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Case # 4

Case # 4. Clinical history. An adult horse Acute onset of CNS signs. Case # 4. Clinical exam. Mild fever Mild hypoglycemia No significant changes in CBC. Case # 4. Video. Case # 4. Neurological exam. Lip twitching Mild ataxia Decreased sensation Mild depression. Case # 4.

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Case # 4

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  1. Case # 4 Clinical history • An adult horse • Acute onset of CNS signs

  2. Case # 4 Clinical exam • Mild fever • Mild hypoglycemia • No significant changes in CBC

  3. Case # 4 Video

  4. Case # 4 Neurological exam • Lip twitching • Mild ataxia • Decreased sensation • Mild depression

  5. Case # 4 Neurological exam • Consistent with multifocal encephalomyelitis • Differential diagnosis: • West Nile virus • Western equine encephalitis virus • Equine protozoal encephalomyelitis • Equine herpes virus • Rabies

  6. Case # 4

  7. Case # 4

  8. Case # 4 Serology in live: ELISA positive for WNV Postmortem: IHC and PCR

  9. Case # 4 In 2002 alone, WNV caused in NA: • Illness in > 3,900 people • > 200 fatalities • Illness in >14,700 horses (and many died) • Disease in wide range of species (143 free-ranging species of birds and 8 wild and 9 domestic mammalian species Leighton FA et al 2003

  10. Case # 5 Clinical history • Young adult cow • Unilateral facial paralysis

  11. Case # 5 Courtesy of Dr. S. Abutarbush

  12. Case # 5 Clinical exam • Mild fever • Mildly inflammatory CBC • Salivation • Droopin ear • Lowered eyelid

  13. Case # 5 Neurological exam • Consistent with unilateral encephalitis of the brain stem • Differential diagnosis: • Listeriosis • ITEM • Rabies • PEM • Brain abscess

  14. Case # 5 Necropsy: No gross lesions Histology: Multifocal suppurative meningoencephalitis

  15. Case # 5 Histology

  16. Case # 6 Clinical history • An adult horse • Acute onset of depression • Self traumatized face, right eye, muzzle and left fetlock

  17. Case # 6 Clinical exam • Head pressing • Febrile • Cortical blindness OD • Right sided CN VII Paralysis

  18. Case # 6 Clinical pathology • CBC: anemia due to chronic disease • Neutrophilia • Hyperfibrinogenemia • Hyperglobulinemia

  19. Case # 6 Necropsy • Cerebral abscessation Bacteriology • Streptococcus equi

  20. Case # 6 Slides

  21. Case # 7 • A rancher brought to you a mixed breed dog with multiple facial scratches. • He suspected that his dog had a fight with a raccoon, because there was a dead raccoon in the backyard. • One day before, a raccoon with strange behavior (not afraid) was observed around his house during the day. • WHAT ARE YOU GOING TO DO?

  22. Case # 7 • Examine vaccination record • Ask about the dead raccoon • Contact district veterinarian (CFIA rep.) if you are not sure what to do next

  23. Case # 7 You wanted to check some other CNS dz. but your client was already back with the raccoon. What are you going to do?

  24. Case # 7 • Dx: • Non suppurative encephalitis with I/N and I/C inclusion bodies consistent with CDV Digital and nasal hyperkeratosis • Conjunctivitis • Comment: • Immunohistochemistry for CDV was positive and rabies test negative

  25. Case # 8 Courtesy of Dr. S. Abutarbush

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