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Diagnostic Plan for an Animal with Neurological Disease, Part 1: Where Is It?
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Signalment
Accurate diagnosis of a neurological disorder must include consideration of an animal's age, breed, and sex. Diseases may be specific to certain species and breeds.
Presenting Complaint
The reason the owner has brought the animal to you.
History
First a general history should be obtained (e.g., acquisition circumstances, environment, travel history, diet, vaccination history, medical history). Second, the history of the presenting complaint should be investigated.
Physical Examination
A physical examination consists of a series of observations that provide information regarding the general health of all body systems. Results of this examination are used to supplement information collected in the history and may implicate involvement of body systems other than the nervous system. For example, an animal presented with a primary complaint of spinal pain may in fact have abdominal pain related to an underlying gastrointestinal or urinary system disorder.
A thorough orthopedic examination should be completed in any dog suspected of having a neurological disorder. Particular attention should be paid to the examination of joints for signs of effusion or abnormal motion. Disorders such as rupture of anterior cruciate ligaments bilaterally or bilateral patellar luxations may mimic paraparesis due to a neural disorder.
Problem List
A complete list of problems should be compiled following completion of a physical examination. All identified problems should be included, despite the fact that certain of the problems listed may not appear to be directly related to the presenting complaint of an animal. Problems should be listed at the most current level of understanding and should be updated, redefined, or combined as more information is collected. Careful attention to maintenance of a problem list ensures that all aspects of an animal's complaint are addressed during a work-up. This is essential, as often there is a tendency for a clinician to focus a work up on an obvious neurological deficit while ignoring a related problem. For example, a dog or cat with signs consistent with spinal cord infarction may have signs that reflect an underlying cardiovascular or endocrine problem. [...]
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