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Study Circle
Presented by: Sachin Shrestha
Semester: 5th (Fifth)
Roll no: 37 (Thirty-Seven)
Venue: Paklihawa Campus
Program: B.V.Sc & A.H
Tribhuvan University
Institute of Agriculture and Animal Science
Paklihawa Campus, Rupendehi
9/6/2023 Mr. Sachin Shrestha 1
9/6/2023 Mr. Sachin Shrestha 2
Neurological Evaluation Of Horse
Introduction
Horse is a dynamic animal which has been in close relation to human
since ages.
We may encounter unusual behavior of the horse like Limping, Unusual
stance, May show sign of depression or over sensitive to the stimuli
These condition shown by horse can have both orthopedic and
neurologic origin
To distinguish the either orthopedic of neurologic origin we need to
make sure whether the condition shown is ‘Regular Irregularity’ or
‘Irregular Irregularity’
If the signs are irregular then we can assure the horse may have
neurologic problems.
9/6/2023 Mr. Sachin Shrestha 3
What examiner need to do?
Examiner need to access the condition to make sure whether the
condition is linked to cranial nerves or spinal nerves or may have
vestibular dysfunction
Examiner need to give a thorough look of the horse from head to tail
to avoid overlooking any important lesions
Examiner need to take special attention to patient history, horse’s
mental state, behavior, stance and clinical examination
Spinal nerves are examined by the menace and other reflexes
Incoordination is examined by checking their gait
9/6/2023 Mr. Sachin Shrestha 4
Methodology
9/6/2023 Mr. Sachin Shrestha 5
Evaluation of Mental Status
Horse is checked for any encephalopathic behavior such as
Compulsive circling, Head pressing, Cortical/Central blindness,
Seizures or significant change in Mentation.
If there is encephalopathic behavior and there is any unknown
vaccination history of rabies then special caution need to be practiced
Horse need to be accessed for Hyper aesthetic, Depressed or
Lethargic, Stuporous, Obtunded and Comatose
9/6/2023 Mr. Sachin Shrestha 6
Normal Horse are alert and responsive, although the spectrum
encompasses very calm, placid horses to overly alert, anxious
individuals
Hyperesthestic horses are hyper-responsive to stimuli and often jerk
or tremor when stimulated
Depressed or lethargic horses may have either mild intracranial
disease, systemic disease, or pain. A thorough physical examination is
necessary to tell the difference
Obtunded horses do not respond to normal stimuli (such as a stranger
walking to their stall door or entering the stall) and only respond to
increased stimuli (such as loud noises, sudden movements, or firm
pressure).
9/6/2023 Mr. Sachin Shrestha 7
Stuporous horses only respond to painful stimuli (such as skin being
squeezed with a hemostat).
Comatose horses do not respond to any stimuli
9/6/2023 Mr. Sachin Shrestha 8
Examining Cranial Nerves
Testing Eyes by Menace response, Pupilary light reflex, normal eyes
position, Palpebral reflex
Likewise normal facial expression, ability to move their ears, blink
and wiggle lips/muzzle are accessed.
Similarly, Masticatory muscle size and its function, Strength of the
tongue (Ability to retract when pulled) are also accessed.
Eating and drinking behavior are also accessed for their ability to
swallow.
9/6/2023 Mr. Sachin Shrestha 9
9/6/2023 Mr. Sachin Shrestha 10
This horse has a wide-based
stance and it has reduced
awareness due to head trauma.
Abnormal position of the
legs may indicate problem
in neck
9/6/2023 Mr. Sachin Shrestha 11
Unilateral tongue-muscle
atrophy in a horse with
unilateral hypoglossal nerve
damage.
9/6/2023 Mr. Sachin Shrestha 12
9/6/2023 Mr. Sachin Shrestha 13
Mydriasis of horse’s right pupil
compared with the left pupil. These
abnormalities were caused by right-
sided oculomotor nerve damage
subsequent to polyneuritis
9/6/2023 Mr. Sachin Shrestha 14
Test Tested nerve Interpretation/abnormal response
Threat reflex Optic (II), Facial (VII) Not blinking the eyes indicates
blindness, should be differentiated
from facial dysfunction
Pupil reflex Optic (II), Oculomotor (III) No constriction of the pupil
Feeling of the
face
Sensory branch facial (VII) No response to stimulation
Facial
symmetry
Motor branch facial (VII) Drooping ear or lip
Eyelid reflex Trigeminal (V), Facial (VII) Blinking the eyes does not work
Nystagmus Oculomotor (III), Vestibular
system
Vestibular disorders (peripheral or
central)
Swallow Glossopharyngeal (IX), Vagus
(X)
Inability to swallow
Tongue tonus Hyoglossus (XII) Tongue is not withdrawn or weak
tone
Table showing the testing of cranial nerves
Examining Spinal Nerves
Horses need to be accessed in recumbent position during which
tendon reflex and withdrawal reflex are checked
While in standing position, cerebro-facial reflex, cutaneous trunci, tail
tone, perineal reflex and anal tone are accessed.
Horses are need to be checked for Hypoalgesia (for loss of sensation),
Hyperalgesia(increased sensation), Abnormal sweating(sympathetic
denervation) and salivation
Horses also need to be accessed for any sign of muscle atrophy
9/6/2023 Mr. Sachin Shrestha 15
Examining Gait and Posture examination
Posture can be evaluated (Head, Neck and Body) while in standing
position
Gait evaluation is done in open space where horse is made to go
through the various tests
9/6/2023 Mr. Sachin Shrestha 16
Gait Test
❖Slow steps on the straight line
❖Spin horse in tight circles
❖Zig-zag steps
❖Going Backwards
❖Pulling the tail at rest and during movement in each direction
❖Small circles step in both direction
❖Trot on the straight line
❖Different transitions steps- trot
❖Different transitions trot- canter
❖Walking on slope
❖Blindfolding the horse or moving the head up to accentuate the symptoms
❖Walking horse on uneven ground
9/6/2023 Mr. Sachin Shrestha 17
9/6/2023 Mr. Sachin Shrestha 18
Key aspects of an
equine neurological
examination
9/6/2023 Mr. Sachin Shrestha 19
Tight circles and the ‘Tail-pull’
9/6/2023 Mr. Sachin Shrestha 20
Horse with fairly typical
symptoms of "equine
motor neuron disease". The
horse stands with its belly
raised. Often, they show
muscle tremors and keep
the start in an abnormal
position. The limbs are
placed too far below the
mass.
What to expect from the gait test?
These gait test will determine various abnormalities like dysmetry,
incoordination, paresis, specific abnormalities due to nerve failure.
Like the horse may frequently stumble, tug with the toe, kick their
feet and often stride length, difficulty in galloping and cannot canter
for long time
9/6/2023 Mr. Sachin Shrestha 21
Gradation of the Ataxia
After diagnosis of Ataxia, it is graded on the range of 0-5
9/6/2023 Mr. Sachin Shrestha 22
9/6/2023 Mr. Sachin Shrestha 23
Degree Description
0 No Neurological abnormalities
1 Subtle neurological abnormalities, more pronounced when moving
and turning backwards
2 Mild neurological abnormalities, continuously visible, more
pronounced when backwards and turning
3 Obvious neurological abnormalities with tendency to trip or fall
when turning or moving backwards, abnormal position at rest
4 Frequent tripping and even falling in motion
5 Lateral pressure ulcers
Degrees of ataxia (to: Mayhew et al., 1978).
9/6/2023 Mr. Sachin Shrestha 24
A diagnostic
flowchart relating to
clinical signs to
specific regions of the
nervous system.
(Adapted from Furr M
and Reed S [2008].)
Reference
• Rijckaert, J. & Lefère, L. & van Loon, G., (2017) “Equine neurologic examination in practice”, Vlaams
Diergeneeskundig Tijdschrift 86(1), 47-55. doi: https://doi.org/10.21825/vdt.v86i1.16304
• https://www.ivis.org/library/aaep/aaep-annual-convention-baltimore-2010/how-to-perform-a-complete-
neurologic-examination-field-and-identify-abnormalities
• https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/equine-lameness-exploring-
conditions-underlying-neurological-causes.pdf
• https://www.rossdales.com/assets/files/Neurologic-conditions-in-the-horse.pdf
• https://www.veterinary-practice.com/article/performing-a-meaningful-neurological-exam
• https://www.nwvetmountvernon.com/site/equine-veterinary-mount-vernon/neurologic-exams
• https://en.wikivet.net/Neurological_Examination_of_Horses_Overview
• https://practicalhorsemanmag.com/health-archive/equine-neurological-disorders-signs-11614/
9/6/2023 Mr. Sachin Shrestha 25
9/6/2023 Mr. Sachin Shrestha 26
Can you now evaluate
my neurological status?

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Neurological Evaluation in Horse.pptx

  • 1. Study Circle Presented by: Sachin Shrestha Semester: 5th (Fifth) Roll no: 37 (Thirty-Seven) Venue: Paklihawa Campus Program: B.V.Sc & A.H Tribhuvan University Institute of Agriculture and Animal Science Paklihawa Campus, Rupendehi 9/6/2023 Mr. Sachin Shrestha 1
  • 2. 9/6/2023 Mr. Sachin Shrestha 2 Neurological Evaluation Of Horse
  • 3. Introduction Horse is a dynamic animal which has been in close relation to human since ages. We may encounter unusual behavior of the horse like Limping, Unusual stance, May show sign of depression or over sensitive to the stimuli These condition shown by horse can have both orthopedic and neurologic origin To distinguish the either orthopedic of neurologic origin we need to make sure whether the condition shown is ‘Regular Irregularity’ or ‘Irregular Irregularity’ If the signs are irregular then we can assure the horse may have neurologic problems. 9/6/2023 Mr. Sachin Shrestha 3
  • 4. What examiner need to do? Examiner need to access the condition to make sure whether the condition is linked to cranial nerves or spinal nerves or may have vestibular dysfunction Examiner need to give a thorough look of the horse from head to tail to avoid overlooking any important lesions Examiner need to take special attention to patient history, horse’s mental state, behavior, stance and clinical examination Spinal nerves are examined by the menace and other reflexes Incoordination is examined by checking their gait 9/6/2023 Mr. Sachin Shrestha 4
  • 6. Evaluation of Mental Status Horse is checked for any encephalopathic behavior such as Compulsive circling, Head pressing, Cortical/Central blindness, Seizures or significant change in Mentation. If there is encephalopathic behavior and there is any unknown vaccination history of rabies then special caution need to be practiced Horse need to be accessed for Hyper aesthetic, Depressed or Lethargic, Stuporous, Obtunded and Comatose 9/6/2023 Mr. Sachin Shrestha 6
  • 7. Normal Horse are alert and responsive, although the spectrum encompasses very calm, placid horses to overly alert, anxious individuals Hyperesthestic horses are hyper-responsive to stimuli and often jerk or tremor when stimulated Depressed or lethargic horses may have either mild intracranial disease, systemic disease, or pain. A thorough physical examination is necessary to tell the difference Obtunded horses do not respond to normal stimuli (such as a stranger walking to their stall door or entering the stall) and only respond to increased stimuli (such as loud noises, sudden movements, or firm pressure). 9/6/2023 Mr. Sachin Shrestha 7
  • 8. Stuporous horses only respond to painful stimuli (such as skin being squeezed with a hemostat). Comatose horses do not respond to any stimuli 9/6/2023 Mr. Sachin Shrestha 8
  • 9. Examining Cranial Nerves Testing Eyes by Menace response, Pupilary light reflex, normal eyes position, Palpebral reflex Likewise normal facial expression, ability to move their ears, blink and wiggle lips/muzzle are accessed. Similarly, Masticatory muscle size and its function, Strength of the tongue (Ability to retract when pulled) are also accessed. Eating and drinking behavior are also accessed for their ability to swallow. 9/6/2023 Mr. Sachin Shrestha 9
  • 10. 9/6/2023 Mr. Sachin Shrestha 10 This horse has a wide-based stance and it has reduced awareness due to head trauma.
  • 11. Abnormal position of the legs may indicate problem in neck 9/6/2023 Mr. Sachin Shrestha 11
  • 12. Unilateral tongue-muscle atrophy in a horse with unilateral hypoglossal nerve damage. 9/6/2023 Mr. Sachin Shrestha 12
  • 13. 9/6/2023 Mr. Sachin Shrestha 13 Mydriasis of horse’s right pupil compared with the left pupil. These abnormalities were caused by right- sided oculomotor nerve damage subsequent to polyneuritis
  • 14. 9/6/2023 Mr. Sachin Shrestha 14 Test Tested nerve Interpretation/abnormal response Threat reflex Optic (II), Facial (VII) Not blinking the eyes indicates blindness, should be differentiated from facial dysfunction Pupil reflex Optic (II), Oculomotor (III) No constriction of the pupil Feeling of the face Sensory branch facial (VII) No response to stimulation Facial symmetry Motor branch facial (VII) Drooping ear or lip Eyelid reflex Trigeminal (V), Facial (VII) Blinking the eyes does not work Nystagmus Oculomotor (III), Vestibular system Vestibular disorders (peripheral or central) Swallow Glossopharyngeal (IX), Vagus (X) Inability to swallow Tongue tonus Hyoglossus (XII) Tongue is not withdrawn or weak tone Table showing the testing of cranial nerves
  • 15. Examining Spinal Nerves Horses need to be accessed in recumbent position during which tendon reflex and withdrawal reflex are checked While in standing position, cerebro-facial reflex, cutaneous trunci, tail tone, perineal reflex and anal tone are accessed. Horses are need to be checked for Hypoalgesia (for loss of sensation), Hyperalgesia(increased sensation), Abnormal sweating(sympathetic denervation) and salivation Horses also need to be accessed for any sign of muscle atrophy 9/6/2023 Mr. Sachin Shrestha 15
  • 16. Examining Gait and Posture examination Posture can be evaluated (Head, Neck and Body) while in standing position Gait evaluation is done in open space where horse is made to go through the various tests 9/6/2023 Mr. Sachin Shrestha 16
  • 17. Gait Test ❖Slow steps on the straight line ❖Spin horse in tight circles ❖Zig-zag steps ❖Going Backwards ❖Pulling the tail at rest and during movement in each direction ❖Small circles step in both direction ❖Trot on the straight line ❖Different transitions steps- trot ❖Different transitions trot- canter ❖Walking on slope ❖Blindfolding the horse or moving the head up to accentuate the symptoms ❖Walking horse on uneven ground 9/6/2023 Mr. Sachin Shrestha 17
  • 18. 9/6/2023 Mr. Sachin Shrestha 18 Key aspects of an equine neurological examination
  • 19. 9/6/2023 Mr. Sachin Shrestha 19 Tight circles and the ‘Tail-pull’
  • 20. 9/6/2023 Mr. Sachin Shrestha 20 Horse with fairly typical symptoms of "equine motor neuron disease". The horse stands with its belly raised. Often, they show muscle tremors and keep the start in an abnormal position. The limbs are placed too far below the mass.
  • 21. What to expect from the gait test? These gait test will determine various abnormalities like dysmetry, incoordination, paresis, specific abnormalities due to nerve failure. Like the horse may frequently stumble, tug with the toe, kick their feet and often stride length, difficulty in galloping and cannot canter for long time 9/6/2023 Mr. Sachin Shrestha 21
  • 22. Gradation of the Ataxia After diagnosis of Ataxia, it is graded on the range of 0-5 9/6/2023 Mr. Sachin Shrestha 22
  • 23. 9/6/2023 Mr. Sachin Shrestha 23 Degree Description 0 No Neurological abnormalities 1 Subtle neurological abnormalities, more pronounced when moving and turning backwards 2 Mild neurological abnormalities, continuously visible, more pronounced when backwards and turning 3 Obvious neurological abnormalities with tendency to trip or fall when turning or moving backwards, abnormal position at rest 4 Frequent tripping and even falling in motion 5 Lateral pressure ulcers Degrees of ataxia (to: Mayhew et al., 1978).
  • 24. 9/6/2023 Mr. Sachin Shrestha 24 A diagnostic flowchart relating to clinical signs to specific regions of the nervous system. (Adapted from Furr M and Reed S [2008].)
  • 25. Reference • Rijckaert, J. & Lefère, L. & van Loon, G., (2017) “Equine neurologic examination in practice”, Vlaams Diergeneeskundig Tijdschrift 86(1), 47-55. doi: https://doi.org/10.21825/vdt.v86i1.16304 • https://www.ivis.org/library/aaep/aaep-annual-convention-baltimore-2010/how-to-perform-a-complete- neurologic-examination-field-and-identify-abnormalities • https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/equine-lameness-exploring- conditions-underlying-neurological-causes.pdf • https://www.rossdales.com/assets/files/Neurologic-conditions-in-the-horse.pdf • https://www.veterinary-practice.com/article/performing-a-meaningful-neurological-exam • https://www.nwvetmountvernon.com/site/equine-veterinary-mount-vernon/neurologic-exams • https://en.wikivet.net/Neurological_Examination_of_Horses_Overview • https://practicalhorsemanmag.com/health-archive/equine-neurological-disorders-signs-11614/ 9/6/2023 Mr. Sachin Shrestha 25
  • 26. 9/6/2023 Mr. Sachin Shrestha 26 Can you now evaluate my neurological status?