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An expert team of veterinary neurologists

Neurology comprises diagnosis and management of conditions involving the central nervous system (brain and spinal cord) and the peripheral nervous system (neuromuscular disease outside the spinal cord).  New referral patients will have a 40-minute consultation to allow a thorough neurological examination followed by a detailed discussion of any proposed diagnostic and surgical interventions, along with an accurate estimation of fees.

Commonly Encountered Conditions:

Disc extrusions: These patients typically present with neck or back pain along with varying degrees of limb weakness or paralysis.  An MRI scan is performed to allow accurate localisation of the disc extrusion and to exclude other neurological diseases.  In acute cases, prompt surgical decompression (hemilaminectomy or ventral slot) is required to provide the best chance of a recovery.

Ischaemic myelopathy: This condition is thought to be caused by blockage of a spinal artery by a fragment of intervertebral disc (fibrocartilaginous embolism or FCE) and these patients present with acute-onset weakness or paralysis.  A prompt neurological examination and MRI scan are required to confirm the diagnosis and to exclude a compressive disc extrusion that would require urgent surgery.  Treatment of these cases comprises physiotherapy and bladder management, and the prognosis can be good to excellent.

Spinal fracture-luxations: Fracture-luxations of the vertebral column are typically seen in polytrauma cases.  Prompt referral of these cases for advanced imaging (CT and MRI) and internal fixation of the fracture leads to an excellent outcome in the majority of patients.

Lumbosacral disease and Wobblers syndrome: Chronic compression of the spinal cord and associated nerve roots, often in the lumbosacral joint or neck, can lead to varying degrees of pain and limb dysfunction.  These complex cases benefit from advanced imaging (MRI and CT) to identify the cause of the myelopathy or radiculopathy.  Surgical decompression by dorsal laminectomy with or without vertebral stabilisation often leads to improved outcomes in these cases.

Congenital vertebral malformations and myelopathies: Commonly seen conditions include hemivertebrae and constrictive myelopathy in brachycephalic breeds; atlantoaxial instability in toy breeds; subarachnoid diverticum; and Chiari-like malformation and syringomyelia.  Advanced imaging (MRI and CT) is required to diagnose these conditions and to allow adequate planning for the complex surgical procedures required to rectify them.

Inflammatory CNS disease: Meningitis (inflammation of the linings of the spinal cord) is very common and can affect dogs of any age and breed.  Presenting signs classically are fever and neck pain, but many patients can have vague, waxing and waning clinical signs.  Inflammation may extend to the spinal cord (meningomyelitis) or the brain (meningoencephalitis), in which case other neurological signs may be present.  Diagnosis usually requires MRI scanning and analysis of cerebrospinal fluid (obtained by a cisternal puncture, a lumbar puncture or both).  Meningitis is usually immune-mediated and treatment requires protracted courses of corticosteroids, often in conjunction with other immunosuppressive drugs.

Seizures: Canine idiopathic epilepsy is the most common cause of seizures.  However, seizures can also be caused by intracranial abnormalities such as brain tumours and encephalitis, and by extracranial disease such as portosystemic shunts and insulinoma.  Bloods, liver function tests, MRI scanning and CSF analysis should be performed in all patients to exclude these disease processes and allow a diagnosis of idiopathic epilepsy to be reached.  Treatment of epilepsy, when required, requires long-term anticonvulsants such as phenobarbitone.

Vestibular disease: The vestibular system is responsible for balance and comprises sensors within the inner ear (peripheral vestibular system) and brain (central vestibular system).  Patients with vestibular disease typically present with a head tilt, leaning or falling to the side, circling and nystagmus (flickering of the eyes from side to side).  Patients with acute vestibular disease are often nauseous.  Causes of vestibular disease include inner ear disease, ischaemic or haemorrhagic stroke, inflammatory disease and neoplasia.  In older patients, vestibular syndrome is often idiopathic.  MRI and CSF analysis are required to differentiate these causes and to ensure optimal treatment of these patients.

Paroxysmal Dyskinesia: Episodic movement disorders such as cramping, spasm and tremors are increasingly recognised in dogs.  Assessment of video footage and a thorough neurological examination are required to exclude epilepsy (which often mimics this condition).  MRI and CSF analysis should be performed to exclude structural or inflammatory brain disease.  With the exception of gluten-sensitive paroxysmal dyskinesia in Border Terriers and episodic falling syndrome in CKCS, these conditions are frustrating to treat.  However, most patients can lead perfectly normal lives in spite of this disease.

Key Benefits:

  • The neurology service is led by specialists in small animal surgery and internal medicine with a combined experience of over four decades in treating medical and surgical neurology cases.

  • Multidisciplinary hospital with a dedicated ICU providing 24-hour inpatient care

  • 24-7 availability with urgent cases and emergencies always seen

  • State-of-the-art facilities and equipment including environmentally controlled theatres, CT, MRI, digital radiography and in-house laboratory

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Neurology Team

Rory Bell - Internal Medicine Specialist

Rory Bell

Rory Bell MVB DSAM DipECVIM-CA MRCVS FHEA Internal Medicine Specialist
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Jonathan Bell - European Specialist in Small Animal Surgery and RCVS Specialist in Small Animal Surgery

Jonathan Bell

Jonathan Bell BVM&S CertSAS DipECVS MRCVS European Specialist in Small Animal Surgery and RCVS Specialist in Small Animal Surgery
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Bob Pettit - Veterinary Surgeon

Bob Pettit

Bob Pettit BVM&S BSc CertSAS MRCVS Veterinary Surgeon
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Andrea Geraci - Veterinary Surgeon

Andrea Geraci

Andrea Geraci MRCVS Veterinary Surgeon
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Rhys Treharne - Resident

Rhys Treharne

Rhys Treharne BVetMed MRCVS Resident
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Victoria Hutchings - ECVS Resident in Small Animal Surgery

Victoria Hutchings

Victoria Hutchings BVSc BSc CertSAS MRCVS ECVS Resident in Small Animal Surgery
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Jo Smith - Surgical Team Leader

Jo Smith

Jo Smith RVN Surgical Team Leader
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Neurology Nurses

Cammi Brown-Nolan - Senior Orthopaedic Nurse

Cammi Brown-Nolan

Cammi Brown-Nolan RVN Senior Orthopaedic Nurse
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Abi Taylor - Senior Soft Tissue Nurse

Abi Taylor

Abi Taylor RVN Senior Soft Tissue Nurse
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Tawny Kershaw - Veterinary Nurse

Tawny Kershaw

Tawny Kershaw RVN Veterinary Nurse
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Kelly Bywater-Taylor - Veterinary Nurse

Kelly Bywater-Taylor

Kelly Bywater-Taylor RVN Veterinary Nurse
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Olivia Cammack - Veterinary Nurse

Olivia Cammack

Olivia Cammack RVN Veterinary Nurse
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Jemma Risdon - Veterinary Nurse

Jemma Risdon

Jemma Risdon RVN Veterinary Nurse
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