Ventroflexion of the neck

60 Ventroflexion of the neck




INITIAL PRESENTATION


Head droop, head drop, ‘dropped head’, chin on or close to sternum



INTRODUCTION


The major antigravity support for the head is supplied by two groups of muscles. The major and minor rhomboids attach to the dorsal spinous processes of the C4–T4 vertebrae medially while the levator scapulae and serratus ventralis insert on the lateral processes of the cervical vertebrae and the ribs.


Cervical ventroflexion occurs in cats but not dogs as a sign of muscle weakness. The cat remains able to see despite the dramatic posture. Other signs such as generalized weakness, resting the head on the ground, and a stiff forelimb gait are noted. Winging of the scapulae in which the dorsal scapulae slightly protrude during weight-bearing is another sign of muscle weakness (Fig. 60.1).


image

Figure 60.1 Ventroflexion in a hypokalaemic cat.





Observation differentiates it from



• A lowered head posture secondary to neck pain or when shifting the centre of gravity forward in paraparesis or severe hindlimb lameness.

• Hypnic jerk which is the sudden drop and recovery of head position when falling asleep.

• Tetraplegia resulting in lateral recumbancy and inability to lift the head from the floor.

• A generalized sudden loss of muscle tone in syncope and narcolepsy-cataplexy.


SIGNALMENT


A 6-year-old neutered female domestic shorthaired cat.



CASE PRESENTING SIGNS


Decreased activity.



CASE HISTORY


There was a 2–3 week history of waxing and waning changes described as a change in personality. The cat lay on top of the shed in the rain, would not mix with the other cats and did not run away. Food was prehended but then dropped. The cat’s head ‘fell forwards’ and the animal dribbled saliva. No vomiting or regurgitation was reported.



CLINICAL EXAMINATION


Clinical examination showed an alert cat with slight neck ventroflexion and a slight right head tilt/turn. She walked without ataxia but her forelimbs became stiff and she stopped walking and lay down, sometimes also lowering her head. Hopping was normal. Proprioception was normal. Muscle tone was normal. Jaw tone and the blink reflex were both decreased. Spinal reflexes were normal. Schirmer Tear Test was 0 mm in the right eye.

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Ventroflexion of the neck

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