Canis ISSN: 2398-2942 Collapse Synonym(s): Weakness Contributor(s): Kyle Braund, Kate Murphy Introduction Pathogenesis Diagnosis Treatment Introduction Cause: it can be very difficult when first presented with an animal that has had 'a funny turn' to establish the etiology. Diagnosis: It is vital to take a complete history from the owners and if the episodes are recurrent to ask them to collect further information during subsequent episodes, eg heart rate, mucous membrane color, responsiveness. Unless episodes are occurring sufficiently frequently it may be impossible to see one yourself. Ask the owners to video an episode if it occurs at home and, if not possible, ensure they give you a very detailed description of the event and that you listen with an open mind. Collapse is a diagnostic challenge and many tests will yield negative results and thus achieving a definitive diagnosis may be impossible. Examination of the patient as close to an episode as possible, ideally during, or shortly after an episode, may be most useful. Follow the diagnostic tree for Collapse Collapse. Pathogenesis EtiologyCardiovascular Arrhythmia Heart: dysrhythmia : Bradycardia. Tachycardia. Output failure: Aortic stenosis Heart: aortic stenosis. Dilated cardiomyopathy Heart: dilated cardiomyopathy (DCM). Hypertrophic cardiomyopathy Heart: hypertrophic cardiomyopathy (HCM). Pulmonic stenosis Pulmonic stenosis. Shock Shock. Hypovolemia, eg ruptured spleen Spleen: trauma or abdominal catastrophe. Pericardial effusion and tamponade. Ruptured chordae tendinae Heart: rupture of chordae tendinae. Shunts: Tetralogy of fallot Tetralogy of fallot. Reverse patent ductus arteriosus (PDA) Patent ductus arteriosus. Thromboembolic disease. Hyperviscosity syndromes, eg polycythemia Polycythemia: secondary. Musculoskeletal Hip dysplasia Hip: dysplasia. Fracture or luxation. Patella luxation Patella: medial luxation. Stifle instability, eg cruciate rupture Stifle: cranial cruciate ligament disease. Spinal disease, eg intervertebral disk prolapse Intervertebral disk: type 1 herniation , diskospondylitis Diskospondylitis. Myositis Idiopathic polymyositis. Botulism Botulism. Myotonia Myotonic myopathy (myotonia). Tetanus Tetanus. Panosteitis Panosteitis. Polyarthritis Polyarthritis / polymyositis syndrome. Neurological Seizure Seizures. Polyneuropathy Peripheral neuropathies , myopathy/radiculoneuropathy (distal denervating disease Distal denervating disease ): Infectious, inflammatory, idiopathic. Endocrine. Toxic. Paraneoplastic. Cauda equina syndrome Cauda equina neuritis. CDRM Spine: fracture / luxation. Myasthenia gravis Myasthenia gravis. Botulism Botulism. Hereditary neuropathies: Scottie cramp Muscular hypertonicity. Narcolepsy/Cataplexy Narcolepsy. Idiopathic vestibular syndrome Vestibular disease: geriatric. Otitis media Otitis media or interna Otitis interna. Intracranial disease: Neoplasia. Trauma. Inflammation, eg meningitis Meningitis. Toxic. Metabolic. Hemorrhage. Metabolic disease Hypoglycemia Hypoglycemia. Hypercalcemia Hypercalcemia: overview. Hypocalcemia Hyperparathyroidism (primary). Hypokalemia Hypokalemia. Hypo/hypernatremia Hyponatremia Hypernatremia. Diabetic ketoacidosis Diabetic ketoacidosis. Uremia Uremia. Anemia Anemia: overview. Polycythemia Polycythemia: primary Polycythemia: secondary. Phaeochromocytoma Pheochromocytoma. Hypothyroidism Hypothyroidism. Hyperadrenocorticism Hyperadrenocorticism. Hypoadrenocorticism Hypoadrenocorticism. Hyperthermia Hyperthermia. Hypothermia Hypothermia. Respiratory Hypoxia: Severe pulmonary disease. Ventilation perfusion mismatch Ventilation-perfusion mismatching : Pulmonary thromboembolus Lung: pulmonary thromboembolism. Airway stenosis: Laryngeal paralysis Larynx: paralysis. Brachycephalic airway obstruction syndrome Brachycephalic airway obstruction syndrome. Airway obstruction: Neoplasia. Foreign body Airway foreign body. Pleural space disease. Small airway disease. Pulmonary parenchymal disease. Methaemoglobinemia. Drug-related. Neoplastic diseases. Diagnosis This article is available in full to registered subscribers Sign up now to purchase a 30 day trial, or Login Treatment This article is available in full to registered subscribers Sign up now to purchase a 30 day trial, or Login Further ReadingPublicationsRefereed papers Recent references from PubMed and VetMedResource. Wray J (2005) Differential diagnosis of collapse in the dog. 3. Cardiovascular and miscellaneous causes. In Practice 27 (3), 128-135 VetMedResource. Wray J (2005) Differential diagnosis of collapse in the dog. 2. Neuromuscular causes. In Practice 27 (2), 62-69 VetMedResource. Wray J (2005) Differential diagnosis of collapse in the dog. 1. Aetiology and investigation. In Practice 27 (1), 16-28 VetMedResource. Greco D S (2001) Diagnosis and treatment of juvenile endocrine disorders in puppies and kittens. Vet Clin North Am Small Anim Pract 31 (2), 401-409 PubMed. Calvert C A (1996) Bradycardia-associated episodic weakness, syncope and aborted sudden death in cardiomyopathic Doberman Pinschers. JVIM 10 (2), 88-93 PubMed. Wright K N et al (1995) Diagnostic and therapeutic considerations in a hypercalcemic dog with multiple endocrine neoplasia. JAAHA 31 (2), 156-162 PubMed. Other sources of information Ettinger S J (2000)Weakness and syncope.In:Textbook of Veterinary Internal Medicine.5th edn. Eds: S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 10-14.