Wellington is a 12 year-old male Pug that presented to Southeast Veterinary Neurology for evaluation of pelvic limb ataxia and fecal incontinence. Wellington was previously healthy, current on vaccinations and fed a commercial diet. He was the only pet in the household. Approximately four months ago, Wellington’s owner noticed that he was starting to ‘scuff’ his back toes when on a walk. Over the next few weeks, Wellington’s owner noticed that he was having fecal incontinence. It was not consistent. Many times he would have a normal bowel movement outside. Some times, feces were found in his bed where he was resting. Other times, Wellington would know that he had to go, would alert mom that he needed to go, but couldn’t hold it long enough to make it outside.
Wellington’s veterinarian performed a thorough examination, CBC, chemistry panel, thyroid, urinalysis and spinal radiographs. His heart, lungs, lymph nodes, abdominal palpation, orthopedic examination, eyes and ears were all normal. There was mild to moderate ‘wearing down’ of his toenails of his pelvic limb digits. His rectal examination was normal. Blood tests were normal and spinal radiographs showed mild spondylosis at T12-13. He had a hemivertebrae at T5. A course of prednisone and exercise restriction was instituted.
According to the owner, medications and rest helped about 10-15%. Wellington’s veterinarian recommended a consultation with Southeast Veterinary Neurology to evaluate his pelvic limb ataxia and fecal incontinence.
Remember, the neurological examination evaluates mentation, gait, postural reactions, spinal reflexes, cranial nerves and spinal palpation.
On examination, Wellington was alert and responsive. His gait is described as “ambulatory upper motor neuron paraparesis with pelvic limb ataxia”. His thoracic limbs are normal. Postural reactions were absent in the pelvic limbs. Spinal reflexes (patellar and flexor withdrawal) were normal. His cutaneous trunci reflex was present, but was much stronger cranial to T11. He did not seem painful.
Here is a video of Wellington’s gait at initial evaluation.
Note how he is wobbly and spastic in his pelvic limbs. His movements are ‘robotic’ and slow. He knuckles over in the pelvic limbs, especially on the right. When he turns, he starts to fall over. Based on his history, signalment, and exam findings you should be able to answer the following questions:
1. Is this a neurological problem?
2. What part of the neurological system is affected? (e.g. what is your neuroanatomical localization?)
3. What is the severity?
4. What are the possible causes.