Is it neuro or ortho? Sorting out lameness, paresis and dogs that won't get up (Proceedings)
Lameness, difficulty walking, and reluctance or inability to rise are common presentations for patients presented to small animal practitioners. Disorders of the central and peripheral nervous systems, spine, long bones, joints, tendons, or musculature can all result in these potential signs. Identifying the organ system and anatomic structures responsible are critical to recommending subsequent diagnostic testing, therapy, and possibly referral to the appropriate specialist. The most critical steps in this evaluation are careful observation of the animal's gait, and a thorough neurologic and orthopedic examination.
Gait examination is arguably the most important part of the evaluation of patients with difficulty ambulating, but is often not performed by veterinary practitioners. The patient should be evaluated while walking towards and away from the examiner, and should also be observed from the side. If the animal is unable to stand or bear weight, adequate support of the limbs in question should be provided while assessing the ability of the animal to voluntarily advance its limbs, bear weight, and move in a coordinated manner.Several abnormalities may be detected with the gait examination. These include:
• Ataxia: incoordination characterized by a failure to walk or move the limbs in a straight line, crossing of the limbs over the body midline, and possibly stumbling and falling. Ataxia indicates neurologic dysfunction, and may be caused by involvement of several areas of the nervous system.