Cauda Equina Compression Syndrome in Dogs
The term Cauda Equina Compression Syndrome (CECS for short) comes up frequently among dog owners. But what does it mean anyway? In my post, I’ll explain what the disease is all about. You will learn how it develops and which symptoms are typical. To that you will learn all about what it means for your dog, what to consider and how to treat a CECS. In CECS, there is narrowing of the spinal canal and compression of the nerve roots at the end of the spinal cord. The nerve fibers are damaged by the direct pressure and by the undersupply of the blood vessels. As a result, neurological deficits develop.
What is the cauda equina?
The cauda equina is the rearmost part of the spinal cord and the bundle of nerves arising from it. It visually resembles a horse’s tail. Hence the name “cauda equina”. These nerves have a very important function. They control defecation and urination. In addition, innervate the tail muscles and a significant portion of the muscles of the hind legs.
How does compression occur and which dogs are affected?
CECS is a degenerative, congenital or traumatic narrowing of the spinal canal. The compression affects the nerve roots from the last lumbar vertebra, as well as sacral and caudal roots. They pass through the region of the lower lumbar spine and sacrum as a so-called cauda equina (horse tail). Compression and the resulting consequences are often gradual. There are a number of triggers for nerve compression. These include lumbosacral stenosis (bony apposition), connective tissue apposition, and connective tissue weakness.
What else can cause compression?
Malformations such as the formation of a transitional vertebra, herniated or bulging discs and spondylosis can also be causes. Furthermore, misuse or overuse in service or sporting dogs, severe obesity and the natural aging process promote the development of compression. In addition to instability between the last lumbar vertebra and the sacrum, a genetic predisposition may also be a cause. Genetically predisposed dog breeds include, for example, German Shepherd, Giant Schnauzer, Boxer, Rottweiler, Siberian Husky and Poodle. Less common triggers are neoplasms, fractures, dislocations, or discospondylitis.
What are the consequences?
The consequences of a CECS are strongly dependent on the extent of compression on the nerves. Complete paralysis of the hind legs may occur in the course of the disease if not treated. Urinary and fecal incontinence may also occur.
The symptoms of CECS
In the beginning, CECS is often dismissed as “lumbago” or “he’s just getting old and can’t do it anymore.” However, if your dog shows one or more of these symptoms, get him checked out urgently. The symptoms are very broad. This is because they are dependent on the pressure exerted on the spinal cord. They usually develop slowly and insidiously over months. The average age at the onset of the first symptoms about 6 years. But there are also very young patients or very old patients. The most noticeable symptom at first is a pain in the transition from the lumbar spine to the sacrum. The dogs avoid all movements that involve increased pressure on the lower back such as jumping, getting into cars, and climbing stairs. Affected dogs often show the classic lambing rut. This means a drooping tail as a result of inadequate nerve conduction. Bending up the tail is very painful for the dog.
These symptoms may also occur
Many dogs have difficulty standing up and lying down. Even lifting legs and shaking becomes a problem. Likewise, coordination and balance decrease significantly. The dogs are restricted in their mobility, lose their joy of movement. The muscles on the back tense, warm spots appear and the dog is very sensitive to touch. The musculature on the hind legs continuously decreases. In addition, many dogs exhibit hind limb tremors due to weakness or pain. Affected dogs now attempt locomotion completely from their front legs. Depending on the severity, the disease progresses to buckling on the hindquarters and neurological deficits. The dogs no longer lift their paws and drag their claws. In the course, complete paralysis and urinary and fecal incontinence may occur.
How can a CECS be diagnosed?
As an initial examination, a two-plane X-ray is useful. Because here spondyloses, tumors, transitional vertebrae, fractures are well visualized. In addition to X-ray diagnostics, a CT scan or MRI is often consulted. This clearly identifies any changes in soft tissues such as ligaments and intervertebral discs.
Can your dog be helped? How can a CECS be treated?
The therapy of a CECS depends on the extent of the neurological deficits. If there are clear signs of paralysis, the literature advises surgery. In surgical intervention, the goal is to decompress the spinal cord by removing the compressing material. If the dog has a pure pain syndrome and coordination difficulties, conservative therapy is usually advised. Conservative treatment involves providing the dog with pain medication and anti-inflammatory drugs. In principle, however, age and general health status should always be taken into account. I would advise you to consider each case on its own merits (keyword: risk of anesthesia).
What happens next? What can you do?
In both cases, i.e. after surgery as well as conservative treatment, physiotherapy should be started immediately. The goal is to relieve pain and relax overworked areas. To maintain and train musculature and mobility and to train nerve conduction to counteract neurological disorders. It is important to train the dog’s coordination and body awareness and to work on a healthy movement pattern.
You should definitely pay attention to that!
In the first 4-6 weeks after treatment, regardless of surgical or conservative treatment, strict leash restriction is the order of the day. The movement and load should be adapted to the state of the disease. Very important are very short exercise sessions throughout the day, than long walks. Jerky movements, tight turns, jumping, climbing stairs and short stops are taboo. Avoid at all costs the riding up of other dogs and the patting and patting on the back by the human. Weight loss is very important for overweight dogs. In wet and cold weather, protect your dog’s back with a coat. The following applies to sporting dogs: competitive sports are taboo. There is a risk of recompression and therefore I recommend sports that are easy on the back and joints.
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