|
|
| (18 intermediate revisions by 5 users not shown) |
| Line 1: |
Line 1: |
| − | {{Unfinished}}
| + | #REDIRECT[[Key-Gaskell Syndrome]] |
| − | | |
| − | Part of a syndrome of generalised autonomic neuropathy. It has been observed throughout Western Europe and The United States.
| |
| − | | |
| − | ==Signalment==
| |
| − | Historically reported most frequently in cats but now also in dogs.
| |
| − | | |
| − | ==Description==
| |
| − | * Degenerative lesions of the autonomic ganglia, spinal cord intermediate grey columns and sympathetic axons
| |
| − | * Aetiology still largely idiopathic
| |
| − | | |
| − | ==Diagnosis==
| |
| − | ===Clinical Signs===
| |
| − | Those of a gneralised autonomic dysfuntion of the gastrointestinal and urinary tracts. Those associated with the oesophagus include:
| |
| − | * Regurgitation
| |
| − | * Megaoesophagus
| |
| − | * Oesophageal hypotmotility
| |
| − | The most frequent clinical signs associated with the syndrome are depression, anorexia, constipation, regurgitation or vomiting and incontinence (faecal and urinary) less frequently.
| |
| − | | |
| − | ===Physical Examination===
| |
| − | Findings associated with the GI system include:
| |
| − | * Dry mucous membranes
| |
| − | * Intestinal distension
| |
| − | | |
| − | ===Radiography===
| |
| − | ====Plain Radiography====
| |
| − | Oesophageal dilatation may be observed.
| |
| − | ====Contrast Radiography====
| |
| − | Oesophageal hypomotility may be evident on barium contrast study.
| |
| − | | |
| − | ==Differential Diagnosis==
| |
| − | There are few differentials on presentation of the many manifestations of the disease. However, early in the course of disease other causes of megaoesophagus need to be considered.
| |
| − | | |
| − | | |
| − | ==Treatment==
| |
| − | ===Supportive===
| |
| − | Including elevated feeding, gastrostomy tube feedings or total paranteral nutrition.
| |
| − | ===Parasympathomimetic Drugs===
| |
| − | Some dogs may show minor improvement on initiation of for example, bethanechol, metoclopramide.
| |
| − | | |
| − | | |
| − | ==Prognosis==
| |
| − | Guarded to poor. Recovery rates in the cat are reported as 20-40% may recover, however this may take 2-12 months. In the dog recovery rates are lower. Despite recovery many are also left with residual impairment including intermittent regurgitation.
| |