Differential Diagnosis of Urinary Incontinence and Cauda Equina Syndrome

Traumatic coccygeal luxation and distal amputation of the tail of an Appaloosa mare

“…Trauma of the caudal and sacral vertebrae in a horse may result in damage to the cauda equina. Depending on the location and degree of trauma, injury of the cauda equina may lead to tail weakness or paralysis, anal hypotonia or atonia, paralysis or weakness of the rectal sphincter, loss of bladder tone or function and paraphimosis in the male (Tutko et al 2002;Furr and Sampieri 2008). Other clinical signs of cauda equina injury include analgesia of the tail, anus and skin of the perineum and muscle atrophy of the coccygeal muscles.…”

“…Initial evaluation of coccygeal trauma should include a complete physical examination, paying special attention for abnormalities in the region of the sacrum and coccygeal vertebrae. Findings suggestive of trauma in this region include abnormal conformation with possible muscle atrophy, paresis of the tail, pain on palpation of the sacrum and coccygeal area, positive response to hindlimb flexion, lack of anal tone and unusual pelvic enlargements found during rectal palpation (Furr and Sampieri ). If there is damage to the pudendal, pelvic or hypogastric nerves, retained faeces in the rectum as well as an enlarged bladder may be identified on rectal palpation (Grant et al .…”