My 14 yo Gelding was diagnosed with small bone spurs in C5-C6. It didn’t show up on x-rays, but did on Ultrasound (he has muscle atrophy in his lower neck). This is after a fall several months ago (treated at the time for EPM) and intermittent stumbling, mostly at the walk, a few times per ride it would feel like with his front foot he had stepped in a small hole. He has muscle Fasciculations maybe once or twice per ride in one front leg. Otherwise he is sound and overall feels balanced in his work. I tried acupuncture, shockwave, massage, Chiro and nothing has been especially helpful. Also put him on Equiox. Last week I opted to get the neck injected with PRP and have Meso done. I am about a week out and seeing little to no improvement. First day he could be walked and trotted under tack he was worse, he had one day where he got through the short ride without any stumbling and now I am back to where I was before the injection. Has anyone had experience similar? Any recommendations? I want to give it a little more time to work, but feel like I have run out of options and may need to think about retirement or at least turn him out for several months and see where he is at.
Any bone changes can cause both neuro signs (tripping) and other symptoms. There is the possibility of compression or irritation of nerve roots and also spinal compression. It could be that this is the cause of the muscle atrophy. (I’ve just retired a 10 yr old due to this. I ended up getting a CT scan/myelogram to sort this all out)
Typically cervical injections are steroids, and they can help anywhere from a little bit to a lot, and for varying time periods. You want to reduce the inflammation. Has the horse had a complete neuro exam? If not, I would get one - they aren’t complicated but you want a vet who really knows how to evaluate.
I hate to say this, but once the changes are there, there isn’t a good path back to “normal”. We actually ended up putting my horse on oral steroids to make him more comfortable; its only been about 2 weeks. But he wont be ridden anymore due to compression. If we can’t wean him down to low dose or if his issues get worse, I will then have to make another decision.
It sucks, I’m sorry for you and your horse.
I’m so sorry you are dealing with this with your horse.
What symptoms did your horse experience that led you to the CT scan? I did have a Neuro done. I took him to Tufts and he was rated grade 1. Because the x-rays looked good they didn’t recommend the Myelogram. I eventually had the ultrasound when things didn’t improve after EPM treatment. That’s when 2 small bone spurs were seen.
Might be worth trying osphos since nothing else seems to help.
Is that something they are now using off label for bone spurs/ neck arthritis?
Starting late last year we began to notice little things. Tripping here and there on days ridden outside the ring. Days of feeling like he had no “oomph”, every now and then looking slightly off in one leg or another. Began showing reluctance to do flying changes ( we were at the point of picking dates for his GP debut, and his one tempi changes had been EASY). Some loss of muscle tone. Reluctance when bending left. Some behavior changes, like he just didnt feel himself. All this got slowly more frequent.
After a number of vet visits to farm which led to nothing specific we took him to a clinic in Ocala, neuro exam showed some issues - grade 1-1.5. He was tested for EpM, Lyme, PSSM, and they did a neck ultrasound. Saw some mild changes in upper part of neck, and moderate action c6-c7. At first I was going to just quit there and retire, but after a week or two I really had to know more details so scheduled the CT scan/myelogram.
PRP is not as fast acting as a steroid injection, and isn’t killing the inflammation. IMHO, give it more time before you assess results - at least 3-4 weeks. I’d also consider giving the horse Osphos.
That is heart breaking. I’m so sorry.
Yes. Bone pain in general is how my vet describes its use
Osphos has a pretty quick effect on bone pain. But if the pain is neuro, it won’t do anything. And I would be cautious about using it in a situation where the body is already laying down too much bone, because it affects normal bone metabolism.
If the concern is nerve pain, a Gabapentin trial could give you more information.
Our vet uses Meloxicam for bone pain.
Thanks. That was something my vet recommended if the injections don’t work…
Thanks, that is good to know and it is nerve pain, so probably wouldn’t help.
You want inflammation down, your vet should’ve done a steroid injection instead of PRP. Was a neuro exam done? You should go get a myelogram done and see if there is any compression causing the tripping and stumbling. Anything with the neck, you’re better off having a myelogram done and figuring out if there’s any compression.
I took him to vet hospital and they xrayed and didn’t think the myelogram would be worth the risk since the x-rays were normal. The reason for the PRP vs steroids was due to insulin resistance.
Oh that makes perfect sense as to why they didn’t do steroids! I dont know if you asked, since they weren’t really talking myelogram, but they are pretty darn pricey if you dont have insurance. Where my horse went, down her in Fla, it is done typically as part of a CT scan, and the total was around $4k. General anesthesia required.
I originally wasn’t going to do one but after a few weeks of pondering, I wanted to know details of what was there.
After the myelogram did you try any treatment or decide that retirement was the best option? I never got the cost, because the x-rays looked like their wasn’t much cause for concern. The assumption was that his Grade 1 Proprioception deficits were due to residual affects of EPM, though I never had the spinal done, so very possible that he never had it. I think I am going to give the PRP a month and then re-evaluate where he is.
Vets were talking about basket surgery which is amazingly expensive, very long rehab (think like suspensory tear) and uncertain outcome. Joint injections briefly considered but spinal compression and possible nerve root pain, as well as multiple areas of bone changes made that a crap shoot. Thus retirement, though he is on a decreasing course of oral steroids to see if we can quiet whatever inflammation is going on. It has its risks, but he is, for now, more comfortable though if he has a day of too much pasture frolic action, he seems a bit NQR the next day. I have no long term plan…
I’m so sorry. That really sucks, especially so young and ready for his GP debut. I’m not optimistic with my gelding, but I will see where he ends up in a few weeks. I have to assume if this doesn’t help there is probably nerve compression. I wish that there were more options…
