More Case Challenges
Communication Tools
     

Case: 01.16.06
Troy

Case Submitted by:
Karen M. Vernau, DVM, Diplomate ACVIM (Neurology)

Troy is a 1-year-old, male, intact, Doberman Pincher that is presented for a 1-month history of lethargy, anorexia, pain and reluctance to walk. Troy is a mostly indoor dog. He is fully vaccinated, does not have a travel history, and has an otherwise unremarkable medical history. Troy lives in Northern California.

On physical examination, no abnormalities are noted. The neurological examination was recorded.

Click on each link to load the video, then click to play. High Res videos are better quality but are larger; recommended for broadband connections. Low Res videos are smaller and quicker to download; recommended for dial-up connections.
  » (click to see Cranial Nerve Exam: High Res | Low Res)
  » (click to see Segmental Reflex Exam: High Res | Low Res)
  » (click to see Palpation Exam: High Res | Low Res)

The results of Troy's neurological examination are:

  1. Mentation: Quiet, but alert and responsive
  2. Cranial nerves: Normal
  3. Gait/Posture: Reluctant to walk, but able to stand. Voluntary movement noted in all four limbs. He stands with his pelvic limbs wide based, and is narrow based in the thoracic limbs. Most of his weight is over the pelvic limbs. The thoracolumbar spine is kyphotic, and the cervical region is maintained in a slightly extended posture.
  4. Postural reactions: Delayed conscious proprioception (CP) in the pelvic limbs. The thoracic limbs were difficult to evaluate, as Troy stood with his thoracic limbs in an extended position, with most of his weight on his thoracic limbs. (Although in the video the CPs appear normal in the thoracic limbs, as the examiner, I did not feel that they could be interpreted in this dog.)
  5. Segmental reflexes: Normal pelvic limb tendon reflexes and withdrawal reflexes. Normal perineal reflex and panniculus reflex. Normal thoracic limb tendon reflexes, but thoracic limb withdrawal reflexes are incomplete and therefore, reduced.
  6. Palpation: Marked cervical pain, questionable pain present on caudal lumbar palpation. (on repeat examinations, he did not have consistent pain in any other area other than his neck)
A minimum database was done (CBC, chemistry panel, urinalysis, thoracic radiographs, abdominal ultrasound); No abnormalities were found. Troy was anesthetized for a complete set of spinal radiographs (lateral and ventrodorsal), a lumbar CSF tap and a lumbar myelogram.          

How would you manage this case? Choose a button below to test your knowledge or skip to the answer.

How would you manage this case?

     

The Weekly Veterinary Challenge is a collaborative effort of WVC and VIN. Designed to provide interactive learning for WVC attendees and VIN members, the Weekly Veterinary Challenge draws on the strengths of both organizations to provide a quality tool for veterinary professionals to test their clinical knowledge and gather additional information - all in a fun and easy-to-use format.

The purpose of the WESTERN VETERINARY CONFERENCE (WVC) is to provide the highest possible quality continuing education to the veterinary medical profession and related groups. The professional material presented at the WVC is state-of-the-art information delivered by nationally and internationally recognized and emerging authorities.

The mission of VETERINARY INFORMATION NETWORK (VIN) is to inspire and facilitate excellence within the worldwide veterinary community. Founded in 1991, VIN is the veterinary profession's premiere online resource, providing veterinary professionals with the information and tools they need to address the demands of modern veterinary practice.

feedback@weeklyveterinarychallenge.com
Copyright WVC and VIN
Western Veterinary Conference
Email: info@westernveterinary.org
Phone: 702.739.6698
URL: http://www.westernveterinary.org/
Veterinary Information Network
Email: VINgram@vin.com
Phone: 800.700.4636
URL: http://www.vin.com/