Subscribe to VETERINARY PRACTICE NEWS   SUBSCRIBER SERVICES   
VPN Logo   
 Home   About Us   Contact Us
 

Animal Neurology Exam Anacortes WA

The four stages require a functional spinal cord and a functional brain, and they help us determine a lesion's severity. Reflexes tell us only where the lesion is localized.

Banfield Pet Hospital - Burlington
(360) 442-4967
1969 Marketplace Dr.
Burlington, WA
 
Bezzola, Pauli, Dvm - Fidalgo Animal Medical Ctr
(360) 293-2186
3303 Commercial Ave
Anacortes, WA

Data Provided by:
Chuckanut Valley Veterinary Clinic
(360) 757-3722
896 N Burlington Blvd
Burlington, WA
 
Mt Vernon Veterinary Hosp Inc
(360) 424-4054
14110 Bradshaw Rd
Mount Vernon, WA

Data Provided by:
College Way Animal Hospital
(360) 848-1189
3801 E College Way
Mount Vernon, WA

Data Provided by:
Banfield Pet Hospital - Bellingham
(360) 325-7502
4379 Meridian St
Bellingham, WA
 
Fidalgo Animal Medical Ctr
(360) 293-2186
3303 Commercial Ave
Anacortes, WA

Data Provided by:
Vets Animal Hospital
(360) 675-4425
61 SE 11TH Ave
Oak Harbor, WA

Data Provided by:
Country Chiropractic Clinic PLLC
(360) 856-5562
22790 Buchanan St
Mount Vernon, WA
 
Cedardale Neuter & Vaccination
(360) 424-5676
1105 Dale Ln
Mount Vernon, WA

Data Provided by:
Data Provided by:

Making Sense of the Neuro Exam

The neurological exam seems to be one of the most confusing concepts in veterinary medicine. Let’s try to clarify things. To simplify, we will focus on the hind legs only.

One way to look at the neuro exam is to divide it into an assessment of “the four stages” and an evaluation of four reflexes.

The patellar reflex causes extension of the stifle. Photo courtesy of Dr. Phil Zeltzman.
The four stages require a functional spinal cord and a functional brain, and they help us determine a lesion’s severity. Reflexes tell us only where the lesion is localized.

Since I am a surgeon and not a neurologist, I talked to Todd Bishop, DVM, Dipl. ACVIM (neurology), of Upstate Veterinary Specialties in Latham, N.Y., to ensure the accuracy of the following information.

Decline Into Nociception

Patients might go through four stages between normalcy and being paralyzed with no deep pain:

  • First-stage patients may feel back pain. They can exhibit pain by vocalizing. Certain breeds, such as beagles, are especially good at expressing their feelings. Others may arch their back.
    .
  • As they get worse, patients may become ataxic or lose proprioception. When a patient knuckles, or doesn’t reposition a flipped paw within a couple of seconds, we say he has proprioceptive deficits.
    .
  • The next step is loss of conscious motor function. This means voluntary motion of the hind legs is weak, even if helped by a sling.
    .
  • The last step is loss of pain sensation, or nociception. It is tested by using a hemostat to pinch a toe. Though nobody enjoys performing this test, doing it correctly is critical. We are trying to cause a painful reaction by stimulating the periosteum of the phalanges.

When a deep pain sensation is present, the patient should have a voluntary reaction such as whining, trying to bite or moving away from the painful stimulus. A very stoic patient may show only dilatation of the pupils.

The order of these four stages is fixed. They occur in the same order and always return in the reverse order. Therefore, there is no need to crush a toe in a patient who has motor function. If he has motor function, he has deep pain by definition. Purists will argue that this is not true with a “spinal walker,” but let’s keep things simple.

The Spinal Cord

The cranial tibial reflex causes flexion of the hock. Photo courtesy of Dr. Phil Zeltzman.
Incidentally, these four stages correlate with the anatomy of the spinal cord. Nerve fibers involved with proprioception are located superficially in the cord. This explains why a mild lesion has mild effects on the patient.

A deeper lesion will affect the nerve fibers that control motor function. And a very severe lesion will apply pressure in the deepest nerve fibers—those that relay deep pain.

These four stages help us determine the severity of the lesion. A dog with proprioceptive deficits is mildly affected. At the other end of the spectrum, a dog with n...

Copyright 2009 BowTie Inc.

Click here to read the rest of this article from Veterinary Practice News