Page 77 - Canine Lameness

4.3 The Neurologic Examination 49

The neurologic examination can be divided into eight parts: (i) mentation status and behavior,
(ii) posture, (iii) gait, (iv) cranial nerves, (v) postural reactions, (vi) muscle mass and tone,
(vii) spinal reflexes, and (viii) perception of sensory stimuli and pain (Table 4.2). This sequence is
the order which the author feels most logically evaluates the nervous system while considering
patient comfort. However, the specific order is far less important than having a systematic way of

Table 4.2 Components of the neurologic examination and interpretation of the patient with lameness
and/or paresis.

Findings/observations Interpretation
Mentation status and Normal UMN or LMN; some intracranial
behavior Abnormal Intracranial

Posture Neck guarding Cervical pain (muscle, joints, meninges, nerve
root, and bone/disc) or referred (e.g. intracranial)
Kyphosis Congenital or acquired malformation, spinal pain,
Scoliosis and abnormal muscle tone
Lordosis
Head turn Prosencephalon or cervical pain
Head tilt Vestibular or cervical pain
Spontaneous knuckling UMN (GP ataxia)
Gait Lameness Orthopedic or LMN
Paresis/paralysis (general) UMN (spastic or normal) or LMN (flaccid)
Monoparesis/‐paralysis LMN (focal disease)
Hemiparesis/‐paralysis UMN more likely
Paraparesis/‐paralysis UMN or LMN (multifocal)
Tetraparesis/‐paralysis UMN or LMN (generalized)
Ataxia All UMN; cerebellar, vestibular, and/or GP ataxia
Cranial nerves Normal UMN or LMN; some intracranial
Abnormal Brainstem; LMN (CNs VII, IX, X, XII most
common), focal or multifocal (e.g.
polyneuropathy)
Postural reactions Normal Orthopedic disease
Some LMN (e.g. NMJ, muscle, and cauda equina)
Delayed or absent UMN (intracranial or spinal cord), LMN, other
(e.g. sedation and systemic illness)
Muscle mass and Normal tone Orthopedic or UMN
tone Hypertonic UMN

Hypotonic or atonic LMN
Muscle atrophy
Acute; severe LMN (neurogenic)
Chronic; mild, moderate, or Orthopedic or UMN
severe
(Continued)