Movement

This TidBit has some shameless promotion of my Webinar scheduled for tomorrow (Wednesday May 27th) from 12-1 and repeated 7-8pm. We will review gait assessment, paw replacement and other critical aspects of the neurologic exam. Space is still available so I hope you will consider joining me! If cost is inhibiting your attendance, please email me. I would rather you attended if you wanted to then skip it just because of cost.

Observation of Movement

Observation of gait is critical to understanding neurologic disease. As a resident I had the pleasure (?) of working with a large cat rescue (i.e. lions and tigers, not supernumerary house cats). Gait assessment provided an incredible window into the cat’s neurologic function. Following observation in an enclosure (your exam room) where the pet can roam freely, the next step is to assess the animal during forced movement. For this component we encourage placing the animal in an area that will make them as secure as possible when walking, so that they provide an accurate gait for analysis. This may be outside on the sidewalk, this may be (for a cat) in an exam room with rugs. You are looking to identify ataxia, paresis, and lameness.
I have heard from several of you that you like tables, so I dug out the two gems below that I used in practice. I hope they help!
 
At the conclusion of gait analysis, the next step is to specifically evaluate long-tract signs. The patient is placed on a rug, or other stable surface, and all four limbs are placed in a neutral position under the animal if they can support weight. Postural reactions evaluate proprioception and can be performed in many ways. Spoiler alert – this is not called conscious proprioception anymore!
 
TABLE 1: GAIT ASSESSMENT. To use simply place a “x” in the box associated with the limb in which you observe an abnormality. For proprioception or motor, choose the grading (mild, moderate, severe) that fits the patient and circle or highlight the correct grade.

LimbLameAtaxiaMotorWrite gradeVestibularCerebellarProprioceptiveAmbulatory ____
Non-ambulatory ___PlegiaR thoracicMild Mod   SevMild Mod   SevL thoracicMild Mod   SevMild Mod   SevR PelvicMild Mod   SevMild Mod   SevL PelvicMild Mod   SevMild Mod   Sev

 
TABLE 2: POSTURAL REACTIONS. N = normal; R = reduced/delayed; A = absent.  

LimbPaw Replacement TestTactile PlacingHoppingExt. Post. ThrustWheel BarrowingR thoracicN          R          AN          R          AN          R          AN          R          AN          R          AL thoracicN          R          AN          R          AN          R          AN          R          AN          R          AR PelvicN          R          AN          R          AN          R          AN          R          AN          R          AL PelvicN          R          AN          R          AN          R          AN          R          AN          R          A

 
Have a case that needs a neurology consult? Let me know! I am seeing patients Monday-Saturday right now with variable hours. Have a question about a case and you don't need a full consult? No problem! The best way to contact me about cases is via email; I typically respond to emails in the evenings so if you need help quicker please call.