Full text loading...
Tail, anal and bladder dysfunction
/content/chapter/10.22233/9781910443125.chap19
Tail, anal and bladder dysfunction
- Author: Joan R. Coates
- From: BSAVA Manual of Canine and Feline Neurology
- Item: Chapter 19, pp 368 - 387
- DOI: 10.22233/9781910443125.19
- Copyright: © 2013 British Small Animal Veterinary Association
- Publication Date: January 2013
Abstract
Lesions that cause tail, anal and bladder dysfunction can involve the S1 to caudal (also known as coccygeal) spinal cord segments and nerve roots; together with the L7 nerve roots these structures form the cauda equina. This chapter looks at clinical signs, lesion localization, pathophysiology, neurodiagnostic investigation, disorders of the tail, anus and bladder, normal and abnormal micturition
Preview this chapter:
Tail, anal and bladder dysfunction, Page 1 of 1
< Previous page | Next page > /docserver/preview/fulltext/10.22233/9781910443125/9781910443125.19-1.gif
/content/chapter/10.22233/9781910443125.chap19
Figures
/content/figure/10.22233/9781910443125.chap19.fig19_1
19.1
Pelvic limb of a 3-year-old Labrador Retriever showing decreased withdrawal reflexes and muscle tone. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_1_thumb.gif
10.22233/9781910443125/fig19_1.png
19.1
Pelvic limb of a 3-year-old Labrador Retriever showing decreased withdrawal reflexes and muscle tone.
/content/figure/10.22233/9781910443125.chap19.fig19_2
19.2
A dog showing signs of tail dysfunction and loss of ‘wag’. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_2_thumb.gif
10.22233/9781910443125/fig19_2.png
19.2
A dog showing signs of tail dysfunction and loss of ‘wag’.
/content/figure/10.22233/9781910443125.chap19.fig19_3
19.3
Palpation of the lumbosacral region in a 10-year-old neutered German Shorthaired Pointer bitch to elicit paraspinal hyperaesthesia. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_3_thumb.gif
10.22233/9781910443125/fig19_3.png
19.3
Palpation of the lumbosacral region in a 10-year-old neutered German Shorthaired Pointer bitch to elicit paraspinal hyperaesthesia.
/content/figure/10.22233/9781910443125.chap19.fig19_4
19.4
(a) Lesion localization for disorders of the tail, anus and bladder; the sacral spinal cord segments and associated nerves (S1–S3) are highlighted. (b) Dorsal (left) and lateral (right) overviews of the caudal lumbar and lumbosacral vertebrae and associated nerve tissue. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_4_thumb.gif
10.22233/9781910443125/fig19_4.png
19.4
(a) Lesion localization for disorders of the tail, anus and bladder; the sacral spinal cord segments and associated nerves (S1–S3) are highlighted. (b) Dorsal (left) and lateral (right) overviews of the caudal lumbar and lumbosacral vertebrae and associated nerve tissue. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA.
/content/figure/10.22233/9781910443125.chap19.fig19_6
19.6
Sagittal section of the L7 vertebra, the intervertebral disc space and the sacrum demonstrating disc protrusion and nerve root compression. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_6_thumb.gif
10.22233/9781910443125/fig19_6.png
19.6
Sagittal section of the L7 vertebra, the intervertebral disc space and the sacrum demonstrating disc protrusion and nerve root compression. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA.
/content/figure/10.22233/9781910443125.chap19.fig19_7
19.7
A 6-year-old Rottweiler with degenerative lumbosacral stenosis. Note that the pelvic limbs are tucked under the caudal abdomen in order to flex the spine and lessen the nerve root compression. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_7_thumb.gif
10.22233/9781910443125/fig19_7.png
19.7
A 6-year-old Rottweiler with degenerative lumbosacral stenosis. Note that the pelvic limbs are tucked under the caudal abdomen in order to flex the spine and lessen the nerve root compression.
/content/figure/10.22233/9781910443125.chap19.fig19_8
19.8
(a) Neutral and (b) extended lateral radiographs of a 7-year-old German Shepherd Dog with degenerative lumbosacral stenosis. Note the ventral spondylosis, proliferation of the articular processes and tunnelling of the dorsal lamina, which is accentuated on extension of the pelvis. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_8_thumb.gif
10.22233/9781910443125/fig19_8.png
19.8
(a) Neutral and (b) extended lateral radiographs of a 7-year-old German Shepherd Dog with degenerative lumbosacral stenosis. Note the ventral spondylosis, proliferation of the articular processes and tunnelling of the dorsal lamina, which is accentuated on extension of the pelvis.
/content/figure/10.22233/9781910443125.chap19.fig19_9
19.9
Abnormal epidurogram showing >50% compression of the epidural space. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_9_thumb.gif
10.22233/9781910443125/fig19_9.png
19.9
Abnormal epidurogram showing >50% compression of the epidural space.
/content/figure/10.22233/9781910443125.chap19.fig19_10
19.10
CT images of degenerative lumbosacral stenosis. (a) Transverse view of proliferative bony changes (arrowed). (b) Sagittal view showing dramatic disc protrusion (arrowed). (c) Serial transverse views demonstrating canal and foraminal stenosis (arrowed). © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_10_thumb.gif
10.22233/9781910443125/fig19_10.png
19.10
CT images of degenerative lumbosacral stenosis. (a) Transverse view of proliferative bony changes (arrowed). (b) Sagittal view showing dramatic disc protrusion (arrowed). (c) Serial transverse views demonstrating canal and foraminal stenosis (arrowed).
/content/figure/10.22233/9781910443125.chap19.fig19_11
19.11
Sagittal T2-weighted (a) neutral and (b) flexed MR images of a 7-year-old German Shepherd Dog with lumbosacral pain and dysuria. There is marked ventral compression of the nerve roots due to disc protrusion at L6–L7 and L7–S1 with loss of epidural fat and attenuation of the thecal sac. In addition, there is dorsal compression due to ligamentous hypertrophy at L6–L7 and L7–S1. On the flexion view, note the improvement in impingement by the ligamentous structures. This provides evidence of dynamic compression at the lumbosacral joint. The dog underwent surgery for dorsal decompression of L6–L7 and L7–S1 as well as stabilization of the lumbosacral joint. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_11_thumb.gif
10.22233/9781910443125/fig19_11.png
19.11
Sagittal T2-weighted (a) neutral and (b) flexed MR images of a 7-year-old German Shepherd Dog with lumbosacral pain and dysuria. There is marked ventral compression of the nerve roots due to disc protrusion at L6–L7 and L7–S1 with loss of epidural fat and attenuation of the thecal sac. In addition, there is dorsal compression due to ligamentous hypertrophy at L6–L7 and L7–S1. On the flexion view, note the improvement in impingement by the ligamentous structures. This provides evidence of dynamic compression at the lumbosacral joint. The dog underwent surgery for dorsal decompression of L6–L7 and L7–S1 as well as stabilization of the lumbosacral joint.
/content/figure/10.22233/9781910443125.chap19.fig19_12
19.12
Postoperative (a) lateral and (b) ventrodorsal radiographs of a 7-year-old German Shepherd Dog with degenerative lumbosacral stenosis following dorsal decompression and articular process stabilization and fusion using an autogenous bone graft. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_12_thumb.gif
10.22233/9781910443125/fig19_12.png
19.12
Postoperative (a) lateral and (b) ventrodorsal radiographs of a 7-year-old German Shepherd Dog with degenerative lumbosacral stenosis following dorsal decompression and articular process stabilization and fusion using an autogenous bone graft.
/content/figure/10.22233/9781910443125.chap19.fig19_13
19.13
Ventrodorsal radiograph of a 5-year-old German Shepherd Dog with lumbosacral pain and evidence of sacralization of L7. Note the absence of the left transverse process of L7. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_13_thumb.gif
10.22233/9781910443125/fig19_13.png
19.13
Ventrodorsal radiograph of a 5-year-old German Shepherd Dog with lumbosacral pain and evidence of sacralization of L7. Note the absence of the left transverse process of L7.
/content/figure/10.22233/9781910443125.chap19.fig19_14
19.14
A young male Bulldog with spina bifida affecting the 12th thoracic vertebra. Note the butterfly vertebra at L4 (arrowed). © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_14_thumb.gif
10.22233/9781910443125/fig19_14.png
19.14
A young male Bulldog with spina bifida affecting the 12th thoracic vertebra. Note the butterfly vertebra at L4 (arrowed).
/content/figure/10.22233/9781910443125.chap19.fig19_15
19.15
Ventrodorsal radiograph of a 12-week-old Pug with paraparesis, flaccid anus with anaesthesia of the perineal region, and urinary and faecal incontinence. The dorsal spinous process of L7 is missing and the sacrum is hypoplastic. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_15_thumb.gif
10.22233/9781910443125/fig19_15.png
19.15
Ventrodorsal radiograph of a 12-week-old Pug with paraparesis, flaccid anus with anaesthesia of the perineal region, and urinary and faecal incontinence. The dorsal spinous process of L7 is missing and the sacrum is hypoplastic.
/content/figure/10.22233/9781910443125.chap19.fig19_16
19.16
(a) A 12-week-old Manx kitten with a meningocele on the tail. The meningocele was covered with a thin layer of epithelium and intermittently leaked CSF. The cat was normal on neurological examination. (b) Intraoperative photograph showing the fistulous tract that extended into the thecal sac. The sacral and coccygeal nerves were unaffected. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_16_thumb.gif
10.22233/9781910443125/fig19_16.png
19.16
(a) A 12-week-old Manx kitten with a meningocele on the tail. The meningocele was covered with a thin layer of epithelium and intermittently leaked CSF. The cat was normal on neurological examination. (b) Intraoperative photograph showing the fistulous tract that extended into the thecal sac. The sacral and coccygeal nerves were unaffected.
/content/figure/10.22233/9781910443125.chap19.fig19_17
19.17
Infection of the L7 and sacral endplates (discospondylitis) and the associated vertebral bodies. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_17_thumb.gif
10.22233/9781910443125/fig19_17.png
19.17
Infection of the L7 and sacral endplates (discospondylitis) and the associated vertebral bodies.
/content/figure/10.22233/9781910443125.chap19.fig19_18
19.18
Ophthalmic examination of a Domestic Shorthaired cat with feline dysautonomia. Note the dried nasal mucosa, the prolapsed nictitating membrane and the dilated pupil of the left eye. The pupil of the right eye is miotic following treatment with 0.1% pilocarpine. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_18_thumb.gif
10.22233/9781910443125/fig19_18.png
19.18
Ophthalmic examination of a Domestic Shorthaired cat with feline dysautonomia. Note the dried nasal mucosa, the prolapsed nictitating membrane and the dilated pupil of the left eye. The pupil of the right eye is miotic following treatment with 0.1% pilocarpine.
/content/figure/10.22233/9781910443125.chap19.fig19_19
19.19
A young male mixed-breed dog with canine dysautonomia demonstrating a dilated anus. (Courtesy Dr D O’Brien) © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_19_thumb.gif
10.22233/9781910443125/fig19_19.png
19.19
A young male mixed-breed dog with canine dysautonomia demonstrating a dilated anus. (Courtesy Dr D O’Brien)
/content/figure/10.22233/9781910443125.chap19.fig19_20
19.20
Ciliary ganglion from a dog with dysautonomia. Note the neuronal death. (H&E stain; original magnification X560) (Courtesy of Dr G Johnson) © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_20_thumb.gif
10.22233/9781910443125/fig19_20.png
19.20
Ciliary ganglion from a dog with dysautonomia. Note the neuronal death. (H&E stain; original magnification X560) (Courtesy of Dr G Johnson)
/content/figure/10.22233/9781910443125.chap19.fig19_21
19.21
Lateral radiograph of a Golden Retriever that was hit by a trolley and presented with a decreased perineal reflex and tail tone. Note the L7 fracture with ventral displacement of the caudal fragment. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_21_thumb.gif
10.22233/9781910443125/fig19_21.png
19.21
Lateral radiograph of a Golden Retriever that was hit by a trolley and presented with a decreased perineal reflex and tail tone. Note the L7 fracture with ventral displacement of the caudal fragment.
/content/figure/10.22233/9781910443125.chap19.fig19_22
19.22
(a) Lateral and (b) ventrodorsal radiographs of a mixed-breed dog with multiple fractures of the right pelvis and sacrum, luxation of the right sacroiliac joint, a compression fracture of the L3 vertebral body and fractures of the L3, L4 and L5 spinal processes. The dog was able to support weight on the left pelvic limb. The spine maintained alignment during flexion and extension on fluoroscopic evaluation. The sacral and pelvic fractures were repaired whilst the spinal fracture was managed medically. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_22_thumb.gif
10.22233/9781910443125/fig19_22.png
19.22
(a) Lateral and (b) ventrodorsal radiographs of a mixed-breed dog with multiple fractures of the right pelvis and sacrum, luxation of the right sacroiliac joint, a compression fracture of the L3 vertebral body and fractures of the L3, L4 and L5 spinal processes. The dog was able to support weight on the left pelvic limb. The spine maintained alignment during flexion and extension on fluoroscopic evaluation. The sacral and pelvic fractures were repaired whilst the spinal fracture was managed medically.
/content/figure/10.22233/9781910443125.chap19.fig19_23
19.23
Radiographic confirmation of a complete caudal vertebral luxation in a cat with avulsion of the tail. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_23_thumb.gif
10.22233/9781910443125/fig19_23.png
19.23
Radiographic confirmation of a complete caudal vertebral luxation in a cat with avulsion of the tail.
/content/figure/10.22233/9781910443125.chap19.fig19_24
19.24
Anatomy of the bladder and urethra. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_24_thumb.gif
10.22233/9781910443125/fig19_24.png
19.24
Anatomy of the bladder and urethra. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA.
/content/figure/10.22233/9781910443125.chap19.fig19_25
19.25
Overview of the neuroanatomy of the storage phase of micturition. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_25_thumb.gif
10.22233/9781910443125/fig19_25.png
19.25
Overview of the neuroanatomy of the storage phase of micturition. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA.
/content/figure/10.22233/9781910443125.chap19.fig19_26
19.26
Overview of the neuroanatomy of the voiding phase of micturition. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_26_thumb.gif
10.22233/9781910443125/fig19_26.png
19.26
Overview of the neuroanatomy of the voiding phase of micturition. Illustration created by Allison L. Wright, MS, CMI, Athens, Georgia, USA.
/content/figure/10.22233/9781910443125.chap19.fig19_29
19.29
Lateral abdominal radiograph of a well house-trained dog with osteoarthritis that was unable to ambulate outside. Note the over-distension of the bladder, which was presumed to be the result of detrusor muscle atony. The urinary bladder was catheterized and emptied for several days before the detrusor muscle regained function. © 2013 British Small Animal Veterinary Association
10.22233/9781910443125/fig19_29_thumb.gif
10.22233/9781910443125/fig19_29.png
19.29
Lateral abdominal radiograph of a well house-trained dog with osteoarthritis that was unable to ambulate outside. Note the over-distension of the bladder, which was presumed to be the result of detrusor muscle atony. The urinary bladder was catheterized and emptied for several days before the detrusor muscle regained function.
Supplements
Degenerative lumbosacral stenosis
An 8-year-old male German Shepherd Dog presented with a 2-month history of difficulty rising and lower back pain. The neurological examination determined that the spinal reflexes were intact. MRI revealed disc protrusion at L2, and ventral and dorsal compression of the cauda equina by proliferative tissue. Neutral and flexion radiographic views demonstrated a dynamic lesion, with improvement of the compression upon flexion. Treatment included a dorsal laminectomy and fusion of the L7 and S1 articular processes with screws and bone autografts. The dog recovered well and resumed a normal lifestyle. (See page 370 in the Manual)
Feline dysautonomia
A 2-year-old Domestic Shorthaired cat presented with acute progressive signs of dry mucous membranes, pupillary dilatation, anorexia and vomiting. The neurological examination demonstrated the maintenance of skeletal muscle strength. In this clip, 0.1% pilocarpine had been administered to the right eye to confirm the diagnosis of feline dysautonomia. The cat was subsequently euthanized. (See page 377 in the Manual)