Page 514 - ONLINE PROCEEDING BOOK WSAVA 2017
P. 514

An Urban Experience
WSVA7-0368
NURSES I
NURSING CARE OF THE SEIZURING PATIENT
S. Platt1
1College of Veterinary Medicine- University of Georgia, Small Animal Medicine & Surgery, ATHENS, USA
NURSING CARE OF THE SEIZURING PATIENT
Simon R. Platt BVM&S MRCVS Dipl. ACVIM (Neurology) Dipl.ECVN
College of Veterinary Medicine, University of Georgia, Athens, GA
A seizure can be de ned as a repetitive neurological event that is the clinical manifestation of excessive and/ or synchronous abnormal neuronal activity in the cerebral cortex. The terms “seizures”, “ ts”, and “convulsions” are synonymous. The term convulsion is generally reserved for seizures that have a generalized motor component. These latter terms are old terminology which is no longer used.
A seizure can have several components. Many of these components are not always appreciated/occur in clinical cases. The actual seizure is called the ictus.
1. Aura: the period of altered motor, sensory, autonomic, or behavior that may occur before the seizure. Behaviorally, animals may hide, appear nervous, or seek their owners.
2. Ictus: the actual seizure. This usually lasts for 1 to 2 minutes (but the length of time is variable) and can have a variable appearance.
3. Post-ictal: the period after the seizure where
animals may return to normal within seconds or
may be abnormal for minutes to hours. Examples of abnormal post-ictal behavior include restlessness, an increased appetite, lethargy, confusion, disorientation, aggression, or blindness.
Seizures are always a sign of abnormal brain function. The neuroanatomic diagnosis for seizures is the prosencephalon. However, the underlying etiology or dysfunction may be from a structural (primary) lesion within the brain (an intracranial etiology) or a disturbance outside the brain (an extracranial etiology) that is affecting the prosencephalon. Other clinical signs that help localize a prosencephalic lesions include:
Abnormal mentation – helps localize to INTRACRANIAL. Any lesion affecting either the reticular activating system or the cerebrum or thalamus can result in an abnormal mentation.
Normal gait – chronic structural lesions affecting the cerebrum or thalamus do not cause a disturbance in the gait (i.e., the gait is normal). This is no necessarily the case for acute structural lesions or metabolic/toxic disease. Occasionally, animals will walk propulsively and will tend to circle toward the side of the lesion.
Postural reactions: Ascending GP information projects to the contralateral thalamus and cerebral cortex. Cranial nerve examination – Abnormalities typically affect the cranial nerve involved in RESPONSES while those involved in the re exes are normal.
Causes of Seizures
The three broad categories for the underlying causes of seizures are intracranial causes, extracranial causes, idiopathic. Depending on the species, idiopathic (also referred to idiopathic epilepsy if there are recurring seizures without an underlying cause) may be common such as in dogs or relatively uncommon as in cats and horses.
Idiopathic / Hereditary Seizures
The term idiopathic epilepsy refers to the syndrome of recurrent seizure activity with an unknown etiology. The recurrent seizure activity has no demonstrable pathologic cause. The seizures are probably due to a number
of diverse biochemical defects that may be inherited. Hereditary seizures may be a preferred terminology for recurrent seizure activity of unknown etiology in which a de ned pattern of inheritance has been demonstrated.
In dogs, a familial predisposition for epilepsy has been reported for the Beagle, Keeshound, Belgian Tervueren, Golden Retriever, Labrador Retriever, Vizla and Shetland sheepdog. In the Bernese mountain dog and in Labrador Retrievers a polygenic, recessive mode of inheritance has been suggested. In Vizslas an autosomal recessive trait has been suggested. Hereditary epilepsy has not been reported in the cat. Despite this, idiopathic seizure can occur but are typically uncommon in cats. The
age of onset is usually between 1 to 5 years of age. Seizures are usually generalized tonic/clonic and last 1 to 2 minutes. Pre-ictal and post-ictal may be seen. Animals are clinically normal in the inter-ictal period (between seizures). The neurological examination is normal. The seizures can occur in clusters (multiple seizures in
a 24 hour period with a return to normal consciousness in between seizures). If untreated and severe, seizure activity can progress to status epilepticus (1 seizure
that lasts longer than 5 minutes; 2 or more seizures that occur without a return to normal consciousness). The diagnosis is suspected based on the history, signalment, but the true diagnosis necessitates the exclusion of all other causes. The physical examination, neurological examination, and diagnostic tests are normal.
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42ND WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND FECAVA 23RD EUROCONGRESS


































































































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