This little-known neurological disease of the spinal cord and spine mainly affects older, large dogs weighing 20 kg or more. The disease develops very slowly but is very painful for the dog and causes progressive paralysis in the hindquarters.
Because it looks like a horse's tail, the rear branch of the spinal cord located in the area where the lumbar vertebrae transition to the sacrum is called the "cauda equina." The nerves emerging here control the muscles of the hindquarters and tail, as well as fecal and urinary excretion. Damage to the spinal cord and nerves in this area is referred to as cauda equina syndrome.
Due to the particular mobility in this area and the corresponding wear and tear, degenerative changes in the vertebral bodies, intervertebral discs, and ligaments connecting the vertebrae occur relatively frequently. The resulting narrowing of the spinal canal (=stenosis) puts pressure on the spinal cord, leading to neurological symptoms.
As the disease develops very gradually, the first signs are often overlooked by the dog owner or attributed to the dog's advanced age. Affected dogs may not want to run as much, are reluctant to jump or only jump into the car or over obstacles with pain, and show difficulty getting up and climbing stairs. At the beginning, lameness in one or both hind limbs may be observed. As the disease progresses, paralysis of the hindquarters occurs, leading to a dragging gait. A distinctive feature of this so-called toe dragging is excessive wear on the front of the claws. Later, sensory disturbances, muscle wasting, tail paralysis, and uncontrolled urination and defecation may occur.
If your dog shows any of these symptoms, please take them to your veterinarian immediately.
Since the symptoms are not always clear-cut, it is particularly important for the treating veterinarian to rule out other conditions such as hip dysplasia, tumors, or fractures. As part of their clinical and specialized neurological examination, they will use various examination methods and reflex tests to obtain initial indications of cauda equina syndrome. Affected dogs usually show clear signs of pain when pressure is applied to the lumbar region or when the tail is overextended.
Further X-ray examination is almost always standard in order to determine the cause and extent of the disease more precisely. However, not all narrowing of the spinal canal is clearly visible on X-rays. Reliable diagnosis of cauda equina syndrome can therefore only be made with a contrast agent examination, known as myelography, or with the help of CT or MRI scans.
In principle, the disease can be treated conservatively or surgically, depending on its severity. In many cases, the affected dog is treated with anti-inflammatory and pain-relieving medication and kept calm, especially in the early stages. However, the prospects for improvement of symptoms are only favorable if the cause of the nerve compression is exclusively due to overloading of the soft tissue structures.
If bony changes in the vertebral bodies lead to narrowing of the spinal canal and associated pain, surgical treatment is essential to relieve the spinal cord and protect it from further damage. Depending on the cause, there are various surgical procedures with the common goal of removing the pressure on the nerve tissue. The success of the operation depends largely on how consistently the aftercare is carried out. Even though the nerve fibers of the cauda equina can regenerate well, it is essential that the dog is rested appropriately during the healing phase. At the same time, physiotherapy and massage should be used to rebuild the muscles of the hindquarters. Furthermore, overweight dogs should definitely be put on a diet. With the petsXL health passport, you can clearly store and monitor your dog's weight data.
After successful surgery and consistent follow-up care, the prospects for recovery are generally favorable. If paralysis has already set in, the prognosis worsens.
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