Year 2: Neurolocalization Poster

During the Module 8 Continual Assessment Task (CAT), I had a personal matter come up, requiring me to take an unexpected week of leave. This left me to independently complete the task of interpreting clinical and video-based information to achieve accurate neuro-localization for an acute hindlimb paralysis case in a five-year-old Border Collie. The assignment required creating a comprehensive academic poster detailing clinical findings, rationale for neurolocalisation, and appropriate diagnostic and management plans. Given the clinical nature of the task, it necessitated integrating extensive neuroanatomical and physiological principles covered during Module 8.

During the Module 8 Continual Assessment Task (CAT), I had a personal matter come up, requiring me to take an unexpected week of leave. This left me to independently complete the task of interpreting clinical and video-based information to achieve accurate neuro-localization for an acute hindlimb paralysis case in a five-year-old Border Collie. The assignment required creating a comprehensive academic poster detailing clinical findings, rationale for neurolocalisation, and appropriate diagnostic and management plans. Given the clinical nature of the task, it necessitated integrating extensive neuroanatomical and physiological principles covered during Module 8.

Initially, the neurology content presented in the module was largely new to me, encompassing extensive information on spinal cord anatomy, neurological pathways, and conditions like intervertebral disc disease (IVDD). Despite the complexity, my enjoyment of the material mitigated feelings of overwhelm, and I approached the task with genuine enthusiasm and curiosity.

Shortly into the task period, a significant personal matter arose, requiring me to take an unexpected week of leave. This development was initially concerning, particularly regarding the completion of the task and my ability to maintain progress. Fortunately, my professor was extremely understanding and supportive, especially since he was also away on family leave during this period. His flexibility and accommodation significantly reduced my anxiety, enabling me to confidently manage the situation independently.

Completing the CAT without peer collaboration posed unique challenges. The primary difficulty was ensuring that my clinical reasoning and diagnostic approach were accurate, as I lacked immediate peer discussion or feedback. To navigate this, I carefully structured my workflow into small, manageable segments and established a detailed day-by-day schedule, setting a clear timeline. I aimed to complete my task with a 20% margin of safety, allowing ample time for review and revision. Throughout this process, I extensively utilized resources such as online veterinary databases, reputable veterinary literature, lecture materials, and evidence-based guidelines, which proved invaluable for verifying my interpretations and decisions.

Upon receiving feedback, it became evident that certain aspects of my neurolocalisation and clinical reasoning required refinement. Initially, I overlooked the clinical significance of withdrawal reflexes and their role in refining lesion localization. Feedback highlighted this gap, clarifying that comprehensive assessment of spinal reflexes could have conclusively localized the lesion to the L4–S3 spinal cord segments rather than suggesting a multifocal lesion. Additionally, I learned that the absence of deep pain sensation reflected lesion severity rather than aiding lesion localization directly. The feedback also brought my attention to fibrocartilaginous embolism (FCE), a differential diagnosis I had not considered. Recognizing the classic pattern highlighted in the feedback— 'dog performing exercise and suddenly yelps and present neurological deficits' —was a key learning point in clinical pattern recognition for acute spinal cord diseases.

Furthermore, feedback clarified misconceptions regarding the utility and prioritization of diagnostic imaging options. Initially, I suggested radiography (X-rays) as a potential diagnostic step. The feedback emphasized that while X-rays have limited value for definitively diagnosing soft tissue lesions like IVDD or FCE, they might still be considered in some acute spinal cases as an initial screening tool, particularly if trauma or bony lesions are suspected differentials, before proceeding to advanced imaging like MRI which is superior for visualizing the spinal cord itself. This reinforced the importance of understanding the specific indications and limitations of each imaging modality to guide cost-effective and diagnostically valuable workups. The critique also addressed the sequencing of clinical decision-making and communication, specifically regarding the premature discussion of euthanasia before surgical intervention. Recognizing the prognostic value of timely surgical management, particularly in cases with absent deep pain response, reshaped my perspective on client communication and clinical decision-making.

This CAT experience significantly enhanced my clinical reasoning skills, establishing a critical thinking pathway that will guide future assessments and case management. The constructive feedback illuminated areas needing improvement, reinforcing the necessity of meticulous clinical evaluations, accurate interpretation of neurological examinations, and careful selection of diagnostic strategies. This exercise underscored the importance of clear, evidence-based client communication regarding prognosis and treatment options, which is essential for responsible veterinary practice.

Moving forward, I plan to deepen my understanding and proficiency in neurological examinations, particularly spinal reflex pathways and differential diagnoses of acute spinal cord disorders. To achieve this, I intend to engage in additional focused reading, clinical placement opportunities, and consistent application of spaced repetition techniques. This proactive approach to ongoing learning and reflection will undoubtedly enhance my clinical competence, bolster confidence, and foster continued professional development in veterinary neurology.