Spine on the line: When to act fast

Mimics and misses: Avoiding the spine trap explores the common and clinically important situations in which dogs and cats present looking “spinal”, but the spinal cord is not the primary problem. Weakness, gait abnormalities and collapse often trigger an instinctive focus on the spine, yet a wide range of vascular, neuromuscular, endocrine, cardiovascular and episodic movement disorders can convincingly imitate myelopathy.
This lecture focuses on recognising when a case does not quite fit the expected spinal pattern. Through case-based discussion, it will highlight practical examination strategies and interpretative cues that help clinicians identify inconsistencies between history, neurological findings and neuroanatomical localisation. Particular emphasis will be placed on assessing onset, progression, symmetry, pain, fatigability and episodic change, as well as recognising patterns that suggest systemic or peripheral disease rather than spinal pathology.
Rather than providing a comprehensive disease review, this talk aims to sharpen clinical judgement and reduce cognitive bias toward a spinal diagnosis. Attendees will be encouraged to pause before committing to advanced spinal imaging and instead ask: “What else could this be?” The ultimate goal is to reduce missed diagnoses, avoid unnecessary investigations, and improve outcomes by identifying the zebras hiding among the horses.

• 1.Identify when clinical signs are inconsistent with true spinal cord disease.
• 2.Recognise common non-spinal conditions that can convincingly mimic myelopathy.
• 3.Apply practical examination tips to avoid common diagnostic pitfalls.
• 4.Know when to step back from spinal imaging and reconsider alternative diagnoses.
• 5.Improve confidence in detecting “mimics and misses” in dogs and cats presenting with gait abnormalities.