Checking serum ammonia is particularly advised in neonatal coma to discern inborn errors of metabolism. Differential diagnosis
A lowered level of consciousness indicate a deficit in brain function. Level of consciousness can be lowered when the brain receives insufficient oxygen (as occurs in hypoxia); insufficient blood (as occurs in shock, in children for example due to intussusception); or has an alteration in the brains chemistry. Metabolic disorders such as diabetes mellitus and uremia can alter consciousness. Hypo- or hypernatremia (decreased and elevated levels of sodium, respectively) as well as dehydration can also produce an altered LOC. A pH outside of the range the brain can tolerate will also alter LOC. Exposure to drugs (e.g. alcohol) or toxins may also lower LOC, as may a core temperature that is too high or too low (hyperthermia or hypothermia). Increases in intracranial pressure (the pressure within the skull) can also cause altered LOC. It can result from traumatic brain injury such as concussion. Stroke and intracranial hemorrhage are other causes. Infections of the central nervous system may also be associated with decreased LOC; for example, an altered LOC is the most common symptom of encephalitis. Neoplasms within the intracranial cavity can also affect consciousness, as can epilepsy and post-seizure states. A decreased LOC can also result from a combination of factors. A concussion, which is a mild traumatic brain injury (MTBI) may result in decreased LOC. Treatment
Treatment depends on the degree of decrease in consciousness and its underlying cause.
There is a much lower risk (about 1 percent) in male dogs and a risk in cats about half that of dogs. In dogs
Causes
The exact causes for the development of canine mammary tumors are not fully understood. However, hormones of the estrous cycle seem to be involved. Female dogs who are not spayed or who are spayed later than the first heat cycle are more likely to develop mammary tumors. Dogs have an overall reported incidence of mammary tumors of 3.4 percent. Dogs spayed before their first heat have 0.5 percent of this risk, and dogs spayed after just one heat cycle have 8 percent of this risk. The tumors are often multiple. The average age of dogs with mammary tumors is ten to eleven years old. Obesity at one year of age and eating red meat have also been associated with an increased risk for these tumors, as has the feeding of high fat homemade diets. There are several hypotheses on the molecular mechanisms involved in the development of canine mammary tumors but a specific genetic mutation has not been identified. Biology
Historically, about 50 percent of mammary tumors in dogs were found to be malignant, although taking into account tumor behavior, one study has estimated true malignancy in mammary tumors to be 21 to 22 percent. Adenomas and fibroadenomas make up the benign types. Malignant mammary tumors are divided into sarcomas, carcinosarcomas, inflammatory carcinomas (usually anaplastic carcinomas), and carcinomas (including adenocarcinomas), which are the most common.