Christopher L. Mariani, DVM, PhD, DACVIM

The brain is an extremely well vascularized organ and is supplied by approximately 15-20% of the total blood flow of the body. This high requirement for blood is necessitated by the brain's high metabolic activity and corresponding need for oxygen and glucose to fuel this activity.

A variety of clinical signs may be seen with inflammatory CNS disease, depending on what area of the nervous system is affected. Involvement of the forebrain (cerebral cortex and thalamus) may result in seizures, altered mentation (stupor, coma, delirium, head pressing), vision abnormalities, and compulsive pacing or circling. Involvement of the brainstem (pons and medulla oblongata) may result in altered mentation, cranial nerve deficits (e.g., vestibular dysfunction [head tilt, nystagmus], facial nerve paralysis, swallowing difficulties, tongue paralysis), ataxia, and proprioceptive deficits.

Neck and back pain are common presenting complaints in veterinary medicine and occur in animals with a variety of signalments. Animals may present with a chronic history of lower-grade discomfort, although acute presentations of moderate to severe pain are common and extremely distressing to owner and pet alike.

Acute paraplegia is a sudden onset of paralysis in the pelvic limbs, and is a common problem in small animal patients. Paraparesis is weakness in the pelvic limbs due to a neurologic cause, and can be quite variable in severity (ambulatory to non-ambulatory).