Archive for the ‘Neuro’ Category

Canine Neurological Diagnosis & Rehabilitation

Monday, April 21st, 2014

lab_treadProblems in the nervous system can be as variable as our patients. Signs and symptoms range from a mild weakness or dragging of the toes to seizures and behavioral changes. Proper suggestions for rehabilitation in these cases are based on signs and symptoms, neurological evaluation and diagnostics, and realistic goals set by guardians and therapists.

As previously mentioned, neurological signs and symptoms are widely varied. Proper diagnosis of the problem is based on a thorough examination, localization to the proper area of the spinal cord, and diagnostics to confirm. Examination involves a full physical examination and a neurological examination. Based on the patient’s history and the signs observed at home and in the clinic, a picture is created to help localize the most likely problem area(s).  A list of differential diagnoses is then created. Diagnostics to isolate the problem may include blood work, urinalysis, radiographs, advanced imaging (MRI, CT) and cerebral spinal fluid analysis. These help to create a good picture of the problem at hand.

When a diagnosis is found, an analysis of the most proper treatment for the patient is identified. Rehabilitation is an important part of this treatment. Using rehabilitation to help patients with neurologic symptoms can help resolve weakness, improve balance, and reteach proper gait patterning—helping patients to move as well as possible. Weakness is addressed by exercises focusing on muscle contractions. It may start as exercises to maintain a standing or sitting position and can progress to advanced exercises on a fit disc, peanut, or pods. These exercises for strengthening also address balance, which is important because every patient needs balance to perform normal functions such as posturing to go to the bathroom and navigating the house. Regular walks (to the patient’s tolerance) can encourage proper gait patterning. If a patient cannot walk without assistance, other modalities can help to encourage normal movement. These can include carts, treadmills with assistance, and swimming. Each of these modalities engage the central pattern generators, spinal cord and brain to retrain the body to walk again. Even if there is no muscular or spinal issue to address, rehabilitation can help patients that are having trouble with integration of information. Exercise and repetition can increase the input to the brain, and the proper amount of input to a specific part of the brain can help maintain nervous cell health. Nerve cells need stimulation in order to remain healthy and active.

In rehabilitation, realistic goals are necessary to anticipate a return to function. Some problems with the nervous system will not allow for full return to function or may even be slowly degenerative. The goals and expectations of rehabilitation should reflect this so that the goals are reasonable for the patient to achieve.

Success in cases of nervous system involvement is dependent on a collaborative effort from the patient, guardian, regular veterinarian, neurologists, and a rehabilitation therapist. With communication, information, and realistic prognoses, a pet can maintain or recover function to live with a good quality of life.