The neuro exam is an extension of the physical exam. No needles or fancy equipment necessary! The neurologist will observe the patient in a quiet, controlled environment, then perform a series of tests to evaluate reflexes, responses, proprioception, sensation, and mentation. Often times gait analysis is an important part of the exam. The first question we are trying to answer with the exam is whether or not the problem the animal is having is due to dysfunction of the nervous system. Once we establish that the problem is likely neurological in origin (rather than, for example, an orthopedic problem), step two is determining what part of the nervous system is affected (i.e., brain, spinal cord, peripheral nerves, muscle, etc). We then combine our neuro exam findings, the known history, the age and breed of the patient, and come up with a plan. Sometimes we can determine the most likely diagnosis and treatment plan just based on exam and history, sometimes other testing is needed (e.g., bloodwork, xrays, MRI, spinal tap, etc). The neuro exam is the first step in determining the best plan for your pet.
Can I be present for my pet’s neuro exam?
Generally no. We will borrow your pet and take them to our quiet exam space. The neuro exam is a non-painful, non-invasive test. Nothing besides the physical and neuro exam is ever performed without further discussion and permission by you.
Why is the neuro exam performed away from the family?
We do this so that we can make the most accurate assessment of your pet. Animals tend to be distracted when their owners are present. Sometimes they are protective of the owner/s. It is also important that the neurologist can focus on the exam and give the patient their undivided attention. Our goal is to obtain the most useful and accurate information we can, and this necessitates observing the patient away from the family.
Why are we asked to fast our pets before the neurology consultation?
Every case is different; the diagnostics that are recommended vary widely and are based on factors specific for each case. Many diagnostics, especially but not limited to those that require sedation or anesthesia, require that the patient be fasted for the test to be performed. Often fasting is recommended in these situations because it improves patient safety, sometimes the fasted state actually affects the outcome of the test results. We ask you to fast your pet before your appointment so that if tests need to be performed, we are able to perform them that day rather than scheduling a second appointment.
There are exceptions (a diabetic patient, for example), and if you are not sure whether it is safe to fast your pet, please call and ask the day before your appointment.
To fast your pet appropriately, please feed dinner the night before the appointment, but do not feed after 8 PM, and do not feed breakfast. Please allow free access to water.
My pet receives medications in the morning. Can I administer them before my appointment?
Yes. Especially if it is a medication that your pet has been receiving chronically, it is fine to give before the appointment. Just give it with a very small amount of food so that their stomach stays as empty as possible.
Is the MRI performed on the day of the initial consult? Can I request a “same day” MRI?
If an MRI is indicated for a patient, we are often able to perform it the same day as the initial consult. We work very hard to accommodate same-day MRIs as it reduces stress for the patient and gets us information as fast as possible. Of course there are days when time does not allow for every case to be scanned, and on those days we may need to schedule stable patients to come in later for a “drop-off” MRI. Urgent/sick patients are always our priority, and if your pet requires an emergency MRI, we will always make that happen as soon as possible.
Can I schedule a “drop-off” MRI for my pet?
For various reasons, it may be appropriate to schedule an MRI for a future date rather than scanning the day of the appointment. In those cases, we will schedule a drop-off MRI. We generally ask that you drop off your pet between 7-8 AM (we will confirm a time when the dropoff appointment is scheduled). We may be able to accommodate later drop-off times if your schedule precludes this timeframe. You will not see the Neurologist prior to the scan, but you will talk to them afterward to discuss the findings. The discharge time varies, but plan that your pet will be with us for several hours (you do not need to stay at the hospital once your pet is checked in). If your schedule necessitates an evening discharge, don’t worry. We will make your pet comfortable and they can stay with us until you are able to pick them up.
What is a spinal tap?
A spinal tap is a procedure that is performed to collect spinal fluid. During the spinal tap, the patient must be perfectly still, therefore it is performed with the patient under general anesthesia. For this reason it is usually done following an MRI while the patient is still anesthetized. Spinal fluid is collected from either an area at the base of the patient’s skull or at the end of the back, near the tail. An approximately 3”x3” area is shaved and the skin is cleaned thoroughly. Then a needle is used to collect a small volume of fluid. This is sent out to a laboratory where we get information about how much protein is present, as well as how many and what kind of cells are present.