Neurobites – December 18 – Subtle Cervical Pain

 

 

Welcome to Neurobites. Each week we feature a useful veterinary neurology tip for our referral community, created by one of our board-certified neurologists.

 

Watch Dr. Joli Jarboe of BVNS Leesburg discuss the signs of subtle cervical pain. A transcript of this video can be found below.

 

 

“This is Noah. So, a lot of times when we look at dogs being assessed for neck pain, one of the hallmark features is to watch how they move and navigate in their surroundings. This is Noah. Noah has a– Come on Noah. So we see a little bit of a two-engine type gait and a pacing gait. Two engine meaning the thoracic limbs are a little shorter strutting compared to the pelvic limbs and a pacing gait, meaning the left limbs are moving in unison and the right limbs are moving in unison. And again, in the wild dog, that’s a mechanism used to conserve energy. And so we see it in our domesticated dogs when they’ve got muscular-skeletal discomfort weakness issues. He’s exhibiting those. So we wanna see how the eye moves his head and neck in his own natural environment.

I’m not sure if you can see, but there is some guarding in the low neck to the cervical thoracic junction. And he moves like someone who slept stiffly. You don’t move your head to the left really tightly, you move your whole body to the left and he’s doing that same thing in the low cervical to cervical thoracic junction. He has great movement of his cranial cervical area and yes, no joint.

So in just watching this dog, I can tell that he’s guarding his low neck region. So we’re gonna go ahead and collect him so I can show you a neat little trick in looking for neck pain, without putting the dog’s neck through cervical range of motion. I get very worried when we take these dogs’ necks and move them that we can make their problem worse acutely. And we can put a dog down if they’ve got a disc protrusion by moving the head and neck laterally up and down. So one of the things that we’d like to do is just palpate in their normal neutral position. I’m rocking the wings of C2. Of C1, sorry, we’re palpating the articular fossettes along the neck. As we go down the musculoskeletal structure.

When we get to the thoracic inlet, the wings or transverse processes of C6 are quite large. Your fingers are naturally gonna find that when you come up ventrally and you rock those. You see that movement, him moving away from that, that shows me that there’s some discomfort there. In a normal situation, a dog isn’t gonna move away from that, if they tolerate being touched. His cervical muscles are tense in the low neck and shoulder area. You see that pinup flicking, that’s a sign of discomfort. So again, I’m more left sided on him. I don’t have to crank his neck around to force the issue. He’s telling me that that hurts. Good sensation of those feet and good withdrawal. Good withdrawal. We’ve also got some paraspinal muscle atrophy along the back and I hope you can see that. Probably some chronic discs in there. ”

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