TRAUMATIC INJURY OF THE SPINAL CORD 235 



nerve a paralysis and anesthesia of the parts behind will 

 result. Breathing will be performed by the diaphragm, the 

 ribs remaining stationary. The patient will also show 

 paralysis of the bowels, bladder, and tail which becomes as 

 limp as a dish-rag ("dish-rag. tail"). The pupils may be 

 unequally dilated but react to light. 



If the cord is crushed in its thoracic portiori the symptoms 

 are the same except that the foreparts of the animal are not 

 paralyzed and the ribs are employed in respirations. 



In the lumbar portion of the cord the symptoms are similar 

 except that tbe paralysis is confined to the hind limbs, tail, 

 rectum and bladder. 



For a time after the injury to the cord the patient may 

 show profuse sweating, marked dyspnea and spasmodic con- 

 tractions of the muscles in the neighborhood of the injury. 

 In large animals sensitiveness along the fracture is rarely 

 noted and crepitation cannot usually be determined. Obvi- 

 ously anesthesia exists behind the point of lesion. 



Course and Prognosis. — Nearly all cases of fracture or dislo- 

 cation of vertebrae are fatal. In horses and cattle death 

 usually ensues within forty-eight hours. Some cases of 

 apparent recovery suffer relapse and death from subsequent 

 dislocation of broken fragments or the formation of masses of 

 callous which encroach upon the cord. 



Diagnosis. — As a rule the diagnosis is not difficult, especially 

 where there has been a history of direct or indirect injury. 

 The bilateral paralysis and anesthesia occurring immediately 

 behind the affected area, the limp tail and the rapid develop- 

 ment of the symptoms are significant. From the standpoint 

 of differential diagnosis fracture of the pelvis (no anesthesia, 

 tail, rectum, or bladder paralysis) and azoturia (history, no 

 tail paralysis, dark urine) should be thought of. 



Treatment. — Treatment is of no avail. Cases which recover 

 are usually the result of hemorrhage only into the cord. With 

 valuable animals it is sometimes advisable to wait one or two 

 days before dispatching the patient, to determine whether or 

 not the symptoms arise from irreparable crushing of tbe cord 

 or a blood-clot. In the latter case approaching recovery is 

 manifested by a rather rapid disappearance of the symptoms. 



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