Charlie - December 2013

Charlie, a 5 year-old neutered male Shih Tzu mix, presented to his family veterinarian for neck pain. Charlie was reluctant to move his head or to jump onto the furniture. Initial evaluation by his veterinarian showed an alert dog with a hunched posture. The head was carried low and the back seemed arched. The remainder of his neurological and general physical examination were unremarkable. His veterinarian discussed possible causes including a slipped disk, meningitis/myelitis, infection, trauma and neoplasia. A referral to Southeast Veterinary Neurology was discussed. Since his signs had just started, medications and strict rest were prescribed. Charlie was prescribed Rimadyl at 2.2mg/kg orally twice daily and Tramadol at 4mg/kg orally three times daily.

Charlie responded very well to medications and crate rest, however four days later he had several generalized seizures. He was evaluated at an emergency clinic. Injections of valium and phenobarbital eventually controlled the seizures, however Charlie was minimally responsive. The owners were warned that Charlie may be ‘brain dead’ and a poor prognosis was given. A referral to Southeast Veterinary Neurology was made.

The neurological examination should answer two main questions:

1. Is this a neurological problem?

2. What is your neuroanatomical localization?

Using this information, you should also be able to make a reasonable list of differential diagnoses.

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