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Animal Neurology Exam Doylestown PA

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.

Circle of Life Veterinary Clinic
(215) 914-5873
920 Town Center
New Britain, PA
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Our Mission Statement:
To nurture the human / pet bond by working in partnership with the owner to ensure the highest quality of life through their entire journey together. It is our goal to provide exceptional medical treatment and preventative care,
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Monday 8:00 AM - 7:00 PM
Tuesday 8:00 AM - 7:00 PM
Wednesday 8:00 AM - 5:00 PM
Thursday 8:00 AM - 7:00 PM
Friday 8:00 AM - 5:00 PM
Saturday 8:00 AM - 2:00 PM
Sunday Closed
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Animal Flea Control, Animal Microchipping, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Surgery

Ark Animal Hospital of Chalfont
(267) 416-0900
1700 Horizon Drive
Chalfont, PA
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$19.99 for a 3 Month Supply of EctoAdvance Flea & Tick Topical Treatment. (Comparable to Frontline Plus - a $35 Value.)
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Monday 8:00 AM - 8:00 PM
Tuesday 8:00 AM - 8:00 PM
Wednesday 8:00 AM - 8:00 PM
Thursday 8:00 AM - 8:00 PM
Friday 8:00 AM - 5:00 PM
Saturday 8:00 AM - 3:00 PM
Sunday 9:00 AM - 12:00 PM
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Animal Flea Control, Animal Microchipping, Bird Vet, Declawing, Exotic Animal Vet, Reptile Vet, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Medical Specialties, Veterinary Surgery, Veterinary Vaccinations

Rockhill Veterinary Associates
(215) 326-9966
3210 State Rd
Sellersville, PA
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$10 off your first visit to Rockhill Veterianry Associates. Voted best Vet for 8 years.
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Monday 8:00 AM - 8:30 PM
Tuesday 8:00 AM - 8:30 PM
Wednesday 8:00 AM - 8:30 PM
Thursday 8:00 AM - 8:30 PM
Friday 8:00 AM - 8:30 PM
Saturday 8:00 AM - 12:00 PM
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24-Hour Vet, Animal Boarding, Animal Flea Control, Animal Grooming, Animal Microchipping, Declawing, Holistic Veterinary Medicine, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Docking, Veterinary Euthanasia, Veterinary House Calls, Veterinary Medical Specialties, Veterinary Surgery

Alpha Veterinary Hospital, Inc.
(215) 948-2939
1430 Old Rte 309
Sellersville, PA
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Monday 9:00 AM - 7:00 PM
Tuesday 9:00 AM - 7:00 PM
Wednesday 9:00 AM - 7:00 PM
Thursday 9:00 AM - 12:00 PM
Friday 9:00 AM - 3:00 PM
Saturday 9:00 AM - 12:00 PM
Sunday Closed
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Animal Flea Control, Animal Microchipping, Declawing, Holistic Veterinary Medicine, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary Medical Specialties, Veterinary Surgery

Spring House Animal Hospital
(215) 326-9951
617 N Bethlehem Pike
Lower Gwynedd, PA
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Monday 9:00 AM - 8:00 PM
Tuesday 9:00 AM - 8:00 PM
Wednesday 9:00 AM - 8:00 PM
Thursday 9:00 AM - 6:00 PM
Friday 9:00 AM - 6:00 PM
Saturday 9:00 AM - 1:00 PM
Sunday Closed
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Animal Flea Control, Animal Microchipping, Declawing, Holistic Veterinary Medicine, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Medical Specialties, Veterinary Surgery

Danboro Veterinary Clinic
(215) 385-3551
4406 Point Pleasant Pike
Danboro, PA
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Monday Closed
Tuesday Closed
Wednesday Closed
Thursday Closed
Friday Closed
Saturday Closed
Sunday Closed
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Animal Flea Control, Animal Microchipping, Declawing, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Medical Specialties, Veterinary Surgery, Veterinary Vaccinations

New Hope Vet Hospital
(267) 702-6947
21 North Sugan Road
New Hope, PA
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Monday 8:00 AM - 7:00 PM
Tuesday 8:00 AM - 6:00 PM
Wednesday 8:00 AM - 6:00 PM
Thursday 8:00 AM - 7:00 PM
Friday 8:00 AM - 6:00 PM
Saturday 8:00 AM - 2:00 PM
Sunday Closed
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Animal Boarding, Animal Daycare, Animal Flea Control, Animal Grooming, Animal Microchipping, Bird Vet, Declawing, Emergency Veterinary Clinic, Equine Vet, Exotic Animal Vet, Holistic Veterinary Medicine, Large Animal Vet, Reptile Vet, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Medical Specialties, Veterinary Surgery

Animal Hospital Of Richboro
(215) 690-1912
700 North 2nd Street Pike
Richboro, PA
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Free gift with first visit!
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Monday 8:00 AM - 8:00 PM
Tuesday 8:00 AM - 8:00 PM
Wednesday 8:00 AM - 6:00 PM
Thursday 8:00 AM - 8:00 PM
Friday 8:00 AM - 6:00 PM
Saturday 9:00 AM - 1:00 PM
Sunday Closed
Services
Animal Flea Control, Animal Microchipping, Declawing, Large Animal Vet, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Medical Specialties, Veterinary Surgery, Veterinary Vaccinations

The Newtown Veterinary Hospital
(215) 315-7589
107 Penns Trail Newtown
Newtown, PA
Hours
Monday 8:00 AM - 8:00 PM
Tuesday 8:00 AM - 8:00 PM
Wednesday 8:00 AM - 8:00 PM
Thursday 8:00 AM - 8:00 PM
Friday 8:00 AM - 8:00 PM
Saturday 8:00 AM - 4:00 PM
Sunday Closed
Services
Animal Boarding, Animal Daycare, Animal Flea Control, Animal Microchipping, Declawing, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary House Calls, Veterinary Surgery, Veterinary Vaccinations

North Penn Animal Hospital
(215) 914-5503
1200 Welsh Road
Lansdale, PA
Hours
Monday 8:00 AM - 8:00 PM
Tuesday 8:00 AM - 8:00 PM
Wednesday 8:00 AM - 8:00 PM
Thursday 8:00 AM - 8:00 PM
Friday 8:00 AM - 8:00 PM
Saturday 9:00 AM - 2:00 PM
Sunday Closed
Services
Animal Boarding, Animal Flea Control, Animal Microchipping, Holistic Veterinary Medicine, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Medical Specialties, Veterinary Surgery, Veterinary Vaccinations

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.
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  • 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...

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