call contact_page duo location_on

Cauda Equina syndrome in dogs and cats at the ABvet clinic

What is Cauda Equina syndrome?

The Cauda Equina in dogs and cats is defined as the extension of the spinal cord by a set of nerves contributing to the innervation of the hind limbs, colon, bladder and perineum.

Photo 1A: Lateral view of a three-dimensional CT scan of the lumbosacral junction showing the emergence of the nerve roots.

The 7th lumbar vertebra joins the coccyx by an intervertebral disc (shock absorbers between the hind limbs and the spine). A nerve exits the spine through the foramen of the 7th lumbar vertebra and contributes to the sciatic nerve, which is the main nerve of the hind limbs.

Photo 1C: Diagram of the lumbosacral junction in the dog with visualization of the cauda equina inside the vertebral canal

Photo 1B: Dorsal view of a three-dimensional scan of the lumbosacral junction in dogs

The lumbosacral junction is the junction between the last lumbar vertebra L7 and the sacrum. Cauda equina syndrome is a group of diseases associated with the compression or degeneration of the nerves in this region.

Most often this syndrome is associated with lumbosacral stenosis (narrowing) but can occur as a result of other diseases such as herniated discs, osteoarthritis called spondylosis (degenerative proliferations), vertebral instabilities or thickening of the joint facets with stenosis of the foramen. If large dogs are predisposed, small dogs and cats can also suffer from this syndrome.

Photo 2: Lateral X-ray of the lumbosacral junction in a dog with severe spondylosis

Photo 3A: Lateral radiograph of the lumbosacral junction in a dog with foraminal stenosis causing sciatica

Photo 3B: Diagram of the lumbosacral junction in transverse view showing the normal size of the foramen.

Photo 3C: Diagram of the lumbosacral junction in transverse view showing stenosis (narrowing) of the foramen.

How can I tell if my pet has cauda equina syndrome?

The clinical signs can be multiple and sometimes very subtle so that cauda equina syndrome is a very poorly recognized cause of pain and lameness by vets. Usually, the animal is presented for orthopedic problems with lameness of one or both hind limbs.

Photo 4: View of an English Setter presented with severe lameness without left hind leg support associated with cauda equina syndrome

Difficulty in standing, sitting, or jumping and climbing stairs may also be reported. Animals with cauda equina syndrome show signs of pain, lameness and sometimes neurological symptoms depending on the severity of the lesions (various nerve deficits, tail paralysis) or even incontinence. Severe neurological deficits are rare.

How is cauda equina syndrome diagnosed at the ABVET specialist clinic in Neuilly sur Seine?

As the symptoms can present many forms, often frustrating, the diagnosis is sometimes difficult. Clinical, orthopedic and neurological examinations are essential. The syndrome of the cauda equina is highlighted by the localization of the pain to the extension of the hips and the pressure on the lumbosacral junction.

Photo 5: Clinical test for pain on pressure on the lumbosacral space

X-rays can be used to rule out tumours, fractures, to highlight arthrosis and suspect stenosis. A CT scan or MRI is the examination of choice to precisely visualize the appearance of the cauda equina and the structures surrounding it. Thus, it is possible with these tools to visualize the vertebral canal, the intervertebral foramens but also to objectivate a subluxation of the facet joints and a possible stenosis of a foramen. The CT scan facilitates a reliable and accurate diagnosis of pathologies affecting the cauda equina and allows clinicians to propose the best treatments.

Photo 2: Lateral X-ray of the lumbosacral junction in a dog with severe spondylosis

Photo 3A: Lateral radiograph of the lumbosacral junction in a dog with foraminal stenosis causing sciatica

Photo 3B: Diagram of the lumbosacral hinge in transverse view showing the normal size of the foramen.

Photo 3C: Diagram of the lumbosacral junction in transverse view showing stenosis (narrowing) of the foramen.

Photo 6: Transverse CT scan of the lumbosacral space in the dog in photo 2 showing severe spinal osteoarthritis with foraminal stenosis (spondylosis)

How is cauda equina syndrome treated at the ABVET specialist clinic in Neuilly sur Seine?

When the symptoms are discrete, a medical treatment based on anti-inflammatory drugs will be initiated and will aim to make the pain disappear which is the main symptom. If this treatment fails, or if the symptoms are more severe, the treatment is surgical. Several techniques exist depending on the cause of the cauda equina syndrome. Laminectomy is an operation which consists of opening the roof of the vertebrae and accessing the herniated disc compressing the roots or releasing the mechanical compression if the medullary canal is narrowed.

Photo 8: Diagram of a dorsal lumbosacral laminectomy to expose the cauda equina

Laminectomy is often combined with facetectomy, which removes the facet joints and soft tissue around the nerve roots, and foraminotomy, which enlarges the vertebral foramen. This technique is usually performed bilaterally. The aim of these techniques is to free the nerve roots (cause of sciatica).

Dorsal spinal fusion is used to fix the unstable intervertebral space. This technique is indicated in cases of major vertebral instability or as an adjunct to a large dorsal laminectomy to ensure postoperative stability of the lumbosacral hinge.

Photo 9: Lateral radiograph of a lumbosacral spinal fusion

What is the prognosis after treatment for cauda equina syndrome?

The prognosis for recovery is excellent for animals operated on before the appearance of irreversible nerve damage. The speed of recovery is related to the severity of the lesions and their age. Generally, animals treated early enough recover a normal quality of life after a few days without any after-effects. The disappearance of pain is generally spectacular.

See also :