Page 311 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

286 CHAPTER 1

VetBooks.ir 1.541 1.542

Fig. 1.541 This horse was hit from behind by a
vehicle and sustained a fracture of the sacrum. The
fracture has healed but left an obvious angulation in the
line of the sacrum halfway between the tail head and
the tuber sacrale. (Photo courtesy Graham Munroe)

Fig. 1.542 A tail that was bandaged too tightly and
sloughed off the distal end. In addition, it caused
varying thickness pressure rubs and ulcerations, which
are now healing. (Photo courtesy Graham Munroe)

motor weakness and, therefore, faecal and urine These should be ruled out using appropriate diag-
(mares) staining. Some injuries may go unnoticed nostic tests.
until swelling of the tail or excessive faecal contami-
nation becomes apparent. More severe neural injury Diagnosis
may result in failure of defecation or micturition. Radiography of the sacrum and tail will confirm
Sacrococcygeal fractures or luxations will result sacrococcygeal fractures, luxations and osteomy-
in local swelling, abnormal movement, anatomical elitis (Figs. 1.543, 1.544). Nuclear scintigraphy
distortion (Fig. 1.541) and pain on palpation and/ may reveal increased radiopharmaceutical uptake on
or manipulation. Hindlimb lameness may also be both the soft tissue and bone phase in the region of
seen, and may be worse under saddle, particularly traumatic injury.
if the caudal sacrum is involved. Ischaemic dam- Infiltration of local anaesthetic solution in the
age is characterised by necrosis (blackening) of the region of injury can establish the significance of coc-
skin (Fig. 1.542). Sacral trauma can also cause tail cygeal injury, particularly in relation to clinical signs
weakness (Fig. 1.543). such as hindlimb lameness.

Differential diagnosis Management
Other conditions that can cause similar clinical signs Reported successful conservative management
include polyneuritis equi, equine protozoal myeli- options for horses with sacrococcygeal fractures
tis and equine herpesvirus myeloencephalopathy. range from reduced exercise alone to epidural