Sensory evaluation is generally performed last. The animals response to both pressure (hyperpathia) and pin prick stimuli (sensory level) applied to along the spinal column musculature may help localize the lesion. Application of painful stimuli to each limb and the tail (deep pain perception) should elicit a behavioral response (e.g., vocalization, turns to look or bite, or attempts to get away from the examiner) indication the presence of sensation.

Hyperpathia is noted when pressure applied to spinous processes and paraspinal muscles of the cervical region or the thoracolumbar regions results in pain and a behavioral response. Pain perception occurs at the level of spinal cord involvement, making hyperpathia an accurate localizing feature of the neurologic exam.

Manipulate the neck through a complete range of motion, extension, flexion and lateral motion. Dogs with cervical pain will resist manipulation and may cry out.

Sensory level is determined by pin-prick stimulus applied to the skin over the back, beginning in the region of the L7 vertebrae and continuing cranially. The junction between an area of depressed behavioral response and one of normal behavioral response is the sensory level. Pain perception is noted one or two segments caudal to the level of spinal cord involvement.

  • Presence or absence of deep pain perception is the most important prognostic test of the neurologic examination and is a reliable indicator of spinal cord integrity.
  • Apply a painful stimuli to an affected limb. A significant behavioral response (e.g., animal attempts to vocalize, turns to look or bite, or attempts to get away from the examiner) indicates the presence of sensation.
  • Withdrawal of a limb is a reflex, not a behavioral response.