Scope of Action

Neurological Disorder

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All living organisms must be able to react appropriately to changes in their environment if they are to survive. The regulation of these reactions is the responsibility of the nervous system, incomparably the most complicated of all the body's systems. The most important role of the nervous system is the reception and correct interpretation of stimuli coming from the environment and its internal environment, in addition to the generation of appropriate responses. Any alteration in it entails a variation in those responses.

Symptoms

The alteration in responses to nervous stimulation referred to above varies depending on the type and severity of the disease, however, there are a series of clinical signs that can make us determine that a certain alteration has a neurological origin:

• Muscle atrophy of variable severity.

• Different degrees of pain.

• Tension in the muscles of the back and extremities.

• Upper or lower motoneuronal signs depending on the location.

• Ataxia and proprioceptive deficiencies (unsteady gait).

• Decrease or loss of motor functions.

• Decrease or loss of superficial or deep painful sensitivity. The correct analysis and study of the detected alterations will be the starting point that will determine the success of our treatment, hence the importance of the neurological examination.

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Neurological Examination

A complete neurological examination must be performed to help us determine the involvement of the neurological system in the condition we are evaluating and that can help us identify other problems that may exist at the same time. The neurological examination should become a systematic and sequential process. In this way, the examiner will ensure that any aspect of the nervous system has been evaluated without leaving anything out. The neurological examination must always be carried out in a quiet place with as few distractions as possible, and it is important that the animal is not tranquilized or sedated before the examination to minimize erroneous interpretations of pain or reflex sensations.

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Examination Process 

The neurological examination begins when the animal first presents at the hospital, since the patient's general appearance provides us with the first indicators, even before the physical examination is performed. Behavior, posture and voluntary movements must be taken into account when we leave the animal free to move within the examination room.

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Animals that do not require hospitalization may have total or partial paralysis (paresis). Both cause obvious and marked abnormal postures in patients. Although paresis can be caused by many factors, it is often the result of a less severe injury than what we might see in a paralyzed animal. If an injury causing paresis worsens, the condition usually progresses to complete paralysis. When we examine quadrupeds with spinal injuries, it must be taken into account that paresis and paralysis do not always affect all 4 legs equally.

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After taking the history and evaluating the general appearance of the animal, the patient's gait is assessed, detecting any detail, even minor, that may be present. Special attention must be shown to each leg and not only those that we must help, ensuring that all 4 are properly examined.

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After behavior, posture, voluntary movements, and gait have been assessed, we begin the physical examination. Palpation allows the examiner to check muscles, bones, and other structures for slight abnormalities. Palpation is carried out systematically, starting with the head, down the neck and continuing through the trunk and extremities. Furthermore, by following the same procedure for each patient, the examiner minimizes the risk of missing something and enables the patient to make an appropriate assessment. One side and the other of the body are compared to assess symmetries. Special attention should be paid to muscle size, tone and strength. They may indicate neurological problems, deviation of joints or limbs, abnormal body loading, or worn toenails. Since a herniated intervertebral disc or any other form of spinal trauma can be painful, the presence of pain during the examination can not only help us make a differential diagnosis but can also help locate an injury.

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Another aspect that must be taken into account due to its fundamental relevance in the diagnostic process are the spinal reflexes used to check the sensory and motor components of the reflex arc. Together with the flexor reflexes, the presence or absence of sensations in each appendage must be assessed. The sensation of pain is usually absent when voluntary movement is also absent. That the perception of pain is intact is indicated to us by the brain's response to pain, for example vocalization (barking or growling), turning the head towards the stimulated side or trying to escape from the stimulus. The absence of deep pain perception usually indicates severe damage to the spinal cord.

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In a complete neurological examination, the different postural reactions must also be assessed. Although these tests include different extremities, they all assess the participation of the brain, spinal cord and peripheral nerves. Abnormal postural reactions indicate a neurological abnormality, but they provide us with limited information regarding the location of the lesion, with the rest of the aspects of the neurological examination being those that help locate the lesion.

Finally, a brief examination of the cranial nerves should also be performed during a neurological evaluation. Animals have 12 cranial nerves, which are mainly responsible for the functions of the head. Abnormal function may indicate a brain injury.

Interpret the neurological exam

After completing the neurological examination, the individual results of each test should be reviewed to help us determine whether or not there is any neurological abnormality and, if so, locate the lesion.

Recovery and Rehabilitation

The objective of physiotherapy in this type of condition will be aimed at:

• Reduce pain.

• Prevent/reduce muscle atrophy.

• Relieve secondary muscle tension.

• Help recover coordination and proprioception.