CES - Cauda Equina Syndrome (Lumbosacral disease)

What is Cauda equina syndrome?

The cauda equina is made up of the tail end of the spinal cord and the adjacent nerve roots. A severe and painful progressive syndrome in the joint at the bottom of the spine (lumbosacral joint). The narrowing of the spinal canal, bulging discs, soft tissue proliferation, collapse of the foramina area, or new bone formation puts pressure on the nerves, making normal function of the back end of the dog very painful. The nerves associated supply the back legs, tail, anus and genitals.

how does it progress?

Early onset signs of cauda equina syndrome are a reluctance for a dog to jump up or climb stairs, a low tail carriage, reduced tail wagging, difficulty squatting to urinate or defecate or whimpering when the back end is touched.

It is most common in medium to large breeds of middle to older age, usually 3+ years old. Working dogs, dogs with long spinal columns, for example Beagles or German Shepherd dogs, are most prone to this syndrome.

Image used from SAGE Veterinary Centres. Please note that BelMar Canine Massage Therapy is no affiliated with SAGE Veterinary Centres.

what causes CES?

The compression of the spinal canal puts pressure on the nerves that exit the spine,  which causes the clinical signs of the syndrome. The pressure could be due to many different issues…

  • A narrowed spinal canal caused by arthritis (very common cause)

  • Intervertebral disc herniation (very common cause)

  • An infected disc

  • Trauma

  • Congenital malformation

  • Spinal tumour

  • Joint instability

  • Inflammatory diseases

  • Neoplasia - An abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should

  • Subluxation - a misaligned vertebrae within the spine from its normal position

  • Fractures

what are the symptoms?

  • Pain in the rear legs, tail and in the back - this is usually the most evident symptom that someone will see

  • Difficulty getting up

  • Poor coordination

  • Posture changes

  • Avoidance or inability to climb stairs

  • Weak rear legs accompanied with muscle atrophy

  • Trouble posturing for urination or defecation, which can lead to incontinence

  • Dragging of the rear paws

  • Unwilling or unable to wag the tail

  • Chewing of rear legs or tail

With non surgical treatment the pain associated with it can be reduced and some mobility can be returned with massage therapy, physiotherapy and hydrotherapy. Some medications can also aid with pain relief and inflammation. There are also surgical options, such as decompressive surgery (easing compression with the removal of bone, protruding discs etc) or lumbosacral distraction stabilisation surgery (replacement of the lumbosacral joint) will also aid, and sometimes remove the syndrome completely, returning the dog to normal working function.

how can massage help?

After it has been determined that there are no contraindications to massage the therapist will be able to use massage:

  • to aid with pain management by stimulating the sensory nerves and overriding the feelings of pain from an area (pain gate theory).

  • Increase mobility in the area while the syndrome is treated

  • Reduces stress, anxiety and muscle tension.

  • Will aid with reducing the effects of overcompensation  

  • Relieve muscle spasms in the affected area

  • Improve circulation and lymphatic drainage whilst your dog is less mobile

  • Encourage the production of endorphins for pain reduction and mental wellbeing

  • Epilepsy

  • The severity of the condition

  • The level of inflammation in the area (heat therapy should be avoided if inflammation present)

  • Skin irritations such as eczema

  • Bruises

Contraindications (reasons to not massage or to alter the massage) to be aware of - if your dog is showing any signs of the following then please let me know and then we can discuss a treatment schedule to work around or outside of the particular issue.

  • Open wounds

  • High blood pressure

  • Diabetes

  • Cardio-vascular conditions

  • Broken bones

  • Pregnancy