Central Journal of Veterinary Medicine and Research Cite this article: Giebels F, Kohn B, Shihab N, Volk HA, Loderstedt S (2014) Evaluation of the biceps tendon refex in dogs. J Vet Med Res 1(3): 1013. *Corresponding author She nja Lo d e rste d t, Sma ll Anima l C linic (WE20), Fre ie Unive rsitä t Be rlin, O e rtze nwe g 19b , 14163 Be rlin, Ge rmany, Te l: 49 30 838 62356 / 422; Email: Submitte d: 17 O c to b e r 2014 Accepted: 13 De c e mb e r 2014 Publishe d: 15 De c e mb e r 2014 Copyright © 2014 Lo d e rste d t e t a l. OPEN ACCESS Ke ywo rds • Biceps tendon refex • Do g ; Inte ro b se rve r-a g re e me nt Research Article Evaluation of the biceps tendon refex in dogs Felix Giebels 1 , Barbara Kohn 1 , Nadia Shihab 2 , Holger A Volk 3 and Shenja Loderstedt 1 * 1 Small Animal Clinic (WE20), Department of Veterinary Medicine, Freie Universität Berlin, Germany 2 Southern Counties Veterinary Specialists, Unit 6 Forest Corner Farm, UK 3 Department of Clinical Science and Services, Royal Veterinary College, University of London, UK Abstract The biceps tendon refex (BTR) of thirty-two dogs with a median age of 5 (0.5- 15) years and a median weight of 17.5 (5.8-57) kg was assessed by two examiners. The examinations were videotaped and evaluated by 12 observers. The observers were divided in three groups depending on level of expertise (neurologists, veterinary surgeons and students). Each group evaluated the refex-presence and refex-briskness. Kappa-analysis and Intercorrelation-coeffcient (ICC) were applied for analysis of interobserver-agreement. Logistic regression analysis was used to investigate the infuence of sex, age, weight, fur length and examiner on the interobserver-agreement. The interobserver-agreement was highest for the neurologist-group and lowest for the student-group. Neither sex, weight, age, fur length or the person who did the exam infuences the interobserver-agreement. The level of expertise is an infuencing factor on interobserver-agreement of canine BTR evaluation. In healthy dogs the BTR can be reliable assessed by veterinary neurologists. The clinical signifcance is still unknown as the BTR was only assessed in healthy dogs. ABBREVIATIONS ANOVA: Analysis of Variance; BTR: Biceps Tendon Reflex; CI (95%): 95% Confidence interval; ICC: Inter Correlation Coefficient; KC: Cohen´s Kappa; KF: Fleiss-Kappa; KW: Weighted Kappa; SE: Standard Error; SEM: Standard Error of the Mean INTRODUCTION In veterinary literature, authors rarely report the biceps tendon reflex (BTR) when describing the neurological examination findings in dogs. The BTR has been described to be non-consistent and challenging to elicit [1-4]. In human medicine, on the other hand the BTR is thought to be reliable and is commonly used for the assessment of the integrity of the cervical segments C5-C6 and the brachial plexus and also for the diagnosis and follow-up of cervical myelopathies [5,6]. In dogs, the musculocutaneous nerve, the function of which is tested by this reflex, originates from the spinal-cord-segments C6-C8 and innervates the canine biceps brachii muscle, a flexor of the elbow. The reflex response involves an elbow flexion and/ or movement over the biceps brachii muscle [3]. In general, segmental spinal cord reflexes can be influenced by a number of factors [4,7] and its evaluation is highly subjective [8,9]. It remains, however, an integral part of the neurological examination to determine the neuroanatomical localization of a lesion and therefore requires being comparable between different observers [10]. Different studies in human medicine aimed to identify such influencing factors and objectify the reflex-activity by different standardization procedures of the examination and the evaluation of the reflex-activity [8,11-13]. The aims of this study were: (1) evaluation of interobserver- agreement of BTR assessment depending on the observer´s level of expertise and (2) detection of influencing factors for the BTR response. MATERIALS AND METHODS Thirty-two dogs of different breeds with a median age of 5 (0.5-15) years and a median weight of 17.5 (5.8-57) kg were included. There were twenty female and twelve male dogs. Eleven (34.4%) dogs were mixed breed (Table 1). Including criteria were a normal clinical, orthopedic and neurological examination and no history of neurological disorders. Examinations were performed by two of the authors (FG, SL) and videotaped under standardised conditions: same room, fixed camera position, lateral recumbency of the dog, same reflex-hammer. Each dog was examined by one or both examiners within one hour, each examination took about 3 minutes. The owner was watching the dog´s head during the examination. Dogs were anonymised by