The aim of the neurology clinic is to offer state-of-the-art diagnostics and treatments in neurology and neurosurgery to dogs and cats referred to the hospital and to progress neurology for companion animals.
The activities of the service range from routine consultations to emergency referrals, daily neurological work-up, neurosurgery and tertiary referrals for advanced procedures. We diagnose and treat brain, spine, spinal cord and neuromuscular diseases.
The neurology/neurosurgery service involves Dr Nicolas Granger, Dr Hélène Vandenberghe, rotating surgery/neurology interns, neurology nurses and a rehabilitation team.
- Work-up for brain diseases includes high-field (1.5 Tesla) magnetic resonance imaging, electrodiagnostic testing of the brain, cisternal cerebrospinal fluid sampling and routine clinico-pathology tests.
- Treatment of brain diseases includes medical management, external vagal nerve stimulation for pain and epilepsy and advanced brain surgeries (surgery for brain neoplasms, shunt placement for malformations etc).
- Work-up for spinal diseases includes high-field (1.5 Tesla) magnetic resonance imaging, CT of the spine, electrodiagnostic testing of spinal pathways, lumbar cerebrospinal fluid sampling and routine clinico-pathology tests.
- Treatment of spinal diseases includes medical management, spinal cord decompression, spinal stabilisation with implants (PAX, VetLOX, SOP systems), or advanced surgeries such as placement of neuroprosthesis for chronic incontinence treatment.
- Work-up for neuro-muscular diseases includes electrodiagnostic testing of muscles and peripheral nerves, muscle and nerve biopsies assessed by experts’ neuropathologists, lumbar cerebrospinal fluid sampling and routine clinico-pathology tests.
- Treatment for neuro-muscular diseases includes medical management and largely involves physiotherapy and rehabilitation.
- We work closely with physiotherapists, including colleagues in sports medicine.
A multidisciplinary approach
Neurology requires a team approach because many problems of the nervous system have consequences on other organs; a large number of medical and surgical conditions also commonly lead to neurological dysfunction; therefore, practicing within a team of medicine, oncology, surgery and intensive care specialists is essential.
Neurosurgery in companion animals is routinely performed by the neurologist, but some surgical treatments are better performed with a team approach involving soft tissue and orthopaedic surgeons. Surgeons are trained in spinal surgery as well.
Finally, companion animals affected by neurological diseases very often improve over time but require support from carer, which largely involves the nursing team and physiotherapist.
We offer referral consultations for acromegaly treatment via transsphenoidal hypophysectomy. Acromegaly is increasingly recognised as a leading cause for uncontrolled diabetes, which can be cured surgically.
Sacral nerve implant for treatment of neurogenic incontinence
This involves placement of a neuroprosthesis on a pair of sacral nerves to allow remote nerve stimulation and bladder emptying; the system is typically indicated in dogs with T3-L3 severe spinal lesions who have not recovered urinary continence; these are often paraplegic cases with no pain sensation; it can be done from a few weeks to several months after onset of signs, some cases having been treated more than a year into their incontinence.