Paralysis and Paresis
Understanding Your Pet's Medical Diagnosis
What are paralysis and paresis?
Paralysis is the loss of the ability to move one or more body parts. It is the loss of voluntary movement "Quadriplegia" is the loss of voluntary movement of all four limbs. "Paraplegia" is loss of voluntary movement in the pelvic (rear) limbs only. "Paresis" is a similar condition; however, paresis is a weakness of voluntary movement or partial paralysis as opposed to a complete lack of voluntary movement. "Quadriparesis" or "tetraparesis" is a weakness in all four limbs, and "paraparesis" is a weakness of the pelvic (rear) limbs only.
What causes paralysis or paresis?
Paralysis or paresis is caused by diseases or malformations involving the nervous system (the brain, the spinal cord, or individual nerves). Whether the animal becomes paralyzed or is weak (paresis) is determined by the amount of damage to the nervous system. The extent of the paralysis or paresis will depend on the areas of the nervous system that are affected. The causes of paralysis or paresis include:
What are the signs of paralysis or paresis?
The signs of paralysis or paresis will depend on the area of the nervous system that is affected and the severity of injury to the nervous system. The pet may be unable to move, walk, or get up. Many spinal cord diseases begin with poor coordination, progress to weakness (paresis), and finally to paralysis. Most pets with paralysis or paresis are alert. The pet may be in pain and may be uncomfortable during the physical examination. The nails on the affected leg(s) may be worn. If the pelvic limbs are paralyzed, it is likely that the bladder also is paralyzed and the pet may have no control of urination or may not be able to urinate. If you suspect paralysis in your pet, be careful when moving the animal as movement could cause further damage. If the paralysis is due to a blockage to circulation rather than a nervous system disorder, the limbs will be cool and the nailbeds may be blue in color.
How is paralysis or paresis diagnosed?
Paralysis or paresis will be diagnosed by obtaining a good medical history and performing a thorough physical examination. The veterinarian also will do an evaluation of the nervous system. The spinal reflexes provide information to localize the nervous system problem to the upper, middle, or lower spinal cord. The femoral pulses will be evaluated to rule out circulatory blockages (such as an embolus). The veterinarian will need to determine the cause of the paralysis or paresis; therefore, many of the diagnostic tests are performed to identify the cause. Diagnostic tests (complete blood counts [CBCs], blood chemistry panels, and urinalysis) may be performed to assess the pet's health status. Blood and urine cultures may be done. Radiographs (X-rays) of the spinal cord can diagnose many abnormalities such as trauma (example, broken back), disk herniations, tumors, congenital malformations, and discospondylitis. Myelograms (special contrast X-rays) may be needed to evaluate problems of the spinal cord. Specialized nerve and muscle tests and biopsies often are needed to obtain a diagnosis of the cause of the paralysis or paresis.
How is paralysis or paresis treated?
The treatment will vary, depending on the cause of the paralysis or paresis, the severity of the signs, and the location of the affected nerves and muscles. Paralysis of some muscles, such as the respiratory muscles, is life threatening and will require emergency veterinary medical attention. Pets with paralysis or severe weakness (paresis) should be treated in the hospital until bladder function can be ascertained. Hand feeding or feeding through special tubes may be done if the muscles of swallowing are affected. Paralyzed animals must be placed on padded bedding and turned from side-to-side frequently to help prevent skin breakdown ("bed sores") and lung congestion. They must be checked and cleaned frequently because they are not able to move away from soiled bedding. The pet may have all activity restricted until spinal trauma and disk herniation can be ruled out. Physical therapy is important to keep muscles and joints from deteriorating in those animals allowed activity. Surgery often is the most effective method of treatment, depending on the condition. The veterinarian may prescribe medication. Animals with ticks should be treated with appropriate insecticides.
What is the prognosis for animals with paralysis or paresis?
The prognosis (outcome) for animals with paralysis or paresis is variable. The outcome for these animals depends on the underlying cause. Many complications including minor problems (such as constipation) or major problems (such as pneumonia, lack of ability to urinate, or permanent paralysis) can occur. Once bladder function has returned, the pet can be cared for at home. If bladder function does not return, bladder evacuation via manual expression or catheterization (insertion of a flexible tube into the bladder) is necessary.
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