Neuro - Cases Flashcards
Winnifred is a 12 year-old female spayed dog that has been acting ‘strangely’ at home for the last few days. Upon examination she does not appear to be aware of the environment. She moves without direction or purpose, and does not appear to interact normally with the person in the room of the environment.
Upon physical examination you note that her conscious proprioception is decreased in all four limbs. Her menance response is absent in both eyes. You note that her facial sensation is decreased bilaterally (she does not move rapidly away from stimulus to the nostrils, but the animal does blink and twitch its facial muscles from the stimulus). All of the other cranial nerve reflexes are present and normal. The rest of her neurologic examination is unremarkable.
Does this animal have neurologic disease?
Most likely yes
The clues are the behavior change, the menace deficits, the facial sensation deficits, and the tetraparesis with normal spinal reflexes.
Winnifred is a 12 year-old female spayed dog that has been acting ‘strangely’ at home for the last few days. Upon examination she does not appear to be aware of the environment. She moves without direction or purpose, and does not appear to interact normally with the person in the room of the environment.
Upon physical examination you note that her conscious proprioception is decreased in all four limbs. Her menance response is absent in both eyes. You note that her facial sensation is decreased bilaterally (she does not move rapidly away from stimulus to the nostrils, but the animal does blink and twitch its facial muscles from the stimulus). All other cranial nerve reflexes are present and normal. The rest of her neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Intracranial - bilateral supratentorial
Winnifred is a 12 year-old female spayed dog that has been acting ‘strangely’ at home for the last few days. Upon examination she does not appear to be aware of the environment. She moves without direction or purpose, and does not appear to interact normally with the person in the room of the environment.
Upon physical examination you note that her conscious proprioception is decreased in all four limbs. Her menance response is absent in both eyes. You note that her facial sensation is decreased bilaterally (she does not move rapidly away from stimulus to the nostrils, but the animal does blink and twitch its facial muscles from the stimulus). All other cranial nerve reflexes are present and normal. The rest of her neurologic examination is unremarkable.
What are the suspected causes?
Tumor, hydrocephalus, cerebrovascular disease, inflammatory brain disease and traumatic injury
Winnifred is a 12 year-old female spayed dog that has been acting ‘strangely’ at home for the last few days. Upon examination she does not appear to be aware of the environment. She moves without direction or purpose, and does not appear to interact normally with the person in the room of the environment.
Upon physical examination you note that her conscious proprioception is decreased in all four limbs. Her menance response is absent in both eyes. You note that her facial sensation is decreased bilaterally (she does not move rapidly away from stimulus to the nostrils, but the animal does blink and twitch its facial muscles from the stimulus). All other cranial nerve reflexes are present and normal. The rest of her neurologic examination is unremarkable.
What diagnostic tests would be most helpful?
Routine laboratory assessments, coagulation assessments if clinical signs indicate, blood pressure. If no obvious systemic abnormality is found then advanced imaging (MR) and CSF assessment if the imaging were normal (take from the lumbar region)
Bobbard is an 8 year-old male-castrated dog that has been acting ‘strangely’ at home for last week. He appears to not react normally to the environment. He has a head turn and circles to the right. The movements of the thoracic limb are exaggerated.
Bobbard’s concious proprioception is significantly decreased on the left side and mildly decreased on the right side. His menace response is absent in the right eye. His facial sensation is absent on the left (when the nostril is stimulated the animal blinks and twitches its facial muscles, but does not move its head rapidly from the stimulus.) All other cranial nerve reflexes are present and normal. He is painful when his cervical area is palpated. The rest of the neurologic examination was unremarkable.
Does this animal have neurologic disease?
Yes
The clues are the behavior change, the menace deficint, the facial sensation deficit, and the tetraparesis with normal spinal reflexes.
Bobbard is an 8 year-old male-castrated dog that has been acting ‘strangely’ at home for last week. He appears to not react normally to the environment. He has a head turn and circles to the right. The movements of the thoracic limb are exaggerated.
Bobbard’s concious proprioception is significantly decreased on the left side and mildly decreased on the right side. His menace response is absent in the right eye. His facial sensation is absent on the left (when the nostril is stimulated the animal blinks and twitches its facial muscles, but does not move its head rapidly from the stimulus.) All other cranial nerve reflexes are present and normal. He is painful when his cervical area is palpated. The rest of the neurologic examination was unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Intracranial - right supratentorial
Bobbard is an 8 year-old male-castrated dog that has been acting ‘strangely’ at home for last week. He appears to not react normally to the environment. He has a head turn and circles to the right. The movements of the thoracic limb are exaggerated.
Bobbard’s concious proprioception is significantly decreased on the left side and mildly decreased on the right side. His menace response is absent in the right eye. His facial sensation is absent on the left (when the nostril is stimulated the animal blinks and twitches its facial muscles, but does not move its head rapidly from the stimulus.) All other cranial nerve reflexes are present and normal. He is painful when his cervical area is palpated. The rest of the neurologic examination was unremarkable.
What are the suspected causes?
Tumor, hydrocephalus, cerebrovascular disease, inflammatory brain disease, traumatic injury, and metabolic diseases
Bobbard is an 8 year-old male-castrated dog that has been acting ‘strangely’ at home for last week. He appears to not react normally to the environment. He has a head turn and circles to the right. The movements of the thoracic limb are exaggerated.
Bobbard’s concious proprioception is significantly decreased on the left side and mildly decreased on the right side. His menace response is absent in the right eye. His facial sensation is absent on the left (when the nostril is stimulated the animal blinks and twitches its facial muscles, but does not move its head rapidly from the stimulus.) All other cranial nerve reflexes are present and normal. He is painful when his cervical area is palpated. The rest of the neurologic examination was unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, coagulation assessments if indicated by clinical signs, blood pressure. If no obvious systemic abnormality found, then advanced imaging (MR) and CSF assessment (if MR is normal)
Bobbard is an 8 year-old male-castrated dog that has been acting ‘strangely’ at home for last week. He appears to not react normally to the environment. He has a head turn and circles to the right. The movements of the thoracic limb are exaggerated.
Bobbard’s concious proprioception is significantly decreased on the left side and mildly decreased on the right side. His menace response is absent in the right eye. His facial sensation is absent on the left (when the nostril is stimulated the animal blinks and twitches its facial muscles, but does not move its head rapidly from the stimulus.) All other cranial nerve reflexes are present and normal. He is painful when his cervical area is palpated. The rest of the neurologic examination was unremarkable.
If CSF assessment was indicated in this patient, where would you collect the CSF from?
The lumbar region
Geoffrey is a 4 year old male castrated cat that has had an acute onset of inability to stand. Upon examination, he is in lateraly recumbency and unable to stand.
His proprioception is significantly decreased on the left hand side and absent on the right hand side. All of his cranial nerve reflex tests are present and normal. You note that he has positional horizontal nystagmus with the fast phase to the left. Everything else on the neurologic examination is unremarkable.
Does this animal have neurologic disease?
Yes
The clues are the tetraparesis with normal spinal reflexes and the nystagmus
Geoffrey is a 4 year old male castrated cat that has had an acute onset of inability to stand. Upon examination, he is in lateraly recumbency and unable to stand.
His proprioception is significantly decreased on the left hand side and absent on the right hand side. All of his cranial nerve reflex tests are present and normal. You note that he has positional horizontal nystagmus with the fast phase to the left. Everything else on the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Intracranial infratentorial (brain stem)
Worse on the right hand side
Geoffrey is a 4 year old male castrated cat that has had an acute onset of inability to stand. Upon examination, he is in lateraly recumbency and unable to stand.
His proprioception is significantly decreased on the left hand side and absent on the right hand side. All of his cranial nerve reflex tests are present and normal. You note that he has positional horizontal nystagmus with the fast phase to the left. Everything else on the neurologic examination is unremarkable.
What are the suspected causes?
Tumor, hydrocephalus, cerebrovascular disease, inflammatory brain disease, traumatic injury, and metabolic diseases
Geoffrey is a 4 year old male castrated cat that has had an acute onset of inability to stand. Upon examination, he is in lateraly recumbency and unable to stand.
His proprioception is significantly decreased on the left hand side and absent on the right hand side. All of his cranial nerve reflex tests are present and normal. You note that he has positional horizontal nystagmus with the fast phase to the left. Everything else on the neurologic examination is unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, potentially coagulation assessments if clinical signs indicate, blood pressure, advanced imaging, and CSF if the imaging studies are normal
Geoffrey is a 4 year old male castrated cat that has had an acute onset of inability to stand. Upon examination, he is in lateraly recumbency and unable to stand.
His proprioception is significantly decreased on the left hand side and absent on the right hand side. All of his cranial nerve reflex tests are present and normal. You note that he has positional horizontal nystagmus with the fast phase to the left. Everything else on the neurologic examination is unremarkable.
If you end up taking CSF in the case, where would you get the sample from?
the lumbar region
Veronica is a 9 year old female spayed dog that has been acting ‘this way’ for the last 10 days. You notice that she has a head tilt to the left side and that she is moving her head in swaying movements from side to side.
Veronica has decreased proprioception on the left side and normal proprioception on the right hand side. All cranial nerve reflex tests are present and normal. She has a positional horizontal nystagmus with the fast phase to the right. The remainder of the neurologic examination was unremarkable.
Does this animal have neurologic disease?
Yes
Veronica is a 9 year old female spayed dog that has been acting ‘this way’ for the last 10 days. You notice that she has a head tilt to the left side and that she is moving her head in swaying movements from side to side.
Veronica has decreased proprioception on the left side and normal proprioception on the right hand side. All cranial nerve reflex tests are present and normal. She has a positional horizontal nystagmus with the fast phase to the right. The remainder of the neurologic examination was unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
The signs are fairly localizing for a left-sided central vestibular abnormality
Veronica is a 9 year old female spayed dog that has been acting ‘this way’ for the last 10 days. You notice that she has a head tilt to the left side and that she is moving her head in swaying movements from side to side.
Veronica has decreased proprioception on the left side and normal proprioception on the right hand side. All cranial nerve reflex tests are present and normal. She has a positional horizontal nystagmus with the fast phase to the right. The remainder of the neurologic examination was unremarkable.
What are the suspected causes?
Tumor, hydrocephalus, inflammatory brain disease, traumatic injury, cerebrovascular disease, and metronidazole toxicity
Veronica is a 9 year old female spayed dog that has been acting ‘this way’ for the last 10 days. You notice that she has a head tilt to the left side and that she is moving her head in swaying movements from side to side.
Veronica has decreased proprioception on the left side and normal proprioception on the right hand side. All cranial nerve reflex tests are present and normal. She has a positional horizontal nystagmus with the fast phase to the right. The remainder of the neurologic examination was unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, coagulation assessments if clinical signs indicate, blood pressure, advanced imaging, and CSF assessment if advanced imaging studies are normal
Veronica is a 9 year old female spayed dog that has been acting ‘this way’ for the last 10 days. You notice that she has a head tilt to the left side and that she is moving her head in swaying movements from side to side.
Veronica has decreased proprioception on the left side and normal proprioception on the right hand side. All cranial nerve reflex tests are present and normal. She has a positional horizontal nystagmus with the fast phase to the right. The remainder of the neurologic examination was unremarkable.
If you need to take a CSF sample from this patient, where would you take it from?
the lumbar region
Paco is an 8 year old male-castrated cat who has been acting ‘this way’ for the last 10 days. You notice that he has a severe head tilt to the right hand side.
All proprioceptive and cranial nerve reflexes are present and normal. You note that he has spontaneous rotary head tilt and that his head seems to move similarly with each beat of the nystagmus. The rest of the neurologic examination was unremarkable.
Does this animal have neurologic disease?
yes
Paco is an 8 year old male-castrated cat who has been acting ‘this way’ for the last 10 days. You notice that he has a severe head tilt to the right hand side.
All proprioceptive and cranial nerve reflexes are present and normal. You note that he has spontaneous rotary head tilt and that his head seems to move similarly with each beat of the nystagmus. The rest of the neurologic examination was unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Signs could reflect either a central or a peripheral vestibular abnormality
Paco is an 8 year old male-castrated cat who has been acting ‘this way’ for the last 10 days. You notice that he has a severe head tilt to the right hand side.
All proprioceptive and cranial nerve reflexes are present and normal. You note that he has spontaneous rotary head tilt and that his head seems to move similarly with each beat of the nystagmus. The rest of the neurologic examination was unremarkable.
What are the suspected causes?
Central vestibular abnormalities: tumor, hydrocephalus, inflammatory brain disease, traumatic injury, and cerebrovascular disease
Peripheral vestibular abnormalities: Middle/inner ear infection, middle/inner ear tumor, traumatic injury, and idiopathic feline vestibular disease
Paco is an 8 year old male-castrated cat who has been acting ‘this way’ for the last 10 days. You notice that he has a severe head tilt to the right hand side.
All proprioceptive and cranial nerve reflexes are present and normal. You note that he has spontaneous rotary head tilt and that his head seems to move similarly with each beat of the nystagmus. The rest of the neurologic examination was unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Otoscopic examination, routine laboratory asssessments, coagulation assessments if indicated by clinical signs, blood pressure, advanced imaging (MR), and CSF assessment if imaging studies are normal
Paco is an 8 year old male-castrated cat who has been acting ‘this way’ for the last 10 days. You notice that he has a severe head tilt to the right hand side.
All proprioceptive and cranial nerve reflexes are present and normal. You note that he has spontaneous rotary head tilt and that his head seems to move similarly with each beat of the nystagmus. The rest of the neurologic examination was unremarkable.
If you were to evaluate the CSF, where would you get the sample from?
the lumbar region
Squidward is an 8 year old male castrated dog that has been acting this way for the last 7 days and the owner noticed that he ‘looked funny.’ You notice that Squidward has an asymmetrical facial appearance.
His menace response is absent on the left side, however he does appear to retract the eye during menace testing. His blinking and palpebral reflex is absent on the left side, however he does appear to retract the eye during palpebral testing. Squidward does not appear to move the facial muscle and ear on the right side. All other cranial reflexes are present and normal. The remainder of the neurologic exam was unremarkable.
Does he have neurologic disease?
Yes
Squidward is an 8 year old male castrated dog that has been acting this way for the last 7 days and the owner noticed that he ‘looked funny.’ You notice that Squidward has an asymmetrical facial appearance.
His menace response is absent on the left side, however he does appear to retract the eye during menace testing. His blinking and palpebral reflex is absent on the left side, however he does appear to retract the eye during palpebral testing. Squidward does not appear to move the facial muscle and ear on the right side. All other cranial reflexes are present and normal. The remainder of the neurologic exam was unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Right facial nerve
Squidward is an 8 year old male castrated dog that has been acting this way for the last 7 days and the owner noticed that he ‘looked funny.’ You notice that Squidward has an asymmetrical facial appearance.
His menace response is absent on the left side, however he does appear to retract the eye during menace testing. His blinking and palpebral reflex is absent on the left side, however he does appear to retract the eye during palpebral testing. Squidward does not appear to move the facial muscle and ear on the right side. All other cranial reflexes are present and normal. The remainder of the neurologic exam was unremarkable.
What are the suspected causes?
Idiopathic facial nerve paralysis, tumor, middle/inner ear inflammation, traumatic injury, and also consider central causes
Squidward is an 8 year old male castrated dog that has been acting this way for the last 7 days and the owner noticed that he ‘looked funny.’ You notice that Squidward has an asymmetrical facial appearance.
His menace response is absent on the left side, however he does appear to retract the eye during menace testing. His blinking and palpebral reflex is absent on the left side, however he does appear to retract the eye during palpebral testing. Squidward does not appear to move the facial muscle and ear on the right side. All other cranial reflexes are present and normal. The remainder of the neurologic exam was unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, coagulation assessments if clinical signs indicate, blood pressure, advanced imaging (MR), and CSF assessment if MR is normal.
Squidward is an 8 year old male castrated dog that has been acting this way for the last 7 days and the owner noticed that he ‘looked funny.’ You notice that Squidward has an asymmetrical facial appearance.
His menace response is absent on the left side, however he does appear to retract the eye during menace testing. His blinking and palpebral reflex is absent on the left side, however he does appear to retract the eye during palpebral testing. Squidward does not appear to move the facial muscle and ear on the right side. All other cranial reflexes are present and normal. The remainder of the neurologic exam was unremarkable.
If you were to take a CSF sample in this patient, where would you take it from?
the lumbar region
Walter is a 6 year old male castrated dog that has been having intermittent seizure-like episodes.
All reflexes are present and normal. You recognize during your examination that Walter is experiencing a classic grand mal seizure. The rest of the neurologic exam is unremarkable.
Does this animal have neurologic disease?
Yes
Walter is a 6 year old male castrated dog that has been having intermittent seizure-like episodes.
All reflexes are present and normal. You recognize during your examination that Walter is experiencing a classic grand mal seizure. The rest of the neurologic exam is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Neuroanatomically, seizures are most often associated with supratentoral or forebrain abnormalities. While this is the area of the nervous system where the seizure activity originates, the disease that results in a seizure may be present in oter symptoms besides the nervous system.
Walter is a 6 year old male castrated dog that has been having intermittent seizure-like episodes.
All reflexes are present and normal. You recognize during your examination that Walter is experiencing a classic grand mal seizure. The rest of the neurologic exam is unremarkable.
What are the suspected causes?
Structural (intracranial), metabolic (extracranial), or idiopathic
Walter is a 6 year old male castrated dog that has been having intermittent seizure-like episodes.
All reflexes are present and normal. You recognize during your examination that Walter is experiencing a classic grand mal seizure. The rest of the neurologic exam is unremarkable.
What diagnostic tests would be the most helpful?
In order of completion: Routine laboratory assessments, coagulation assessments if indicated by clinical signs, blood pressure, advanced imaging (MR), and CSF assessment if MR is normal (take from lumbar region)
Edgar is a 4 year old male castrated cat that you are seeing 3 days after a seizure-like episode. You are able to examine him during one of his episodes and notice that he has dilated pupils, is falling to one side, and salivating. These are all signs of a focal seizure.
All reflexes are pesent and normal. The remainder of the neurologic examination is unremarkable.
Does this animal have neurologic disease?
yes
Edgar is a 4 year old male castrated cat that you are seeing 3 days after a seizure-like episode. You are able to examine him during one of his episodes and notice that he has dilated pupils, is falling to one side, and salivating. These are all signs of a focal seizure.
All reflexes are pesent and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Neuroanatomically, seizures are most often associated with supratentoral or forebrain abnormalities. While this is the area of the nervous system where the seizure activity originates, the disease that results in a seizure may be present in oter symptoms besides the nervous system.
Edgar is a 4 year old male castrated cat that you are seeing 3 days after a seizure-like episode. You are able to examine him during one of his episodes and notice that he has dilated pupils, is falling to one side, and salivating. These are all signs of a focal seizure.
All reflexes are pesent and normal. The remainder of the neurologic examination is unremarkable.
What are the suspected causes?
Structural (intracranial), metabolic (extracranial), and idiopathic
Edgar is a 4 year old male castrated cat that you are seeing 3 days after a seizure-like episode. You are able to examine him during one of his episodes and notice that he has dilated pupils, is falling to one side, and salivating. These are all signs of a focal seizure.
All reflexes are pesent and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, coagulation assessments if indicated by clinical signs, blood pressure, advanced imaging (MR), and CSF assessment if MR is normal (take from lumbar region)
Allen is a 3 year old male castrated cat that is presenting for a change in behavior for the past week.
You notice that he is experiencing intermittent, apparently involuntary movements that primarily involve the left thoracic limb.
Does this animal have neurologic disease?
It is uncertain
Allen is a 3 year old male castrated cat that is presenting for a change in behavior for the past week.
You notice that he is experiencing intermittent, apparently involuntary movements that primarily involve the left thoracic limb.
What is the neuroanatomical diagnosis (where is the lesion)?
Ultimately, the movement is resulting from depolarization of certain muscles or muscle groups. These muscles could be depolarizing spontaneously because of a primary muscle abnormality. Spontaneous nervous system activation could occur, for example, during a seizure, or result from peripheral nerve activation.
Allen is a 3 year old male castrated cat that is presenting for a change in behavior for the past week.
You notice that he is experiencing intermittent, apparently involuntary movements that primarily involve the left thoracic limb.
What are the suspected causes?
The differential diagnosis would include diseases that could result in spontaneous activation of either nerves (including central and peripheral nerves) or muscle.
Allen is a 3 year old male castrated cat that is presenting for a change in behavior for the past week.
You notice that he is experiencing intermittent, apparently involuntary movements that primarily involve the left thoracic limb.
What diagnostic tests would be the most helpful?
In order of completion: Routine laboratory assessments
To assess for central nervous system: Advanced imaging (MR) and CSF if MR is normal
To assess for peripheral nervous system disease: Serum creatinine kinase, possible electromyography and nerve conduction studies, serum anti-ACH antibody titer for myasthenia gravis
Based on the tests above potentially nerve or muscle biopsy.
Poe is a 4 month old intact male dog that has been this way since the dog was able to move. You notice that he is uncoordinated with exaggerated movements.
You note that the menace response is absent in both eyes but his vision is normal. All other cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
Does this animal have neurologic disease?
Yes
The clues are the exaggerated movements, coupled with the normal conscious proprioceptive assessments. The menace deficit with normal vision is also an important clue
Poe is a 4 month old intact male dog that has been this way since the dog was able to move. You notice that he is uncoordinated with exaggerated movements.
You note that the menace response is absent in both eyes but his vision is normal. All other cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Intracranial infratentorial unconscious proprioceptive system disorder (including the cerebellum)
Consistent with cerebellar system abnormality.
Poe is a 4 month old intact male dog that has been this way since the dog was able to move. You notice that he is uncoordinated with exaggerated movements.
You note that the menace response is absent in both eyes but his vision is normal. All other cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What are the suspected causes?
Congenital cerebellar disease, anomalous cerebellar disease, inherited degenerative condition such as storage disease, hydrocephalus, inflammatory brain disease, and traumatic injury
Poe is a 4 month old intact male dog that has been this way since the dog was able to move. You notice that he is uncoordinated with exaggerated movements.
You note that the menace response is absent in both eyes but his vision is normal. All other cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, coagulation assessments if clinical signs indicate, blood pressure, advanced imaging (MR), and CSF assessment if MR is normal (take from the lumbar region)
Edith is a 7 year old female spayed dog that has a history of progressive pelvic limb dysfunction over the last 3 weeks. You notice that she has exaggerated movements of the pelvic limbs. The inter-step distance are inconsistent between the left and right resulting in an irregualr footfall pattern. Occasionally she will sink lower on one of the pelvic limb when contacting the ground, and then over flex on the immediately following flight phase of the limb. When looking at Edith from behind you notice that she does not walk in a straight line and tends to sway from side to side.
You note that proprioception is decreased on both pelvic limbs, but the proprioception on the thoracic limbs are normal. The rest of the neurological examination is unremarkable.
Does this animal have neurologic disease?
yes
Edith is a 7 year old female spayed dog that has a history of progressive pelvic limb dysfunction over the last 3 weeks. You notice that she has exaggerated movements of the pelvic limbs. The inter-step distance are inconsistent between the left and right resulting in an irregualr footfall pattern. Occasionally she will sink lower on one of the pelvic limb when contacting the ground, and then over flex on the immediately following flight phase of the limb. When looking at Edith from behind you notice that she does not walk in a straight line and tends to sway from side to side.
You note that proprioception is decreased on both pelvic limbs, but the proprioception on the thoracic limbs are normal. The rest of the neurological examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Based on the conscious and unconscious proprioceptive deficits in the pelvic limbs and the normal spinal reflexes, the neuroanatomical diagnosis is a T3-L3 spinal cord abnormality.
Edith is a 7 year old female spayed dog that has a history of progressive pelvic limb dysfunction over the last 3 weeks. You notice that she has exaggerated movements of the pelvic limbs. The inter-step distance are inconsistent between the left and right resulting in an irregular footfall pattern. Occasionally she will sink lower on one of the pelvic limb when contacting the ground, and then over flex on the immediately following flight phase of the limb. When looking at Edith from behind you notice that she does not walk in a straight line and tends to sway from side to side.
You note that proprioception is decreased on both pelvic limbs, but the proprioception on the thoracic limbs are normal. The rest of the neurological examination is unremarkable.
What are the suspected causes?
Tumor, intervertebral disk disease, inflammatory spinal disease, traumatic injury, spinal vascular disease, and diskospondylitis/osteomyelitis
Edith is a 7 year old female spayed dog that has a history of progressive pelvic limb dysfunction over the last 3 weeks. You notice that she has exaggerated movements of the pelvic limbs. The inter-step distance are inconsistent between the left and right resulting in an irregular footfall pattern. Occasionally she will sink lower on one of the pelvic limb when contacting the ground, and then over flex on the immediately following flight phase of the limb. When looking at Edith from behind you notice that she does not walk in a straight line and tends to sway from side to side.
You note that proprioception is decreased on both pelvic limbs, but the proprioception on the thoracic limbs are normal. The rest of the neurological examination is unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, spinal radiographs, advanced imaging (MR), CSF assessment if imaging studies are normal (from the lumbar region)
Fred is an 8 month old male dog that is presenting for progressive problems walking for the past four months. You notice that the dog has exaggerated movements of all four limbs. The interstep distance are inconsistent between the left and right, and front and back resulting in an irregular footfall pattern. Ocassionally he will sink lower on one of the pelvic limbs when contacting the ground, and then over-flexing on the immediately following flight phase of the limb (some would label this as hypermetria). When you look at Fred from behind, he does not travel in a straight line, but rather sways from side to side (some would label this as ataxia).
You notice that proprioception is mildly decreased on all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurological examination is unremarkable.
Does this animal have neurologic disease?
Yes
The clinical signs are suggestive of proprioceptive deficits in all limbs
Fred is an 8 month old male dog that is presenting for progressive problems walking for the past four months. You notice that the dog has exaggerated movements of all four limbs. The interstep distance are inconsistent between the left and right, and front and back resulting in an irregular footfall pattern. Ocassionally he will sink lower on one of the pelvic limbs when contacting the ground, and then over-flexing on the immediately following flight phase of the limb (some would label this as hypermetria). When you look at Fred from behind, he does not travel in a straight line, but rather sways from side to side (some would label this as ataxia).
You notice that proprioception is mildly decreased on all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurological examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Based on the conscious and unconscious proprioceptive deficits in all of the limbs and the normal spinal reflexes, the neuroanatomical diagnosis is a C1-C5, spinal cord abnormality
Fred is an 8 month old male dog that is presenting for progressive problems walking for the past four months. You notice that the dog has exaggerated movements of all four limbs. The interstep distance are inconsistent between the left and right, and front and back resulting in an irregular footfall pattern. Ocassionally he will sink lower on one of the pelvic limbs when contacting the ground, and then over-flexing on the immediately following flight phase of the limb (some would label this as hypermetria). When you look at Fred from behind, he does not travel in a straight line, but rather sways from side to side (some would label this as ataxia).
You notice that proprioception is mildly decreased on all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurological examination is unremarkable.
What are the suspected causes?
Degenerative condition, congenital condition, anomalous condition, cervical vertebral malformation/malartriculation (Wobbler’s syndrome), inflammatory spinal disease, traumatic injury, tumor, and diskospondylitis/osteomyelitis
Fred is an 8 month old male dog that is presenting for progressive problems walking for the past four months. You notice that the he has exaggerated movements of all four limbs. The interstep distance are inconsistent between the left and right, and front and back resulting in an irregular footfall pattern. Ocassionally he will sink lower on one of the pelvic limbs when contacting the ground, and then over-flexing on the immediately following flight phase of the limb (some would label this as hypermetria). When you look at Fred from behind, he does not travel in a straight line, but rather sways from side to side (some would label this as ataxia).
You notice that proprioception is mildly decreased on all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurological examination is unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments, spinal radiographs, advanced imaging (MR), and CSF assessment if imaging reveals nothing (take from lumbar areas)
Roswald is a 4 year old male castrated dog that is presenting for progressive problems walking for 4 days. You notice that he is dragging his pelvic limbs. He also intermittently does not support his own weight in these limbs and will sink closer to the ground upon weight bearing.
You note that he has significantly decreased proprioception in both pelvic limbs, but normal proprioception in both thoracic limbs. His cranial nerve reflexes are present and normal. You also note that he has a painful reaction upon palpation of the thoraco-lumbar junction. The remainder of the neurologic examination was unremarkable.
Does he have neurologic disease?
Yes
The clinical signs are suggestive of proprioceptive deficits in the pelvic limbs
Roswald is a 4 year old male castrated dog that is presenting for progressive problems walking for 4 days. You notice that he is dragging his pelvic limbs. He also intermittently does not support his own weight in these limbs and will sink closer to the ground upon weight bearing.
You note that he has significantly decreased proprioception in both pelvic limbs, but normal proprioception in both thoracic limbs. His cranial nerve reflexes are present and normal. You also note that he has a painful reaction upon palpation of the thoraco-lumbar junction. The remainder of the neurologic examination was unremarkable.
What is the neuroantatomical diagnosis (where is the lesion)?
Based on the conscious and unconscious proprioceptive deficits in the pelvic limbs and the normal spinal reflexes, the neuroanatomical diagnosis is a T3-L3 spinal cord abnormality
Roswald is a 4 year old male castrated dog that is presenting for progressive problems walking for 4 days. You notice that he is dragging his pelvic limbs. He also intermittently does not support his own weight in these limbs and will sink closer to the ground upon weight bearing.
You note that he has significantly decreased proprioception in both pelvic limbs, but normal proprioception in both thoracic limbs. His cranial nerve reflexes are present and normal. You also note that he has a painful reaction upon palpation of the thoraco-lumbar junction. The remainder of the neurologic examination was unremarkable.
What are the suspected causes?
Intervertebral disk disease, inflammatory spinal disease, traumatic injury, tumor, and diskospondylitis/osteomyelitis
Roswald is a 4 year old male castrated dog that is presenting for progressive problems walking for 4 days. You notice that he is dragging his pelvic limbs. He also intermittently does not support his own weight in these limbs and will sink closer to the ground upon weight bearing.
You note that he has significantly decreased proprioception in both pelvic limbs, but normal proprioception in both thoracic limbs. His cranial nerve reflexes are present and normal. You also note that he has a painful reaction upon palpation of the thoraco-lumbar junction. The remainder of the neurologic examination was unremarkable.
What diagnosstic tests would be most helpful?
In order of completion: Routine laboratory assessments, spinal radiographs, advanced imaging (MR), and CSF assessment if imaging shows nothing (take from lumbar area)
Kirk is an 8 year old male castrated dog that is presenting for progressive problems walking for 3 months. You notice that he has his head in a downward posture. His thoracic limbs appear to have somewhat short steps, while the pelvic limbs have more irregular steps.
You note that he has mildly decreased proprioception in all four limbs. He also has decreased thoracic withdrawal reflexes on both sides. The cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
Does this animal have neurologic disease?
Yes
The clinical signs are suggestive of proprioceptive deficits in all of the limbs
Kirk is an 8 year old male castrated dog that is presenting for progressive problems walking for 3 months. You notice that he has his head in a downward posture. His thoracic limbs appear to have somewhat short steps, while the pelvic limbs have more irregular steps.
You note that he has mildly decreased proprioception in all four limbs. He also has decreased thoracic withdrawal reflexes on both sides. The cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Based on the conscious and unconscious proprioceptvee deficits in all of the limbs and the normal spinal reflexes in the pelvic limb with decreased reflexes in the thoracic limbs, the neuroanatomical diagnosis is a C6-T2 spinal cord abnormality.
The gait is also characteristic of an abnormality in this region of the spinal cord
Kirk is an 8 year old male castrated dog that is presenting for progressive problems walking for 3 months. You notice that he has his head in a downward posture. His thoracic limbs appear to have somewhat short steps, while the pelvic limbs have more irregular steps.
You note that he has mildly decreased proprioception in all four limbs. He also has decreased thoracic withdrawal reflexes on both sides. The cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What are the suspected causes?
Cervical vertebral malformation/malarticulation (Wobbler’s syndrome), inflammatory spinal disease, traumatic injury, tumor, and diskospondylitis/osteomyelitis
Kirk is an 8 year old male castrated dog that is presenting for progressive problems walking for 3 months. You notice that he has his head in a downward posture. His thoracic limbs appear to have somewhat short steps, while the pelvic limbs have more irregular steps.
You note that he has mildly decreased proprioception in all four limbs. He also has decreased thoracic withdrawal reflexes on both sides. The cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments, spiral radiographs, advanced imaging (MR), and CSF assessment if imaging is normal (collect from lumbar region)
Paula is an 8 year old female spayed dog that is presenting for being acutely unable to stand. You notice that she is in a laterally recumbent position and in fact unable to stand.
You note that she has severely decreased/absent proprioception in all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
Does Paula have neurologic disease?
Yes
The clinical signs are suggestive of proprioceptive deficits in all limbs
Paula is an 8 year old female spayed dog that is presenting for being acutely unable to stand. You notice that she is in a laterally recumbent position and in fact unable to stand.
You note that she has severely decreased/absent proprioception in all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Based on the conscious and unconscious proprioceptive deficits in all of the limbs and the normal spinal reflexes, the neuroanatomical diagnosis is a C1-C5 spinal cord abnormality
Paula is an 8 year old female spayed dog that is presenting for being acutely unable to stand. You notice that she is in a laterally recumbent position and in fact unable to stand.
You note that she has severely decreased/absent proprioception in all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What are the suspected causes?
Intervertebral disk disease, inflammatory spinal disease, traumatic injury, tumor, diskospondylitis/osteomyelitis, and spinal cord vascular disease
Paula is an 8 year old female spayed dog that is presenting for being acutely unable to stand. You notice that she is in a laterally recumbent position and in fact unable to stand.
You note that she has severely decreased/absent proprioception in all four limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments, spinal radiographs, advanced imaging, and CSF assessment if imaging studies are normal (take from lumbar area).
Margie is a 2 year old female spayed dog that is presenting for being found acutely unable to stand. You notice that she in fact is unable to stand and support weight on the pelvic limbs.
You note that the proprioception in the pelvic limbs are severely decreased/absent. The patellar and withdrawal reflexes in both pelvic limbs are absent. You also note that the deep pain sensation is absent in the pelvic limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
Does this animal have neurologic disease?
Yes
The clinical signs are suggestive of severe proprioceptive deficits in the pelvic limbs
Margie is a 2 year old female spayed dog that is presenting for being found acutely unable to stand. You notice that she in fact is unable to stand and support weight on the pelvic limbs.
You note that the proprioception in the pelvic limbs are severely decreased/absent. The patellar and withdrawal reflexes in both pelvic limbs are absent. You also note that the deep pain sensation is absent in the pelvic limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Based on the conscious and unconscious proprioceptive deficits in the pelvic limbs and the normal spinal reflexes, the neuroanatomical diagnosis is a L4-S3 spinal cord abnormality.
Margie is a 2 year old female spayed dog that is presenting for being found acutely unable to stand. You notice that she in fact is unable to stand and support weight on the pelvic limbs.
You note that the proprioception in the pelvic limbs are severely decreased/absent. The patellar and withdrawal reflexes in both pelvic limbs are absent. You also note that the deep pain sensation is absent in the pelvic limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What are the suspected causes?
Intervertebral disk disease, spinal cord vascular disease, inflammatory spinal disease, traumatic injury, tumor, and diskospondylitis/osteomyelitis
Margie is a 2 year old female spayed dog that is presenting for being found acutely unable to stand. You notice that she in fact is unable to stand and support weight on the pelvic limbs.
You note that the proprioception in the pelvic limbs are severely decreased/absent. The patellar and withdrawal reflexes in both pelvic limbs are absent. You also note that the deep pain sensation is absent in the pelvic limbs. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, spinal radiographs, advanced imaging (MR), and CSF assessment if imaging studies are normal (sample from lumbar region)
Bertha is a 6 year old female spayed dog that is presenting for acute onset of clinical signs that have persisted for 3 weeks. You notice that she has her head in a downward posture.
Proprioception is decreased on all four limbs. You note that she has severe cervical pain. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
Does this animal have neurologic disease?
Yes
Based on the pain and proprioceptive deficits in the limbs
Bertha is a 6 year old female spayed dog that is presenting for acute onset of clinical signs that have persisted for 3 weeks. You notice that she has her head in a downward posture.
Proprioception is decreased on all four limbs. You note that she has severe cervical pain. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Based on the conscious and unconscious proprioceptive deficits in all of the limbs and the normal spinal reflexes in the pelvic limb with decreased reflexes in the thoracic limbs, the neuroanatomical diagnosis is a C1-T5 spinal cord abnormality
Bertha is a 6 year old female spayed dog that is presenting for acute onset of clinical signs that have persisted for 3 weeks. You notice that she has her head in a downward posture.
Proprioception is decreased on all four limbs. You note that she has severe cervical pain. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What are the suspected causes?
Intervertebral disk disease, inflammatory spinal disease, traumatic injury, tumor, and diskospondylitis/osteomyelitis
Bertha is a 6 year old female spayed dog that is presenting for acute onset of clinical signs that have persisted for 3 weeks. You notice that she has her head in a downward posture.
Proprioception is decreased on all four limbs. You note that she has severe cervical pain. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, spinal radiographs, advanced imaging (MR), and CSF assessment if imaging studies are normal (sample from lumbar region)
Willard is a 3 year old male castrated dog that is presenting for walking ‘funny’ for 2 weeks. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, the Willard forms a kyphotic posture in the lumbar region, and the thoracic limb inter-step distance becomes shorter. With consistent movement, the dog will simultaneously advance both pelvic limbs. His mouth has an open appearance and salivation is obvious.
You note that the palpebral reflex is mildly decreased in both eyes. The rest of the cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
Does Willard have neurologic disease?
Probably yes
Willard is a 3 year old male castrated dog that is presenting for walking ‘funny’ for 2 weeks. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, the Willard forms a kyphotic posture in the lumbar region, and the thoracic limb inter-step distance becomes shorter. With consistent movement, the dog will simultaneously advance both pelvic limbs. His mouth has an open appearance and salivation is obvious.
You note that the palpebral reflex is mildly decreased in both eyes. The rest of the cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
The shorter inter-step distance can be a sign of either pain in or around the limbs, or of peripheral nerve, muscle, or neuromuscular junction dysfunction. If a musculoskeletal assessment does not find an obious cause for diffuse limb pain, then this gait is most characteristic of LMN dysfunction
Willard is a 3 year old male castrated dog that is presenting for walking ‘funny’ for 2 weeks. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, the Willard forms a kyphotic posture in the lumbar region, and the thoracic limb inter-step distance becomes shorter. With consistent movement, the dog will simultaneously advance both pelvic limbs. His mouth has an open appearance and salivation is obvious.
You note that the palpebral reflex is mildly decreased in both eyes. The rest of the cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
What are the suspected causes?
Degenerative neuropathies/myopathies, acquired neuropathies/myopathies, traumatic injury, inflammatory nerve diseases, toxic nerve diseases, and myasthenia gravis
Willard is a 3 year old male castrated dog that is presenting for walking ‘funny’ for 2 weeks. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, the Willard forms a kyphotic posture in the lumbar region, and the thoracic limb inter-step distance becomes shorter. With consistent movement, the dog will simultaneously advance both pelvic limbs. His mouth has an open appearance and salivation is obvious.
You note that the palpebral reflex is mildly decreased in both eyes. The rest of the cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments, Serum creatine kinase, tensillon response test, possibly electromyography and nerve conduction studies, Serum anti-ACH antibody titer for myasthenia gravis, based on these tests potentially nerve or muscle biopsy
Richard is a 7 month old male castrateed dog that is presenting for progressive inability to walk normally over the last 3 days. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, he forms a kyphotic posture in the lumbar region. With consistent movement, Richard will simultaneously advance both pelvic limbs (bunny hop).
Proprioception is decreased in all four limbs. You note that the palpebral reflex is decreased in both eyes. The remainder of the cranial nerve reflexes are present and normal. Willard also has decreased withdrawal reflexes in all four limbs and his patellar relfexes are absent in both pelvic limbs. The remainder of the neurological examination is unremarkable.
Does Richard have neurologic disease?
It is uncertain
Richard is a 7 month old male castrateed dog that is presenting for progressive inability to walk normally over the last 3 days. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, he forms a kyphotic posture in the lumbar region. With consistent movement, Richard will simultaneously advance both pelvic limbs (bunny hop).
Proprioception is decreased in all four limbs. You note that the palpebral reflex is decreased in both eyes. The remainder of the cranial nerve reflexes are present and normal. Willard also has decreased withdrawal reflexes in all four limbs and his patellar relfexes are absent in both pelvic limbs. The remainder of the neurological examination is unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
Based on the conscious proprioceptive deficits in all limbs with decreased spinal reflexes, these signs are most consistent with the diffuse LMN presentation
Richard is a 7 month old male castrateed dog that is presenting for progressive inability to walk normally over the last 3 days. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, he forms a kyphotic posture in the lumbar region. With consistent movement, Richard will simultaneously advance both pelvic limbs (bunny hop).
Proprioception is decreased in all four limbs. You note that the palpebral reflex is decreased in both eyes. The remainder of the cranial nerve reflexes are present and normal. Willard also has decreased withdrawal reflexes in all four limbs and his patellar relfexes are absent in both pelvic limbs. The remainder of the neurological examination is unremarkable.
What are the suspected causes?
Degenerative neuropathies/myopathies, Acquired neuropathies/myopathies, Tick paralysis, Polyradiculoneuritis, Botulism, Traumatic injury, Inflammatory nerve diseases, Toxic nerve diseases, Myasthenia gravis
Richard is a 7 month old male castrateed dog that is presenting for progressive inability to walk normally over the last 3 days. You notice that his gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, he forms a kyphotic posture in the lumbar region. With consistent movement, Richard will simultaneously advance both pelvic limbs (bunny hop).
Proprioception is decreased in all four limbs. You note that the palpebral reflex is decreased in both eyes. The remainder of the cranial nerve reflexes are present and normal. Willard also has decreased withdrawal reflexes in all four limbs and his patellar relfexes are absent in both pelvic limbs. The remainder of the neurological examination is unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments, Serum creatine kinase, possibly electromyography and nerve conduction studies, Serum anti-ACH antibody titer for myasthenia gravis, based on these tests potentially nerve or muscle biopsy
Dorothy is a 7 month old female dog that is presenting for progressive inability to walk normally over the last 7 days. Her gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, she tends to “crab” i.e. the pelvic limbs advance to one side of the dog.
Her cranial nerve reflex tests are all present and normal. The remainder of the neurologic examination is unremarkable.
Does this dog have neurologic disease?
Uncertain
Dorothy is a 7 month old female dog that is presenting for progressive inability to walk normally over the last 7 days. Her gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, she tends to “crab” i.e. the pelvic limbs advance to one side of the dog.
Her cranial nerve reflex tests are all present and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomic diagnosis (where is the lesion)?
The shorter inter-step distance can be a sign of either pain in or around the limbs, or of peripheral nerve, muscle, or neuromuscular junction dysfunction. If a musculoskeletal assessment does not find an obvious cause for diffuse limb pain, then this gait is most characteristic of “LMN” dysfunction.
Dorothy is a 7 month old female dog that is presenting for progressive inability to walk normally over the last 7 days. Her gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, she tends to “crab” i.e. the pelvic limbs advance to one side of the dog.
Her cranial nerve reflex tests are all present and normal. The remainder of the neurologic examination is unremarkable.
What are the suspected causes?
Degenerative neuropathies/myopathies, acquired neuropathies/myopathies, traumatic injury, inflammatory nerve diseases, toxic nerve diseases, and myasthenia gravis
Dorothy is a 7 month old female dog that is presenting for progressive inability to walk normally over the last 7 days. Her gait in the pelvic limbs is more short-stepped, and this progressively worsens with continued movement. During the movement, she tends to “crab” i.e. the pelvic limbs advance to one side of the dog.
Her cranial nerve reflex tests are all present and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments, Serum creatine kinase, tensillon response test, possibly electromyography and nerve conduction studies, Serum anti-ACH antibody titer for myasthenia gravis, based on these tests potentially nerve or muscle biopsy
Spork is a 6 year old female spayed cat that is presenting for walking funny for 3 weeks. You note that she walks with an over-flexed posture in the pelvic limbs. During the flight phase of the gait, cycle Spork does not flex the hock joints appropriately resulting in the stifle having to flex more than normal.
Her proprioception was decreased in both pelvic limbs. You also note that her withdrawal reflexes are decreased in both pelvic limbs, but the patellar reflexes are normal. All cranial nerve reflexes are present and normal. The remainder of her neurological examination was unremarkable.
Does Spork have neurologic disease?
Yes
Spork is a 6 year old female spayed cat that is presenting for walking funny for 3 weeks. You note that she walks with an over-flexed posture in the pelvic limbs. During the flight phase of the gait, cycle Spork does not flex the hock joints appropriately resulting in the stifle having to flex more than normal.
Her proprioception was decreased in both pelvic limbs. You also note that her withdrawal reflexes are decreased in both pelvic limbs, but the patellar reflexes are normal. All cranial nerve reflexes are present and normal. The remainder of her neurological examination was unremarkable.
What is the neuroanatomical diagnosis?
The clinical signs are suggestive of bilateral nerve dysfunction
Spork is a 6 year old female spayed cat that is presenting for walking funny for 3 weeks. You note that she walks with an over-flexed posture in the pelvic limbs. During the flight phase of the gait, cycle Spork does not flex the hock joints appropriately resulting in the stifle having to flex more than normal.
Her proprioception was decreased in both pelvic limbs. You also note that her withdrawal reflexes are decreased in both pelvic limbs, but the patellar reflexes are normal. All cranial nerve reflexes are present and normal. The remainder of her neurological examination was unremarkable.
What are the suspected causes?
Peripheral nerve diseases - Degenerative neuropathies/myopathies, acquired neuropathies/myopathies, traumatic injury, inflammatory nerve diseases, and toxic nerve diseases
Spinal cord abnormalities - Lumbosacral disease, instability, degeneration, invertebral disk disease, inflammatory spinal disease, traumatic injury, tumor, and disk spondylitis/osteomyelitis
Spork is a 6 year old female spayed cat that is presenting for walking funny for 3 weeks. You note that she walks with an over-flexed posture in the pelvic limbs. During the flight phase of the gait, cycle Spork does not flex the hock joints appropriately resulting in the stifle having to flex more than normal.
Her proprioception was decreased in both pelvic limbs. You also note that her withdrawal reflexes are decreased in both pelvic limbs, but the patellar reflexes are normal. All cranial nerve reflexes are present and normal. The remainder of her neurological examination was unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments
For spinal cord disease - Advanced imaging (MR) and CSF assessment
For peripheral nerve disease: Serum creatine kinase, possibly electromyography and nerve conduction studies
Based on the above tests - potentially nerve and muscle biopsy
Manny is a 5 year old male castrated dog that is presentig for limb dysfunction over the past 6 weeks. You notice that he over-flexes at the right tarsal joint with weight bearing. His toes are retracted caudally.
You palpate the region of the gastrocnemius tendon and note that is is enlarged, firm, and painful. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
Does this animal have neurologic disease?
No
Manny is a 5 year old male castrated dog that is presenting for limb dysfunction over the past 6 weeks. You notice that he over-flexes at the right tarsal joint with weight bearing. His toes are retracted caudally.
You palpate the region of the gastrocnemius tendon and note that is is enlarged, firm, and painful. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
The clinical signs are suggestive of musculokeletal abnormality of the gastrocnemius tendon or mechanical supporting structures that result in tarsal extension.
The normal proprioception and withdrawal reflex also support a non-neurologic cause for this abnormality
Manny is a 5 year old male castrated dog that is presenting for limb dysfunction over the past 6 weeks. You notice that he over-flexes at the right tarsal joint with weight bearing. His toes are retracted caudally.
You palpate the region of the gastrocnemius tendon and note that is is enlarged, firm, and painful. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
What are the suspected causes?
Gastrocnemius tendon rupture, gastrocnemius muscle disease, and Calcaneal fracture
Manny is a 5 year old male castrated dog that is presenting for limb dysfunction over the past 6 weeks. You notice that he over-flexes at the right tarsal joint with weight bearing. His toes are retracted caudally.
You palpate the region of the gastrocnemius tendon and note that is is enlarged, firm, and painful. All cranial nerve reflexes are present and normal. The remainder of the neurologic examination was unremarkable.
What diagnostic tests would be most helpful?
Routine laboratory assessments, palpation of the gastrocnemius muscle region, ultrasound of the gastrocnemius muscle/tendon, and radiographs of the calcaneal/tarsal region
Mitchum is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the left thoracic limb. The limb is externally rotated at the shoulder and the limb moves in a circumducted motion when advancing.
All cranial nerve reflexes are normal and present. The rest of the neurologic examination was unremarkable.
Does Mitchum have a neurologic disease?
No
Mitchum is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the left thoracic limb. The limb is externally rotated at the shoulder and the limb moves in a circumducted motion when advancing.
All cranial nerve reflexes are normal and present. The rest of the neurologic examination was unremarkable.
What is the neuroanatomical diagnosis (where is the lesion)?
The clinical signs are suggestive of musculoskeletal abnormality. The gait characteristics are those of an infraspinatus muscle/tendon contraction.
Mitchum is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the left thoracic limb. The limb is externally rotated at the shoulder and the limb moves in a circumducted motion when advancing.
All cranial nerve reflexes are normal and present. The rest of the neurologic examination was unremarkable.
What is the suspected cause?
Infraspinatus muscle/tendon contracture
Mitchum is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the left thoracic limb. The limb is externally rotated at the shoulder and the limb moves in a circumducted motion when advancing.
All cranial nerve reflexes are normal and present. The rest of the neurologic examination was unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments and musculoskeletal examination
Moon Pie is a 1 year old female dog that is presenting for limb dysfunction for 8 weeks. You notice that she is simultaneously advancing both pelvic limbs (bunny hopping).
All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
Does Moon Pie have neurologic disease?
No
Moon Pie is a 1 year old female dog that is presenting for limb dysfunction for 8 weeks. You notice that she is simultaneously advancing both pelvic limbs (bunny hopping).
All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What is the neuroanatomical diagnosis?
most likely musculoskeletal
Moon Pie is a 1 year old female dog that is presenting for limb dysfunction for 8 weeks. You notice that she is simultaneously advancing both pelvic limbs (bunny hopping).
All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What is the suspected cause?
Bilateral hip dysplasia
Moon Pie is a 1 year old female dog that is presenting for limb dysfunction for 8 weeks. You notice that she is simultaneously advancing both pelvic limbs (bunny hopping).
All cranial nerve reflexes are present and normal. The remainder of the neurologic examination is unremarkable.
What diagnostic tests would be most helpful?
In order of completion: Routine laboratory assessments, musculoskeletal examination, radiographs of clinically affected regions
Hot dog is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the pelvic limb. Immediately past the apex of the flight phase of the gait cycle, his foot is rapidly moved (jerked) medially. The stifle may be internally rotated and the hock slightly more externally rotated.
All of the cranial reflexes are present and normal. The neurologic examination was unremarkable.
Does Hot Dog have a neurologic disease?
No
Hot dog is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the pelvic limb. Immediately past the apex of the flight phase of the gait cycle, his foot is rapidly moved (jerked) medially. The stifle may be internally rotated and the hock slightly more externally rotated.
All of the cranial reflexes are present and normal. The neurologic examination was unremarkable.
What is the neuroanatomical diagnosis?
The clinical signs are suggestive of musculoskeletal abnormality. The gait characteristics are those of a fibrotic myopathy
Hot dog is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the pelvic limb. Immediately past the apex of the flight phase of the gait cycle, his foot is rapidly moved (jerked) medially. The stifle may be internally rotated and the hock slightly more externally rotated.
All of the cranial reflexes are present and normal. The neurologic examination was unremarkable.
What is the suspected cause?
Fibrotic myopathy
Hot dog is a 6 year old male castrated dog that is presenting for limb dysfunction for 8 weeks. You notice that he has unusual movement of the pelvic limb. Immediately past the apex of the flight phase of the gait cycle, his foot is rapidly moved (jerked) medially. The stifle may be internally rotated and the hock slightly more externally rotated.
All of the cranial reflexes are present and normal. The neurologic examination was unremarkable.
What diagnostic tests would be helpful?
In order of completion: Routine laboratory assessments and musculoskeletal examination
