Development of a Modified Glasgow Coma Scale for Raptorial Species with Head Trauma
American Association of Zoo Veterinarians Conference 2019
Sarah K. Reich1, DVM; Krista A. Keller1,3, DVM, DACZM; Devon Hague2, DVM, DACVIM (Neurology); Kari Foss2, DVM, DACVIM (Neurology); Matthew C. Allender1,3, DVM, MS, PhD, DACZM; Julia Whittington1, DVM
1Zoological Medicine, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA; 2Neurology and Neurosurgery, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA; 3Wildlife Epidemiology Laboratory, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
The Glasgow Coma Scale, widely used in human medicine, is a simple and practical method for assessment of impaired neurologic status.1,2 The objectives of this study were to 1) develop a Modified Glasgow Coma Scale (MGCS) for use in raptors presenting with head trauma and 2) assess the agreement of MGCS scores between examiners with varying experience backgrounds. Seventeen native raptors presenting to the University of Illinois Wildlife Medical Clinic were included in this prospective study based upon clinical signs or history suggestive of head trauma. All raptors received a MGCS assessment by three individuals within 8 h of presentation: a veterinary student, a wildlife veterinarian, and a board-certified or resident veterinary neurologist. Each animal received a score (1–5) in three separate categories: motor activity, level of consciousness, and brainstem reflexes. An overall score was tabulated from the categories. Agreement between the three individual scores was assessed via Cronbach’s alpha and intraclass correlation. There was excellent-good agreement in all three assessment categories as well as overall score, indicating that the MGCS would be comparable between different experience backgrounds. As the initial assessment of patients in wildlife rehabilitation may not always be performed by a veterinarian, it is important that any evaluation tools be practical for multiple experience levels. The ability to rapidly and reliably determine prognosis in patients can also help in the assessment of quality of life while undergoing rehabilitation. Further research is underway evaluating the potential prognostic value of the MGCS in raptor species with head trauma.
1. Sternbach GL. The Glasgow coma scale. J Emerg Med. 2000;19:67–71.
2. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974;2:81–84.