QUARTERLY BEAT / JULY 2025
NEUROLOCALIZATION
DOGS AND CATS
IN
Wondering how to trace back your patient’s abnormal gait to where the root problem is? We’ve got you covered! In this VETgirl article, Dr. Missy Carpentier, DACVIM (Neurology) provides a comprehensive review of small animal neurolocalization. Read on to refresh your knowledge of how to read the map of central nervous system signs in cats and dogs!
Missy Carpentier, DVM, DACVIM (Neurology) Minnesota Veterinary Neurology, Columbus, MN The main goal of the neurologic examination is to identify if the patient is truly neurologic, and if so, further identify the specific area of the nervous system that is affected, known as neurolocalization. Neurolocalizing your patient is the only way that you can make an appropriate list of differentials and come up with the best recommendations for your patient. I am not going to go through the step-by-step neurologic examination – you can open any textbook and find this information – but I am going to review the main points of the neurologic examination and discuss how you use this information to neurolocalize your patient. IS YOUR PATIENT NEUROLOGIC? The first goal of the neurologic examination is to identify if your patient’s signs are neurologic in origin – this can sometimes be the hardest part! Below are the bullet points for a good neurologic examination. To me, the most important part of the neurologic examination is the hands-off evaluation. Don’t worry if you don’t know what muscle belly you are supposed to be hitting and what the reflex is called - you can neurolocalize most patients based on their signalment, history, and gait evaluation. This doesn’t mean that you shouldn’t be performing a hands-on neurologic examination to the best of your abilities but think of the hands-on part of the exam as further solidifying what part of the nervous system is affected.
HANDS-OFF NEUROLOGIC ASSESSMENT SIGNALMENT Many neurologic disorders have an age and breed predilection that is helpful when forming your list of differentials. HISTORY/PRESENTING COMPLAINT The first question that I have my technicians ask when they go into the room is what brought the owners in to be evaluated. We encourage the owners to give as much descriptive information as they can about their concerns. If they start to use medical terminology and they are not in the medical field, we will ask them to clarify what they mean (i.e., if they come in saying their dog had a tonic clonic seizure with loss of consciousness and autonomic dysfunction, ask for an actual description to be sure they didn’t just pull this information from Google and that truly is what occurred). Allowing the owners to describe abnormal events in detail also allows us to pick up additional information about the event or clinical signs that the owner may not know are important to the history. You should be able to gather the following information from the owners:
NEUROLOCALIZATION REGIONS 1. Brain
• Onset • Duration • Progression • +/- Lateralization • Presence of hyperesthesia • Presence or absence of improvement with medications
• You can get more specific but just figuring out if the brain is involved or not is a great place to start. Below you will find information regarding cerebellar signs that can allow you to be more precise.
2. C1-C5 myelopathy 3. C6-T2 myelopathy 4. T3-L3 myelopathy 5. L4-S3 myelopathy 6. Diffuse lower motor neuron 7. Multifocal
Other important information to obtain from the owners includes how long they have had the pet, vaccine status, travel history, use of preventative medications, access to toxins, any history of trauma, if any other animals or littermates are affected, diet, current medications, and any pertinent prior medical history.
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