{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