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Animal Neurology Exam Rockville MD

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.

Montgomery Animal Hospital
(301) 920-7517
12200 Rockville Pike
Rockville, MD
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Hours
Monday 7:30 AM - 7:00 PM
Tuesday 7:30 AM - 7:00 PM
Wednesday 7:30 AM - 7:00 PM
Thursday 7:30 AM - 7:00 PM
Friday 7:30 AM - 6:00 PM
Saturday 8:00 AM - 3:00 PM
Sunday Closed
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Animal Boarding, Animal Daycare, Animal Flea Control, Animal Microchipping, Declawing, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary Medical Specialties, Veterinary Surgery

VCA North Rockville Animal Hospital
(301) 202-4096
1390 East Gude Drive
Rockville, MD
Hours
Monday 7:30 AM - 7:00 PM
Tuesday 7:30 AM - 7:00 PM
Wednesday 7:30 AM - 6:00 PM
Thursday 7:30 AM - 7:00 PM
Friday 7:30 AM - 7:00 PM
Saturday 8:00 AM - 2:00 PM
Sunday Closed
Services
Animal Boarding, Animal Daycare, Animal Flea Control, Animal Grooming, Animal Microchipping, Bird Vet, Declawing, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary Medical Specialties, Veterinary Surgery

VCA Veterinary Referral Associates
(301) 569-2687
500 Perry Parkway
Gaithersburg , MD
Hours
Monday 24 Hours
Tuesday 24 Hours
Wednesday 24 Hours
Thursday 24 Hours
Friday 24 Hours
Saturday 24 Hours
Sunday 24 Hours
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24-Hour Vet, Bird Vet, Emergency Veterinary Clinic, Exotic Animal Vet, Reptile Vet, Small Animal Vet, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary Medical Specialties, Veterinary Surgery

Negola's Ark Veterinary Hospital
(301) 363-7493
9401 Fields Rd
Gaithersburg, MD
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Hours
Monday 8:00 AM - 6:00 PM
Tuesday 8:00 AM - 8:00 PM
Wednesday 8:00 AM - 8:00 PM
Thursday 8:00 AM - 6:00 PM
Friday 8:00 AM - 6:00 PM
Saturday 8:00 AM - 12:00 PM
Sunday Closed
Services
Animal Boarding, Animal Daycare, Animal Flea Control, Animal Microchipping, Declawing, Emergency Veterinary Clinic, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary Medical Specialties, Veterinary Surgery, Veterinary Vaccinations

Falls Road Veterinary Hospital
(301) 363-7129
10229 Falls Rd.
Potomac, MD
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 - 6:00 PM
Friday 8:00 AM - 6:00 PM
Saturday 8:00 AM - 1:00 PM
Sunday Closed
Services
Animal Boarding, Animal Daycare, Animal Flea Control, Animal Grooming, Animal Microchipping, Declawing, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary Surgery, Veterinary Vaccinations

Kenhaven Animal Clinic
(301) 363-7449
12311 Wilkins Ave
Rockville, MD
Hours
Monday 9:00 AM - 1:00 PM
Tuesday 9:00 AM - 1:00 PM
Wednesday 9:00 AM - 1:00 PM
Thursday 9:00 AM - 1:00 PM
Friday 9:00 AM - 1:00 PM
Saturday 9:00 AM - 1:00 PM
Sunday Closed
Services
Animal Boarding, Animal Flea Control, Animal Grooming, Animal Microchipping, Declawing, Emergency Veterinary Clinic, Exotic Animal Vet, Holistic Veterinary Medicine, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Medical Specialties, Veterinary Surgery, Veterinary Vaccinations

Flower Valley Veterinary Clinic
(301) 683-8444
4201 Norbeck Rd
Rockville, MD
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New Clients will receive one Healthy Pet Complimentary First Wellness Exam.
Hours
Monday 8:00 AM - 6:00 PM
Tuesday 8:00 AM - 6:00 PM
Wednesday 8:00 AM - 6:00 PM
Thursday 8:00 AM - 6:00 PM
Friday 8:00 AM - 6:00 PM
Saturday 9:00 AM - 1:00 PM
Sunday Closed
Services
Animal Flea Control, Animal Grooming, Animal Microchipping, Declawing, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary Surgery, Veterinary Vaccinations

Animalia Mobile Clinic
(240) 406-7227
16698 Oakmont Ave
Gaithersburg, MD
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New clients welcome! Call today to schedule an appointment!
Hours
Monday Closed
Tuesday Closed
Wednesday 12:00 PM - 5:00 PM
Thursday Closed
Friday Closed
Saturday Closed
Sunday 12:00 AM - 5:00 PM
Services
Animal Flea Control, Animal Microchipping, Declawing, Emergency Veterinary Clinic, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Surgery, Veterinary Vaccinations

Seven Locks Animal Hospital
(301) 388-8759
7817 Tuckerman Ln
Potomac, MD
Hours
Monday 8:00 AM - 6:00 PM
Tuesday 8:00 AM - 6:00 PM
Wednesday 8:00 AM - 6:00 PM
Thursday 8:00 AM - 6:00 PM
Friday 8:00 AM - 6:00 PM
Saturday 8:00 AM - 12:00 PM
Sunday Closed
Services
Animal Flea Control, Animal Microchipping, Declawing, Emergency Veterinary Clinic, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Euthanasia, Veterinary House Calls, Veterinary Medical Specialties, Veterinary Surgery

A Cat Practice
(301) 244-8930
2816 Linden Ln
Silver Spring, MD
Hours
Monday 7:00 AM - 5:30 PM
Tuesday 7:00 AM - 5:30 PM
Wednesday 7:00 AM - 5:30 PM
Thursday 7:00 AM - 5:30 PM
Friday 7:00 AM - 5:30 PM
Saturday 8:00 AM - 4:00 PM
Sunday Closed
Services
Animal Flea Control, Animal Microchipping, Declawing, Holistic Veterinary Medicine, Small Animal Vet, Spaying/Neutering, Veterinarians, Veterinary Dentistry, Veterinary Docking, Veterinary Euthanasia, Veterinary Medical Specialties, Veterinary Surgery

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...

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