How I Approach...The Circling Cat

Introduction

The purpose of a neurological examination in veterinary medicine is to provide an answer to four specific questions:

• Does the patient have a neurological problem?

• Where is it?

• What are the differential diagnoses?

• What diagnostic tests must be performed to confirm my suspicions?

  The first objective of the examination is to establish whether or not we are dealing with a disorder that is neurological in nature. Once this has been established, the second step is to identify the neuroanatomical area involved in the pathological process, based on the clinical signs present; this important assessment is referred to as neurolocalization (1).

Key Points

• Circling can be defined as a change in gait whereby the patient, incapable of moving in a straight line, follows a circular pathway.

• Circling is a very significant clinical sign for localizing a neurological lesion, as it specifically suggests the involvement of the anterior encephalon (forebrain).

• Neurolocalization is a basic but essential step in the approach to the neurological patient, as it allows the clinician to formulate a list of differential diagnoses based on the neuroanatomical area involved.

• In feline medicine, a neurological examination is often limited to a few hands-on tests; the patient’s compliance can be affected by its temperament and other factors such as pain or stress.