Collapse

56 Collapse



INTRODUCTION


Sudden onset of collapse is a common presenting sign in small animal practice but not all such animals are afflicted with neurological disease. Physical examination, haematology and biochemistry are invaluable in distinguishing neurological lesions from other causes of weakness such as fever, sepsis or hypovolaemia. Always try to ascertain the level of mental awareness of the animal during and after the collapse. Systemically unwell animals are depressed (obtunded), which mimics cerebral disease. Syncopal animals lose consciousness but return to normal mentation almost immediately, unlike seizure activity, which usually leaves the animal more lethargic than normal for a variable period of time lasting minutes to hours. A severely depressed mentation (stupor) or a persistent lack of response to stimuli (coma) signal dysfunction of the brainstem or cerebrum. Stupor and coma occur in metabolic or structural encephalopathies. Signs of vestibular disease causing a loss of balance and subsequent collapse are usually strikingly obvious on examination. An animal that has acutely lost balance is mentally alert but usually pays less attention to the owner, as it struggles to regain its footing.


Collapse may be sustained (recumbency), or may occur episodically, with spontaneous resolution.






Causes of collapse






Table 56.1 Distinguishing seizures from syncope































  Syncope Seizure
Associated activity May or may not be associated with exercise, feeding, Valsalva manoeuvre Often at rest
Duration of collapse <1 minute >1 minute
Convulsive movements Rare Common
Urine incontinence Unusual Common
Return of mental alertness Within seconds Usually quiet, lethargic for minutes to hours
Mucous membranes Pale Cyanosis or normal

The history and physical examination localized the cause of collapse in the following dogs of identical age and breed.






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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Collapse

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