Mark Neer, DVM, DACVIM
First case: Infraspinatus muscle contracture in the dog
The word encephalopathy literally means "disease or disorder" of the brain.
It is helpful to develop an ordered approach to this problem.
There are varied opinions about this definition but for this discussion we will define a patient as refractory when: 1) an anticonvulsant (AC) has been used as monotherapy, the high end of the "therapeutic" blood level has been achieved for the AC and the patient continues to have the same or an increased number of seizures (szs); 2) a patient that has developed side effects from an AC that now precludes its use; or 3) the patient that has been well controlled for months or years and recently has had a significant increase in sz frequency.
Generalized weakness can present a formidable problem solving challenge for the veterinary clinician.
If the owner calls your clinic first, and states that the animal is recumbent, instruct them to transport the animal on a plywood stretcher or similar firm support system if at all possible.