{168912

‘One More Harlem’ Gibson

15 yo Saddlebred gelding

5 wk history of severely decreased range of motion in the caudal cervical region and swelling of the right neck

Unwilling to bend or flex the neck and unable to lower head to graze, eat, or drink

Muscle relaxants, topical anti inflamatories and gastroprotectants

Recently, anorectic with considerable loss of weight and muscle tone

Cervical range of motion was severely decreased

Cutaneous sensation and reflexes- WNL Normal gait

very mildly hypermetric in the hind limbs, normal forelimbs

Navigated up hill normally, extremely cautious to navigate down both the hill and curb, and extremely reluctant to lower his head

ASSESSMENT: neurologic examination overall did not reveal and significant abnormalities to explain the right sided cervical swelling and neck pain.

Most common pathologies of the equine cervical spine degenerative joint

disease of the articular facet joints, osteochondrosis of the vertebral bodies, intervertebral disk prolapse, and various soft tissue injuries

T1

C7C7

T1

C7

T1

DiscospondylitisNeoplasia(hemangiosarcoma)/ osteomyelitis with collapse of disc space

TraumaChronic intervertebral disc disease?

Differential diagnoses

Equine cervical intervertebral discs- no nucleus pulposus, but rather a central fibrocartilaginous area which becomes more fibrous peripherally Decreases intervertebral disc disease in horses

Age related degenerative changes exist, though typically without clinical signs Discs degeneration with bulging of the dorsal

longitudinal ligament may compress nerve roots

All reported cases of IVDD within cervical spine One thoracic lesion in a donkey

11 yo Saddlebred Chronic non specific clinical signs

Multiple thoracic spinal anomalies may have

predisposed Suspected chronic, end-stage presentation of CVS

Inflammatory disease of the intervertebral discs and vertebral bodies

Tortuous vessels near endplatesMost common in dogs

Reports in cats, pigs, horses, alpacasTypically hematogenous spread of bacteria or fungi

Discospondylitis

Rare in horses Vague, insidious clinical signs

Vertebral pain, fever, muscle atrophy (presumably disuse)

Neurologic deficits uncommon Most commonly reported in cervical spine,

but case reports of thoracic and lumbar cases Bacterial- hematologic spread or local

infiltration Often a presumptive dx based on response to abx

therapy Trauma?

Discospondylitis

Discospondylitis

Dyson, 2011

VRUS, 2006

VRUS, 2006

T1

C7

Has been reported to determine the focus of bacterial infection

Ciprofloxacin is widely distributed in the body and excreted via the kidneys

Retained at sites of active bacterial infection revealing areas with viable, proliferating bacteria with DNA gyrase Conflicting reports regarding specificity

Monitor healing?

(99mTc) ciprofloxacin scintigraphy?

Standing cervical centesis if concurrent neurologic signs

Detomidine and Morphine Angle probe dorsoventrally Aim needle ventrolateral-dorsomedialVRUS, 2012

Prognosis is usually guarded, though several case reports of full recovery

Long term IV antibioticsSurgical curettage +/- stabilization

Prognosis