FAQ

General

What is a neurologic exam and will I be able to watch?

  • The purpose of the neurologic exam is to determine whether your pet has a neurologic disease and the most likely location (neurolocalization) of the disease within the nervous system. It is important to note that the neurological exam only suggests the location of the disease, and does not tell us which disease is present. Most of the time, the clients are present for their pet’s neurologic exam.

What is MRI?

  • Magnetic Resonance Imaging (MRI) is the most advanced diagnostic imaging tool available. This safe, non-invasive procedure allows more complete viewing of the body than any other modality. This technology uses no ionizing radiation, such as x-rays. The patient is placed onto a table surrounded by a powerful magnet. Minute signals are produced as the body responds to the magnetic field. These signals are converted to a cross-sectional image, allowing radiologists and other specialists to look deep into the body for injury or disease.

Will it be possible to have an MRI of my pet done the same day as my first appointment with the neurologist?

  • Often (but not always). If your pet has not been fed for 8-12 hours before your appointment, special arrangements may be made after the consultation to peform an MRI or CT scan the same day as your appointment. However, general anesthesia is required for an MRI or CT scan. The procedure requires careful pre-anesthesia evaluation by our staff and careful monitoring during anesthesia.

How long does an MRI take?

  • A thorough scan of the brain or spinal cord takes 1.5-2 hours to complete. However, the entire process (exam, prep work, scan time, and recovery) generally takes half of the day. You will be given a realistic time schedule so you can plan the rest of your day.

Can my pet eat prior to the appointment?

  • It is recommended to fast your pet for 12 hours prior to your scheduled appointment time. Your pet may have water during this time, but no food. This will help expedite some laboratory tests that may need to be performed, and if needed, potentially allow surgery or other tests requiring anesthesia, to be done the same day as your appointment.

What should I expect after anesthesia for an MRI?

  • Your pet will stay in the hospital until it is awake enough to walk. Once you return home you may offer your pet half of their regularly fed meal. Avoid allowing them to drink large volumes of water all at once. Do not be alarmed if they do not want to eat the evening after anesthesia – this is normal. Unless otherwise noted, it is acceptable to start the medications the following morning if your pet does not want to eat the evening after discharge.

How much fur will be shaved on my pet if he/she needs surgery or a spinal tap?

  • Prior to surgery, your pet will have the fur around the surgical site shaved to obtain a sterile field. The extent of area shaved will depend upon the procedure being performed. Most patients will have small areas shaved for placement of IV catheters, intra-operative monitoring, pain medication patches, or where the spinal tap is performed. Depending on the location of the spinal tap, a small square may be shaved at the base of the skull or just above the tail.

Medications

Can my pet’s seizure medications be given together?

  • Yes, unless directed otherwise.

Can my pet still receive flea/tick and heart worm preventative?

  • Heart worm preventative are almost always ok. The tick preventatives: Bravecto, Nexgard, Simparica, and Credelio should be avoided if you pet has seizures.

My medication instructions say to give every 8 hours. Do I have to wake up in the middle of the night to give them?

  • For medications listed as “every 8 hours” or “three times a day” can be given first thing in the morning, in the early afternoon, and before bed.

My pet vomited after getting his/her medication. What should I do?

  • If you see the full tablet/capsule in the vomit, try dosing again in about 1 hour. If the vomiting persists, contact your veterinarian. If you do not see the tablet/capsule in the vomit, resume the normal dosing when those medications are next due.

Seizures

What is a seizure?

  • A seizure is a sudden surge of electrical activity in the brain. Brain cells either excite or inhibit (stop) other brain cells from sending messages. Usually there is a balance of cells that excite and those that can stop these messages. However, when a seizure occurs, there may be too much or too little activity, causing an imbalance between exciting and stopping activity. The chemical changes can lead to surges of electrical activity that cause seizures. Seizures are not a disease in themselves. Instead, they are a symptom of many different disorders that can affect the brain.

What medications are used to treat seizures?

  • Frequent medications used are: Phenobarbital, Potassium Bromide, Zonisamide, Levetiracetam, Gabapentin, Pregabalin and Topiramate.

Does Phenobarbital cause liver damage?

  • The risk of liver damage is individual and mainly dependent on the serum drug levels. If the serum drug level is kept at 30 mg/dL or lower the risk of liver failure is relatively low.

Should my pet with epilepsy still be vaccinated?

  • As long as your pet has not been diagnosed with an immune-mediated disease, routine vaccines are ok to continue.

What side effects are tolerable before I need to start worrying?

  • The side effects will be dependent on which medications are being used and the dose. These side effects should be discussed beforehand. Typically, the side effects are the worst 2-3 weeks after starting a new medication and then often reduce in severity.

Is it safe to leave my pet alone or should he/she always have someone present in case of a seizure?

  • Most people do not have someone to watch their pet 24 hours a day. If you can, great, but it’s not necessary in most cases. It is important to keep your pet in a space where he/she can have a seizure safely. A smaller room or a crate is ideal. A place without access to stairs generally works well. If you have other pets in the house, it is safest to confine your pet away from all other pets. You cannot predict what will happen in the event of a seizure and sadly other pets will often attack the seizuring pet. If possible, have a friend, neighbor, or relative come over to check on your pet if you are gone more than 6-8 hours.

Can seizures cause brain damage?

  • For an isolated seizure that lasts 1-3 minutes, the risk of significant brain damage is low. We become more concerned about brain damage when pets have prolonged seizures (>5 minutes) or severe cluster seizures at home.

What should I do when my pet has a seizure?

  • Remain calm. Protect your pet from injuring themselves by falling off furniture, down stairs, etc. You cannot stop the seizure with restraint. Avoid their mouths as some animals will inadvertently bite during a seizure. When you are able, administer the post-seizure medication protocol recommended by your neurologist.

What triggers a seizure to occur in my pet?

  • We don’t know. Most pets don’t have “triggers” and their seizures are frustratingly unpredictable. Some animals may have triggers such as stress, anxiety, fireworks, etc, but this is less common.

Disc Surgery

What is a herniated disc?

  • Intervertebral discs are the cushions in the space between the bones of the spine. Sometimes these discs can weaken over time that can make them swell or rupture. This rupture, also known as a herniated disc, ruptured disc, or intervertebral disc disease (IVDD), leads to two types of damage to the spinal cord: compression and concussion. The extent of the damage is determined by the type of force, the degree of force applied to the spinal cord, and the length of time that the force was applied. The severity of the compression and / or concussion will determine the degree of neurologic impairment.

How long will my pet be in the hospital after surgery?

  • Most pets are hospitalized for 2-4 days depending on the procedure.

What is the rest period after surgery?

  • For the first 4 weeks after surgery your pet will need to be confined to a crate or small room. He/she will be allowed to go outside a few times a day to urinate and defecate. The next two weeks he/she will be allowed a little more time outside. After 6 weeks, he/she will begin to resume near-normal activity aside from jumping, stairs, and excessive play with other animals. The long term restrictions are in place to reduce the chance of a recurrence in the future.

Can my dog go up and down stairs long term after disc surgery?

  • Ideally, all higher-impact maneuvers including stairs would be avoided. If your pet has to do stairs after the immediate restriction period has ended it is best to limit them as much as possible and to be done in a slow and controlled manner.

My pet was paralyzed before surgery, when will he/she walk again?

  • A prognostic timeline should be discussed with you before surgery as all cases are different, but generally speaking if your pet has a good prognosis, most are walking unassisted within 2 weeks. Full recovery can often take 8-12 weeks after surgery.

Can my pet have another disc problem after surgery?

  • The recurrence rate is around 10-15%, but not all recurrences need surgery.