El Caballo Neurológico Agudo: Evaluación y Primeros Auxilios
When called upon to examine an acutely neurologic horse, the possibility of rabies should be kept in mind until proven otherwise, as well as the risk of injury to the patient, other animals or humans. If rabies is a possibility, the number of people attending the animal should be minimized, and a list of people having been in contact with the horse should be kept. Gloves should be worn by all attendants, and if possible only people that have been vaccinated and have a current titer should attend the horse. If the horse is unsteady, it should not be moved until knowledgeable personnel are available.
The goals of the examination in acute neurologic disease are to:
1- Confirm that the nervous system is involved
2- Rule out involvement of other body systems
3- Arrive at a list of possible differentials
4- Initiate treatment and supportive care until further diagnostic tests can be performed
5- Facilitate referral of the horse for further diagnostic and/or treatment
Weanlings are more at risk for cranial trauma during halter breaking or handling. Young horses (<2 y-o) suffering from ataxia without cranial nerve signs should be examined for CVI/CVM, although lower cervical vertebral lesions (C6 to T1) are more common in older horses. Equine protozoal myelitis (EPM) is more common in young adult horses, and is rarely seen in horses <2 years of age.
Arabian foals are at risk for cerebellar abiotrophy. Miniature horses can suffer from narcolepsy, which can mimic neurologic disease. EPM is more common in Thoroughbreds, Stanndardbreds and Quarter horses.
There is no sex predisposition for neurologic disease, although males are more at risk for CVI/CVM.
The geographic location of the animal should be ascertained. For example, encephalitides are more common in the southern states such as Florida. Rabies is more endemic in certain states, as is botulism. A complete vaccination history should be obtained, including particularly rabies, herpes virus and encephalitides if in an endemic area. Stabling practices, access to pasture, quality of pastures, need to be documented. The possibility of wound botulism through recent injections, wounds or castration should be documented. Although many neurologic disesases may appear acute in onset, careful questioning can reveal the presence of subtle deficits that were overlooked.