Case 5

	SIGNALMENT: German shepherd, m/c, 9 years
	HISTORY: Difficulty getting up and using rear legs for the past 5-6 months. Originally thought to be hip dysplasia. Antiinflammatory medication has not helped. Signs are progressive and dog is now knuckling and falling on rear legs. Dog does not seem painful.
	PHYSICAL EXAMINATION: T 101 HR 72 RR panting CRT <2.0 secs. MM pink WT 85 lbs. See neurological examination.
	NEUROLOGICAL EXAMINATION:

E. POSTURAL REACTIONS:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

LEFT	REACTIONS	RIGHT
	Proprioceptive Positioning PL TL
0		0
2		2
2	Wheelbarrowing	2
	Hopping PL TL
0-1		0-1
2		2
0	Extensor Postural Thrust	0
NE	Hemistand-Hemiwalk	NE
2	Tonic Neck	2
	Placing, tactile PL TL
NE		NE
NE		NE
	Placing, visual PL TL
NE		NE
NE		NE

F. SPINAL REFLEXES:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, +4=clonic, NE=not examined)

LEFT	REFLEX, SPINAL SEGMENT	RIGHT
4	Quadriceps (L4-L6)	4
3	Flexion, PL (L5-S1)	3
2	Flexion, TL (C6-T1)	2
2	Triceps (C7-T1)	2
present in PL	Crossed Extensor	present in PL
2	Perineal (S1-S2)	2

G. CRANIAL NERVES:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

LEFT	(Response/Test)	RIGHT
2	Menace (CN II & VII)	2
2	Palpebral (CN V & VII)	2
2	Pupil Size	2
	PLR’S Stimulate left eye Stimulate right eye (CN II & III)
2		2
2		2
0	Strabismus	0
0	Nystagmus	0
2	Facial Sensation (CN V)	2
2	Mastication (CN V)	2
2	Swallowing/Gag (CN IX & X)	2
2	Tongue (CN XII)	2

H. SENSATION:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

Location	TL region
Hyperesthesia	present
Superficial pain	+2
Deep pain	+2

	Generalized LMN		Peripheral nerve
	Spinal Cord C1-C5		Spinal Cord C6-T2
	Spinal Cord T3-L3		Spinal Cord L4-S3
	Cauda equina		Peripheral vestibular
	Central vestibular		Brainstem
	Cerebral cortex		Cerebellum
	Cranial neuropathy		Myopathy
	Musculoskeletal	Expert's Anatomic Diagnosis

LESION LOCATION:            Where is the lesion located? Right Left Bilateral Expert's Lesion Location REVIEW RADIOGRAPHS: Lumbosacral:     Thoracolumbar:     Cervical:     Skull:     Appendicular          WHICH SET ILLUSTRATES THIS CASE?