When to Visit a Veterinary Neurologist

istockphoto.comWelcome to part three in a series of articles intended to help you determine when your pet might benefit from a visit with a veterinary specialist. Last week we covered veterinary dermatology. This week’s focus is on the specialty of neurology.

Just as is true with other specialists, veterinary neurologists spend a minimum of three years completing internship and residency training following veterinary school. During this time they master the nuances of a plethora of neurological diseases, from brain tumors and epilepsy to meningitis and intervertebral disk disease (slipped disk). Not only are they adept at treating their patients medically, they are also gifted surgeons performing the most delicate sorts of surgeries required when working in and around the brain and spinal cord.

The physical exam performed by a neurologist is quite different than what you are likely used to seeing. You will observe gentle probing of the nostrils, ears, eyes, and throat. There will be flexion and extension of every joint, tapping of the knees and elbows with a reflex hammer, stretching of the neck into a variety of yoga-like poses, two legged hopping exercises, and inspection of the patient when rolled upside down. All of these observations help the neurologist “localize the lesion” (figure out which part of the nervous system is malfunctioning).

When should your pet be evaluated by a board certified veterinary neurologist? Here are some suggestions:

  • Your pet has a neurological disorder that is not getting better or is getting worse despite multiple visits with your family veterinarian.
  • Your pet has a gait abnormality the cause of which cannot be clearly determined.
  • Your pet has partial or complete disuse of one or more legs.
  • Your pet has seizures that are not well controlled with medication.
  • Your pet has an unexplained change in behavior.
  • Your pet is experiencing pain the source of of which cannot be identified.
  • Your pet has been diagnosed with a neurological disorder, particularly one with which your family veterinarian has limited experience.
  • You simply want to be more certain about the advice you’ve received from your family veterinarian.
  • The breed you fancy is prone to neurological disease. For example, Great Danes and Doberman Pinchers are predisposed to cervical spondylomyelopathy (abnormal alignment of bones within the neck that can result in pinching of the spinal cord) and Dachshunds are notorious for developing intervertebral disk disease (slipped disk). A visit with a veterinary neurologist will allow you to preemptively learn more about the disorder as well as any preventative measures you might be able to take at home.

To find a board certified veterinary neurologist in your community or learn more about this specialty, visit the American College of Veterinary Internal Medicine. Neurology is a subspecialty within this organization. Be forewarned, there simply aren’t enough veterinary neurologists to go around. If there are none practicing in your neck of the woods, I encourage you to seek help from an internal medicine specialist for neurological issues that can be treated medically. For neurological issues requiring surgical management, the best substitute for a neurologist is a veterinarian who specializes in surgery.

Have you and your pet ever visited a veterinary neurologist? What was the reason and what was the outcome?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
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Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

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8 Responses to “When to Visit a Veterinary Neurologist”

  1. Natalie says:

    With the dog we have now, we consulted a neurologist because our dog had moderate back pain and it wasn’t clear from other diagnostics whether it was a pinched spinal cord or something else.

    He wasn’t incapacitated by it. But he’s a young dog and we wanted to be sure there wasn’t something like surgery we could do to resolve his back pain. I didn’t want to wait until he was severely incapacitated and then discover that we could have fixed the problem years earlier. So in this case it was a matter of making certain that we were doing everything that could be done.

    End result was that his pain is most likely orthopedic, that there is so surgery or other procedure that can fix it, and that we are doing all that we can for him. So it gave us confidence in our treatment plan.

    Peace of mind for us, which was worth a lot when dealing with a problem in a young dog with no other major health problems!

  2. Lynn says:

    Maxwell, my spaniel started walking as though he had a few cosmos too many, wobbly and dragging his front paws. This occurred over a 2 week period, prgressively getting worse. Our vet recommended that we see a neurologist. Next day we took max in for an MRI spinal tap and blood work. Dr Samut (love her) diagnosed him with cryptoccosis which caused a swelling on his spine just below the brain. He was on fluconazol for almost 18 months, but we saw improvement right away. He was walking running jumping playing normally after a few months but he was kept on the med until the fungus was gone. We were so grateful that a specialist could quickly diagnose and treat what was a very scary episode. ( we think he contracted it when we had extensive grading done on our property that stirred up bird poop!)

  3. Natalie says:

    Hi Jana,

    I too would recommend consulting with a neurologist even if you do not plan to do advanced diagnostics. The physical examination a neurologist can complete often can tell the neurologist a lot about the problem.

    With the last neurologist we worked with, for example, he noted that by the time he does an MRI or a CAT scan he usually will have a pretty good idea of what he is likely to find based on the physical examination. And treatment often can proceed on the basis of that informed opinion without the confirming scan.

    Perhaps more important is the example of a friend whose golden retriever developed seizures. Her dog was very lethargic, couldn’t walk well, had trouble standing… and the GP vet did not have enough training to recognize whether her symptoms were a result of her disorder or of the medication for the disorder. As soon as the neurologist saw a video of her behavior, he recognized that it was a side effect of the medication and took her off of the medication immediately.

    That neurologist also essentially diagnosed her condition based on her symptoms and her human caretake opted not to do the confirming diagnostic scans. In her case, her symptoms pretty clearly demonstrated that there was a brain tumor and where it was located. So again, the scan would be confirming only. They treated based on the informed opinion.

    When one of our dogs had an unexpected event where he couldn’t stand up, the GP vet, who is better than average skill-wise, saw that some symptoms fit vestibular but others didn’t. He sent us immediately to the neurologist who determined that it was most likely a vascular event.

    In every case, a good neurologist made a much more specific and useful diagnosis. I know I sound like a broken record but with neurologists, a good one is worth her or his weight in gold. That golden retriever might have been euthanized prematurely but for the expertise of the neurologist.

  4. speakingforspot says:

    Great question Stacy. Any time a dog develops significant unexplained behaviors, a consultation with a neurologist makes great sense. Such behavioral changes are relatively common in older dogs, associated with senility (often referred to as canine cognitive disorder) for which medication can be tried. A neurologist will be able to help rule out other diseases that may cause similar symptoms.

  5. Janine says:

    We’ve been to a neurologist a few times, most recently because my male GSD started having grand mal seizures several months ago. I’m lucky to live near the NC State University Vet School, especially considering how often my shepherds have needed specialists. Duncan is actually now part of a clinical trial to see if external vagal nerve stimulation can help reduce/control seizures.

  6. Very nice article!

    (I think when you wrote “The disease you fancy is prone to neurological disease” you meant “the BREED you fancy”!)

    Could you say a little more about when a neurologist might be helpful with a senior dog who might have some mental deterioration?

  7. speakingforspot says:

    Hi Jana. Great question. I would encourage a visit with a specialist even if not ready to proceed forward with their recommendations. The consultation should provide a great deal of information which should be helpful in making good medical decisions on your pet’s behalf. The consultation is nothing more than that- in no way will you be obligated to do anything more.

    Dr. Nancy

  8. Jana Rade says:

    Would it make sense to visit a neurologist even though we don’t feel it’s the time to pursue neither MRI diagnostics or surgery?