+

Final Presentation for Independent Study Mentorship at a Veterinary Hospital

Nicole Stelling 6th Period

Introduction:

Mentor: Larry Fleming, D.V.M. Place of mentorship: Marina Bay Animal Hospital ISM Teacher: Mrs. Robin Holk Essential Question: How can differential diagnoses and treatment plans be developed for a dog with seizures based on clinical signs and test results? Hypothesis: Clinical signs and test results can be utilized to develop a flow chart allowing the veterinarian to make effective treatment plans for seven infectious diseases that cause seizures. Some of the information in this presentation comes from outside sources.

My Mentor And I:

Dr. Larry and I entering the X-ray room

Dr. Larry and I looking at rays

X-

About My Mentor

Dr. Larry graduated from University of Illinois. He has been practicing since 1987. He founded Marina Bay Animal Hospital in 1993. His special interests in the veterinary field are internal medicine, ultrasound, surgery, and dentistry. His favorite thing about job is seeing the interaction between the clients and their pets. His favorite hospital memory is mingling with clients at the open house after the hospital addition.

Pictures Of Me During My Mentorship:

Working on the Ideex

Looking through the microscope

Working on the computer

Examining Jack

Looking at an X-ray

Looking at an X-ray

My Project:

I analyzed information that I obtained through research and case studies to develop a system for diagnosing and treating seven of the most common infectious diseases in the area that cause seizures.

What Is A Seizure?
Seizures

are transitory disturbances of brain function and are the clinical manifestation of paroxysmal cerebral disorders that appear suddenly out of a background of normality and then disappear with equal abruptness.

Epilepsy Natural

reaction of normal brain to transient physiologic stress or insult

Extracranial Intracranial

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d.

Stages Of A Seizure:

Prodrome Aura Ictus Postictal Interictal

signs period

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d.

Symptoms of A Seizure:

Agitation
Teeth chomping Frenzied barking Clinginess or seeking seclusion Confusion Collapse Rigidity or muscle twitching

Temporary cessation of breathing or blindness

Vomiting or inappropriate urination or defecation

Citation: Rylander, Helena, D.V.M., D.A.C.V.I.M.. "Vestibular Syndrome." Veterinary Medicine 107.7 (2012): 316322. Print.

Making A Diagnosis: History:

Ask the client about:

Description of prodrome, aura , or ictus Frequency Duration When the events occur Postictal signs Length of postictal period Significant injuries or illnesses within the last four years Family history of seizures Dogs diet Vaccination status Potential exposure to toxins

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d.

Making A Diagnosis: Age of Onset:

Less

than six months

Between
Late

six months and five years

onset

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d.

Making A Diagnosis: Intracranial or Extracranial?

Examine
Physical

interictally

examination Neurological examination Minimum database

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d.

Canine Distemper:

Serious,

contagious viral infection with no known cure by air, direct, or indirect contact
attenuated vaccines

Spread

Improperly Initially

attacks tonsils and lymph nodes

Then

attacks respiratory, urogenital, gastrointestinal, and nervous systems

Citation: Ford, Richard B., DVM, MS, Diplomate ACVIM & ACVPM(Hon). "Canine Vaccination Guidelines." Today's Veterinary Practice Sept.-Oct. 2012: 20-26. Print.

Canine Distemper: Symptoms:

In the initial stages:

High fever Reddened eyes Watery discharge from nose and eyes Persistent coughing Vomiting Diarrhea Lethargy Anorexia

In later stages:

Fits, seizures, tremors, paralysis, and attacks of hysteria

Some strains:

abnormal enlargement or thickening of the pads on feet

Citation: Ford, Richard B., DVM, MS, Diplomate ACVIM & ACVPM(Hon). "Canine Vaccination Guidelines." Today's Veterinary Practice Sept.-Oct. 2012: 20-26. Print.

Canine Distemper: Diagnosis:

Biochemical

tests and urinalysis -

lymphopenia
Serology
Test

test positive antibodies

for antibodies- haired skin, nasal mucous, and footpad epithelium

Citation: Ford, Richard B., DVM, MS, Diplomate ACVIM & ACVPM(Hon). "Canine Vaccination Guidelines." Today's Veterinary Practice Sept.-Oct. 2012: 20-26. Print.

Canine Distemper: Treatment:

No

antiviral drugs are effective in treating the disease

Alleviate

symptoms- IV fluids, antibiotics, anti-seizure medications

for pneumonia, dehydration, seizures recovered dogs do not spread or carry the virus

Monitor

Fully

Citation: Ford, Richard B., DVM, MS, Diplomate ACVIM & ACVPM(Hon). "Canine Vaccination Guidelines." Today's Veterinary Practice Sept.-Oct. 2012: 20-26. Print.

Canine Distemper: Prognosis and Prevention:

Recovery Chance

is possible

for survival depends on strain of virus and strength of immune system

Citation: Ford, Richard B., DVM, MS, Diplomate ACVIM & ACVPM(Hon). "Canine Vaccination Guidelines." Today's Veterinary Practice Sept.-Oct. 2012: 20-26. Print.

Canine Distemper: Prevention:

Routine
Isolation Avoid

vaccinations

Exposure

Citation: Ford, Richard B., DVM, MS, Diplomate ACVIM & ACVPM(Hon). "Canine Vaccination Guidelines." Today's Veterinary Practice Sept.-Oct. 2012: 20-26. Print.

Toxoplasmosis:

Caused

by a parasite

Unwashed fruits and vegetables, cat feces

Affects Both

nearly all warm-blooded animals

acute and chronic forms

Acute- more symptomatic

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Seizures. N.d

Toxoplasmosis: Symptoms:

Neurological signs Lethargy Uncoordinated gait Paralysis Respiratory problems Fever Weight loss Vomiting Diarrhea Abdominal pain Jaundice
Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d

Toxoplasmosis: Diagnosis:
Health

history/exposure
exam Database

Physical

Minimum

Leukopenia,

neutropenia, and lymphopenia High liver enzymes

Polymerase
Antigens

chain reaction test/ serological tests fluid

Seizures. N.d

and antibodies

Cerebrospinal

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Toxoplasmosis: Treatment:

Antibiotics
Hospitalization
Severe

cases/ suppressed immune system

Prevent
IV

further progression of symptoms

fluids

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Seizures. N.d

Cryptococcosis:

Fungal Bird

infection

droppings and decaying vegetation

Contracted
Passes

though dogs nasal passages

into the brain, eyes, lungs, and other

tissues
Can

infect stomach and intestines

Seizures. N.d

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Cryptococcosis: Symptoms:
History

of problems/sluggishness Mild fever Nervous system signs Skin ulceration Enlarged lymph nodes Vomiting Diarrhea Lack of appetite Nasal discharge
Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d

Cryptococcosis: Diagnosis:

Biopsy Aspirates Blood Spinal Blood

and urine cultures tap tests - antigens

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Seizures. N.d

Cryptococcosis: Treatment:
Duration

of treatment- 3 months to 1 year

Antifungal Inpatient

drugs

supportive care care

Outpatient

Removal
Monitor

of masses

blood work the response to treatment- maintain low titers

Measure Central

nervous system treatment- lifelong

Seizures. N.d

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Histoplasmosis:
Caused

by the Histoplasma capsulatum

fungus
May

be inhaled or ingested
bird, poultry, and bat

Contaminated

droppings
Enters

intestinal tract

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Seizures. N.d

Histoplasmosis: Symptoms:
Weight

loss Diarrhea Difficulty breathing Lethargy Lymphadenitis Fever Pale mucous membranes Jaundice Hepatosplenomegaly
Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d

Histoplasmosis: Diagnosis:

Minimum Blood

database

tests- antibodies

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Seizures. N.d

Histoplasmosis: Treatment and Prevention:

Inpatient

treatment - malabsorption basis

Outpatient

Medications Cage Limit

rest exposure
Seizures. N.d

Citation: Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine.

Ehrlichiosis:
Rickettsia
Spread Inhabit Seen

infection

by ticks white blood cells

throughout year in all of continental

U.S.
Chronic

and severe forms

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Ehrlichiosis: Stages and Symptoms:

Acute

stage

Enlarged

lymph nodes, lethargy, lack of appetite, difficult respiration, and limb edema

Subclinical Chronic

stage

stage

Abnormal

bleeding, severe weight loss, fever, trouble breathing, joint inflammation, eye pain, neurologic signs, and paralysis

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Ehrlichiosis: Diagnosis:
Health

history - ticks database

Minimum

thrombocytopenia,

decreased neutrophils, anemia, increased lymphocytes, proteins in urine

Polymerase

Chain Reaction Test

Testing

for antibodies
fluid

Cerebrospinal

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Ehrlichiosis: Treatment:
Clear

body of organism
dog antibiotic therapy

Stabilize Standard

Anti-inflammatory
Fluid

drugs

therapy

Other Calm,

drugs and therapies

quiet place for rest and recovery

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Ehrlichiosis: Prognosis and Prevention:

Best Most

when treatment is begun early dogs recover well

Infection

may remain in body and could return at later time

blood tests

Repeat Avoid

exposure

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Babesiosis:
Caused

by protozoal parasites

several species and subspecies

Tick

transmission, blood transfusions, or transplacental transmission

Incubation

period averages about 2 weeks

infect and replicate in the red blood cells

Piroplasms Release

of hemoglobin

Immune-mediated hemolytic anemia Parasite induced red blood cell destruction

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Babesiosis: Symptoms
Lack Pale

of energy gums loss

Weight Fever

Enlarged Jaundice

abdomen

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Babesiosis: Diagnosis:
Health

history- ticks
physical exam database

Complete Minimum Wrights

stain antibody test - antibodies

Immunoflourescent Polymerase

chain reaction test more

sensitive
Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Babesiosis: Treatment and Prevention:

Hospitalization Outpatient Monitor

basis

progress

2 to 3 negative PCR tests

Multi-dog
Tick

household or kennel

prevention and prompt removal

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Bartonellosis:

Bacterial

disease

Affects

dogs, cats, and humans

Zoonotic

Fleas,

sand flies, lice, and ticks.

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Bartonellosis: Symptoms:
Dogs

and humans- common spectrum of clinical symptoms Fever Lameness Inflammation Nose bleed Vomiting Diarrhea Coughing
Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Bartonellosis: Diagnosis:
Complete

exam

Minimum

database

Decreased

number of platelets, anemia, leukocytosis, abnormal liver enzymes, hypoalbuminemia

Culturing

organisms from blood chain reaction

Polymerase

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Bartonellosis: Treatment and Prevention:

No

well-established antibiotic protocol on symptoms prognosis varies

Based

Overall Monitor

Prevent

exposure - ticks

Citation: Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print.

Conclusion:

With this research it has been determined that a flow chart can be developed based on clinical signs and test results which can be used to make diagnoses and treatment plans for seven of the infectious diseases that can cause seizures.

Thank You!
I

really enjoyed this opportunity and I know the information I have learned about veterinary medicine will benefit me in my career.
would like to thank:
My mentor, Dr. Larry Fleming, for allowing me to have this opportunity, mentoring me, and helping me with my project All the staff at Marina Bay Animal Hospital for their help My teacher, Ms. Robin Holk, for helping me with the class and my project My parents for driving me everywhere

Bibliography:
Cocker, Sarah E., D.V.M., D.A.C.V.I.M., and Sharon K. Theisen, D.V.M., D.A.C.V.I.M.. "Refractory Seizures in a Dog." Clinician's Brief 10.5 (2012): 71-73. Print. Ford, Richard B., DVM, MS, Diplomate ACVIM & ACVPM(Hon). "Canine Vaccination Guidelines." Today's Veterinary Practice Sept.-Oct. 2012: 20-26. Print.

Rylander, Helena, D.V.M., D.A.C.V.I.M.. "Vestibular Syndrome." Veterinary Medicine 107.7

(2012): 316-322. Print. Starkey, Lindsay, DVM, and Susan Little, DVM, PhD, Diplomate ACVIM (Parasitology). "Defeating Ticks." Today's Veterinary Practice Sept.-Oct. 2012: 40-44. Print. Taylor, Steve, D.V.M., Diplomate, American College of Veterinary Internal Medicine. Seizures. N.d