COMMON NEUROLOGICAL PROBLEMS IN VETERINARY MEDICINE

The two most common problems a veterinary neurologist/neurosurgeon sees are seizures and back pain which can lead to an inability to walk.  A neurologist not only has the tools to diagnose these problems (MRI) but also has the knowledge and ability to treat these problems.  Your veterinarian may send you to a specialty hospital or you may need to seek emergency care if your pet experiences either of these problems when your veterinarian is closed”.

Seizures most commonly are due to epilepsy where there are seizures without an identifiable underlying disease process. Other causes for seizures include brain diseases such as brain tumors, encephalitis or stroke. Low blood sugar or calcium and some intoxications can also cause seizures.

They commonly occur while sleeping and can involve violent paddling, excessive salivation, urination and defecation and loss of consciousness. Contrary to popular belief, dogs will not choke on their tongue and you should NEVER put your hand in their mouth to avoid being bit. After a seizure, patients are temporarily confused. It can help to soothe or gently restrain them to keep them safe but be cautious as occasionally in this ‘post ictal” phase, they may not recognize you and can sometimes behave aggressively.

Treatment usually involves daily medications (often 2 or 3 times a day) and carries drawbacks such as cost, side effects and the need to keep a rigid dosing schedule. As with anything, treatment shouldn’t be worse than the disease. If seizures are infrequent or mild (more than a few months between seizures) it may be best to monitor without medications. If seizures are more than every 2 months however, medications should be started. Medications are also recommended for when dogs have “cluster seizures”, meaning more than one in 24 hours.

Seizures sometimes require seeking emergency medical attention. If a dog has 3 or more seizures in 24 hours or any seizure lasting more than 5 minutes, emergency treatment should be sought.

This is the most common cause of spinal cord dysfunction in dogs and occurs when the disk that lives between each of the vertebrae herniates or ruptures leading to compression of the spinal cord and interruption of the signals travelling between the brain and the limbs. A herniated disk can happen at any time and almost never is due to an injury or trauma, but rather happens in dogs with a genetic predisposition.  The most common breeds are Dachshunds and French Bulldogs, but most  small breed dogs and some large breed dogs can also develop disk herniations.

Symptoms can range from mild (back pain) to severe (complete paralysis). Sometimes symptoms are obvious (dragging the rear limbs) and other times less obvious (hunched back, reluctance to jump, reclusiveness or spontaneous yelping), Medical management with rest and pain medications can be effective in half the cases, whereas surgery is successful in 95% or more of the cases.

Diagnostic testing with MRI or CT is necessary to confirm the diagnosis and guide treatment decisions. Medical management can be reasonable when symptoms are mild but if a dog becomes uncoordinated or weak in the back legs or loses the ability to walk, immediate veterinary attention should be sought. Veterinary neurologists can assess patients to determine if further testing should be performed and then, if necessary, interpret the tests and perform surgery. Even paralyzed dogs have a good chance for recovery if treated in a timely manner.