Cauda Equina Syndrome in Dogs: Causes, Symptoms & Treatment

A dog's spine comprises twenty-seven vertebrae excluding the tail, with shock-absorbing discs between them, supported by muscles and ligaments. The spinal cord, protected within these bones, ends at the sixth lumbar vertebra in the lower back. The nerves branching here, called the cauda equina (Latin for 'horse's tail' due to their appearance), control a dog’s back legs, tail, bladder, and rectum. When these nerves become compressed, it leads to cauda equina syndrome (CES), a serious condition affecting a dog’s hindquarters and causing significant discomfort.

The Causes of Cauda Equina Syndrome in Dogs

Cauda equina syndrome arises when the nerves in the lower spine are compressed. This can be due to several underlying issues, including congenital bone deformities, herniated or bulging intervertebral discs, infections affecting discs or adjacent vertebrae, fractures, partial vertebral dislocations, tumours, nerve inflammation, and spinal infections. The most prevalent form of CES in dogs is degenerative lumbosacral stenosis, wherein pathological changes like disc thickening and ligamentous hypertrophy narrow the spinal canal and compress nerves. Arthritis may also cause thickening of spinal joints, compounding nerve compression.

Veterinarians carefully rule out other conditions with similar symptoms, such as fibrocartilaginous embolic myelopathy (spinal stroke), degenerative spinal cord disease (myelopathy), muscle diseases (myopathy), myasthenia gravis, blood clots in hind limb arteries, hip dysplasia, cruciate ligament rupture, and polyarthritis, to ensure accurate diagnosis and treatment planning.

Breeds Most Affected by Cauda Equina Syndrome

CES typically affects larger or older dogs, with the average onset around six to seven years of age, and males appearing more commonly affected. Breeds with higher risk include German Shepherds (German Shepherd puppies), Great Danes (Great Dane puppies), Airedale Terriers (Airedale Terrier puppies), Irish Setters (Irish Setter puppies), English Springer Spaniels (English Springer Spaniel puppies), Boxers (Boxer puppies), Labrador Retrievers (Labrador Retriever puppies), and Golden Retrievers (Golden Retriever puppies). These breeds’ size and spinal anatomy make them more prone to developing the disorder.

Recognising the Symptoms of Cauda Equina Syndrome

Symptoms often appear subtly before progressing. Early signs include weakness or intermittent lameness in the back legs, a crouched stance, and an abnormal gait. Dogs may show pain, reluctance to jump or climb stairs, or strange movements of their hind legs. Advanced symptoms include urinary and faecal incontinence, difficulties with defecation, inability or unwillingness to wag or raise the tail, and self-mutilation of the tail due to tingling sensations. These signs warrant prompt veterinary assessment.

Diagnosing Cauda Equina Syndrome

An accurate diagnosis begins with a detailed medical history and observations of symptom onset. A thorough spinal examination is essential. Diagnostic tests commonly recommended include:

• Electromyography to assess nerve and muscle function
• X-rays for detecting bony changes or tumors
• Myelogram or epidurogram imaging to highlight nerve compression
• CT or MRI scans to visualise soft tissues and detailed spinal anatomy

If tumours are suspected, chest X-rays may be performed to check for spread, though small tumours might not be visible.

Treatment Options and Prognosis

Treatment is tailored to the individual dog’s severity. Initially, exercise restriction combined with a prescribed course of anti-inflammatory medication over four to six weeks aims to alleviate nerve inflammation and pain. About half of dogs respond well to conservative therapy. In cases where symptoms persist or worsen, surgical options such as a laminectomy may be considered to relieve nerve compression. Surgery requires hospitalisation and dedicated post-operative care. Prognosis varies and is guarded due to the complexity of the condition and potential nerve damage.

Careful, early veterinary evaluation and responsible management are vital to improve the quality of life for dogs affected by cauda equina syndrome. Maintaining a healthy weight and regular check-ups can also aid in prevention and early detection, especially for at-risk breeds.

When Should You See a Vet?

Quick Answer: Seek veterinary advice promptly if your dog shows persistent hind limb weakness, changes in gait, pain, or difficulties with tail movement or toileting, especially in breeds prone to cauda equina syndrome.

Early detection and treatment of cauda equina syndrome can help prevent progression and improve outcomes. If your dog exhibits any signs mentioned, particularly those affecting mobility, bladder or bowel control, or showing unusual pain behaviours, arrange a vet consultation without delay. Your vet will guide you through diagnosis and discuss the best treatment to support your dog's health and comfort.