cauda_equina_hund

Thema: Cauda Equina Syndrom

AW: Cauda Equina Syndrom

AW: AW: Cauda Equina Syndrom

AW: Cauda Equina Syndrom

Auf die OP habe verzichtet, trotz dass die TД mir sie nahegelegt hat. Aber ich lieЯ sie nicht mehr operieren, 1. hatte ich das Geld (ab 1500 Ђ aufwдrts) nicht und zweitens hдtte sie die schwere OP nicht mehr verkraftet. Ich hatte sie dann auch nur noch ein halbes Jahr, dann muЯte ich sie einschlдfern lassen, weil die Organe versagten, ob das mit dem CES zusammengehдngt hat glaube ich nicht, denn das Herz und die Lunge waren stark vergrцЯert. Behandelt wurde sie aber als es bekannt wurde mit Anabolika und Muschelextrakt, sie brauchte auch keine Schmerzmedikamente. Die Muskeln hatten sich auch wieder aufgebaut. Sie lief Spaziergдnge bis zu 3 Std. problemlos mit, manchmal rannte sie auch, aber ьber Hindernisse lieЯ ich sie nicht mehr springen, auch nicht ins Auto.

Petra und Zorro

AW: Cauda Equina Syndrom

AW: Cauda Equina Syndrom

Hab Dir den folgenden Text von der site: www.dalamtinertreff.de kopiert. Ich hoffe ich krieg keinen Дrger wegen dem copyrecht.

Rьckenmark und Wirbelsдule sind in der Embryonalentwicklung anfangs gleich lang, so das jeder Nervenzweig durch das auf gleicher hцhe befindliche Zwischenwirbelloch (Foramen Intervertebrale) austreten kann. Wдhrend der Entwicklung nimmt die Wirbelsдule mehr an Lдnge zu als das Rьckenmark. Die Nervenendigungen kцnnen somit nicht mehr auf gleicher Hцhe aus dem Wirbelkanal (Canalis Vertebralis) austreten. Vielmehr verlaufen Sie eine Strecke in dem Wirbelkanal bis zu der entsprechenden Austrittstelle. Ab dem Ende des Rьckenmarkes (Conus medullaris) enthдlt der Wirbelkanal nur noch eine dichte Masse von nach hinten verlaufenden Nervenwurzeln, die wegen Ihrer Дhnlichkeit mit einem Pferdeschwanz als Cauda Equina bezeichnet werden. Die untersten Wurzeln treten durch das Kreuzbein aus.

Das Cauda Equina Syndrom ist Teils genetisch veranlagt , teils durch Leistungssport forciert und es tritt meist mit 3-5 Jahren eine Absenkung des Kreuzbeins ein. Dies verengt mehr und mehr den Wirbelkanal und ьbt Druck auf die dort befindlichen Nervenstrдnge aus.

Der Krankheitsverlauf ist langsam und zieht sich ьber Monate bis Jahre hinweg. Meist beginnt es, das die Rute nicht mehr so hoch getragen wird und im laufe der Zeit immer schlaffer hдngt. Der Hund verweigert zunehmend Sprьnge und wird vorsichtiger in seinen Bewegungen.

Die Krankengeschichte (Anamnese) und eine ausfьhrliche klinisch-neurologische Untersuchung sind von дuЯerster Wichtigkeit. In vielen Fдllen kann der Arzt schon nach einer grьndlichen Anamnese und einer klinischen Untersuchung mit groЯer Wahrscheinlichkeit feststellen, ob ein Cauda Equina Syndrom vorliegt. Eine Rцntgenaufnahme, Kontrastmitteluntersuchung (Myelographie) oder eine Computertomographie (CT) kцnnen die Diagnose bestдtigen oder widerlegen.

Das Dach des Kreuzbeins wird entfernt, somit ist der Druck auf den Rьckenmarkskanal entfernt. Im weiteren verlauf bildet sich hier eine Bindegewebsartige Platte die das Rьckenmark schьtzt.

Zur Linderung der Schmerzen und der Neurologischen Ausfдlle am erfolgversprechendsten ist Hypericum. (Tierarzt oder Tier-Heilpraktiker fragen)

AW: Cauda Equina Syndrom

AW: Cauda Equina Syndrom

AW: Cauda Equina Syndrom

gut erklдrt. Danke!

Rцntgenbilder ohne Befund.

Ich muЯ nur aufhцren zu grьbeln.

Macht leider nicht jeder TA.

Дhnliche Themen zu Cauda Equina Syndrom

Hallo zusammen, kaum sind die Nдhte der letzten OPs verheilt, kommt auch schon der nдchste Hammer. Ilka hat nun zum 2. Mal in Folge sehr starke.

Hallo zusammen, in letzter Zeit geht es meinem Nero wieder nicht besonders gut. Vor 2 Wochen zog er das eine Hinterbein so komisch nach. Das gab.

Hallo bei welcher hunderasse ist diese krankheit ьberwiegend bekannt ? Cauda Equina Syndrom Spondiliosen an der Wirbelsдule Ein Golden.

Hallo zusammen, Im Tierheim haben wir im Moment sehr oft sehr schlecht gezьvhtete Rassehunde aus Italien. Und stдndig wieder und wieder das.

Hallo! Mich wьrde mal interessieren, wie viele Hunde hier sind, die unter dieser Krankheit leiden? Ich habe noch nie etwas davon gehцrt und auf.

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Cauda equina syndrome

Back pain is a common complaint, but when it occurs suddenly and also includes sudden numbness in the genital area, difficulty urinating, and weakness in the legs — it is a medical emergency. Cauda equina syndrome is often caused by a large disc herniation in the lower back that compresses the nerve roots at the end of the spinal cord. These nerves send messages to and from the bladder, bowel, and legs. If they remain squeezed for too long, irreversible damage can occur. Prompt surgery to relieve the pressure may prevent permanent damage and restore bladder and bowel function.

What is cauda equina syndrome?

Cauda equina syndrome is a rare condition but has serious consequences if not treated promptly. It is most often caused by a large disc herniation in the lower back that compresses the nerve roots at the end of the spinal cord (Fig 1). These nerve roots are bundled together and resemble the tail of a horse. This is how they get their name. Cauda equina means "horse's tail" in Latin.

Unlike most back problems that are longstanding or chronic, cauda equina is an acute event, like a stroke or heart attack. It most often develops rapidly, within as few as 6 to 10 hours. Classic symptoms of back pain, coupled with a sudden onset of numbness in the genital area and sudden urinary retention, are signs of a medical emergency. Relieving compression quickly can determine whether one resumes a normal life or lives with incontinence and paralysis of the legs.

Less often, in people with recurrent back problems, cauda equina can come on gradually, with a slow progression of urinary symptoms. Because cauda equina syndrome is a disorder of the nerves that control the bladder, its symptoms can be similar to those caused by bladder or prostate problems.

What are the symptoms?

The symptoms of cauda equina compression include problems with bladder, bowel, or sexual function, such as trouble urinating (retention) or trouble holding it (incontinence). Most people have searing pain in the low back and buttocks as well as numbness and tingling in the “saddle area” (the rectal and genital areas and the inner thighs). Pain may travel down the back of the thigh, past the knee, to the calf and foot (sciatica). An individual might experience weakness or paralysis in the leg or foot, especially when getting up out of a chair. Extreme leg weakness and loss of bladder or bowel function are signs of an emergency; if this has occurred, seek medical help immediately.

What are the causes?

A large ruptured disc can cause cauda equina syndrome. During a herniation, the gel-like center of a spinal disc can bulge or rupture through a weak area in the disc wall and compress the nerves. In the majority of cases, the disc herniation occurs at the L4-5 or L5-S1 discs in the lumbar spine. A sports injury, fall, or car accident can fracture the spine or tear a muscle and damage nerves. Other causes include a narrowing of the spinal canal (stenosis), a tumor, an infection, or a hemorrhage.

How is a diagnosis made?

A careful medical exam will confirm or rule out a suspected diagnosis of cauda equina. Evaluation includes a medical history and physical exam. A loss of sensation in the anal area is a clear finding. A patient who complains of severe leg weakness, numbness in the genital area, or loss of bladder or bowel function will undergo an MRI scan to reveal the extent to which the herniation is compressing the spinal nerves. The doctor may also order a CT scan or a myelogram.

What treatments are available?

For a patient with acute cauda equina syndrome, surgery is likely an urgent need. The goal is to relieve pressure on the spinal nerves to restore sensation and muscle function to the bladder, bowel, and legs. Depending on the cause, one of the following surgeries may be performed:

Discectomy for a herniated disc removes the portion of the disc that is compressing the nerves. The surgeon makes a small incision in the middle of the back. The spinal muscles are moved aside to expose the bony vertebra. A window of bone is removed to expose the nerve root and disc. The portion of the ruptured disc compressing the spinal nerves is carefully removed.

Spinal decompression for stenosis removes the bone spurs and ligaments compressing the nerves. A small incision is made in the back. The surgeon removes the bone that forms the roof of the spinal canal. Next, soft tissue and bone spurs are removed to create more room for the nerves. Tumors and other lesions can also be removed.

Clinical trials

Clinical trials are research studies in which new treatments -drugs, diagnostics, procedures, and other therapies- are tested in people to see if they are safe and effective. Research is always being conducted to improve the standard of medical care. Information about current clinical trials, including eligibility, protocol, and locations, are found on the Web. Studies can be sponsored by the National Institutes of Health (see ClinicalTrials.gov) as well as private industry and pharmaceutical companies (see CenterWatch.com).

Recovery & prevention

Some bladder and bowel functions are automatic, but those under voluntary control may be lost if you have cauda equina syndrome. This means you might not know when you need to urinate or move your bowels or you might have difficulty doing so.

Recovery from cauda equina depends on the severity of symptoms and how long the nerves were compressed before surgery was performed. The chance of full recovery for those who have urinary retention is worse [1,2]:

• Of those who have numbness and tingling in the genital area (incomplete CES), 90% regained normal bladder, bowel, and sexual function.
• Of those who suffer bladder retention (complete CES), 20% may have permanent incontinence and loss of sensation in the pelvic area.

Residual problems after surgery may take some months to resolve. Rehabilitation methods such as bladder re-training may be required.

People who suffer permanent injury will face adjustments in their daily lives. Physical therapists can help them learn important self-care skills, including self-catheterization, stress management, and relaxation techniques. Additional assistance can be provided by a social worker, a support group, a sex therapist, or a psychiatrist (for depression).

In rare cases, paralysis of the legs may occur.

Sources & links

If you have questions, please contact Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.

1. Tien Chau AM, Xu LL, Pelzer NR, Gragnaniello C. Timing of Surgical Intervention in Cauda Equina Syndrome - a Systematic Critical Review. World Neurosurg. Nov 12, 2013 [ePub]

2. Lavy C, James A, Wilson-MacDonald J, Fairbank J. Cauda equina syndrome. BMJ 338:b936, 2009

reviewed by > William Tobler, MD, Mayfield Clinic, Cincinnati, Ohio

Mayfield Certified Health Info materials are written and developed by the Mayfield Clinic. This information is not intended to replace the medical advice of your health care provider.

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Patients who come to Mayfield with neck or back problems are given a rapid review of their medical condition within a few days, not weeks. It's a treatment process called Priority Consult.

Nearly 80 percent of our spine patients are able to recover with nonsurgical treatment. But when physical therapy, medications, and spinal injections fail to relieve pain, we help patients with surgery.

We treat more than 2,250 patients with herniated lumbar disc problems each year.

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Cauda equina syndrome

Cauda equina syndrome (hyperesthesia syndrome) is a degenerative lumbosacral stenosis resulting in cauda equina compression, commonly reported in German Shepherd dogs [2] and other large breed dogs such as the Doberman.

This disease of dogs is commonly observed in middle-aged large-breed dogs and occurs when soft tissue and bony changes, possibly in conjunction with abnormal motion of the lumbosacral joint, impinge on the nerve roots or vasculature of the cauda equina [3] .

Causes if this disease include degenerative disc disease, herniated lumbar discs (discospondylitis), synovial cysts [4] spinal stenosis, spinal neoplasia, ischemic insults, arteriovenous malformations or fragments of the fractured bones.

The consequent vertebral instability leads to a polyradiculoneuritis [5] , resulting in compression of L3 - S5 nerve roots with consequent nerve degeneration [6] and neurological disease.

The cauda equina nerve roots provide the sensory and motor innervation of most of the lower extremities, the pelvic floor and the sphincters. Therefore, in a fully developed cauda equina syndrome, multiple signs of sensory disorders may appear [7] .

Affected dogs show an insidious development of urinary and fecal incontinence, hindlimb paresis and hemiparesis with ataxia, knuckling of hind paws and eventual paralysis.

Diagnosis is based on presenting clinical signs and is usually confirmatory on radiographic, CT or MRI imaging, with signs of vertebral compression and sometimes gas-filled lumbosacral disk space (vacuum disk phenomenon) and facet phenomena between the degenerated L5 - L6 dorsal articular facets [8] .

In cases involving severe clinical signs, surgical intervention is usually required, such as hemilaminectomy.

Use of NSAIDs such as carprofen, meloxicam, gabapentin or leflunomide may alleviate pain associated with this condition.

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Cauda Equina

Cauda Equina er en sygdom mellem korsbenet (sacrum) den sidste lændehvirvel (L7). Sygdommen kaldes også korsledsinstabilitet eller L7-S1 syndrom. Simpelt sagt er der mindre bevægelse i denne overgang end der er mellem hundens andre ryghvirvler og cauda equina opstår når der dannes slidgigtsforandringer her. Dette resulterer i at pladsen til rygmarv og nerver bliver mindre og ofte ses det at selve disken mellem L7 og S1 er beskadiget, så kanalen bliver endnu mindre. Dette øger trykket på rygmarven og nerverne og resultater vil blive nervebeskadigelse på sigt.

De mest almindelige symptomer på cauda equina er smerter og smerten kan synes at komme fra lænden, bagbenene eller halen. Herudover vil man opleve muskelsvind på bagparten, samt en spændt forpart. Tester man hundens proprioception ved at vende bagpoten så hunden står på oversiden af den, så vil man også se en nedsat reaktion af denne.

Hvordan kan hundemassage hjælpe?

Som massør vil jeg naturligvis arbejde på at løsne de muskelrelaterede problemer der er ved denne sygdom. Det betyder blandt andet at få løsnet forparten, da hunden vil kompensere for smerterne i bagparten ved at overbelaste denne. Vigtigt er også at få blodcirkulation i bagbenene øget og at få hunden til at bruge bagparten så tæt på korrekt som muligt. Jeg vil benytte mig af passive bevægelser og hundemassage for at holde gang i bagparten og for at minde hunden om at bruge benene.

Er din hund blevet opereret for sygdommen skal vi have struktureret et genoptræningsforløb som inkluderer hundemassage, men også træningsøvelser.

Trænger din hund til at blive løsnet op?

Kontakt mig for at booke en tid til din hund

Cookies er nødvendige for at få hjemmesiden til at fungere, men de giver også info om hvordan du bruger vores hjemmeside, så vi kan forbedre den både for dig og for andre. Acceptér

Cauda equina hund

Deutsche Zeitschrift für Akupunktur

Zusammenfassung

Es wird über einen neunjährigen Amerikanisch Kanadischen Schäferhund mit Cauda-equina-Syndrom und Gonarthrose berichtet. Nach eingehender orthopädischer und TCM-Untersuchung wurde der Hund sechsmal im Abstand von einer Woche akupunktiert. Begleitend erhielt er ein Chondroprotektivum. Der Hund zeigte sehr schnell eine Besserung in seinen Bewegungen.

This case report describes the diagnosis and treatment of a nine year old American Canadian Shepherd dog with cauda equina syndrome and gonarthrosis.

After careful examination (including principles of traditional Chinese Medicine) and thorough general physical and orthopedic examination the dog was acupunctured on six occasions on a weekly basis.

Additional chondroprotective therapy was administered. The dog's condition improved considerably within six weeks.

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Degenerative lumbosacral stenosis in dogs

Degenerative lumbosacral stenosis is a common cause of cauda equina syndrome and a relatively frequent neurologic disorder in older dogs. If this condition is recognized early, treatment may help alleviate significant morbidity.

The terminology applied to clinical syndromes that affect the spinal cord segments, the spinal nerve roots, and the spinal nerves that contribute to the sciatic nerve innervation of the perineum, urinary bladder, urethral and anal sphincters, and tail can be confusing. Specifically, diseases that affect these structures can result in varying degrees of pelvic limb paresis and urinary and fecal incontinence because they are components of the seventh lumbar (L7) spinal nerve, the first through the third sacral (S1-S3) spinal nerves, and the caudal nerves.

The term lumbosacral disease encompasses any pathologic condition that affects the region of the spinal cord segments that contribute to the sciatic nerve and sacral and caudal nerves. Cauda equina syndrome implies pathologic conditions that affect the last several pairs of spinal nerve roots. Thus, lumbosacral disease and cauda equina syndrome are not specific conditions. Instead, they are the clinical manifestations of a variety of diseases that result in dysfunction of either the lumbosacral spinal cord segments or spinal nerve roots, respectively. Consequently, these two syndromes can result in similar clinical signs.

A detailed discussion of all these causes is beyond the scope of this article. Instead, this article concentrates on the anatomical structures, clinical signs, diagnostic evaluation, therapeutic interventions, and prognosis involved in degenerative lumbosacral stenosis.

To understand the neurologic signs and various diseases that affect the lumbosacral region of the nervous system, a strong knowledge of the anatomy is needed.

The L4-S1 spinal cord segments are known as the lumbosacral intumescence since the spinal cord is grossly enlarged in this area because of the large collection of neuronal cell bodies in the gray matter that contribute to pelvic limb innervation. As the spinal cord ends, it tapers. This anatomical tapering is called the conus medullaris. 4 In dogs, the spinal cord terminates within the vertebral canal at about the level of the L6 vertebra, depending on the dog's size. 4 In large dogs, the end of the spinal cord tends to be more cranial than in smaller breeds. 5 Consequently, the cell bodies that contribute to the L7 spinal nerve are approximately located within the spinal canal at L4-L5 vertebrae. 6 The cell bodies for the sacral and caudal nerve roots are located slightly more caudally. This disparity between the end of the spinal cord and the vertebral canal is the result of the differential growth patterns of these two structures, with the spinal cord ceasing development before the completion of vertebral column growth. 4

Even though the spinal cord ends, the dura mater continues caudally as a dural sac, known as the lumbar cistern. 4 In dogs, the dural sac continues caudally for a variable distance, occasionally within the sacral vertebral canal. The ventral (motor) and dorsal (sensory) nerve roots exit and enter the spinal cord, respectively, within the dura mater as intradural nerve roots. Although they are known as extradural spinal nerve roots, they remain covered by meninges as they traverse the spinal canal to exit their respective intervertebral foramina.

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Cauda equina syndrome

Cauda equina syndrome refers to a collection of symptoms and signs that result from severe compression of the descending lumbar and sacral nerve roots. It is considered a diagnostic and surgical emergency.В

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Epidemiology

Cauda equina syndrome is rare with prevalence estimated at approximately 1 in 65,000 (range 33,000 to 100,000) 1 .В It has, however,В been estimated to occur in

1% (range 0.1-2%) of herniated lumbar discs 2,3 .В

Clinical presentation

Cauda equina syndrome can present either acutely or chronically and requires two sets of symptoms/signs 1-3 :

1. perianal and "saddle" paraesthesia
2. bowel, bladder and/or sexual dysfunction

There is a host of associated symptoms and signs, which may be unilateral or bilateral and have a variable presence 1-3,6 :

• low back pain
• radiculopathy/sciatica
• lower limb paraesthesia and/or motor weakness
• reduction/absence of lower limb reflexes
• decreased rectal tone

Classification

Cauda equina syndrome (CES) can be classified into two entities 1,2 :

1. Incomplete (CES-I):В perianal/saddle paraesthesia but urinary retention/incontinence has not fully developed although the loss of urgency or decreased sensation may be present.В
2. Cauda equina syndrome with retention (CES-R):В perianal/saddle paraesthesia with urinary retention or incontinence.В

CES-R accounts for

60% (range 50-70%) and CES-I accounts for

40% (range 30-50%) of presentations 6 .В

Aetiology

There is a long list of conditions that can cause cauda equina syndrome (some of these are very rare)В 1-3 :

Risk factors

• congenital or acquired spinal canal stenosis 3
• recent lumbar spinal surgery 2

Radiographic appearance

Plain radiograph

• limited value; may demonstrate gross degenerative or traumatic bony disease 2

CT myelogram

• useful in patients in whom MRI is contraindicated or not available
• partial or complete blockage of contrast
  • may demonstrate an "hourglass" shape to the contrast-filled thecal sac in complete blockage 2

• imaging modality of choice 2,3
• sagittal and axial T1 and T2 sequences are usually sufficient 4
• post-contrast and STIR sequences may be required if infective causes are suspected 3,4

Treatment and prognosis

Cauda equina syndrome is considered a diagnostic and surgical emergency, although there is some debate about the timing of surgery (and depends on acute vs. chronic) but surgical decompression within 24 hours seems to have the best outcomes 1,3,6 . Patients with CES-R have a poorer outcome 3 . Approximately 20% of patients will have a poor outcome in terms of urological and/or sexual function as well as lower limb paraesthesia and weakness 6 .В

Quiz questions

References

• 1. McNamee J, Flynn P, O'Leary S et-al. Imaging in cauda equina syndrome-a pictorial review. Ulster Med J.82 (2): 100-8. Free text at pubmed - Pubmed citation
• 2. Gitelman A, Hishmeh S, Morelli BN et-al. Cauda equina syndrome: a comprehensive review. Am J. Orthop. 2009;37 (11): 556-62. Pubmed citation
• 3. Lavy C, James A, Wilson-MacDonald J et-al. Cauda equina syndrome. BMJ. 2009;338 (mar31 1): b936. doi:10.1136/bmj.b936 - Pubmed citation
• 4. Emergency Radiology. Cambridge University Press. ISBN:0521672473. Read it at Google Books - Find it at Amazon
• 5. Wilmink J. Lumbar Spinal Imaging in Radicular Pain and Related Conditions. Springer. ISBN:354093829X. Read it at Google Books - Find it at Amazon
• 6. Gardner A, Gardner E, Morley T. Cauda equina syndrome: a review of the current clinical and medico-legal position. Eur Spine J. 2011;20 (5): 690-7. doi:10.1007/s00586-010-1668-3 - Free text at pubmed - Pubmed citation
• 7. Lan HH, Chen DY, Chen CC et-al. Combination of transverse myelitis and arachnoiditis in cauda equina syndrome of long-standing ankylosing spondylitis: MRI features and its role in clinical management. Clin. Rheumatol. 2007;26 (11): 1963-7. doi:10.1007/s10067-007-0593-2 - Pubmed citation
• 8. Shaw PJ, Allcutt DA, Bates D et-al. Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy. J. Neurol. Neurosurg. Psychiatr. 1991;53 (12): 1076-9. Free text at pubmed - Pubmed citation
• 9. Bowie EA, Glasgow GL. Cauda Equina Lesions Associated with Ankylosing Spondylitis. Br Med J. 2011;2 (5243): 24-7. Free text at pubmed - Pubmed citation

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