Tail-Pull Injuries in Cats

In the literature

Couper E, De Decker S. Evaluation of prognostic factors for return of urinary and defecatory function in cats with sacrocaudal luxation. J Feline Med Surg. 2020. doi: 10.1177/1098612X19895053

The Research …

Sacrocaudal luxations (ie, tail-pull injuries) are relatively common in cats and present as a limp, sometimes painful, tail. Assessing nerve function is important during physical examination of patients presented with this condition; testing should be performed for distal and proximal tail sensation, anal tone, and perineal reflex. Damage to the caudal nerves can cause decreased sensory and motor function to the tail, and damage to the pelvic and pudendal nerves affects urine and fecal continence.

The goal of this study was to assess long-term outcome and prognostic factors in cats with sacrocaudal luxation. Seventy cats were evaluated retrospectively; 60 had absent tail tone and 53 had absent tail-base sensation. Anal tone was absent in 20 cats and decreased in an additional 13 cats. Inability to urinate voluntarily was noted in 53 cats; inability to defecate voluntarily was observed in 29 cats. Twenty-one of the cats with an inability to defecate voluntarily were constipated, whereas 8 were fecally incontinent.

Of the 61 cats for which urinary outcomes were available, 90% regained voluntary urinary function; 87% of those regained it in <30 days. Cats with a flaccid incontinent urinary bladder had a significantly worse prognosis, with only 50% regaining urinary control at a median of 33 days. With regard to fecal continence, 25% of those incontinent at presentation remained so, and 68.4% of those experiencing constipation at the time of injury continued to experience it at the time of follow-up. Age, sex, tail-base sensation, anal tone, perineal sensation, fecal continence, degree of vertebral displacement, and tail amputation did not affect outcome. Despite nerve dysfunction commonly being noted at the time of injury, most cats regained function with time. Because early tail amputation did not affect outcome, the authors did not recommend this as a treatment for cats with sacrocaudal luxation.

… The Takeaways

Key pearls to put into practice:

• Cats with sacrocaudal luxation should undergo a thorough neurologic examination, including careful evaluation of bladder and anal tone.

• Overall, cats with sacrocaudal luxation have a good prognosis for return to function; urinary incontinence with a flaccid bladder may be associated with a worse prognosis.

• Based on the high percentage of cats that returned to function in this study, aggressive decisions about euthanasia or tail amputation should not be made until at least 6 weeks postinjury.