Tail Trauma in Cats

Cats

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Tail trauma is an occasional problem mainly in outdoor cats. Also known as broken tail, luxated-subluxated tail or dislocated tail, clinical signs can vary from a kink in the tail to complete paralysis with fecal-urinary incontinence.

Most cats with tail trauma have a flaccid, paralyzed tail. Lacerations may or may not be present.

What to Watch For

  • Returning from outside with a limp tail
  • Pain at the base of tail
  • Urinary-fecal incontinence

    The most important factor in regards to your pet's prognosis is the nerve sensation to the tail and area around the rectum. This is best assessed by your veterinarian. Although your cat can live with a paralyzed tail, it can become soiled with urine and feces. Removal (amputation) may be recommended. Cats with urinary incontinence have a higher incidence of infection of the urinary bladder and infection of the kidney.

    Diagnostic Tests

    Your veterinarian will perform a complete physical and neurologic examination to assess your cat's injury. If your cat cannot feel his tail and has absent anal tone, treatment options will be limited.

    Other tests your veterinarian may recommend include:

  • Chemistry profile
  • CBC
  • Urinalysis
  • Radiograph (x-ray) of your cat's spine and chest

    Treatment

    If your cat can feel his tail, rest may be the best treatment, although surgical repair may be attempted. Tails can be surgically repaired when the vertebrae are luxated (dislocated) or even repaired if there is a fracture through one of the tail bones. Surgery may not be needed as tails seem to heal well without surgery.

    If your cat cannot feel his tail and there is urinary/fecal incontinence, there is a small chance that he will be able to regain some urinary-fecal function.

    In cases of a traumatic-paralyzed tail, most veterinarians recommend that the cat's tail be amputated to prevent further injury to the nerves that supply the urethra and anus. A cat with an amputated tail is not handicapped in the least.

    Treatment also involves helping your cat urinate and defecate. Your veterinarian may recommend stool softeners if your cat becomes constipated. Your cat may need his bladder expressed if there is no sensation to the urethra. There are some medications that may help your cat urinate more normally.

    Home Care

    Your cat will need to rest in a crate or cage following tail trauma. Your veterinarian will need to re-evaluate your cat with a neurologic examination and sometimes radiographs.

    If your cat has difficulty urinating, your veterinarian may need to monitor his urine for infection. Finding the right balance of medications for your cat will take time and patience. Your cat's need for medication may change over time.

  • Tail trauma is known also as broken tail, luxated-subluxated tail, or dislocated tail. It is an occasional problem mainly in outdoor cats and can be the result of vehicle accidents, tails caught in doors or, unfortunately, malicious causes.

    The most important factor in your pet's prognosis is the sensation to the tail and area around the rectum. The nerve, the pudendal nerve, that supplies the sphincters of the urethra and anus is located on the spinal cord at the base of the tail. Trauma to the tail often causes forcible separation or detachment of the pudendal and coccygeal (tail) nerves, or avulsion.

    Nerve trauma is classified pathologically as neuropraxis, axonotmesis and neurotmesis depending on the amount of damage that has occurred to the nerve. The classification scheme allows your veterinarian to give a prognosis.

  • Neuropraxis indicates sensation is still present and carries a good prognosis for return to function. It usually takes up to 30 days before you can determine if your cat's nerve function will return.

  • Axonotmesis is a less severe nerve trauma that indicates separation of the nerve with preservation of the myelin and other support structures to the nerve. In the early stages of axonotmesis, sensation may be lost but should return in 10-14 days after the trauma. Prognosis is guarded for full return to function.

  • Neurotmesis indicates complete separation of the nerve and supporting structures. Prognosis is grave for any improvement in nerve function.

    Management of a cat with no urinary or fecal control is a challenge to the most committed owner. Most animals need to have their bladder expressed 2-3 times per day. Bathing and drying the tail area is also required at least daily. Cats with urinary incontinence have a higher incidence of infection of the urinary bladder (cystitis) and kidney (nephritis). Animals also have problems with decubital ulcers (bedsores), urine scald and fecal dermatitis when they cannot control the urinary and anal sphincters.

  • Diagnosis In-depth

    Your veterinarian will perform a complete physical and neurologic examination to assess your cat's injury. The neurologic examination usually focuses on the sensation and motor to the tail and anus.

  • Other tests your veterinarian may recommend include chemistry profile and CBC.

  • A urinalysis may need to be repeated frequently if your cat is not urinating completely.

  • A radiograph (x-ray) of your cat's spine and chest. The spinal radiograph is to assess for presence and severity of the vertebral fracture as well as associated trauma. The chest radiograph is required to assess for pulmonary bruises or contusions, pneumothorax and diaphragmatic hernia that can occur concurrently to the trauma that caused the tail trauma.

    Treatment In-depth

    If your cat cannot feel his/her tail and has absent anal tone, your treatment options will be limited. If there is urinary/fecal incontinence, there is a small chance that he will be able to regain some urinary-fecal function. The urinary and fecal incontinence is caused by trauma to the pudendal nerve that supplies function to the urethra and anus. The injury is called a cauda equina avulsion and the nerve trauma is classified according to the degree of nerve damage.

    If your cat has decreased sensation to the tail, you will need to observe him closely and allow frequent neurologic examinations by your veterinarian.

    In cases of a traumatic-paralyzed tail, most veterinarians recommend that cat's tail be amputated to prevent further injury to the pudendal nerve that supplies the urethra and anus. Amputation also prevents the tail from becoming soiled with feces and urine, which is a major health concern for these cats.

    If your cat frequently has cystitis (urinary bladder infections), a specific therapy of antibiotics may be recommended and may include low-dose antibiotics or weekly alternating therapy. Another option is to treat with a urinary antiseptic such as methenamine.

    Following amputation, your cat should rest in a crate. This will allow him to heal adequately and will assure the best chance to regain nerve function. A cat with an amputated tail is not handicapped in the least.

    Treatment also involves helping your cat urinate and defecate. Your veterinarian may recommend stool softeners if your cat becomes constipated. Some stool softeners are mineral oil based such as hairball remedies or fiber based such as metamucil. Other stool softeners are DSS and lactulose.

    Your cat may need his bladder expressed if there is no sensation to the urethra. There are some medications that may help your cat urinate more normally. Some of these drugs are bethanachol, phenylpropanolamine, diethylstilbesterol, phenoxybenzamine, diazepam and flavoxate.

  • Bethanachol functions to increase the strength of the bladder contraction and is given 2-3 times per day.

  • Phenylpropanolamine and diethylstilbesterol are drugs that can increase the urethral sphincter strength. The dosing intervals for these drugs vary with the response and the severity of weakness.                                                                 

  • Phenoxybenzamine, diazepam and flavoxate can decrease spasticity of the urethral sphincter. These drugs are given two to three times daily.

  • The drugs are prescription drugs and require close monitoring by you and your veterinarian. Your cat will need rechecks to assess response to therapy. Depending on your cat's injury, you may need to adjust the medications.

    Home Care

    Your cat will need strict bed rest in a crate or cage following tail trauma. You may need to bathe and medicate your cat frequently if he has difficulty urinating.

    Your veterinarian will need to re-evaluate your cat with a neurologic examination. The injury may need to be re-examined by x-ray as well. If your cat has difficulty urinating, your veterinarian may need to monitor his urine for infection by performing urinalysis and cultures.

    Finding the right balance of medications for your cat will take time and patience. Your cat's need for medication may change over time.

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