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Hi all,
Today I saw a 6 yo F/S retired racing greyhound who likely suffered an FCE on 30th December 2018. Initially she had hind limb paralysis and was urinary and fecally incontinent. MRI showed increased signal intensity in the spinal cord from L4 - L5/6 but no other abnormalities (from L2 - sacrum). Today she has a walking tolerance of 10 - 20 minutes, some weakness of the hind limbs R > L, she has normal hind limb DTRs and CPs. She no longer has true incontinence but needs to go more frequently including twice through the night and has no active tail movement. Her owners are very concerned about the lack of tail movement as she soils her tail every time she urinates or defecates. They are happy to wipe her when they are home but are concerned about her hygiene when they are out during the day and are considering amputation of the tail. Any ideas on IF or HOW I can go about trying to improve her tail function?

Hey Kristie!

Thank you for presenting this case! Super interesting!

So, it's interesting because if the FCE was affecting the spinal CORD, then the most inner portion should be spared (more so than the outer bits - motor and such). However, if the FCE affected the nerve roots (cauda equina) then anything is possible, and nerves / Nerve Roots and FCEs have always seemed to be a little less resilient than spinal cord FCE's.

It doesn't much matter really, because you're looking to stimulate the nerves / nerve roots that impact the tail. There's some fabulous early research on rats, laser, and peripheral nerve injuries. You can laser both the nerve roots (sacral) and I'd high dose laser over the caudal lumbar spine (cauda equina), AND then laser the base of the tail (muscles & peripheral nerves). Laser higher than you'd think. There really is no upper limit. So whatever you might think - double it! Time will be your limiting factor!

Have the owners stimulate the tail. Rubbing it. Rolling it. Gentle tail pull traction. Anything to stimulate nerves. Have them purchase a portable PEMF unit (i.e. Assisi Loop, Heal Fast Loop, or something similar), and use it daily or even twice daily.

Try e-stim on the muscles at the base of the tail. Can you get a muscle contraction? This will tell us if it's a severe LMNL (no contraction), or if there's a contraction, it's a recovering LMNL (axonotmesis or neuropraxia) or an UMNL... Basically, a contraction is a good sign. No contraction... not a good sign.

This could also be a good case to refer for acupuncture. Great for nerve stimulation! If no-one to refer to, then simply look up points at near around the tail, as well as common points for anything spinal / neurologic. (Bai Hui, GV, 3, 4, 14, BL 40 & 60. I'd also do GB 30). All of the other points, you'll be hitting when you do laser over the nerve roots and caudal L/S in general.)

Do a double check of the SIJ's and individual mobility of the coccygeal vertebra - oh well, and the L/S too while you're at it. The manual assessment might find something and/or general mobs can also stimulate the nervous system.

You could get the owners doing hot/cold compresses (30's of each back and forth for 5 - 10 minutes)... Just more stimulus. This wouldn't be my first choice... but if the owners are looking for more to do at home, I could make an argument in favour of giving it a try.

There you go, this should give you lots to try. Fingers crossed something helps!

Cheers,

Laurie

I have a quick questions about your PEMF recommendations. I have the Assisi loop, but I am wondering why the Heal Fast Loop is so much cheaper. Is it as good as the assisi?
Thanks

Hey Vet Gal,

We sell Heal Fast loops at my clinic. They're cheaper and I do think they are beneficial. I don't actually know how you'd do a side by side comparison of the two units. But I do hear that Assisi is purported to be stronger. If this was a laser discussion... I'd have ways to look that up to verify. With PEMF, I don't have the same tools (and I don't know that calculations exist.)
The current is generated by running an electrical current through a wire. Does a bigger wire generate a stronger current... or more wires? I don't know!
Sorry! I've not found the answer to that!

Laurie