Practical Neurology with Dr. James Cellini

Whether you're working an overnight ER shift or seeing neurologic cases in general practice, neurology can feel intimidating—but it doesn't have to be. In this episode of 2 A.M. Consult, Dr. Deer is joined by board-certified veterinary neurologist Dr. James Cellini to break down some of the most common neurologic emergencies into practical, immediately applicable clinical pearls.

Together, they discuss the approach to seizure patients, choosing anticonvulsants, managing cluster seizures, assessing deep pain in IVDD patients, and why deep pain—not withdrawal reflexes—is one of the most important prognostic indicators. They also cover vestibular disease, differentiating central versus peripheral lesions, when time can be your best diagnostic tool, and how to approach referral conversations with pet owners.

Rather than focusing on complex neuroanatomy, this episode is packed with practical decision-making tips, common misconceptions, and real-world advice that emergency and general practice veterinarians can apply on their very next shift.

In this episode you'll learn:
• The first neurologic exam finding to assess in a comatose patient
• Practical seizure management pearls and rescue medication protocols
• How to differentiate withdrawal reflexes from true deep pain perception
• Medical management versus surgical considerations for IVDD
• How to localize vestibular disease and when to suspect central disease
• Tips for discussing neurologic referrals and prognosis with clients

If you've ever found yourself staring at a seizuring patient, a rolling vestibular dog, or a suddenly paraplegic Dachshund at 2 a.m. wondering what to do next, this episode is for you.