Case: Cauda Equina Syndrome

Thank you to Thea Madill from St. George's University for sharing not one but TWO great pieces as part of our Cases and Abstracts category!  What a thorough and interesting case work-up - take a look!

A 3-year-old FS Great Dane was presented for orthopedic evaluation to further work-up the complaint of a chronic progressive hind limb weakness. Aside from this weakness, that was more notably reported when walking up and down stairs, she was behaving normal at home. On dynamic evaluation, she had an evidently ataxic gait in the hind limbs, and some urine dribbling was noted but initially thought to be due to excitement. On observation of her hindlimbs, her toenails were significantly shorter and appearing filed down in comparison to the forelimbs. She appeared painful when palpating her vertebrae moving caudally towards her tail and upon palpation of the lumbosacral joint, she let out a loud yelp. She was also painful when her tail was lifted.  At this point in the exam, it became suspicious that she was seeing the wrong department, and was referred to see a neurologist. This long-standing unknown cause of weakness was later diagnosed on MRI as Lumbosacral Stenosis, or Cauda Equina Syndrome. Demonstrated in this MRI T2 weighted image is narrowing of the spinal canal at the level of the lumbosacral articulation.