Allow the patient to explore the exam room and observe how it interacts with its environment, the owner(s), and your staff.
Levels of consciousness
- Alert & responsive
- Dull: decreased responsiveness (obtunded)
- Stupor: non-responsive except to a noxious stimulus (e.g., pinching toes)
- Coma: non-responsive even to a noxious stimulus
- Disoriented: confused, loss of bearings
- Demented: inappropriate response to environment/stimulus, agitated, abnormal behavior*
- Other terms occasionally used: hyperactive, somnolent, aggressive
Possible lesion locations
- Dull, stupor, or coma: Forebrain or brainstem
- Disoriented: Most commonly observed in patients with vestibular dysfunction (peripheral or central)
- Demented: Most commonly forebrain
Using the term “depressed” is discouraged in veterinary neurology as this is a psychological term that means a patient is sad, morose, despondent, miserable, blue, morbid, etc. Since veterinary patients cannot describe how they are feeling, the word “depressed” to describe an animal is technically inaccurate. This term should be avoided. The term “demented” means “mentally ill, insane, or suffering from dementia.” As a result, it technically should not be used in veterinary neurology, but it is the term most frequently used to characterize patients that are agitated and acting strangely.