Veterinary Medicine - July 2008 - (Page 358)

Practical Matters clinical advice and reminders from your colleagues PEER-REVIEWED PEER-REVIEWED Don’t jump to conclusions in ataxic dogs frantic owner brings in a 4-year-old Scottish terrier after it suddenly collapses in the backyard. The owner reports that the dog cannot use its back legs. Your initial thought may be that this dog has a spinal cord disease such as intervertebral disk disease (IVDD). However, this dog turns out to have bilateral cruciate ligament ruptures. Dogs with bilateral cruciate disease can have clinical signs similar to those of IVDD. Many owners will describe their dogs as being wobbly before losing the ability to walk. In a case such as this, the dog is refusing to walk because it is in pain, not because it is unable to walk. Careful neurologic and orthopedic examinations will help you distinguish between the diagnoses. Dogs with bilateral cruciate disease will not have conscious proprioceptive deﬁcits and may choose to walk with a sling or other support. Supporting a portion of the dog’s weight is necessary when ﬂipping the paw over to test proprioception. Otherwise, the dog may be in too much pain to right the paw. Stiﬂe pain, effusion, and a cranial drawer sign will be present. Dogs with spinal cord disease generally have conscious proprioceptive deﬁcits even if they are able to ambulate. Hip dysplasia is another orthopedic disease that occasionally mimics neurologic disease. Severe hip pain, especially in obese dogs, can also make a dog appear ataxic. Dogs with extremely small ranges of motion in their hips may drag their paws in an effort to avoid ﬂexing the hip. Again, thorough orthopedic and neurologic examinations can help you distinguish among these problems. Dogs with both cauda equina syndrome and hip dysplasia exhibit pain on hip extension. However, dogs with hip dysplasia also exhibit pain on hip abduction and sometimes ﬂexion. Dogs with cauda equina syndrome commonly exhibit pain when their tails are lifted or the lumbosacral region is pressed while supporting the dog’s weight. So keep orthopedic problems in mind when evaluating dogs that suddenly collapse or exhibit ataxia. The results of thorough orthopedic and neurologic examinations will point you down the right Wanda J. Gordon-Evans, DVM, PhD, diagnostic and treatment path. DACVS Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois Urbana, IL 61802 A Vaginal cytology: Its value in detecting the cause of vulvar discharge V ulvar discharge can be a diagnostic challenge because the inciting problem may arise from the urinary tract, uterus or uterine stump, or vagina. As a general rule, mucoid discharge is associated with vaginitis; mucopurulent to purulent discharge is associated with vaginitis, metritis (postpartum), pyometra (during or after diestrus) or uterine stump pyometra, and, occasionally, brucellosis; and hemorrhagic discharge is associated with the subinvolution of placental sites (postpartum), neoplasia of the genitourinary tract, coagulopathy, the presence of blood parasites (ehrlichiosis or babesiosis), or physiologic estrus (vaginal epithelial cells corniﬁed). Microscopically assessing the discharge to determine its character often leads to further appropriate diagnostic The discharge may arise from the urinary tract, uterus, uterine stump, or vagina. tests. More information is gathered by collecting a vaginal cytology specimen than by looking at the discharge only. To collect a specimen, moisten a nonsterile cotton-tipped applicator, insert it at the dorsal commissure of the vulva, advance Editors’ note: See Dr. Joan R. Coates’ videos on performing a neurologic examination at www.vetmedpub.com/NeuroExam. 358 July 2008 VETERINARY MEDICINE Getty Images http://www.vetmedpub.com/NeuroExam

Table of Contents Feed for the Digital Edition of Veterinary Medicine - July 2008

Veterinary Medicine - July 2008 Contents Leading Off Practical Matters Idea Exchange Clarification Dental Corner The Diagnostic Approach to Hematuria Guidelines for Evaluating Hypercalcemic Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - July 2008

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