Consequences Of Spinal Cord Injury On Gastrointestinal Function
Fecal incontinence is a more common problem in dogs that suffer acute contusive or vascular lesions of the spinal cord, such as acute nucleus pulposus extrusion or fibro-cartilaginous embolism, respectively compared to compressive lesions. This might be because parenchymal lesions are more centrally located within the spinal cord or perhaps resulting from dilation of the spinal canal. This is seen in dogs with chronic compression of the spinal cord from sub-arachnoid diverticulum, such as in Pugs where fecal incontinence is common. The prognosis for dogs with acute contusive or vascular lesions is further discussed in the treatment section below.
With lower motor neuron lesions , the anal sphincter is weak or absent and this causes constant leakage of feces. This is a much more serious problem to manage the dog in hospital and at home and can lead to megacolon in the author’s experience.
What Are The Symptoms
The symptoms of cauda equina compression include problems with bladder, bowel, or sexual function, such as trouble urinating or trouble holding it . Most people have searing pain in the low back and buttocks as well as numbness and tingling in the âsaddle areaâ . Pain may travel down the back of the thigh, past the knee, to the calf and foot . An individual might experience weakness or paralysis in the leg or foot, especially when getting up out of a chair. Extreme leg weakness and loss of bladder or bowel function are signs of an emergency if this has occurred, seek medical help immediately.
How Do I Take Care Of Myself
The best thing you can do for yourself if you have symptoms is to see a healthcare provider. Continue getting help from healthcare providers after you have surgery, including:
- Physical therapists.
- Primary care healthcare providers.
See if your family and friends are willing to help you as well. Youll need support.
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Cauda Equina Syndrome And Incontinence
Cauda equina syndrome is a condition that causes squeezing or compression in the cauda equina sac of nerves at the base of the spinal cord, resulting in lower back pain and urinary incontinence. As the nerves are pinched, they are unable to properly function and may result in the involuntary loss of urine.
Cauda equina symptoms include weakness in the legs, numbness or tingling in the lower back and legs, and incontinence.
In some cases, cauda equina can be treated by surgically decompressing the spine, depending on the extent of damage involved with the nerve tissue.
What Is Bladder Management
Bladder management is an ongoing set of treatments and practices that help keep your bladder and kidneys healthy and free from infection and other problems.
- Bladder management cannot fix or solve the problems caused by your SCI, but it can help you manage them to improve your health and quality of life. With appropriate management you can prevent incontinence and damage to the kidneys.
- You can work with your doctor to choose which bladder management option fits into your lifestyle and maintains bladder and kidney health.
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How Can I Know If My Bladder And Sphincter Are Working Correctly
Doctors can do a urodynamics test to see how well your bladder and sphincter are working:
- A catheter goes up through your urethra into the bladder.
- Your bladder is slowly filled with fluid.
- Doctors then measure how your bladder and sphincter respond to the fluid in the bladder.
- The test can help inform which bladder management option is best for you.
Can Spinal Problems Cause Digestive Issues
Spinal problems can cause digestive issues.
The spinal cord is responsible for sending nerve signals throughout the body, including the digestive system. Therefore, any issues impacting the function of the spinal cord and the proper communication between nerves can potentially cause digestive problems.
Spinal cord injuries can cause various bowel problems,
- difficulty moving waste through the colon or large intestine
- difficulty controlling bowel movements
- hard stools that are difficult to pass
- abdominal pain
- a feeling of fullness quickly after eating, which can lead to decreased eating
Herniated disks can protrude and cause GI issues,
- excessive peristalsis, or the passage of food through the digestive system
- tenesmus, or the sensation of needing to have a bowel movement even though there is no more stool to expel
Moreover, health experts associate ankylosing spondylosis, which is another spinal condition, with inflammatory bowel disease . Ankylosing spondylosis is an inflammatory disease and a type of arthritis that can cause the vertebrae to fuse. As a result, a persons spine curves forward.
People with this condition chronic digestive tract inflammation that resembles IBD.
Common spinal problems include:
Two types of nerves control the digestive system: extrinsic and intrinsic.
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Management Of Urinary Retention And Incontinence In The Acute Phase And Early Weeks After Spinal Cord Injury
Diligent management of retention and overflow incontinence in the acute phase of spinal cord injury is paramount. It involves preventing bladder over-distention and ensuring bladder emptying but also managing the dog as a whole and implementing hygiene measures that will prevent complications. The spinal patient might be especially susceptible to developing complications such as decubital ulcers and urinary tract infection because of the combination of neurogenic incontinence , recumbency and reduced immunity after spinal cord injury potentially sustained by poor nutrition. Although these factors have not been clearly studied and established as risks in dogs after spinal cord injury, they are in people and for the time being, it appears logical to consider these as such. Guidelines for the management of urinary retention and incontinence in the acute phase are proposed in Table 1.
Table 1. Acute phase of spinal cord injuryin hospital management .
What Are The Causes
A large ruptured disc can cause cauda equina syndrome. During a herniation, the gel-like center of a spinal disc can bulge or rupture through a weak area in the disc wall and compress the nerves. In the majority of cases, the disc herniation occurs at the L4-5 or L5-S1 discs in the lumbar spine. A sports injury, fall, or car accident can fracture the spine or tear a muscle and damage nerves. Other causes include a narrowing of the spinal canal , a tumor, an infection, or a hemorrhage.
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Types Of Spinal Stenosis
Spinal stenosis develops when the normal wear and tear of aging causes the spaces within the spine to narrow. There are 3 types of spinal stenosis lumbar, cervical and thoracic that are diagnosed based on the location of narrowed portion of the spinal canal. It’s possible to have more than one type of spinal stenosis.
Cervical stenosis Cervical stenosis is diagnosed when narrowing affects the area around the spines top seven vertebrae.
Thoracic stenosis When spinal stenosis affects anywhere along the longest portion of the spine, extending from the bottom of the neck to the abdomen, thoracic stenosis is diagnosed.
Lumbar stenosis The most common type of spinal stenosis, lumbar stenosis affects the lower back. The lumbar spine, which includes the spine around five vertebrae, begins about 6 inches below the shoulder blades.
How Is It Treated
In mild cases of spinal stenosis, symptoms can usually be controlled with medicine to relieve pain, exercise to maintain strength and flexibility, and physiotherapy. If your symptoms are severe, you have progressive weakness of your muscles, or the pictures of your spine show that your spinal cord or nerves are being tightly squeezed, your doctor is likely to recommend to relieve the pressure. This surgery may be done from the front or the back of the neck. It involves removing some of the disc, bone, and/or tissue that may be pressing on the nerve roots. Vertebrae are often joined together surgically to provide stability to the spine.
Cervical spinal stenosis can potentially cause serious problems with the nervous system, including problems with bowel or bladder control and permanent loss of strength and feeling in the arms, hands, legs, and chest. Your doctor will not wait for you to have severe symptoms of pain, weakness, and numbness before considering treatment to relieve pressure on your spinal cord and nerves.
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The Neck Bones Connected To The
Your neck contains several important structures, including but certainly not limited to the seven cervical vertebrae, the enclosed spinal cord, and the spinal canal.
The spinal canal is formed by the bones of your spine and protects your spinal cord, which is a big bundle of nerves that allows you to move, feel, and control important bodily functions like bladder and bowel control.
If any kind of damage occurs in this area, your bladder, among other organs, can be affected.
The Study Of Urinary Incontinence With The Canine Translational Model Of Spinal Cord Injury
Figure 2. Schematic demonstrating placement and function of a canine sacral nerve stimulator for bladder emptying in chronically paraplegic dogs in dogs with T3-L3 spinal cord lesions, the sacral nerves below the lesion remain intact and can be accessed via lumbo-sacral laminectomy a book electrode containing two gutters can receive a pair of sacral nerves when the implant is slotted underneath the dural cone and cauda equina the implant is connected via a cable to a sub-cutaneous transducer that can be palpated by the clinician and the owner the transducer is activated with a remote system brought close to the skin and the transducer this generates an electrical current that flows to the implant, stimulate the sacral nerves, and leads to efficient bladder emptying.
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How Is Cauda Equina Syndrome Diagnosed
Your healthcare provider will diagnose your cauda equina syndrome by interviewing you about your symptoms, assessing your physical abilities, performing tests and ordering imaging tests. Theyll assess your abilities by having you:
Youll be diagnosed with cauda equina syndrome if you have two sets of symptoms:
- Bowel, bladder and/or sexual problems.
- Paresthesia of the backs of your legs, butt, hip and inner thighs.
What Treatments Are Available
For a patient with acute cauda equina syndrome, surgery is likely an urgent need. The goal is to relieve pressure on the spinal nerves to restore sensation and muscle function to the bladder, bowel, and legs. Depending on the cause, one of the following surgeries may be performed:
Discectomy for a herniated disc removes the portion of the disc that is compressing the nerves. The surgeon makes a small incision in the middle of the back. The spinal muscles are moved aside to expose the bony vertebra. A window of bone is removed to expose the nerve root and disc. The portion of the ruptured disc compressing the spinal nerves is carefully removed.
Spinal decompression for stenosis removes the bone spurs and ligaments compressing the nerves. A small incision is made in the back. The surgeon removes the bone that forms the roof of the spinal canal. Next, soft tissue and bone spurs are removed to create more room for the nerves. Tumors and other lesions can also be removed.
The Link Between Spinal Stenosis And Walking Concerns
Your lumbar region is where your spinal cord ends in a collection of nerves that look like a horses tail, called the cauda equina. These nerves send and receive messages to and from your pelvic area and legs.
Stenosis of your spinal canal interrupts these messages. As a result, lumbar spinal stenosis can cause walking problems.
Contact your doctor right away if you have severe pain and difficulty standing up. You may have developed cauda equina syndrome, which puts stronger pressure on the nerves at the bottom of your spinal cord. If left untreated, this syndrome can cause permanent nerve damage.
Symptoms of cauda equina syndrome include:
- disturbance or loss of bladder or bowel function
- numbness in your inner thighs, back of legs, genital area, or anal region
- severe pain or weakness in your legs that makes it difficult to stand up
If you have lumbar spinal stenosis, you may notice symptoms while walking or standing. These can include:
- lower back pressure when upright
- pain in your back, buttocks, or legs
- leg numbness, cramping, or tingling
- muscle weakness
- a weak foot that drops when you walk
You may feel relief from these symptoms when you lean forward, sit, or crouch, or while riding a bike or pushing a shopping cart. This is because a forward-leaning position reduces pressure on your nerves.
Spine Disorders With Potential To Cause Nbd
- is a common cause of neurogenic bladder dysfunction. The spinal cord need not be severed to cause paralysis below the injured level of the spine . Bruising of the spinal cord or inadequate blood flow can damage the cord’s ability to transmit nerve signals.
- occurs when the spinal nerve roots in the lower back are compressed. Although cauda equina syndrome is a rare occurrence, it is a serious medical situation requiring urgent care.
Causes of CES include:
Can Spinal Stenosis Cause Bladder Problems
Can spinal stenosis cause bladder problems
Can Spinal Stenosis Cause Bladder Problems. Spinal stenosis spinal stenosis is a term used to describe a narrowing of the spinal canal. You loose all bladder control and it is a very serious matter.that is when you call your surgeon and get you butt into surgery asap. If left untreated, this syndrome can cause permanent nerve damage. The higher up in the spinal cord an injury occurs, the more muscles are affected.
What are the dangers of a stenosis in the neck? Quora From quora.com
If you are unable to void urine you should immediately go to the emergency room for treatment. You may also have pain or numbness in your legs. Lumbar spinal stenosis can cause cauda equine syndrome, which needs medical attention right away. Disturbance or loss of bladder or bowel function. Pain is often most noticeable in the arm for cervical spinal stenosis and progresses, developing more severe symptoms if not adequately treated , such as a loss of sensation and function in all limbs . The higher up in the spinal cord an injury occurs, the more muscles are affected.
Clinical Characteristics Of The Recovery
The prognosis for recovery of urinary continence in dogs with non-compressive T3-L3 spinal cord injury seems similar to those with a compressive injury, with 9198% of dogs with hind limb dysfunction and present deep pain regaining urinary continence . However, interestingly, 1523% of dogs remain faecally incontinent in the chronic phase of recovery , suggesting that the injury perhaps affects spinal cord tracts differently to acute compressive intervertebral disc herniation. Indeed, contusive and vascular lesions induce more centrally located damage than is induced by compressive intervertebral disc extrusion, likely affecting the descending inhibitory control of the defecation reflex. The possibility of persistent fecal incontinence should be conveyed to owners of these cases.
Secondary lesions of the lower urinary tract in the acute and then chronic phases of spinal cord injury are poorly described in companion dogs. There is a clear occurrence of urinary tract infections that is discussed alongside the management methods to drain the bladder in the following parts of this article. But the histopathological changes of the bladder or kidneys are not described in companion dogs although there are data in experimental dogs .
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Can Walking Help Spinal Stenosis
Walking is a good exercise for spinal stenosis. Its low impact, and you control the pace and distance.
However, if walking triggers your symptoms, choose a different type of exercise. Discuss alternative movement options with your doctor.
If youre able to walk without symptoms, incorporate this activity into your routine. Some ways to walk more include:
- taking out the family dog
- parking a few blocks away from your destination
- running short errands on foot
What Is Cauda Equina Syndrome
Cauda equina syndrome is the compression of a collection of nerve roots called the cauda equina. Nerves send and receive electrical signals all across your body. The collection of nerve roots, shaped like a horses tail, is located at the bottom of your spinal cord.
Because of the cauda equina nerves, you can move and feel sensations in your legs and urinary bladder. Compressed cauda equina nerves can cause pain, weakness, incontinence and other symptoms. This syndrome can cause permanent damage, including paralysis, if left untreated. Quick treatment might prevent permanent damage like paralysis.
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Mechanical Techniques To Manage Bladder Emptying
There are three proposed methods employed to empty the bladder in dogs following spinal cord injury: manual emptying intermittent aseptic catheterization and placement of a indwelling catheter.
Intermittent sterile catheterization is also simple, guarantees an almost complete bladder emptying. But it is more invasive, carries a risk of introducing an infection in the bladder, can potentially cause urethral inflammation and stricture if done frequently, and might also appear challenging to untrained staff in particular in female dogs. In female dogs, the clinicians’ preference might also often be to leave indwelling catheter in place rather than repeating sterile catheterization.
Placement of an indwelling catheter has similar advantages and disadvantages with the previous method but can lead to bladder mucosa minor trauma and bleeding , therefore blocking the catheter. It is usually used for a short time during hospitalization because it will be difficult for the owner to manage it at home. The use of a closed bag system and long-term placement of the catheter removes the need for repeated catheterization and is comfortable for the nursing team and the dog, also reducing the risk of urine scald especially for large dogs.