What Is Veterinary Neurology?
Veterinary Neurology is the branch of medicine that treats diseases of the nervous system: the brain, spinal cord, nerves, and muscles in pets. This encompasses such common problems as epilepsy, herniated disks, spinal and head injuries, meningitis, and cancers of the nervous system. A board certified veterinary neurologist is a licensed veterinarian who has obtained additional intensive training in veterinary neurology and has been certified by either the American College of Veterinary Internal Medicine (ACVIM) in the United States or the European College of Veterinary Neurology (ECVN) in Europe to specialize in veterinary neurology.
While your general practitioner veterinarian can diagnose and treat many health problems, certain diseases and conditions require the care of a doctor who has had specialized, intensive training in veterinary neurology in order to provide the very best outcome for your pet.
Why Does My Pet Need A Veterinary Neurologist?
Just as your own primary care physician may feel the need to refer you to the care of a specialist from time to time, your general practitioner veterinarian may feel your pet needs a veterinary neurologist to help diagnose or treat a problem. While your general practitioner veterinarian can handle many aspects of your pet's care, just as in human medicine, there is sometimes a need for the attention of a specialist. You can be assured that a veterinarian who knows when to refer you and your pet for more specialized diagnostic work or treatment is one that is caring and committed to ensuring that your pet receives the highest standard of medical care for his or her condition.
Specifically, veterinary neurologists can provide the following:
- A thorough neurologic examination, which may be videotaped for future reference.
- Brain and spinal cord imaging, including CT and bone scans, MRI, ultrasound, myelography, and radiography.
- Spinal fluid tap and analysis.
- Intensive care.
- Neurosurgery of the brain, spinal cord, and peripheral nerve system.
- Electrophysiologic examination of nerves and muscles.
- Knowledge of clinical trials available to pets with specific neurologic disorders.
Will My Regular Veterinarian Still Be Involved?
In many cases, your regular veterinarian will still supervise your pet's veterinary care, especially if your pet is coping with multiple disease states or conditions. In other cases, your referral doctor will take over the majority of your pet's medical care for the duration of its referred treatment. It depends on your pet's particular problem.
Did You Know?
- In an emergency, the safest way to transport a seizuring or unconscious pet to its veterinarian, for both you and the pet, is in an airline crate.
- There are less than 100 veterinary neurologists in the United States today.
- Seizures are the most common neurological problem in companion animals.
- Intervertebral disk disease is the most common spinal cord problem in dogs.
Frequently Asked Questions
- What Additional Training Does A Veterinary Neurologist Have?
A veterinarian who has been awarded this specialty status by the ACVIM will list the initials, 'DACVIM (Neurology),' after his or her veterinary degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVIM. The word 'Diplomate' typically means the specialist has achieved the following:
• Obtained a traditional 8 year veterinary degree (four years of college plus four years of veterinary school).
• Completed a one year internship and an additional two to three years of advanced training, including a residency at an approved program where the doctor will have trained with some of the best experts in the field and obtained hands on experience.
• Following this training, the aspiring veterinary neurologist must pass a series of examinations covering all aspects of general internal medicine and neurology.
After completing and passing all of these rigorous requirements, the veterinarian is then recognized by his or her peers as a board certified specialist in veterinary neurology. Many veterinary neurologists are also trained in neurosurgery, while others limit their practice to the medical aspects of the discipline and work with a surgeon on the cases requiring surgery. When your pet needs the care of a veterinary neurologist, years of intensive training and additional education will be focused on helping him or her to recover from his or her problem or enjoy the highest quality of life possible.
- What are Examples of Neurologic Diseases In Pets?
• Congenital deafness
• Viral infection (canine distemper, feline infectious peritonitis, feline leukemia, rabies)
• Fungal infection (Cryptococcus, Coccidioides)
• Tick-borne infections (Rocky Mountain Spotted Fever, Ehrlichia)
• Granulomatous Meningioencephalitis (GME)
• Myasthenia gravis
• Hepatoencephalopathy (brain dysfunction due to liver disease)
• Toxicity due to pesticides, lead, ethylene glycol (antifreeze), certain antibiotics
• Nutritional disorders, such as thiamine or vitamin E deficiency
• Traumatic brain or spinal cord injury
• Degenerative myelopathy
- What Problems Does A Veterinary Neurologist Diagnose and Treat?
Veterinary neurology is a challenging field in that some diseases are solely neurologic in origin while in other cases, the neurologic problem may be related to an underlying systemic disease. In the first case, the
veterinary neurologist may be able to treat the neurologic problem directly. In the second case, resolution of the neurologic problem may hinge on the correct diagnosis and treatment of the underlying disease. For example, certain viral infections may result in neurologic signs.
- What Is A Neurologic Veterinary Emergency?
• Complete loss of function of any or all limbs
• Recurrent or intractable pain, specifically of the back and neck
• Head trauma
• Spinal trauma
• Severe depression or inability of the patient to respond to its environment
- What Is Epilepsy In Pets?
Depending on the source, the incidence of epilepsy among the general pet population is estimated at between 0.5 and 2.3%. Epilepsy refers to chronic, recurrent seizures and can be inherited or acquired. Thus, epilepsy is a clinical condition, not a specific disease. Idiopathic epilepsy refers to recurrent seizures in which no identifiable cause is found to explain the seizures, such as metabolic disease, toxin exposure, encephalitis, or brain tumors. Seizure diagnosis involves ruling out common causes of seizures. Initially, your veterinary neurologist will likely order a series of blood tests to help rule out metabolic and toxic causes of seizures. Depending on the age of your pet, the course of the seizures, and the results of the neurological examination, the neurologist may recommend an MRI or CT scan of the brain and/or a spinal fluid tap to look for signs of encephalitis or brain cancer.
Idiopathic epilepsy is most common in purebred dogs, with an age of onset between one and five years of age (often before three years). Dogs and cats with idiopathic epilepsy are completely normal between seizures and have a normal neurological examination.
If your pet's first seizure occurs before 1 year of age or after 5 years of age, is not normal between seizures, or if there are any abnormalities on neurological examination, the veterinary neurologist may recommend advanced diagnostics, such as an MRI of the brain, to help determine the cause of the seizure
- What are Signs of Neurologic Disease In Pets?
• Behavior changes
• Altered consciousness (e.g., depression, disorientation, coma
• Complete or partial paralysis
• Neck or back pain
• Generalized weakness or weakness in one area of the body
• Incoordination or imbalance
• Gait or stance abnormalities (e.g., straddling or shuffling of rear limbs; crouched position)
• Loss of sensory function (sight or hearing)
• Head tilt
• Fecal or urinary incontinence
In some cases, your veterinarian may be able to simply consult with the veterinary neurologist about your pet's care. In other cases, it is necessary to actually refer you to the specialist. Veterinary neurologists are trained in state of the art diagnostic techniques and will utilize advanced imaging such as CT or MRI scans to look at the structures of the nervous system. With electrodiagnostic tests, a neurologist can examine the function of the peripheral nervous system, particularly the nerves and muscles. Spinal fluid analysis can provide clues to such infectious diseases as encephalitis or meningitis. Veterinary neurologists also will be able to make appropriate recommendations for your pet's rehabilitation period, especially after such major procedures as back surgery. Lengthy recuperation times can be necessary, and your pet may be referred to rehabilitation facilities offering such services as water or physical therapy. Pain management will also be addressed.
- What are Veterinary Neurological Exam Basics?
Neurological examinations typically proceed from head to tail, with all areas of the body being given systematic attention in that order. In addition, your pet may be videotaped for future reference and to help train other veterinarians.
Mental status: The pet will be observed to determine whether it interacts normally with its owner, other people and animals, and the environment.
Gait and body posture: The veterinary neurologist will watch the animal walk around the room, in the hallway, or up and down stairs. Additionally, the neurologist will make observations regarding the animal's body posture.
Cranial nerve examination: The pet's senses of sight, smell, and hearing will be checked, as well as its ability to chew, swallow, and move its tongue, eye, and facial structures normally. Response to pain will also be checked.
Physical examination: The pet's body will be palpated for any signs of pain or muscle atrophy. The veterinary neurologist will also perform a number of tests with the pet's limbs to check reflexes and reactions, such as turning a pet's paw over to see if the pet will reposition it to the normal stance, and lifting a pet up off the ground and lowering it back down to see how it positions its legs upon contact with the ground.
Reflex testing: Just as in humans, a veterinary neurologist may check a pet's reflexes as part of the examination process.
- What Neurological Diagnostic Tests are used?
• Myelogram: Contrast dye radiographic study of the spine.
• CSF tap: Cerebral spinal fluid removed from the spinal cord and analyzed.
• Electromyography: Electrical impulses are used to diagnose the function of nerves and muscles.
• Imaging techniques such as MRI and CT.
Services Offered in Neurology
- Multimodal analgesia
- Comprehensive peri-operative monitoring
- Electrocardiography (ECG)
- Blood chemistry analyzer
- Hematology analyzer
- In-house STAT laboratory
- Magnetic Resonance Imaging (MRI)
- Computed Tomography (CT scanning)
- Digital radiography
- Ultrasound-guided fine needle aspiration
- Pulse oximetry and end tidal capnography
- Aggressive analgesia
- Seizure diagnosis and management
- Non-surgical spinal cord disease diagnosis and management
- Neuromuscular disease diagnosis and management
- Electromyography (EMG)
- Cerebrospinal fluid collection and analysis
- Brain and spinal MRI
- CT Myelography
- Spinal radiography and fluoroscopy
- CT scan (brain, bullae, skull, spine)
- Contrast Enhanced Radiation Therapy (CERT)
- Physical Rehabilitation
- Advanced anesthetic monitoring
- Brain and spinal surgery
- Stem cell therapy
- Ventral slot surgery
- Dorsal laminectomy (cervical and lumbosacral)
- Craniotomy/craniectomy-diagnostic and therapeutic
- Spinal distraction and stabilization