I just completed my two-week neurology rotation. You might think that, because I love dog brains, this would have been right up my alley. Actually, I love the parts of brains that help us learn, fear, trust, and love. Veterinary neurology, on the other hand, is a big game of Hunt the Lesion. A dog comes in uncoordinated and with a head tilt. Where in its brain, cranial nerves, or spinal cord is the problem?
A good neurologic exam can localize the problem to the cerebrum, the cerebellum, one or more of the cranial nerves, the spinal cord in front of the front legs, the spinal cord over the front legs, the spinal cord between the front and back legs, the spinal cord over the back legs, the spinal cord behind the back legs, or something more general (a diffuse muscle, nerve, or muscle/nerve junction problem). Once we had an idea where the problem was, we usually sent the animal in to the MRI scanner (a luxury at a large referral hospital; we received a lot of animals coming in just for the MRI, referred from places that don’t have them). This allowed us to see exactly where the lesion was, and to get some information about what kind of lesion it was (intervertebral disc extruded into the spinal canal? A stroke? Cancer?).
I did enjoy neurology, even though Hunt the Lesion isn’t my favorite game. There was a surprising amount of basic medicine to learn; I got a lot more comfortable with how to manage post-surgical animals (we did lots of vertebral surgeries), as well as how to approach a diagnosis (young animals are more likely to have congenital or infectious problems or to have eaten toxins; older animals are more at risk for stroke or cancer). Practicing basic medicine is always good! So it was an enjoyable rotation, but now I am really looking forward to my upcoming four whole weeks of elective time.