A worried client walks into the examination room, holding the dog. The dog is tetraplegic and the condition was getting worse during last week. They have seen another vet already, who has run several tests, but couldn’t say what is wrong with the dog.
When the owners seek veterinarian help with a case like that, one thing is very important: to make complete neurological exam as a part of clinical examination. Finding out if it goes about neurological problem, checking the dog’s mental status, its cranial and segmental reflexes, proprioception … and finally localize the lesion. In some cases, doing that can almost get you to the diagnosis. Or for sure narrow down the number of tests you need to run.
This case was one of those. The dog’s mental status was completely normal, all cranial reflexes worked fine, but there was paralysis and reduced segmental reflexes in all four legs. Interesting was, that the dog couldn’t walk, but could still wag its tail.
After I attended OKEAN neurology course, I know that paresis or paralysis with reduced segmental reflexes in all 4 limbs is one of criterions, that localize the problem in the peripheral nervous system and not in the head or spine. It is a rare condition and we only have few diagnoses left, which we have to rule out. No need for expensive MRI or CT scans, which would not show us anything valuable.
The dog has long path of recovery ahead until he will get better, and the owners will have to be patient and offer a lot of supportive care to him. Do you know what was the diagnosis? 😉