What is BAER (Brainstem Auditory Evoked Response) testing all about?

What Is BAER (Brainstem Auditory Evoked Response) Testing All about ?

The process of hearing is extremely intricate. Whether the sound is loud or soft, high or low an incredible number of very intricate biological processes have to occur in a strictly choreographed manner. 

When you think about it, it is amazing that so many of us DO hear. There are such a multitude of places along the biological path of hearing where malfunctions can occur, it’s amazing that there are relatively few individuals that are deaf. 

Sound begins its journey into our senses, our consciousness, as waves transmitted through the air. These air waves then cause vibrations in the tympanum or ear drum. These sound waves move the ear drum and then move three tiny bones (the smallest bones in the body) that sit within the middle ear. This moves liquid within the cochlea, a spiral, sea shell shaped organ, of the inner ear. Another series of membranes are moved by the liquid which causes small, pigmented hair cells to move. These are receptors for the 8th cranial nerve (CN VIII). At this point the movement triggered by the sound waves is now conducted through the nerve and the brainstem as electrical activity within the skull. 

Dogs and cats, just like people, can be born deaf. This is typically due to sensorineural deafness or a dysfunction of the sensors that allow sound to enter the nervous system as electrical impulses (the hair cells). 

BAER testing is a hearing test. In veterinary medicine we cannot rely on the pets response to sound to check their ability to hear.  Dogs and cats with hearing deficiencies can depend heavily on vibration and visual input to compensate for their hearing loss. It can be very difficult to tell if a pet is completely deaf or even deaf in one ear. They are very capable in adapting and compensating for their disabilities.  Rather than depending on our observations (subjective analysis) we use BAER tests (objective analysis) to follow the sound as it is conducted from the inner ear to the brainstem. 

Few dogs are trained to raise their paw (or finger as a person would) when they hear a to a certain tone. BAER testing helps us analyze their ability to hear without relying on their conscious responses. BAER testing is easily performed on either an awake or anesthetized pet.  We recommend that the pet be at least 6 weeks old and preferably 12 weeks old for this test. When they are less than 12 weeks old there is a slight risk of false negative tests (this means that a hearing ear might tests as deaf). 

Each ear is tested separately and 3 small needles are placed under the pets skin, one at the top of the head, the next at the base of the ear being tested and the last, a ground lead, is somewhere out on the pets body. The needles at the base of the ear and the top of the head will record the electrical activity as it is conducted from those little hair cells into the brain stem.  Then an ear phone or ‘clicker ‘ is placed in the pets ear and it will emit a clicking tone at a volumes of 80-100 decibels. We use an 87 decibel sound. The machine then records each click as it is conducted along the 8th cranial nerve and on through the brain stem. 

A pet that has a hearing response on the BAER test will demonstrate a series of peaks that occur at certain time intervals on a graph. This is a normal BAER test.

If the pet has an inherited deafness or deafness as a result of damage to the inner ear and the hair cells within the inner ear , the test would have no peaks and would be flat(see below).

BAER testing can be used to check for other interruptions in the hearing process such as tumors of the 8th cranial nerve and damage of areas within the brainstem. 

At our office, BAER testing is performed on awake patients, we seldom find that we need to sedate or anesthetize puppies and kittens that are tested. Sometimes when more detailed tests are indicated or a pet is particularly uncooperative anesthesia can be used. 

BAER testing should be performed on any pet suspected of being deaf or one of the breeds listed below, prior to their being adopted into a new home. Deaf animals can make great pets and companions, but owners must be aware of their special needs so they can  learn to communicate with their new pet and train that animal adequately. This will allow the pet to avoid injury and learn to function well within the household. 

Dog and Cat breeds associated with reported congenital

 (inherited deafness)

Akita	French Bulldog	Springer Spaniel
American-Canadian Shep	German Shepherd	Sussex Spaniel
American Eskimo	Great Dane	Tibetan Spaniel
Am. Staffordshire Terrier	Great Pyrenese	Tibetan Terrier
Australian Blue Heeler	Ibizan Hound	Toy Poodle
Australian Cattle Dog	Italian Greyhound	Walker American Foxhound
Australian Shepherd	Jack Russel Terrier	West Highland White Terrier
Beagle	Kuvasz	Whippet
Bichon Frise	Labrador Retriever	Yorkshire Terrier
Border Collie	Maltese	Felines
Borzoi	Miniature Pinscher	European White
Boston Terrier	Miniature Poodle	White Cornish Rex
Boxer	Mixed Breed Dog	White Devon Rex
Bull Terrier	Norwegian  Dunkerhound	White Manx
Cardigan Welsh Corgi	Nova Scotia Duck Tolling Retriever	White Persian
Catahoula Leopard Dog	Old English Sheepdog	White Scottish Fold
Cavilier King Charles Span.	Papillon	White Turkish Angora
Chihuahua	Pit Bull Terrier	White American Shorthair
Chow chow	Pointer	White British Shorthair
Cocker Spaniel	Puli	White Exotic Shorthair
Collie	Rhodesian Ridgeback	White Oriental Shorthair
Dalmatian	Rottweiler
Dappled Dachshund	Saint Bernard
Doberman Pinscher	Schnauzer
Dogo Argentino	Scottish Terrier
English Bulldog	Sealyham Terrier
English Cocker Spaniel	Shetland Sheepdog
English Setter	Shropshire Terrier
Fox Hound	Siberian Husky
Fox Terrier	Soft Coated Wheaten Terrier

From: Dewey CW. A practical guide to canine and feline neurology 2003;Ames: Iowa State Press: 232.

Read more...

Mittens The Laundress

One of the really great things about my job is everyone that visits me has a funny or entertaining story about their pet that they share during their visit. Sometimes they tell me what they went through to get the cat in her carrier, or about their pets entertaining activities at home, regardless of the exact details, inevitably there is some kind of a story. These stories illustrate to me how much we value the companionship of our pets, how important they are to our families and how boring things would be without them.

Sometimes there are stories like the one about Mittens and her owner Julie. Julie and her husband, Tim, visited with me at a recent community event. Julie enjoyed talking about their dog, Mittens. Mittens was adopted as a puppy by her two sons and at the time they already had two dogs. Her sons were responsible for caring for Mittens and they developed an interest in training her. Mittens quickly learned the basics and then she learned how to skate board, pick up objects on command and retrieve. She seemed to have a real aptitude for learning and the whole family enjoyed her antics.  A few years ago Julie had extensive spinal surgery that left her with limited mobility. Bending and picking up even the lightest objects was a challenge. Julie quickly realized that Mittens was ready and willing to help pick things up. Mittens was not a service dog, nor were Julie and her family professional trainers, but together they were the perfect team. 

Mittens can remove laundry from the dryer (the video is attached above). Tim was so excited to show me the video, he went home to get his camera so we could see Mittens in action! Julie explained that Mittens enjoys tidying up so much that she picked up the parts her son had laying out in the garage while he was repairing a car and brought them to her! 

Mittens and Julie’s story reminded me of another patient. A few years ago, I treated an Australian Cattle dog named, Mason. Tom, his owner, explained that he had been a very busy executive, traveling around the world. However, he developed a severe seizure disorder and became housebound. He had always wanted a dog, but had never had the time for a pet. Tom said he thought, with everything else going so badly for him, he could at least adopt the canine companion he always wanted. So he went to the local shelter and adopted Mason. Mason had been surrendered because he had a few problems, but Tom felt they were a perfect match. Unfortunately, Mason was not the easiest to live with at first. But they became closely bonded in a very short time. Slowly, Tom began to realize that Mason could tell when he was going to have a seizure. This gave Tom the ability to intervene and avoid a seizure and gradually his seizures subsided. Tom and Mason began leaving the house. They walked more and more, getting further and further from their home, something Tom never thought he could do again. Soon, Tom and Mason were able to begin leaving their home for trips. Tom began driving and working, always with his friend at his side. He explained that he has been seizure free for years and he attributed his cure to Mason. Now Mason is a first class world traveler and Tom’s constant companion.

These stories make me wonder what forces conspire to bring these people and their companions together at just the right time. Maybe sometimes the helping hand we are looking for is actually a paw.

Read more...