Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 254

Most dogs recover within weeks after the onset of ischaemic CVA with only supportive care (Garosi et al., 2005a). Prognosis depends on the severity of the neurological dysfunction, occurrence of complications and the underlying cause of CVA, if identified. In a retrospective study on 33 dogs with MRI or histologic diagnosis of ischaemic CVA, no association was identified between type (lacunar or territorial) or location (telencephalic, thalamic/midbrain, cerebellar) of infarct and patient outcome. Dogs with concurrent medical conditions had significantly shorter survival times than those with no identifiable medical condition and were significantly more likely to suffer from recurrent neurologic signs because of subsequent infarcts. In a retrospective study on 75 dogs with an MRI diagnosis of nontraumatic intracranial haemorrhage, outcome was poor in the majority of dogs with hypertension (Lowrie et al., 2012).

Table 5.1. Change of appearance of intracranial haemorrhage over time (Bradley, 1993; Thomas et al., 1997).

Box 5.2. Diagnostic investigations to identify the underlying aetiology of ischaemic or haemorrhagic CVA.

Diagnostic investigations to identify the underlying aetiology of ischaemic CVA:

• Serial blood pressure measurements;

• Haematology;

• Serum biochemistry profile;

• Urinalysis;

• Urine protein/creatinine ratio;

• Serum antithrombin III activity;

• D-dimers;

• Thromboelestography;

• Infectious disease testing (e.g. serology, PCR);

• Endocrine testing for hyperadrenocorticism, thyroid diseases, diabetes mellitus and pheochromocytoma;

• Thoracic radiographs;

• Abdominal ultrasound;

• Echocardiography and electrocardiography.

Diagnostic investigations to identify the underlying aetiology of haemorrhagic CVA:

• Serial blood pressure measurements;

• Haematology;

• Serum biochemistry profile;

• Buccal mucosa bleeding time;

• Prothrombin time (PT);

• Activated partial thromboplastin time (APTT);

• Infectious disease testing (e.g. serology, PCR);

• Thoracic radiographs;

• Abdominal ultrasound;

• Faecal analysis to investigate parasitic infestation (such as A. vasorum).

Post-stroke epilepsy has a negative effect on stroke recovery and quality of life in people (Arntz, 2013).