Description of neurological mimics presented to the neurology service of a small animal referral hospital

Abstract

Background Clinicians observe that cats and dogs referred to neurology services often do not have an underlying neurological disorder. There has been no analysis of the frequency or categorisation of these neurological mimics. Methods Retrospective study of 520 cases was carried out. Data on signalment, presenting clinical signs, neurological examination findings and final diagnosis were collected. Final diagnoses were classified as primary neurological, non‐neurological in origin but with neurological clinical manifestation, completely non‐neurological (neurological mimics) or undiagnosed. Presenting clinical signs and neurological examination results were compared between neurological mimics and primary neurological cases using Chi‐square or Fischer exact test. Relative risk (RR) was calculated for significant associations. Results A total of 74% were primary neurological conditions, 8% neurological mimics, 3% non‐neurological with neurological manifestation and 15% undiagnosed. An animal referred for lameness was approximately five times more likely to be diagnosed as a neurological mimic than as a primary neurological disorder (RR = 5.42, p < 0.001). Cases with a normal neurological examination were approximately 15 times more likely to be a neurological mimic (RR = 14.97, p < 0.001). Conclusion Thorough examination with consideration of alternative diagnoses is important when a neurological condition is suspected in an animal that presents with lameness or normal neurological examination.

High‐field magnetic resonance imaging findings in a young dog with septic arthritis of the shoulder joint

“…Most of these limitations are applicable to the previously reported case 6 as well, and exemplify the difficulty in differentiating clinically between so-called 'neurological' and 'orthopaedic' lameness. 10 The author does not necessarily recommend to perform an MRI in all cases with a similar presentation like this and neither necessarily in every case of septic arthritis, as literature on the use thereof in dogs with septic arthritis to provide a sound scientific basis is lacking. Indeed, radiographic or computed tomographic findings and subsequent diagnostic tests based on the findings thereof may have yielded the same diagnosis.…”

“…Due to the latter, it is not possible to definitively differentiate between ‘neurological’ and ‘orthopaedic’ lameness or a combination thereof. Most of these limitations are applicable to the previously reported case 6 as well, and exemplify the difficulty in differentiating clinically between so‐called ‘neurological’ and ‘orthopaedic’ lameness 10 . The author does not necessarily recommend to perform an MRI in all cases with a similar presentation like this and neither necessarily in every case of septic arthritis, as literature on the use thereof in dogs with septic arthritis to provide a sound scientific basis is lacking.…”

Traumatic injury of left femoral nerve causing unilateral hindlimb lameness in a cat

“…This may lead to what has been termed 'incorrect referral' . 5 The authors would like to point out that 'incorrect' referral may not be the most suitable term as it suggests that a mistake was made. In cases such as the one we reported here, it seems perfectly reasonable for a general practitioner to refer a lame patient to an orthopaedic specialist.…”

“…Lameness in small animals can have a variety of causes, including orthopaedic and neurological disorders. [1][2][3][4][5] Traumatic brachial plexus injury is a frequent cause for monoparesis or monoplegia in dogs and cats. 6,7 Damage to peripheral named nerves, such as the radial or sciatic nerve injury, are reported fairly frequently in large animals such as horses and cattle, and small animals such as dogs and cats.…”

“…Lameness in small animals can have a variety of causes, including orthopaedic and neurological disorders 1–5 . Traumatic brachial plexus injury is a frequent cause for monoparesis or monoplegia in dogs and cats 6,7 .…”