Neurology Is Open
What Is a Veterinary Neurologist?
VSC Neurologists have undergone multiple years of advanced training and passed a series of rigorous exams to become Diplomats of the American College of Veterinary Internal Medicine. They are recognized experts in the diagnosis and treatment of diseases of the nervous system, which includes the brain and spinal cord, as well as peripheral nerves and muscles.
When you meet one of our veterinary neurologists, they will collect a detailed history and perform a careful neurologic exam on your pet. Together, the history and exam findings will allow them to determine if your pet has a neurologic problem and, if so, better understand which part of the nervous system is affected. The next step will often be diagnostic testing to learn more about the cause.
Diagnosing Neurological Disease
X-Ray (Radiography)
X-rays of the spine may be helpful for detecting fractures, bone tumors, arthritis, and infections of the intervertebral disc.
CT (Computed Tomography) Scan
CT scanners use X-rays rotating around a circular gantry to produce a three-dimensional representation of the patient. The area of interest can be viewed from different angles (planes) and even sectioned into thin “slices”. Because the patient must lie completely still for several minutes, pets are typically sedated for their CT exam. CT is often the preferred choice for investigating problems that affect bone. VSC offers on-site CT scans at both our Vienna and Gaithersburg locations.
MRI (Magnetic Resonance Imaging) Scan
Unlike x-ray and CT which rely on ionizing radiation, MRI uses a magnetic field combined with pulsed radio waves to produce images. Like CT, MRI produces images in three dimensions, giving us a detailed insight into the patient’s anatomy and any possible pathology. It is the preferred imaging modality for visualizing soft tissue, including the nervous system. MRI is a relatively slow process, and it may take anywhere from 45 minutes to 2 hours to complete the scan; patients need to be perfectly still and are therefore kept under general anesthesia during this time. VSC is proud to offer on-site MRI scans at both our Vienna and Gaithersburg locations.
Cerebrospinal Fluid Analysis
Cerebrospinal fluid (CSF) is produced within the brain and surrounds the brain and spinal cord to provide a protective cushion. Using a fine needle, a small volume of CSF is collected while the patient is under anesthesia. This fluid can be analyzed for evidence of diseases within the central nervous system including inflammation, infection, and cancer.
Treatment of Neurological Disease or Injury
While certain conditions may be treated with medicines, others may have a better outcome with surgery. At VSC our neurologists are experts in both medicine and neurosurgery. Once a diagnosis is made, they will discuss the treatment options with you and help formulate the best plan for you and your pet.
Common Symptoms of Neurologic Disease
Gait and Postural Abnormalities:
- Knuckling over when standing or walking
- Dragging or scuffing nails or paws when walking
- Uncoordinated movement or walking “drunk” (ataxia)
- Weakness (paresis) or complete loss of movement (paralysis)
Pain:
- Neck or back pain
- Increased sensitivity to touch (hyperesthesia)
- Decreased or absent pain sensation
Seizures and Movement Disorders:
- Generalized seizures / whole body convulsions
- Focal seizures, e.g. facial twitching
- Episodes of stiffness and/or collapse
Altered Mentation or Behavior:
- Confusion or disorientation, e.g. getting lost in familiar surroundings
- Behavior changes, e.g. changes in personality, changes from the normal routine, accidents in the house, increased nighttime activity
- Circling
- Head pressing
- Dullness, stupor or coma
Vestibular Abnormalities:
- Poor balance, e.g. leaning, falling or rolling to the side
- Head tilt
- Rapid, spontaneous eye movement from side to side (nystagmus)
Cranial Nerve Deficits:
- Drooping of the face, e.g. lip or ear
- Inability to blink
- Drooping of the upper eyelid
- Abnormal or unequal pupil size
- Dropped jaw (inability to close the mouth)
- Difficulty swallowing
Neuromuscular Signs:
- Generalized weakness (fatigue, collapse, difficulty rising)
- Exercise intolerance (weakness that worsens with activity)
- Muscle atrophy
- Muscle tremors
- Regurgitation after eating
- Voice (bark) change
Urinary or Fecal Incontinence:
- Dribbling urine
- Dropping stool
- Inability to urinate
Neurologic Conditions That We Diagnose and Treat
Disorders of the Brain (Encephalopathies):
- Inflammatory conditions, e.g. granulomatous meningoencephalitis, necrotizing meningoencephalitis, eosinophilic meningoencephalitis
- Infection, e.g. bacterial, viral, fungal or protozoal
- Neoplasia, i.e. primary and secondary brain tumors
- Vascular disease, e.g. hemorrhagic and ischemic stroke
- Developmental abnormalities, e.g. congenital hydrocephalus, caudal occipital malformation syndrome (COMS), intracranial arachnoid cyst
- Degenerative conditions, e.g. lysosomal storage disease
- Metabolic diseases, e.g. hepatic encephalopathy
- Nutritional abnormalities, e.g. thiamine deficiency
- Head trauma
Seizures:
- Primary/idiopathic epilepsy
- Secondary/symptomatic epilepsy
- Reactive seizures
- Refractory epilepsy
- Status epilepticus
Narcolepsy/Cataplexy
Movement Disorders:
- Idiopathic head tremor
- Intention tremor
- Essential tremor
- Orthostatic tremor
- Scotty cramp
- Episodic falling syndrome
- Lafora’s disease
Balance Disorders:
- Peripheral disease, e.g. idiopathic vestibular disease, otitis media-interna, hypothyroidism, tumor, toxin
- Central disease, e.g. infectious / inflammatory conditions, neoplasia (cancer), toxin
Cerebellar Disease:
- Congenital abnormalities, e.g. caudal occipital malformation syndrome, cerebellar hypoplasia, cerebellar abiotrophy, Dandy-Walker syndrome, lysosomal storage disease
- Neoplasia, i.e. primary and secondary brain tumors
- Infection, e.g. viral disease (feline panleukopenia virus, canine parvovirus) or protozoal disease (Toxoplasma, Neospora)
- Inflammatory conditions, e.g. granulomatous meningoencephalitis
- Vascular disease, e.g. ischemic stroke
- Intracranial arachnoid cysts
Tremor Disorders:
- Inflammatory conditions, e.g. corticosteroid responsive tremor syndrome
- Congenital abnormalities, e.g. dysmyelinogenesis (hypomyelination / dysmyelination)
- Toxins
Disorders of the Spinal Cord (Myelopathies):
- Degenerative conditions, e.g. degenerative disc disease, cervical spondylomyelopathy (Wobblers), degenerative myelopathy (DM)
- Developmental disorders, e.g. congenital vertebral malformations, syringomyelia / hydromyelia
- Neoplasia, e.g. spinal tumors
- Inflammatory disease, e.g. meningitis/meningomyelitis
- Infectious disease, e.g. discospondylitis
- Vascular disease, e.g. fibrocartilaginous embolism (FCE)
- Trauma, e.g. vertebral fracture and/or luxation
- Miscellaneous, e.g. spondylosis deformans, disseminated idiopathic skeletal hyperostosis (DISH)
Disorders of the Cauda Equina:
- Degenerative, e.g. degenerative lumbosacral stenosis, Type I degenerative disc disease
- Developmental, e.g. congenital malformation of the cauda equina
Spinal Trauma:
- Spinal cord concussion / compression / contusion
- Vertebral fracture / luxation
- Traumatic intervertebral disc herniation
Disorders of the Peripheral Nervous System:
- Degenerative/inherited disease, e.g. laryngeal paralysis, dancing Doberman disease, megaesophagus, idiopathic facial paralysis, idiopathic self-mutilation, spinal muscular atrophy, dysautonomia, lysosomal storage disease
- Metabolic disease, e.g. diabetic neuropathy, hyperadrenocorticism (Cushing’s) neuropathy, hypothyroid neuropathy
- Neoplasia, e.g. malignant nerve sheath tumors, paraneoplastic neuropathy
- Inflammatory disease, e.g. optic neuritis, idiopathic polyradiculoneuritis (coonhound paralysis), trigeminal neuritis
- Trauma, e.g. brachial plexus injury
- Toxin, e.g. Vincristine neuropathy
Disorders of Muscle (Myopathies):
- Degenerative/developmental disorders, e.g. muscular dystrophy, centronuclear myopathies, exercise intolerance and collapse (EIC), myotonia congenita, fibrotic myopathy, episodic muscle hypertonicity (“Scotty cramp”), myokymia, neuromyotonia
- Metabolic disease, e.g. hypokalemic myopathy, hyperadrenocorticism (Cushing’s) myopathy, hypothyroid myopathy, malignant hyperthermia, exertional myopathy, mitochondrial myopathies, glycogen storage disorders
- Inflammatory/infectious disease, e.g. masticatory myositis, extraocular myositis, autoimmune polymyositis, dermatomyositis, feline hyperesthesia syndrome, infectious myositis, tetanus
- Ischemia, e.g. ischemic neuromyopathy (saddle thrombus)
- Trauma, e.g. iliopsoas muscle injury, coccygeal muscle injury (limber tail, cold tail, frozen tail)
Disorders of the Neuromuscular Junction:
- Autoimmune disease, e.g. acquired myasthenia gravis
- Congenital, e.g. congenital myasthenia gravis
- Toxin, e.g. blue-green algae, botulism, organophosphates, tick bite paralysis