Tetraparesis with neck pain in the dog: neurolocalisation
5-year-old Beagle with neck pain for 3 days; today it walks with ataxia and weakness in all four limbs. Mental status and cranial nerves are normal.
| Parameter | Result | Reference |
|---|---|---|
| Postural reactions | Delayed in all four limbs | Normal |
| Withdrawal and patellar reflexes | Normal to increased in all four | Normal |
| Muscle tone | Increased in all four limbs | Normal |
Where is the lesion located?
chevron_right Show answer and explanation
A. C1-C5 spinal cord
Correct. Upper motor neuron signs in all four limbs (normal or increased reflexes, increased tone) with normal mental status and cranial nerves localise the lesion to C1-C5.
B. C6-T2 spinal cord
A C6-T2 lesion would cause lower motor neuron signs in the thoracic limbs (reduced withdrawal, reduced tone, short stride), not increased reflexes.
C. Brainstem
Brainstem lesions also cause upper motor neuron tetraparesis, but they are usually accompanied by altered mental status or cranial nerve deficits.
D. Generalised neuromuscular disease (polyradiculoneuritis)
It causes lower motor neuron signs in all four limbs (hyporeflexia and hypotonia) and does not cause neck pain.
lightbulb Key takeaway
In C1-C5 lesions all four limbs show upper motor neuron signs and the pelvic limbs are usually more affected. Common differentials: cervical disc herniation, steroid-responsive meningitis-arteritis in young dogs, atlantoaxial instability in toy breeds and meningoencephalomyelitis. Severe lesions can compromise ventilation.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.