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Salter-Harris Fracture Classification

Salter-Harris Classification of Separations or Fracture-Separations Involving a Growth Plate and the Adjacent Metaphysis and Epiphysis

Type of Fracture Radiographic Findings Principal Anatomic Region Involved
Type 1 Physeal separation, displacement of the epiphysis from the metaphysis at the growth plate Proximal humerus and femur, distal femur
Type 2 Small corner of the metaphyseal bone fractured, with displacement of the epiphysis from the metaphysis at the growth plate Distal femur and humerus, proximal humerus, proximal tibia
Type 3 Fracture through the epiphysis and part of the growth plate, with the metaphysis unaffected Distal humerus
Type 4 Fracture through the epiphysis, growth plate, and metaphysis; several fracture lines possible Distal femur, distal humerus
Type 5 Compression of the growth plate. Soft-tissue swelling but no bony abnormalities seen following the injury. Distal ulna, distal radius, distal femur

Modified from Piermattei D, Flo G: Brinker, Piermattei, and Flo’s handbook of small animal orthopedics and fracture repair, ed 3, St Louis, 1997, Saunders.

Seizures

Causes

Modified from de Lahunta A: Veterinary neuroanatomy and clinical neurology, St Louis, 1983, Saunders.

Extracranial

Hypoglycemia:
Glycogen storage diseases
Beta-cell neoplasm of pancreas/insulinoma
Youth and malnutrition (especially small or toy breeds)
Youth and GI disease (especially small or toy breeds)
Insulin excess during treatment for diabetes mellitus
Intestinal leiomyosarcoma
Hypoxemia:
Cardiorespiratory disease (e.g., severe bradycardia or severe tachycardia, disorders producing polycythemia)
Hepatoencephalopathy
Renal disease, especially nephrotic syndrome (embolism)
Hypocalcemia
Hyperkalemia
Hyperlipoproteinemia
GI disease:
Parasitism
“Garbage intoxication”
Polycythemia:
Right-to-left shunt (e.g., reversed patent ductus arteriosus, tetralogy of Fallot, atrial or ventricular septal defect with concurrent pulmonic stenosis or pulmonary hypertension)
Renal neoplasm (erythropoietin-producing)
Chronic lung disease
Polycythemia vera

Intracranial

Inflammation:
Canine distemper encephalitis, toxoplasmosis, cryptococcosis, neosporosis
Other viral encephalitides: rabies FIP meningoencephalitis in cats
Neoplasia:
Primary or metastatic
Malformation:
Hydrocephalus, lissencephaly-pachygyria
Injury
Degeneration:
Thiamine deficiency in cats
Cerebral infarction in cats
Intoxications: lead, mercury, arsenic, chlorinated hydrocarbons, organophosphates, hexachlorophene, ethylene glycol, radiopaque media for myelography, metaldehyde, tremorgenic mycotoxins (penitrem A, roquefortine), blue-green algae, chocolate, marijuana, ethanol/ methanol/fermented materials (e.g., bread dough), prescription human medications

Idiopathic Epilepsy

FIP, Feline infectious peritonitis; GI, gastrointestinal.

Seizures: Causes Grouped According to Age

Prevalence of Common Seizure Disorders in Relation to Patient’s Age at Time of Onset of First Seizure

Modified with permission from Braund KB: Clinical syndromes in veterinary neurology, St Louis, 1994, Mosby, p 242.

Age at Onset: Before 8 Months

Rare: Idiopathic Epilepsy Mainly:

Developmental disorders (e.g., malformations, hydrocephalus)
Encephalitis or meningitis
Trauma
Extracranial causes:
Hepatic encephalopathy (e.g., portocaval shunt)
Hypoglycemia
Intoxications
Intestinal parasitism

Age at Onset: 8 Months to 4 Years

Mainly: Idiopathic Epilepsy Seldom:

Developmental disorders (e.g., malformations, hydrocephalus)
Trauma
Encephalitis or meningitis
Acquired hydrocephalus
Neoplasia
Extracranial causes:
Hepatic encephalopathy (e.g., portacaval shunt, liver disease)
Hypocalcemia
Electrolyte disturbances
Hypothyroidism
Intoxications

Age at Onset: More Than 4 Years

Seldom:

Idiopathic epilepsy
Trauma
Encephalitis or meningitis
Acquired hydrocephalus
Extracranial causes:
Hepatic encephalopathy (e.g., serious liver disease)
Hypocalcemia
Electrolyte disturbances
Hypothyroidism

Increasing:

Neoplasia
Degenerative disorders
Vascular disorders
Extracranial causes:
Hypoxia
Hypoglycemia

Seizures: Characteristics and Differentiation

Seizures, Differentiation from Other Events

Seizures, Refractory or Poorly Controlled

Factors Responsible for Inadequate Control of Seizures

Modified with permission from Kirk RW, Bonagura JD, editors: Kirk’s current veterinary therapy XI: small animal practice, St Louis, 1993, Saunders, p 986.

Medication and Dosage

Improper choice of drug
Insufficient drug dosage
Delayed increase in dosage
Inadequate increase in dosage
Too rapid change of medication
Too rapid reduction of dosage
Excessive fluctuations in serum concentrations
Inappropriately combined drugs
Failure to monitor serum levels
Noncompliance
Drug-drug interactions

Other Precipitating Factors

Additional medications
Additional diseases
Physical or psychological stress

Diagnostic Failures

Extracerebral causes of seizures
Progressive brain lesions
Misidentification of episodes
Syncope
Myasthenia gravis
Narcolepsy/cataplexy

Serotonin Syndrome–Inducing Agents

Substances That Potentially May Cause Serotonin Syndrome

Agent General Comments for Each Category of Agent
Foods or supplements:
L-5-HTP, L-tryptophan, Griffonia seed extract
Aged cheese, chicken liver
• L-5-HTP is an OTC supplement used in humans for depression, insomnia; serotonin syndrome (SS) reported as a result of accidental ingestion in dogs.
• Tyramine present in certain foods can interfere with MAO inhibitors’ action and enhance their toxicity.
Medications that increase presynaptic release of serotonin:
Amphetamine
Methylphenidate
Ecstasy (MDMA; 3,4 methylenedioxymethamphetamine)
Bromocriptine
l-dopa
• In addition to CNS excitation from amphetamine, signs of confusion, disorientation, hallucination, and rigidity may be due to SS.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on S

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