Abstract
The emphasis in these articles is not on the ‘must-have’ diagnostic tools that only few have ready access to, but on the clinical skills and approach that all can learn and develop.
The number of pet owners demanding that their cat benefits from the same expert care, diagnostic facilities and treatment modalities available to themselves has increased sharply over the past 15 years. In response to this demand, the number of referral clinics has rapidly increased and advanced diagnostic modalities such as computed tomography (CT) or magnetic resonance imaging (MRI) have become ‘must-haves’. Neurological conditions that previously necessitated post-mortem studies for diagnosis can now be identified ante-mortem, helping owners to make better treatment decisions for their pet.
Many veterinary practitioners consider neurology to be one of the most difficult specialities. This apprehension is heightened when faced with an uncooperative feline patient. This hurdle has too often pushed the clinician into neglecting the neurological evaluation in favour of making the best guess at which diagnostic tests may achieve a diagnosis. The temptation is all the greater if the clinician has ready access to these must-have tools of modern referral facilities.
Anyone dealing with feline neurology patients has been (or certainly will be) reminded that advanced diagnostic tools are not a substitute for the ‘classical’ approach to a neurological patient. This approach relies primarily on establishing if and where a lesion is within the nervous system, based on the neurological examination (ie, determining the neuroanatomical diagnosis). A shortlist of differentials is then drawn up, based on the history and neuroanatomical diagnosis, and diagnostic tests are carefully chosen to investigate this list of differentials. The choice and interpretation of these tests must rely on a clear knowledge of the neuroanatomical diagnosis and the expected disease processes.
The failure to consider lesion location within the nervous system, and what kind of disease processes may be there, is the most common cause of failure in the diagnosis of neurological conditions in cats. Although it is incorrect to consider advanced imaging tools such as CT or MRI as ‘gimmicks’ per se, these must-haves certainly become gimmicks without the right clinical thought processes.
The rationale for this special feline neurology issue of JFMS ‘clinical practice’, therefore, has been primarily to present a logical clinical approach to the common neurological complaints seen in practice. Ultimately, the goal is to provide the practitioner with the necessary clinical tools to take on the challenge of a neurological examination in a cat and to tackle common neurological complaints such as seizures, ataxia, paresis or weakness. As you will discover, the emphasis in these articles is not on the must-haves that only few have access to, but on the clinical skills and approach that all can learn and develop.
I am grateful to all the authors who have contributed their time, knowledge and expertise to this special issue. Aside from their excellent clinical and teaching skills, all of the contributors share a drive and enthusiasm for continuing to develop veterinary neurology. I hope you will thoroughly enjoy this special issue and, from now on, relish dealing with feline neurology patients.
Our feline patients deserve more than the‘best guess’ approach to diagnosis
