Performing an at home neurologic examination

Modified Neurologic Exam: Owner Instructions

This guide will help you provide essential diagnostic data for our teleneurology study. By following these steps, you allow a neurologist to "virtually" examine your pet from the comfort of home.

You will likely need a helper to record the video while you perform the exam. However, if you are working alone, a stable tripod is perfectly sufficient.

⚠️ Safety First

• Know Your Limits: Only perform the parts of this exam that you feel comfortable with and that are safe for your pet.

• Stop if in Pain: Do not attempt any part of this exam if your pet is in severe pain, shows signs of aggression, or if movement risks further injury.

• Bladder Health Warning: If your pet cannot urinate on their own, do not apply pressure to the bladder unless you have been explicitly trained by a veterinary professional. Improper technique can cause a life-threatening bladder rupture.

Section 1: Spontaneous Events

If your pet experiences a "fit," "spell," or seizure, try to record as much of the event as possible from start to finish.

• Document how long the event lasts.

• Note any unusual behaviors immediately before or after the event (e.g., pacing, dazing, hiding).

Section 2: The Walking Exam (For Pets Able to Walk)

Perform as many of these steps as you can safely manage. If your pet is NOT able to walk, please skip this section entirely and go directly to Section 3.

• Free Movement: Record your pet interacting with their environment off-leash for 1–2 minutes on a non-slip surface (like carpet, yoga mats, or grass). After a minute, try to get them excited using your voice or a favorite toy. (If possible, record a bathroom break to help us observe their ability to posture and void).

• On-Leash Walk: Using a harness or collar and a short leash (max 4 feet), walk your pet at a slow, controlled pace down a flat, non-slip walkway. Record from the side, ensuring the camera captures how they turn around. If possible, also record them walking directly toward and away from the camera.

• Obstacle Test: Have your pet walk over a low obstacle (e.g., a broom handle, folded yoga mat, or pool noodle) so we can see how they lift and place their legs.

Section 3: The Assisted Exam (For Pets Unable to Walk)

• Mentation & Effort: Have your pet lie on their side on a soft, supportive surface (avoid bare concrete). Call their name and try to get them excited to see if they attempt to sit or stand up on their own. Record any voluntary leg movements they make.

• Assisted Walking: * For small pets with rear-leg issues only: Place a sling or a rolled towel under their belly to support their hind end. Gently guide them forward at a slow walking pace and record from the side.

  • For pets with weakness in all four legs: If you have a full-body harness, support them into a standing position and slowly move them forward, recording from the side. If you do not have a harness, you can use a snugly fitted t-shirt to support them, ensuring they cannot trip on the fabric. You may also support their chest/belly with your hands, depending on the pet's size.

  • For large pets: If your pet is too heavy to lift safely, do not attempt the assisted walk. Leave them resting comfortably on their side and only record the "Mentation & Effort" step above.

Section 4: The "Food & Face" Test (For ALL Pets)

• Scent & Vision: Hide a high-value treat in one of your closed hands. Bring both hands toward your pet to see if they can sniff out the correct one. Once they find it, hold the treat out and move it slowly side-to-side and up-and-down to see if their head and eyes follow it.

• Chewing & Swallowing: Record a close-up, side-view video of your pet eating a treat and drinking water. We are looking at their jaw motion, tongue symmetry, and swallowing reflex.

• Cranial Nerve Reflexes: * Menace Response: Move your hand quickly toward your pet's eye to see if they blink. Tip: Use a flat palm or spread fingers, and be careful not to create a gust of wind, which can cause a false blink.

  • Palpebral Reflex: Gently tap the inside corner (near the nose) and the outside corner of each eyelid with your finger to check for a protective blink.

  • Pupillary Light Reflex (PLR): Turn on your phone camera's flashlight (torch mode) before aiming it at your pet. Bring the light slowly toward one eye to record the pupil shrinking (constricting), then move it across to the other eye. Give your pet a 10-second rest, then repeat the test starting with the opposite eye.

Section 5: Hands-On Assessment (For ALL Pets)

• Paw Knuckling (Proprioception): While your pet is standing (or supported by a sling), gently flip one paw over so they are resting on their knuckles. Record how quickly they flip the paw back to a normal, flat position. Repeat this for all four paws.

• Limb Tone & Reflexes: Place your pet on their side in a relaxed position.

  • Gently guide the "up legs" (the legs facing the ceiling) through a smooth "bicycle" motion to feel for stiffness or limpness.

  • Gently pinch or tickle the webbing between the toes of the "up legs" to see if they pull the leg away. (Note: If your pet is sensitive about their feet or tries to bite, skip this step).

  • If you have watched the instructional video on the patellar reflex, you may use the blunt end of a butter knife to gently tap the knee tendon of the top hind leg to look for a reflex twitch.

  • ⚠️ Crucial Spinal Warning: If your pet is non-ambulatory (cannot walk) or in pain, do not forcefully flip them over to test the other side. Only test the side facing up.

• Anal Tone: If you were unable to capture a video of your pet passing a bowel movement earlier, lift the tail gently and lightly touch the skin around the anus with a cotton swab (Q-tip) to check for a quick contraction or "wink."