CCAT Neurological Condition Rehabilitation 4 — Questions and Answers
Question 1: Which condition is most likely in a large-breed dog presenting with symmetric, progressive pelvic limb ataxia and proprioceptive deficits beginning at 8 years of age with no spinal pain?
- Acute intervertebral disc herniation
- Degenerative myelopathy (DM) (Correct answer)
- Lumbosacral stenosis
- Cervical spondylomyelopathy (Wobbler syndrome)
Correct answer: Degenerative myelopathy (DM)
Degenerative myelopathy is a progressive, non-painful spinal cord disorder that typically affects large breeds beginning in middle to old age.
Question 2: Cavaletti poles are used in neurological rehabilitation primarily to improve which function?
- Cardiovascular endurance
- Limb clearance, stride length, and conscious proprioception (Correct answer)
- Rotator cuff strength in the thoracic limbs
- Cervical range of motion
Correct answer: Limb clearance, stride length, and conscious proprioception
Cavaletti poles require the patient to consciously lift and place each limb, improving proprioceptive awareness and correcting gait abnormalities.
Question 3: A dog with lumbosacral stenosis has decreased withdrawal reflex in both pelvic limbs and tail paralysis. Which nerve roots are most likely affected?
- L1-L3
- L4-S3 (Correct answer)
- T13-L1
- C6-T2
Correct answer: L4-S3
Lumbosacral stenosis compresses the cauda equina (L4-S3 nerve roots), causing LMN signs to the pelvic limbs, perineum, tail, and bladder.
Question 4: Which manual therapy technique is MOST appropriate to address reduced hip extension range of motion in a dog with chronic spinal cord injury and associated muscle atrophy?
- High-velocity low-amplitude spinal manipulation
- Passive stretching of the iliopsoas and hip flexors (Correct answer)
- Trigger point dry needling of the erector spinae
- Joint mobilization of the lumbosacral articulation
Correct answer: Passive stretching of the iliopsoas and hip flexors
Passive stretching of hip flexors helps maintain or restore joint range of motion and prevent adaptive shortening in neurologically impaired patients.
Question 5: In hydrotherapy for a dog with severe LMN hindlimb paresis, what modification is MOST important for patient safety?
- Increasing water temperature to above 40°C to relax muscles
- Providing manual support of the hindquarters throughout the session (Correct answer)
- Using rapid water current to stimulate stepping reflexes
- Submerging the patient to shoulder level without support
Correct answer: Providing manual support of the hindquarters throughout the session
Manual hindquarter support prevents the patient from sinking and aspirating water, and allows the therapist to facilitate proper limb movements during hydrotherapy.
Question 6: Which clinical sign differentiates central vestibular disease from peripheral vestibular disease in dogs?
- Presence of head tilt
- Nystagmus with a vertical or changing direction fast phase (Correct answer)
- Tendency to roll or fall toward the side of the lesion
- Reduced balance on elevated surfaces
Correct answer: Nystagmus with a vertical or changing direction fast phase
Vertical or direction-changing nystagmus strongly suggests central vestibular disease, as peripheral disease typically produces horizontal or rotary nystagmus with a fixed fast phase.
Question 7: Which exercise progression is CORRECT when rehabilitating a dog recovering from spinal cord injury through the stages of neurological recovery?
- Treadmill running → passive ROM → standing balance → cavaletti
- Passive ROM → assisted standing → supported treadmill walking → cavaletti poles (Correct answer)
- Cavaletti poles → hydrotherapy → passive ROM → standing balance
- Swimming → dry land running → passive ROM → balance board
Correct answer: Passive ROM → assisted standing → supported treadmill walking → cavaletti poles
Neurological rehabilitation progresses from passive mobility, to assisted weight bearing, to supported locomotion, and finally to challenged proprioceptive exercises as function returns.
CCAT Neurological Condition Rehabilitation 4
Which condition is most likely in a large-breed dog presenting with symmetric, progressive pelvic limb ataxia and proprioceptive deficits beginning at 8 years of age with no spinal pain?