods to eradicate genetic defects 88
3.6 Diseases due to multifactorial causes 89
4 Basic Laboratory Investigations 92
4.1 Indications 92
4.2 Haematology 93
4.2.1 Anaemia 93
4.2.2 Polycythaemia 94
4.2.3 Leukocytosis 94
4.2.4 Leukopaenia 95
4.2.5 Thrombocytopaenia / thrombocytosis 95
4.3 Biochemical blood parameters 95
4.4 Urine investigations 98
5 Anaesthesia 100
5.1 Basics of neuroanaesthesia 100
5.1.1 Control of intracranial pressure 101
5.1.2 Control of the carbon dioxide partial pressure 102
5.1.3 Control of blood pressure 103
5.1.4 Pharmaceuticals 103
5.1.5 Positioning 104
5.1.6 Supervision of anaesthesia and hypothermia 104
5.1.7 Fluid therapy 104
5.1.8 Recovery period 105
5.2 Specific procedural techniques 105
5.2.1 CSF collection 105
5.2.2 Myelography 106
5.2.3 Hemilaminectomy, dorsal laminectomy, ventral slot, subluxation and fracture stabilisation 107
5.2.4 Intracranial disease 109
5.2.5 Electrodiagnostic investigations 109
5.2.6 Imaging using computed tomography (CT) and magnetic resonance imaging (MRI) 111
6 Neuroradiology 114
6.1 Indications 114
6.2 Examination methods 116
6.2.1 Radiology 116
6.2.2 Radiological tomography (linear tomography) 117
6.2.3 Ultrasonography 117
6.2.4 Computed tomography and magnetic resonance imaging 118
6.2.5 Methods used in nuclear medicine 123
6.3 Spine 124
6.3.1 Radiography 124
6.3.2 Myelography 133
6.3.3 Discography 138
6.3.4 Epidurography 139
6.4 Specific diseases 139
6.4.1 Degenerative diseases 139
6.4.2 Tumours 143
6.4.3 Anomalies 147
6.4.4 Trauma 149
6.4.5 Metabolic diseases 149
6.4.6 Vascular diseases 149
6.4.7 Inflammatory diseases 150
6.5 Skull 152
6.5.1 Principles of interpreting imaging examinations 153
6.5.2 Viscerocranium 153
6.5.3 Cranial cavity 156
6.5.4 Intracranial tumours 162
6.5.5 Non-neoplastic diseases of the brain 166
7 Electrodiagnostics 180
7.1 Electrodiagnosis of the peripheral nervous system (PNS) 181
7.1.1 Electromyography (EMG) 182
7.1.2 Electroneurography 184
7.1.3 Auditory evoked potentials (AEP) 188
7.2 Electrodiagnostic examinations of the CNS 190
7.2.1 Electroencephalography 190
7.3 Biopsy 196
7.3.1 Muscle biopsy 196
7.3.2 Nerve biopsy 197
8 Rehabilitation 198
8.1 Physiotherapy 198
8.1.1 Hydrotherapy 199
8.1.2 Massage 199
8.1.3 Kinesiotherapy 201
8.1.4 Electrotherapy 202
8.1.5 Thermotherapy 205
8.1.6 Magnetic field therapy 205
8.2 Adjuvant therapeutic measures 205
8.2.1 Bladder management 205
8.2.2 Decubitus prophylaxis 206
8.2.3 Individual attention 208
9 Neuropharmacology 210
9.1 Antibiotic therapy in neurological disease 210
9.1.1 Classes of antibiotics and their antibiotic spectra 210
9.1.2 Choice of antibiotic depending on neurological lesion localisation 213
9.2 Steroid therapy 214
9.2.1 Chemistry, pharmacokinetics and clinical pharmacology 214
9.2.2 Physiological and pharmacological effects 215
9.2.3 Side-effects 216
9.2.4 Therapeutic uses 216
9.3 Analgesics 218
9.3.1 Principles of pain physiology and therapy 219
9.3.2 Opioids 220
9.3.3 Non-steroidal anti-inflammatory drugs 220
9.3.4 Other medications and treatments used in pain relief 223
10 Neurosurgery 226
10.1 Instrumentation 226
10.2 Brain 227
10.2.1 Brain tumours 228
10.2.2 Cranial trauma 231
10.2.3 Hydrocephalus 232
10.3 Spinal cord / Spine 233
10.3.1 Diseases of the intervertebral discs 233
10.3.2 Diseases of the cervical intervertebral discs 234
10.3.3 Diseases of the thoracolumbar intervertebral discs 237
10.3.4 Diseases of the lumbosacral intervertebral discs 239
10.3.5 Tumours of the vertebral body, spinal cord and nerve roots 239
10.4 Spinal fractures / luxations 242
10.4.1 Emergency measures 242
10.5 Peripheral nerves 249
10.5.1 Principles of peripheral nerve surgery 249
10.5.2 Frequency 249
10.5.3 Problems 250
10.5.4 Techniques 250
10.6 Surgery of the middle and inner ear 254
10.6.1 Anatomy of the middle and inner ear 254
10.6.2 Techniques 255
11 Acupuncture 258
11.1 Introduction 258
11.1.1 Acupuncture in traditional Chinese medicine (TCM) 258
11.1.2 The acupoints 258
11.1.3 Choice of acupoints 259
11.1.4 Activation of the acupoints 259
11.2 The use of acupuncture in neurological disease 260
11.2.1 Choice of therapy 260
11.2.2 Possible indications for acupuncture 260
11.2.3 Combined treatment 260
11.2.4 Acupuncture as a prophylactic measure 260
11.3 Acupunctural analgesia and postoperative pain relief 261
12 Stabilization of the Neurological Emergency Patient 264
12.1 General aspects 264
12.1.1 Introduction 264
12.1.2 The respiratory tract and artificial respiration 264
12.1.3 Circulation 266
12.1.4 Neurological status 270
12.1.5 Pain 270
12.2 Stabilization of selected neurological emergencies 271
12.2.1 Craniocerebral trauma 271
12.2.2 Status epilepticus 275
12.2.3 Intoxications 278
12.3 The neurological intensive-care patient 284
12.3.1 Introduction 284
12.3.2 The Rule of 20 284
13 Peripheral Nervous System and Musculature 298
13.1 Introduction 298
13.1.1. Classification of the changes in the PNS 298
13.1.2 Clinical symptoms 300
13.1.3 Adjunct investigations 300
13.2 Mononeuropathies 302
13.2.1 Traumatic damage to individual nerves of the fore- and hindlimbs 302
13.2.2 Avulsion of the brachial plexus 307
13.2.3 Sacrocaudal fractures and luxations 309
13.2.4 Peripheral nerve sheath tumours 310
13.2.5 Lymphoma 313
13.3 Polyneuropathies 314
13.3.1 Inherited polyneuropathies 314
13.3.2 Acquired polyneuropathies 318
13.4 Neuromuscular transmission abnormalities 327
13.4.1 Presynaptic disturbances 327
13.4.2 Synaptic disturbances 330
13.4.3 Postsynaptic disturbances 331
13.5 Monomyopathies 335
13.5.1 Ischemic myopathies 335
13.5.2 Myositis of the masticatory muscles 337
13.5.3 Extraocular myositis 338
13.5.4 Myopathy of the gracilis and semitendinosus muscles 339
13.5.5 Myopathy of the infraspinatus muscle 339
13.5.6 Myositis ossificans 340
13.5.7 Coccygeal myopathy (limber tail, cold tail) 341
13.6 Polymyopathies 342
13.6.1 Acquired polymyopathies 343
13.6.2 Congenital myopathies 348
14 Spinal Cord 360
14.1 Spinal cord diseases 361
14.1.1 Vascular diseases 361
14.1.2 Inflammatory changes 364
14.1.3 Traumatic diseases 366
14.1.4 Anomalies 368
14.1.5 Metabolic diseases 375
14.1.6 Neoplastic diseases 376
14.1.7 Degenerative diseases of the spine and spinal cord 378
14.2 Bladder disturbances 392
14.2.1 Micturition reflex 392
14.2.2 Patients with micturition disturbances 394
15 Vestibular Apparatus 398
15.1 Functional anatomy 398
15.2 Disturbances of vestibular function 399
15.2.1 Paradoxical vestibular syndrome 400
15.2.2 Clinical symptoms with bilateral disease 401
15.3 Neurological examination of a vestibular syndrome 401
15.4 Diseases of the peripheral vestibular apparatus 402
15.4.1 Otitis media / interna 403
15.4.2 Congenital vestibular diseases 405
15.4.3 Metabolic causes 406
15.4.4 Idiopathic causes (geriatric or idiopathic syndrome) 407
15.4.5 Neoplastic disease 407
15.5 Diseases of the central vestibular apparatus 408
15.5.1 Metabolic causes 408
15.5.2 Neoplastic diseases 409
16 Cerebellum 412
16.1 Anatomy and physiology 412
16.2 Symptomatology and localisation of cerebellar lesions 413
16.3 Differential diagnoses (VITAMIN D) and investigation methods 416
16.4 Diseases 417
16.4.1 Congenital cerebellar disease 417
16.4.2 Acquired diseases of the cerebellum 421
17 Brain Stem 426
17.1 Anatomy 426
17.2 Diseases 426
17.2.1 Infarct of the brain stem 426
17.2.2 Inflammatory diseases of the brain stem 427
17.2.3 Tumours of the brain stem 434
17.2.4 Malformations of the brain stem and the caudal cranial fossa 435
17.2.5 Metabolic-toxic diseases of the brain stem 437
17.2.6 Diseases of the cranial nerves 438
17.2.7 Deafness 440
17.3 Neuro-ophthalmology 443
17.3.1 Abnormal pupillary light reflexes (PLR) 443
17.3.2 Central blindness 446
17.3.3 Internal ophthalmoplegia 446
17.3.4 External ophthalmoplegia 448
17.3.5 Horner\u2019s syndrome 448
17.3.6 Feline and canine dysautonomia 448
17.3.7 Feline spastic pupils 450
17.3.8 Hemidilatation of the pupils in the cat 450
17.3.9 Facial nerve paralysis 450
17.3.10 Pourfour du Petit syndrome 451
17.3.11 Strabismus 451
18 Cerebrum 454
18.1 Anatomy and physiology 455
18.2 Neuroanatomical localisation 455
18.3 Adjunct investigations 457
18.4 Diseases of the cerebrum 457
18.4.1 Vascular disease 457
18.4.2 Inflammatory / infectious diseases 458
18.4.3 Trauma 462
18.4.4 Anomalies 465
18.4.5 Metabolic / toxic diseases 468
18.5 Epilepsy 473
18.5.1 Idiopathic or primary epilepsy 473
18.5.2 Secondary or symptomatic epilepsy 478
18.5.3 Hyperaesthesia syndrome in the cat (\u201cRunning fits\u201d) 480
18.6 Differential diagnoses for primary and secondary epilepsy 480
18.6.1 Cataplexy / narcolepsy 480
18.6.2 Syncope 480
18.7 Neoplasia 484
18.7.1 Neuroepithelial tumours 486
18.7.2 Meningiomas 487
18.7.3 Tumours from surrounding tissues and metastases 487
18.8 Degenerative diseases 488
18.8.1 General criteria 489
18.8.2 Specific diseases 489
19 Behavioural Problems and Abnormal Behaviour 494
19.1 Aggression in the dog 494
19.1.1 Dangerous dogs and prognosis 494
19.1.2 Status-related aggression 497
19.1.3 Status-related aggression between dogs in the same household 498
19.1.4 Aggression between dogs that meet by chance 499
19.1.5 Fear-related aggression 499
19.1.6 Pain-related aggression 500
19.1.7 Territorial aggression 500
19.1.8 Maternal aggression, abnormal or lack of maternal behaviour, and infanticide 500
19.1.9 Aggression as a part of hunting behaviour 501
19.1.10 Aggression as part of play behaviour 501
19.2 Aggression in the cat 501
19.2.1 Territorial aggression 501
19.2.2 Fear-related aggression 502
19.2.3 Play and hunting aggression 503
19.2.4 Maternal aggression 503
19.2.5 Re-directed aggression 503
19.2.6 Therapy 503
19.3 Problems associated with excretory behaviour of cats 504
19.3.1 Excretory behaviour outside of the litter tray 504
19.3.2 Marking with urine (spraying) 505
19.4 Fears and phobias in the dog and cat 507
19.4.1 Fear of animate and inanimate stimuli 508
19.4.2 Situation-related fears and phobias 508
19.5 Compulsive disturbances 509
19.5.1 Manifestations of compulsive disturbances in the dog and cat 510
19.6 Cognitive dysfunction in the dog and cat 511
19.7 Medical behavioural therapy 512
19.7.1 Important neurotransmitter systems 513
19.7.2 Benzodiazepines 513
19.7.3 Tricyclic antidepressants 514
19.7.4 Selective serotonin reuptake inhibitors 514
19.7.5 Buspirone 515
19.7.6 Monoamine oxidase B inhibitors 515
20 Parasitic Neurological Diseases of the Dog and Cat 518
20.1 Trypanosomiasis in the dog 518
20.2 Neosporosis in the dog 518
20.3 Toxoplasmosis in the cat and dog 520
20.4 Babesiosis in the dog 521
20.5 Acanthamoeba infections 522
20.6 Encephalitozoonosis 522
20.7 Neurological diseases caused by helminths 523
20.7.1 Infection with space-occupying cysticerci 523
20.7.2 Infection with migrating larvae 523
20.7.3 Angiostrongylosis of the dog 523
20.8 Neurological diseases caused by arthropods 524
20.9 Borreliosis 524
Appendices 528
Appendix 1: Comparative sectional anatomy of the canine and feline brain 530
Appendix 2: Breed-specific diseases of the dog 556
Appendix 3: List of inheritable neurological diseases of the dog 561
Appendix 4: List of inheritable neurological diseases of the cat 564
Appendix 5: Drugs 574
Appendix 6: Epidemiological overview of the neurological diseases seen in dogs between 1989 and 2000 at the Small Animal Clinic in Bern, Switzerland 589
Subject Index 600
A 600
B 600
C 600
D 601
E 601
F 602
G 602
H 602
I 603
J 603
K 603
L 603
M 603
N 604
O 604
P 605
Q 605
R 605
S 605
T 606
U 606
V 606
W 607
Z 607