TheraPaws Neurological Assessment
917 West Foothill Boulevard, Upland California 91759 (909) 202-7582
Patient's Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
History of present Injury and course of progression throughout the day
Aggravation/Ease
Pet's job and abilities at present
Veterinary intervention including diagnosis, recommendations, medications
Diagnostic Tests
radiographs
ultrasound
myelogram
MRI
Blood tests
Other
Pertinent Past Medical History
Other pertinent questions
Stairs
Bowel incontinence
Bladder incontinence
Licking/chewing
Signs and symptoms in AM
Signs and symptoms PM
Signs and symptoms with activity
Loss of appetite
Change in hair coat
Depression
Anxiety
Reduced mobility or interest in activity
Increased thirst
Clumsiness
Other
Exam: general observations (temperament, condition, activity level, ...)
Stance
Sit
Lying
Ambulation
Walk
Trot
Crossing Over
Sit to stand (and back again)
Turns (both directions)
Extremities (general): tone, bulk, joints, muscles, toes/toenails, dermatitis, lick granulomas, ulcers, heat, swelling, tenderness
Extremities (range of motion): flexion, extension, adduction, abduction
Neurological Test: balance on displacement while standing/walking
Neurological Test: paper slide test
Neurological Test: placing reflex
Neurological Test: crossed extensor reflex
Muscle and Tendon Reflexes: tendons, perianal,hopping, parawalking, Babinski, clonus
Examiner's additional comments
Examiner's Name
First Name
Last Name
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