Student Case Presentation
Management of multiple vertebral sequestrums following epidural anesthesia
| Date/Time: |
8/27/2026 2:00 PM
|
| Presenter: |
Madison Chadwell |
| Veterinary School: |
TN |
Abstract:
A 7-year-old polled Hereford heifer used as a high-value embryo donor for in vitro fertilization presented for evaluation of a progressively enlarging mass at the tail base. The lesion was first noted as a small “bump” approximately 1 month prior to presentation, but has rapidly increased in size, prompting referral for further evaluation.
On presentation, A fistula dorsal to the first intercoccygeal joint was present with copious amounts of purulent discharge and exposed caudal vertebrae. Radiographs were taken and indicated infection involving the sacrum and caudal vertebrae with associated pathologic fractures. The tail was paralyzed, but anal and vulvar tones were present
Initial treatment included surgical debridement and a caudectomy, followed by aggressive wound management. Systemic therapy included broad spectrum antibiotics and anti-inflammatory treatments. Re-evaluation radiographs of the sacrum indicated the development of cranial sequestrum of the caudal sacral vertebrae and sequestrectomy was attempted. The initial standing approach was aborted due to persistent skin sensation, the cow experienced major hypertension during the first general anesthesia event forcing prematurely ending the procedure and finally the sequestrectomy was performed during a second general anesthesia after successful completion of oocyte collection during the week prior to the surgery. Multiple pieces of bones were removed, and the wound was left to heal by second intention over the following weeks.
Surprisingly, this cow maintained anal and labial tone through the caudal rectal nerves (S4-S5) and pudendal nerve (S3) respectively. She has maintained normal ambulation indicating no alteration of the sciatic nerves’ roots (L5-S2). It appears in this case that the cow was able to wall off the infection to protect the subarachnoid space around the third sacral vertebrae. Epidurals are common procedures in cattle, and related complications are rare. This case highlights the importance of skin cleaning prior injecting into the epidural space.
