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Encephalopathy, Vascular 293

and 1146). The most severe cases may require Recommended Monitoring Prevention
mechanical ventilation (p. 1185). Respiratory rate and effort (± assessment of When left unobserved, puppies and kittens
VetBooks.ir Chronic Treatment until stabilized. Healing of burns also should to electrical cords can be avoided. Diseases and Disorders
should be crated or otherwise confined so access
oxygenation) should be monitored frequently
be monitored.
Treat burns with antibiotics, wound clean-
Technician Tips
ing, surgical debridement, and closure, as
needed. Soft food can be fed or a feeding PROGNOSIS & OUTCOME When administering treatments, stress should be
tube used if burns are in the mouth. Puppies minimized, and treatments should be conducted
will commonly eat despite severe oral Depends on the degree of pulmonary edema. in a stepwise manner.
injury. Overall survival appears to be greater for cats
than dogs. Critical period is the first 24-48 Client Education
Nutrition/Diet hours after electrical shock; if the animal Education about re-exposure and removal of
Offer soft or blenderized food. If oral burns survives this period, it will likely survive to damaged or faulty electrical cords
are severe and the patient will not eat, enteral discharge with minimal or no permanent
nutrition may be instituted by placement of aftereffects. SUGGESTED READING
a nasoesophageal (p. 1107) or esophagostomy Mann FA: Electrical and lightning injuries. In
(p. 1106) tube. PEARLS & CONSIDERATIONS Silverstein DC, et al, editors: Small animal critical
care medicine, St. Louis, 2009, Saunders, p 687.
Possible Complications Comments
Infection of non-healing burns, acute respiratory Noncardiogenic pulmonary edema can be AUTHOR: Megan Whelan, DVM, DACVECC, CVA
EDITOR: Benjamin M. Brainard, VMD, DACVAA,
distress syndrome. A rare but possible long-term difficult to treat. Treatment is symptomatic, DACVECC
complication is cataract formation. with no specific recommendations.

Encephalopathy, Vascular Client Education
Sheet

BASIC INFORMATION • Global cerebral hypoxia is most commonly another organ system that can suggest a
seen with adverse anesthetic events or after predisposing disease.
Definition resuscitation from cardiopulmonary arrest. • Neurologic examination findings will
Brain dysfunction resulting from a disease process vary depending on the part of the brain
that compromises its blood supply; categorized GEOGRAPHY AND SEASONALITY affected.
as ischemic (due to occlusion of a vessel) or • Some cases of feline ischemic vascular events ○ Cerebellum: hypermetria, head tilt, ataxia,
hemorrhagic (due to rupture of vasculature). It in North America have been linked to intra- and intention tremors
can involve a focal region or the entire brain. cranial migration of Cuterebra larva. ○ Forebrain: circling, seizures, changes in
Clinical signs correlate to the neuroanatomic area • Angiostrongylus vasorum, a parasite of the vision, proprioceptive deficits, and rarely,
that is affected (forebrain, cerebellum, brainstem). European mainland and Atlantic Canada, vestibular signs
can induce marked coagulation abnormalities
Synonyms that result in intracranial hemorrhage in dogs. Etiology and Pathophysiology
Stroke, infarction, vascular event, cerebrovas- Clinical Presentation • Ischemia to brain tissue causes decreased
cular accident oxygen delivery and impairs energy metabo-
DISEASE FORMS/SUBTYPES lism, leading to neurologic dysfunction.
Epidemiology • Cerebrovascular accidents are ischemic or • Dysfunction can range from mild (with
SPECIES, AGE, SEX hemorrhagic in nature; ischemic events are reversible signs) to severe (causing brain
Any species, age, or sex can be affected. more common. necrosis).
• Ischemic events are further classified as
GENETICS, BREED PREDISPOSITION lacunar or territorial infarctions, depending DIAGNOSIS
Greyhounds and Cavalier King Charles spaniels on the size of the vessel involved.
are overrepresented in ischemic cerebrovascular • Global ischemia occurs infrequently and is Diagnostic Overview
disease. usually associated with an adverse anesthetic Vascular encephalopathy should be considered
event. in animals with a peracute onset of nonpro-
RISK FACTORS gressive signs of brain dysfunction. Definitive
• Focal ischemic events can be associated with HISTORY, CHIEF COMPLAINT diagnosis is based on findings from MRI of
hypertension or a hypercoagulable state. Dis- The chief complaint will vary depending on the the brain. Animals with a cerebrovascular
eases that can cause a hypercoagulable state region of the brain affected, but clinical signs accident should be screened thoroughly for a
include hyperadrenocorticism, renal disease are characteristically peracute to acute in onset predisposing disease. If an underlying cause
(particularly protein-losing nephropathy), and nonprogressive after 24 hours. Common is recognized, appropriate treatment can help
and neoplasia. presenting signs include seizures, behavioral prevent recurrence.
• Hemorrhagic infarcts can be seen in changes, circling, falling, or difficulty walking.
association with diseases that induce a Differential Diagnosis
hypocoagulable state, such as liver failure, PHYSICAL EXAM FINDINGS • Neoplasia
sepsis, immune-mediated thrombocytopenia, • General physical examination findings can • Inflammatory disease, sterile or infectious
and disseminated intravascular coagulation. be unremarkable or reveal abnormalities in • Trauma

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