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Localize: RHL weakness
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How about the possibility of sciatic nerve neuropathy, either peripheral or corresponding spinal cord segment, and the peudo-hyperreflexia of patellar reflex? In patients with sciatic nerve dysfunction, I think it is not rare to see extension of the limb.
Did you confirm the diagnosis by MRI scan?
Takashi Uemura, KyotoAR veterinary neurology center in Kyoto, Japan.
Can I rule out the possibility entirely? No. But, the dog’s absent withdrawal was due to increased tone in the right pelvic limb that was overriding the withdrawal reflex. The dog also had a cutaneus trunci cutoff on the right at L3. Based on these, a UMN lesion was thought most likely. Unfortunately, no, I was not able to confirm the diagnosis via MRI…it was a presumptive diagnosis based on a return to normal with no specific medications (i.e., no prednisone, antibiotics, etc.).
TO whom it may concern;
Thank you very much for your additional explanation. I see your points.
As you know, in dogs with sciatic nerve paresis or paralysis especially acutelly occurred ones, withdrawal reflex may be absent when we pinch the interdigital skin of the lateral side but may be present by pinching medial side.
By the facts that the absence of pain, remarkable asymmetry of severeness of the symptom, relatively quick recovery without specific treatment, I agree with your differential diagnosis.
Ultimately, it is always difficult to show ‘live impression’ of the examiner on the video.
Thank you very much.
And, why not the sciatic right nerve only?
I coud’nt see mild left pelvic paresis at all.
I think it’s harder to see in the video, but there was definitely left pelvic limb paresis when looking at the dog in person. The dog had a normal patellar reflex and withdrawal in the left pelvic limb suggesting no LMN dysfunction in that leg. The dog’s absent withdrawal in the right pelvic limb appeared to be due to increased muscle tone that was overriding the withdrawal reflex. The dog also had a cutaneus trunci cutoff on the right at L3. Based on these, a UMN lesion was thought more likely.