Limber tail syndrome
Synonym(s): cold water tail, limp tail, broken wag, broken tail, swimmer's tail.
Introduction
- Limber tail syndrome - also called cold water tail, limp tail, broken wag or broken tail - describes a relatively common condition in sporting dogs.
- Cause: ischemic damage to the tail muscle, generally after swimming or exposure to cold or wet weather.
- Signs: limp tail.
- Diagnosis: clinical signs typical.
- Treatment: symptomatic. Warm packs, analgesics and rest.
- Prognosis: excellent - full recovery usually seen within days.
Presenting signs
- Acutely flaccid tail hanging down from the tail base or held horizontally for 8-10 cm (3-4 inches) and then drops down .
- The hair of the proximal tail is raised and dogs may resent palpation.
- The tail remains in this position even when the dog moves about.
Age predisposition
- Typically young adult dog.
- Affected dogs range from 6 months -9 years old.
- In English Pointers most typically around 2 years old.
Breed/Species predisposition
- Though limber tail is rare in the dog population as a whole, it is common in hard-training pointing and retrieving dogs. In a study in US in 1997 it occurred in about 4% of over 2000 hunting dogs studied.
- Most often seen in working breeds especially:
- English Pointers Pointer.
- English Setters English Setter.
- Foxhounds Foxhound (English).
- Beagles Beagle.
- Labrador Retrievers Retriever: Labrador.
- Golden Retrievers Retriever: Golden.
- Flat-coated Retrievers Retriever: Flat-coated.
Pathogenesis
Etiology
- Cause of limber tail is not known although it is thought to be associated with hard workouts (especially in unfit dogs), heavy hunting, and swimming or bathing in water that is too cold or too warm. It commonly is seen in retrievers and pointers as they start back into heavier training in the fall or in young dogs out for the first time from overuse of the tail muscles.
- Affected Pointers almost always have a history of prolonged cage transport, a hard workout the previous day, or exposure to cold or wet weather.
Predisposing factors
General
- Climate changes, especially:
- Exposure to wet, cold weather.
- Underconditioning or overexertion.
- Being confined in a crate for long periods of time.
- Tail conformation (high set or very active).
- Gender (males more frequently affected).
- Nutritional factors have also been suggested as possible causes.
Pathophysiology
- Ongoing studies suggest that limber tail is associated with muscle damage in the tail with dogs examined early in showing elevated muscle enzymes, eg creatine phosphokinase.
- In a study of affected pointers evidence of coccygeal muscle damage:
- Mild elevation of creatine kinase early after onset of clinical signs.
- Needle electromyographic examination showing abnormal spontaneous discharges restricted to the coccygeal muscles several days after onset.
- Histopathologic evidence of muscle fiber damage.
- Specific muscle groups, namely the laterally positioned intertransversarius ventralis caudalis muscles most severely affected. These muscles are used in lateral flexion (side-to-side motion) or wagging of the tail.
- The tail muscles are located in a small space between the coccygeal vertebrae, and an outer layer of dense connective tissue. Because there is not room for the muscles to expand, they essentially become entrapped by a natural tourniquet, resulting in decreased blood flow.
- Pathology is associated with ischemic damage to the coccygeal muscles, which is confirmed by histology, and is suggested to be related to compartment syndrome.
- Compartment syndrome is characterized by pain, swelling, lack of arterial pulses and paralysis in muscle groups that are adjacent to the bone enclosed by thick fascial layers.
Timecourse
- Acute onset.
- Complete recovery is usually seen by 2 weeks and often occurs within a few days.
- May recur in later training in 1/3 of the cases.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Houlton J E (2008) A survey of gundog lameness and injuries in great Britain in the shooting seasons of 2005/2006 and 2006/2007. Vet Comp Orthop Traumatol 21 (3), 231-237 PubMed.
- Steiss J, Braund K, Wright J, Lenz S, Hudson J, Brawner W, Hathcock J, Purohit R, Bell L, and Horne R (1999) Coccygeal Muscle Injury in English Pointers (Limber Tail). JVIM 13 (6), 540-548 PubMed.