This is a story I’ve wanted to write, but put off tackling for a long time. That’s partly because a post explaining what to expect when your dog sees a veterinary neurologist includes lots of details. And I didn’t miss any of them.
It’s also because I wanted to be sensitive to pet families on a budget. I remember being surprised when I took my dog Sophie for her initial exam. I didn’t realize the consult and diagnostic tests would be as expensive as they were. So, if you schedule an appointment with a neurologist please be prepared for this fact.
That said, your visit will reveal so many details about your dog’s medical condition and prognosis for the future, your head will be spinning. I learned that from my recent interview with veterinary neurologist, Dr. Martin Young, DVM, DACVIM. The wealth of information he shared had me typing on my keyboard as fast I could.
Dr. Young explained what his goals are when he does a neuro exam, what he learns from diagnostic tests, how he makes a diagnosis and how he formulates a treatment plan for his patients. So hopefully, I haven’t missed any details and this story helps you understand the benefits of having your dog see a neurologist.
Before I share the interview, here are some facts about neurology specialists for pets
Veterinary neurologists diagnose and treat conditions that affect the nervous system. These include disorders of the: brain, spinal cord, nerves and muscles.
They handle paralyzed dogs that have:
- Ruptured discs
- IVDD (Intervertebral Disc Disease)
- Spinal tumor
- Degenerative Myelopathy
- Infections of the spinal cord
- Birth defects of the spinal cord
- Injuries to the head or spine
- Vestibular disease
- Brain tumor
What it takes to become a neurologist
Veterinarians who practice general medicine have 4 years of undergraduate education and an addition 4 years at a University of Veterinary Medicine.
Neurology specialists have another 3 years of neurology/neurosurgery residency and then there’s 1 year of neuro internship. That means, the neurologist who examines your dog has 4 years of specialty training for the job.
About Dr. Martin Young
My interview with Dr. Young wouldn’t have been possible without help from another pet mom of paralyzed dogs. Chrissy S. made the introduction. Dr. Young has treated 4 of her disabled pets. Chrissy also runs the Paralyzed Dog Support Group on Facebook, which a great resource for pet owners.
Dr. Young received his Master of Science degree in Anatomy and Neurobiology from Colorado State University where he also received his Doctor of Veterinary Medicine. He spent the first few years in general practice. Later he completed a small animal medicine and surgery internship before being accepted as the first resident in the Bush Veterinary Neurology Service (BVNS) residency program in 2008. After his residency Dr. Young continued his practice with BVNS in Virginia.
BVNS is the largest Neurology/Neurosurgery veterinary hospital in the U.S. It has 5 locations in Virginia plus one in Maryland and one in Atlanta.
The interview – What to expect when your dog sees a veterinary neurologist
1.Why is it important for my dog to be examined by a veterinary neurologist?
“Dr. Young explained that “many ailments have similar symptoms.” A neurologist has the skills to pinpoint what is really going on in your dog’s body.
For instance, a dog with a ruptured disc due to IVDD has symptoms that look a lot like an FCE Stroke (Fibrocartilagenous Embolism). Both have a sudden onset, cause severe pain and leave your dog unable to walk. But the treatment for each condition is very different.
2. What will happen during the exam?
The BVNS website explains that most patients are referred by their primary veterinarian and records will be sent prior to your visit. If diagnostic tests are planned, you’ll be asked to withhold food and water from your dog before the exam.
When you arrive at the hospital, you’ll be asked to complete a patient history form. This will be reviewed with you during the exam and is a big part of helping the specialist understand what’s going on. They’ll want to know details such as whether the problem started suddenly or over a period of time, how long your dog has been in pain and if the condition has gotten worse. Every bit of information helps.
In the exam room your dog’s vital signs will be taken and a thorough neurological exam will be performed. The vet will evaluate your dog’s gait, posture, level of pain and mental status.
Your dog will be checked for: weakness, how they hold their head, the sensations they feel and if it hurts more to walk up or down stairs. Each detail is a map to the effected part of the spine. And it tells the vet if the problem is acute or progressive.
The vet will also ask about changes in your dog’s behavior. For instance: Is your dog hiding from you, sleeping more or pacing with anxiety? Each symptom is a clue.
3. What happens when tests like an MRI are ordered?
Dr. Young said that after the initial exam he’s likely to order a diagnostic test. The most common one for neurology patients is an MRI. It’s a powerful tool that looks at the spine on a “cellular level.” It uses magnets, radio waves and computer imaging to get a precise picture of the layers in your dog’s spine.
MRI (Magnetic Resonance Imaging) is used to: confirm a diagnosis, learn the severity of a condition, determine if a dog is a candidate for surgery and to rule out a problem so the correct one can be found.
Note: Dogs are anesthetized during an MRI. So, if you’ve been asked to without food before the exam, please be sure to comply. Or you’ll have to reschedule the test.
4. Are there other diagnostic tests?
The suspected condition helps determine which diagnostic test a specialist will use, and they have variety to choose from. These include: CT scan, CT myelogram, Cerebrospinal Fluid Analysis (CSF), Electrodiagnostic studies, EEG, Nerve conduction studies and Brainstem Auditory Evoked Response (BAER).
You can read about the purpose of each of these tests in our popular post: What To Expect When Your Dog Needs An MRI and Other Tests.
5. Other ways a neurologist makes a diagnosis
Dr. Young said he doesn’t order tests without a “clear-cut” reason. Many times, he relies on the age and breed of your dog to make a diagnosis.
He gave 3 very different examples:
If a Dachshund comes to the hospital with back pain or paralysis, there’s a 90% chance it’s a disc problem. That’s because the breed is prone to IVDD. In this case, an MRI is ordered to determine if there are multiple discs involved and to see if the dog is a candidate for surgery.
On the flip side, if a 7 or 8-year-old German shepherd comes in with hind end weakness, Dr. Young said his thoughts immediately turn to the progressive disease – Degenerative Myelopathy. Shepherds are at the top of the list of susceptibility for DM. In this case, Dr. Young said he would order a blood test to see if the dog is a carrier for DM. And if that came back negative, he would order an MRI or look at the spinal fluid to see if there’s a hidden condition like a compression, a tumor or an infection.
And if a young Labrador retriever or other medium-sized dog presented with paralysis or hind end weakness, Dr. Young said he would suspect a severe infection. He said, “As long as the dog hasn’t been in an accident of some kind, there’s a 50 percent chance the cause is due to an infection.”
Click here to read about: Advanced Imaging Procedures To Diagnose Degenerative Myelopathy
6. Does the neurologist performing the exam, also do the surgery and follow up care with my dog?
“Yes, in all regards,” said Dr. Young. “I do the surgery and follow up until a patient is ready to go home. Dogs usually stay in the hospital 24-48 hours or until they’re eating, drinking and peeing on their own. Then they go home with instructions for light physical therapy. I see them again in 2 weeks post-surgery and again at 6 weeks.
After that time, they’re referred back to their primary vet. Before they go, I usually recommend professional physical therapy for the dog or exercises owners can do at home. I also educate owners about lifestyle changes in order to prevent the recurrence of a disc injury. 40-60% of dogs reinjure themselves. So, we discuss how to prevent their dog from jumping on and off a sofa and other ways to protect their spine.”
7. What if there isn’t a neurologist in my town?
Dr. Young recommends you enlist the help of your primary veterinarian for this. Your vet can call a specialist for information. Then the primary vet can do the exam and report the findings to the neurologist who in turn can recommend treatment options.
Dr. Young also suggests going to a “teaching hospital” for surgery or care if a private specialist isn’t nearby.
“Dogs have a better outcome when treatment is started in a reasonable time frame. Disc disease is not going away and the spinal cord can atrophy or become scarred. It’s best to remove the compressive area.”
I can’t thank Dr. Young enough for sharing his time and expertise. His insight about how he makes a diagnosis was eye-opening. My personal experience with the neurologist in my city was less than stellar. And it’s made me reluctant to recommend this type of exam to other pet owners. But Dr. Young’s compassion for our animals and his vast knowledge in the field of neurology, renewed my faith in how a specialist can benefit your paralyzed dog.
Photos courtesy: Bush Veterinary Neurology Service