Felis ISSN 2398-2950

Tail pull injury

Synonym(s): Sacrococcygeal and intercoccygeal vertebral luxations

Contributor(s): Laurent Garosi, Simon Platt

Introduction

  • Cause:  traction on the tail following road traffic accident.
  • Signs: range from paralysed tail, urinary and/or fecal incontinence to partial loss of sciatic nerve function.
  • Diagnosis:  history, clinical signs and radiographic confirmation.
  • Treatment:  tail amputation, manual expression or catheterization of the bladder, pharmacological aids in case of reflex dyssynergia.
  • Prognosis: cats with tail base sensation and good anal tone on presentation are expected to regain urinary continence. Cats that do not become continent within 1 month usually fail to regain urinary function.

Pathogenesis

Etiology

  • Result most commonly from road traffic accidents in which the tail gets momentarily trapped which causes a luxation or fracture at the base of the tail (sacrococcygeal or intercoccygeal vertebral fracture/luxation).

Pathophysiology

  • Traction of the cauda equina caused by traction of the tail.
  • Result in injury to lumbosacral intumescence, nerve rootlets, cauda equina and associated peripheral nerves supplying innervation to the tail, perineal region, anal and bladder sphincters Peripheral nerve: trauma.
  • Can result in complete severance of all structures of the nerve (neurotmesis), disruption of the axons with the endoneurial and Schwann cell sheaths remaining intact (axonotmesis) or transient physiological conduction block of nerve transmission in the absence of structural damage (neurapraxia).
  • Neurotmesis implies that regeneration, and thereby functional recovery, is severely impaired while axon regeneration remains a possibility with axonotmesis.
  • Rapid recovery would be expected with neurapraxia as there is no loss of axon continuity.
  • Current clinical tests cannot discriminate between these types of injury.
  • Differentiation of these subtypes of lesion and their location (intradural rupture of the rootlets versus true avulsion in which the motoneuron/proximal axon is avulsed from within the CNS) would depend on surgical exploration.

Timecourse

  • Acute onset following exogenous trauma (most commonly road traffic accident).

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from VetMed Resource and PubMed.
  • Eminaga S, Palus V, Cherubini G B (2011)Acute spinal cord injury in the cat.  Causes, treatment and prognosis. J Fel Med Surg 13, 850-862 PubMed.
  • Tatton B, Jeffery N, Holmes M (2009) Predicting recovery of urination control in cats after sacrocaudal injury: a prospective study.  JSAP 50, 593-596 PubMed.
  • Smeak D D, Olmstead M L (1985) Fracture/luxations of the sacrococcygeal area in the cat: a retrospective study of 51 cases. Vet Surg 14, 319-324.

Other sources of information

  • Moise N S, Flanders J A (1983) Micturition disorders in cats with sacrocaudal vertebral lesions. In: Current Veterinary Therapy VIII. Ed R W Kirk. W B Saunders, Philadelphia, PA, USA. pp 722-726.


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