arthritis in neck . Do they take xrays or ultrasound to locate

[blueribbonpanel]

Past history of horse showed neurological signs, not walking straight, unbalanced when putting neck down, weak rear end. Did a ton of tests, treated for multiple things, epm, etc. Finally found he had arthritis in his neck and injected c3-4-5 on both sides of neck and cured the problem. Trouble is, I don’t have all the history or any xrays from this, and I think this needs to be done again. Only because he is lame on the left front and blocks everywhere won’t make him sound and shows some uncomfortable-ness when palpated on neck in certain spot. Current xrays show no problems anywhere in foot or pastern. I was told they can’t take good xrays of the neck unless you go to a university or some big clinic, which is impractical for me.

Has anyone encountered this problem and had it treated by injections. Age of horse is 19. BTW, bute and/or previcox doesn’t help at all. Can you relate your cases and help shed some light on this for me. Thank you.

[nu2u]

Xrays were done on my horses neck in his stall at home over 10 years ago…if you even suspect an arthritic neck do not under any circumstances try to make that horse put it’s head/neck in a position it does not want…could result in a very sharp zinger of a nerve pinch pain that causes (normally calm n cool)horse to rear with devastating results(rib fractures, perforated diaphragm, contusions…had to be euthanized, totally sucky way to realize horse had very early arthritic changes when xrays were taken post rear/fall)<<<<< the voice of experience. To be honest considering the risk of what could happen if he tries to please and then suddenly basically pinches/compresses the nerve I would try to live with in the horse’s limits then manage obvious pain, honestly for your safety and his just hack on a loose rein and enjoy him while you can. This is not the type of pain that comes on gradually like an aching joint or tired muscle, it is like ZOW my nerve been ZAAPPPED! pretty much described to me as “all the sudden he just felt like an electric shock”

[IPEsq]

If you already know where the arthritis is, then they can do ultrasound to see if there’s any effusion there again. The injections are guided by ultrasound anyway. My horse’s arthritis was Dx’d by a combo of Xray (including high powered ones at a big clinic) and ultrasound. When we did injections a couple months later, they used ultrasound to confirm the affected areas and to mark/shave his neck before prepping the injection sites. I suppose if they saw no fluid at one joint anymore then they would have decided not to inject there. For example, we had also done shockwave up at the poll for a different issue and thought about doing a PRP injection there. Ultrasound taken at the time of doing the neck injections revealed the shockwave pretty much cured the effusion at the ligament attachment so there was no place appropriate for that injection.

[horsepoor]

My horse was x-rayed here at my home barn using the usual portable digital machine that my vet uses for everything. We then did the injections using ultrasound for guidance.

Why don’t you have the previous x-rays? If it was a previous owner that did them, maybe you could contact them to get copies?

[2tempe]

Don’t know where you are, but if the vet has good equipment, xrays can be done at the farm as can the ultrasound-guided injections.
That said, I have a 25+ yr old who had them over 3 years ago. Worked wonders then, neuro symptoms now returned. I posted a thread a couple weeks ago wondering about the success of a second round. The vet I used for the first set said he doesn’t often do them twice because they don’t work so well the second time. Anecdotal response to my thread also gave me similar answers. Some said no change, some said they only worked for a short period of time.

As an aside, I haven’t pursued this further as my horse sprouted a case of cellulitis 8 days ago, and he is struggling with that. Lots of oozing all around the leg and skin has opened in two troubling spots. Hoping and praying that no infection sets in to either fetlock joint or tendon sheath…

[cbv]

I just injected my gelding for the second time. Seemed to help.

[blueribbonpanel]

I found out through digging thru past vet records (asking for copies) that the horses neck was injected 3 different times by 3 different vets, and each vet used a different product. (this was about l3 months ago. I am still trying to find out why so many times in such a short time and what actually worked. Currently horse shows no signs of having a stiff neck, or not using the neck is the normal way. Can graze, eat hay from a high hay bag, etc. Really doesn’t seem anything wrong with the neck, but people are suggesting that is why the horse is lame on the left front. This is because various blocks of foot and pastern, and different injections there, did NOT make the horse sound. Right now there’s a bad abscess in the other foot so have to hold off with the vet work until that’s done…always something…!!! I also was told by 2 vets that they can’t inject anything if there is an abscess in the foot because of bad bacteria in the system. Has anyone ever heard this. Thanks all. Any input is appreciated

[IPEsq]

Steroids are contraindicated if there is any sort of bacterial infection.

I think that knowing where the injections were will go a long way into your current diagnostics. X-ray has various purposes for the neck–to identify trouble areas a little bit less expensively than ultrasound and to be used by a radiologist to measure looking for spinal cord compression. Ultrasound can see whether you have any effusion on a suspected trouble joint area. So, in your case, you might just want to go with ultrasound of the cranial and caudal joints at C3-4-5 unless your vet wants to start all over to build up a complete record.

It’s not that unusual that you’d do the injections separately. Say horse has a pretty obvious issue at C3-4 and not so bad at one of the others (I’m not sure if you mean he was injected at C2-3 C3-4 and C4-5 or C3-4 C4-5 and C5-6). The options are to do one-sided injections of the affected joint space, bilateral injections (which was done with yours), because often times that gives more relief even if the “problem” is on one side. Or to do all the clearly problematic and more mildly abnormal joints at once to just throw the book at the issue.

In my horse’s case, he had a clear OCD at C3-4 on the left side. There was effusion but no OCD at C4-5 and C5-6, also on the left side. My vet opted to 6 injections (bilateral joints for all 3 locations). Her reasoning was that she’d rather do that than do just C3-4 and then not be able to tell whether there was much improvement and then have to go back and do the others. Or, maybe she’d get lucky and all we needed to do was the one. By doing all 3, we will never know if we could have gotten by with fewer injections.

I had a bit of an insurance claim time crunch, had been drawing things out with alternate therapies and theories, and so we all agreed to just do the 6 injections and hope to be done with it.

In your horse’s case, it could have been a situation of trying it piece by piece and then discovering it took all 6 injections to make a difference. That suggests that you’d be looking to do 6 again, but you can see on ultrasound if there is still effusion at each of the previous sites and you and your vet can make the call. And if there is something like an OCD in there, you can also see that on ultrasound.

I don’t know why the vets each used a different product other than they had a specific preference for the type of steroid to use. I know several vets who prefer a certain steroid in the neck that my vet does not particularly like for that purpose, and she told me why she preferred a different one. If the horse’s records are spotty and horse is bouncing around between vets, that could explain the different agents used.