## Overview Cauda equina syndrome is a constellation of neurologic signs caused by disease of the nerve roots that form the cauda equina at the end of the spinal cord. Affected horses show varying combinations of hind-limb weakness, urinary incontinence, fecal retention, and loss of tail tone. Causes include trauma, equine protozoal myeloencephalitis, polyneuritis equi, and space-occupying lesions. ## Causes Trauma to the sacrum, infectious or inflammatory neuritis, protozoal myelitis, and neoplasia can all damage the cauda equina. The specific cause determines treatment and prognosis. ## Diagnosis Neurologic examination demonstrates lower-motor-neuron signs to the tail, anus, bladder, and hind limbs. Rectal examination, cerebrospinal fluid analysis, and advanced imaging help identify the lesion. Testing for Sarcocystis neurona or other infectious agents is often performed. ## Treatment Therapy is directed at the underlying cause when known (antiprotozoal drugs, anti-inflammatories, or surgical decompression). Supportive care includes bladder management, fecal softeners, and prevention of urine scald. ## Recovery and Prognosis Prognosis is guarded and depends on the cause and severity. Some horses with inflammatory disease improve; severe trauma or advanced denervation often leaves permanent deficits. ## Prevention No specific prevention exists beyond minimizing sacral trauma and controlling known infectious risks where possible.
hindlimb weakness or ataxia; urinary incontinence; fecal retention; reduced tail tone; muscle atrophy of the hindquarters in chronic cases
## Overview Cauda equina syndrome is a constellation of neurologic signs caused by disease of the nerve roots that form the cauda equina at the end of the spinal cord. Affected horses show varying combinations of hind-limb weakness, urinary incontinence, fecal retention, and loss of tail tone. Causes include trauma, equine protozoal myeloencephalitis, polyneuritis equi, and space-occupying lesions. ## Causes Trauma to the sacrum, infectious or inflammatory neuritis, protozoal myelitis, and neoplasia can all damage the cauda equina. The specific cause determines treatment and prognosis. ## Diagnosis Neurologic examination demonstrates lower-motor-neuron signs to the tail, anus, bladder, and hind limbs. Rectal examination, cerebrospinal fluid analysis, and advanced imaging help identify the lesion. Testing for Sarcocystis neurona or other infectious agents is often performed. ## Treatment Therapy is directed at the underlying cause when known (antiprotozoal drugs, anti-inflammatories, or surgical decompression). Supportive care includes bladder management, fecal softeners, and prevention of urine scald. ## Recovery and Prognosis Prognosis is guarded and depends on the cause and severity. Some horses with inflammatory disease improve; severe trauma or advanced denervation often leaves permanent deficits. ## Prevention No specific prevention exists beyond minimizing sacral trauma and controlling known infectious risks where possible.
hindlimb weakness or ataxia; urinary incontinence; fecal retention; reduced tail tone; muscle atrophy of the hindquarters in chronic cases