C5, C6, C7 severe OA in an 8 year old

[Birddog1]

Hi, I am seeking input from the hive based on your personal experiences. The risk is that I bombard myself with more and more opinions, but I see how helpful this forum can be to others. I have four vets involved (and collaborating!) I have read every neck thread to date…

I have an 8 year old Lusitano that has recently been diagnosed with moderate to severe C5, C6, and C7 osteoarthritis, large OCD fragments, and likely nerve root compression. X-rays of C-spine from PPE in 2022 were read as normal, but over-read recently by my vet as mildly enlarged. New films were taken a month ago. The level of severity increases from C5 to C7. Radiographs are the only diagnostics thus far, no CT myelogram. No overt neurologic signs, but some equivocal findings by my vet - he explains that neuro exams are fairly subjective, however. I am fortunate to live very near to a top equine hospital and a neurologist visit is scheduled in the coming weeks.

Etiology is unknown. This is not a problem in her breeding line that I’m aware of, there was no known accidents and she has not been trained harshly and has only trained to schooling second level - so work hasn’t been super intense. Never shown due to issues with progressing in training and tension (now I know why).

She is also metabolic despite weight loss after a period of weight gain. Hyperinsulin and hyperglycemic. Steroids are risky to contraindicated.

This was discovered as part of a workup following an inability to progress in training (with a full time, highly skilled GP dressage trainer) and with recent regression in performance, spookiness, hind end discomfort (swapping behind, rough canter, stifle inflammation - treated).

I go back and forth between retiring vs. riding very lightly (just me now that her dressage days are over, a not very talented amateur). I bought this horse with the goal to develop her up the levels (with a trainer) and so this is a massive shift in focus and there is grief involved.

My question - how much more grief can I anticipate? Has anyone else had a young horse with this level of OA findings, not neurologic, but at a cross roads as to how to proceed? I am fortunate that I am able afford her care and she is very loved. She is fun and safe if I am not asking too much under saddle. I am also risk averse and don’t want to push her with light riding if this could suddenly worsen. I am trying to strengthen myself for the emotional toll of the coming months? years?

Thank you

[Simkie]

I’m so sorry, what a shocking diagnosis.

I retired my mare at about that age with changes only at C6/C7 when a second round of neck injections didn’t provide the relief the first round did. We’d diagnosed it because she didn’t swing evenly from behind.

I expected her neck stuff to progress over time and watched her really carefully for signs of that. But it never really changed. She always looked just a little weird behind if you really paid attention, but it wasn’t painful for her. I put her down earlier this year at 26 due to something entirely unrelated.

All to say: this sort of thing often is progressive, but sometimes it is not. You’ve apparently had a lot of progression in not much time, which is concerning, but that doesn’t necessarily mean it will continue at that rate.

I would approach riding with a great deal of caution–at the very least, until you get the fuller picture from your referral clinic. Nerve pain can be very sudden and severe, and unpredictable, and lead to some really big responses. Your horse may also not really know exactly where her parts are in space, which can also be dangerous. It may not be very safe, or fair to her, to ride.

[FjordBCRF]

My gelding will be 8 on Saturday, and last year we discovered he had some mild degenerative changes at C6, and he has some mineralization at poll/C1. This was all presenting with knee buckling, and he did go down with me on him once; thankfully we were both ok.

He is a Fjord, so not a great candidate for steroids due to the metabolic predisposition and we are managing pretty well after going on 1 pill of Equioxx a few months ago and electro-stim acupuncture helps a lot too. I also own a BEMER and he gets that most days. I do find that seems to really help warm him up before a ride or a drive.

I do a lot of groundwork and PT with him, poles/hills/balance pads etc to help support everything. Jec Ballou’s books are my bible for that. I got to audit one of her clinics last fall and it was awesome. We are currently in a pretty good place; up to about an hour of trail riding, and 40 mins/2 miles of driving his cart with 5-10 mins of trotting. I’m very thankful we have the driving option, its better overall with not having to help balance a rider on his back as much.

With all that said, I chose not to proceed any further with any kind of training. We were schooling second level. From here on out, we take it a day at a time, I listen to him and take his lead on how he seems to be feeling, and every day that I can ride him I look at as a gift.

[Birddog1]

Thank you so much for sharing your experience. I love that you still had 18 years with her. Do you mind if I asked how much groundwork or exercise you kept her in? I worry about my girl and her metabolic state, and will need to keep up a decent exercise regimen of some kind.

Your comments regarding caution riding are important and that is where my biggest question mark is right now.

[Simkie]

@Birddog1

Do you mind if I asked how much groundwork or exercise you kept her in?

Really none. She didn’t need anything to reduce her weight, so she was just a pasture pet and ran my little herd here. She was just the best boss mare. She was always very spry, even in her old age, and was always at the lead in pasture races.

But it would’ve been very tenable to do something with her, just letting her kind of drive how much and what she wanted to do. Not sure that would’ve been riding her…but I probably could’ve hand walked her all over hill and dale, or ponied her off another horse on the trails. Repetitive circles and such probably would’ve been out. Anything that requiring swinging evenly or loading equally behind would’ve been out, because of her specific deficit.

I think there’s a great deal of listening to the horse with this, which you’ve clearly done to get to this diagnosis. As long as they’re willing and happy, things are probably okay. Just do keep in mind those proprioceptive deficits.

[RedHorses]

Mine was 14 when diagnosed as neurological, probable Wobbler based on xrays. He had been able to compensate enough that neurological issues were never considered in previous years. His progress over those pre diagnosis years was erratic, with many things that in hindsight could be attributed to the neurological impairment.

In my horse’s case things went downhill very rapidly. He did have enough impairment that he fell in his field - often enough that I saw him fall once or twice a year throughout his life. He obviously fell at times when no one saw him as he would come in very painful at times.

At the initial diagnosis the vet said they couldn’t advise that a neurological horse was safe to ride. I had found my horse was better when ridden regularly, probably because I was always reminding him to use all his body parts properly (it must have had a physiotherapy type of effect). Knowing that he was neurological gave me the knowledge to stop riding if he started showing signs of degeneration like minor tripping that I I might otherwise have dismissed.

I did do a lot of postural exercises in hand and mounted, and he was doing really well until a couple of months later. I think he must have fallen in his paddock. He was never really happy after that, and two months later I had the cervical xrays done. With an “I think it’s a Wobbler” diagnosis from the internal medicine vet specialist who reviewed the xrays that matched the symptoms, I decided to give him the summer (provided he was comfortable) and euthanize in the fall.

I stopped trying to ride at that point, and for most of the summer my horse made it plain he didn’t want to do anything with me other than going in the barn for his dinner. No grooming, no handwalks. In the early fall, after watching me clicker train the two year old, my horse decided he wanted some attention and we did some clicker training working towards lying down on cue. He was still lying down, rolling, and getting up without any trouble and I thought it could be a useful trick at the end. He never quite got to understand what I wanted, and was finding the almost there posture uncomfortable so I quit.

The regular falls and near misses were a big part of why I euthanized when I did. We have real winter here, with months of cold, snow and ice. I wasn’t willing to risk him going down and breaking something. He was also always uncomfortable in the cold, needing to be kept more heavily blanketed than my other horses. I witnessed him nearly fall twice in his last couple of weeks. We had a cold spell for a few days about a week before the end and he was really unhappy until I put a midweight blanket on him - in temperatures well above freezing.

The timeline:
Suspicion of neurological issues - spring 2022

Diagnosed neurological - November 2022

Diagnosed Wobbler after neck xrays - April 2023

Euthanasia October 2023.

[Simkie]

I am so, so sorry with how quickly that went, RedHorses.

[Birddog1]

Wow, really appreciate this summary of what you went through. Thank you

[RedHorses]

Thank you.

In November I honestly thought I’d have him around until my senior was ready to go, and I had decided to let them go together. I never expected to have my senior horse longer.

2023 was brutal. I couldn’t love on him because he didn’t enjoy grooming or touch. He asked for scritches occasionally, and would come and stand with me if was in the paddock and didn’t touch him. The best and worst part was that we seemed to have finally gotten everything sorted out at our last competition in 2021 and were ready to go forward in 2022.

[4horses]

You wonder how many horses have these issues and never get a diagnosis? Or are currently being ridden and asked to compete, with unaware owners.

You know the horse better than any of us. We can all tell you, if in doubt, retire her and don’t ride her.

I think, for the most part, horses will try to tell us if they are uncomfortable with something. Do you feel comfortable continuing to ride her? Can you keep eyes on her often enough to tell if she develops new symptoms which would make her dangerous to ride?

[Birddog1]

These are good questions, yes I see her at least daily and spend quite a bit of time with her. She lives 5 minutes from my home at a very nice facility.

I am leaning towards the retire side of things. She has always been a horse that doesn’t love touch, and I know her so well that I can pick up pretty easily when she is having an uncomfortable day - even from the ground. She tends to wear her heart on her sleeve. She is on Equioxx and has seemed generally more receptive, and not just tolerant, to touch since I started that.

I do wonder how many horses have similar issues and don’t get diagnosed. That is what breaks my heart here, how long she must have been dealing with his and telling me in her way, and I didn’t quite hear her.

[2tempe]

I have been down this path. Regarding riding: this is a decision only you can make, but if you do, I would consider riding in a long/low frame. Any type of collection is not your friend. Any signs of neuro - ie tripping, etc - dont ride.
Regarding the nerve compression, its hard to know, my gelding had a “thing” where every once in a while he would let out a big buck and take off. For me, for trainer. There was always the “oh something spooked him” thought. BUT fast forward a couple years, he got similar diagnosis bad lower cervical, mild from poll to mid neck. MRI showed the nerve compression AND he had something called foraminal encroachment where bony protrusions compress the nerves from the spine. We began to wonder if his little “thing” was a response to the nerve issue. No real way to know. All this was diagnosed when the horse was around 11. He is retired. BTW, I did the CT Myelogram. $$ but I wanted to know. I feel for you, this is a hard place to be.

[IPEsq]

Were you present for the PPE? Those OCD lesions (and probably some of the arthritis) would have been there by 5-6 years old. You may have seen I had a horse with a OCD fragment in the neck back when imaging was less common on PPE. Someone may have given you a different horse’s X-rays. If one thing was missed, ok, maybe they weren’t taken at quite the right angle or something. For that many issues, it smells very fishy.

Hard to say without being able to try some steroids as a diagnostic to see if you can narrow down which things are affecting the horse the most.

For the nerve root compression, there may be a surgery option depending on what a CT shows.

[IPEsq]

The new -flozin drugs can be very effective at helping control insulin (and as a result, weight) including for ones that are limited in their ability to exercise.

[BroncoMo]

I generally avoid sharing my story because of the magnitude of grief, and it could scare someone whose situation is not the same, but here it goes.

In mid 2023, I leased a horse from a friend of mine that I hade bred. 7 year old hunter, fairly broke but still a bit green over fences. The first show we took him to after 3 weeks in training (in July), he showed his green-ness, but showed great potential.

3 weeks later, he was backsliding some. Acting out at lead changes, and in hindsight, anxiety. He was a big (18 hands) dopey and quiet horse, so his “acting out” presented more as a lazy protest. Regardless, he was sort of running through lead changes. We thought it was a bit of a training plateau.

We tried to show him in August and it was a disaster; freight training through lead changes, trouble focusing down lines though could jump singles ok. We decided he had something physical going on and would have a thorough work up when returning home. He developed shipping fever and had to have several weeks off to recover. When he returned to work, he was perfectly fine, jumping around and changing leads softly and quietly.

We tried to show him in October and the disaster was ten fold worse. His first class, we couldn’t even get him over a 12" cross rail in the warm up pen. We scratched his classes and I walked him straight to the vet trailer. It was discovered he had severe kissing spines throughout his thoracic region. We immediately started planning a rehab plan with surgery on the table as an option. We opted to go conservatively to start with and opted for conditioning with ground work and saddle changes.

This was going well for a bit, albeit a short amount of time. By December, his topline had improved and he was riding flawlessly. We opted to show him at the end of December/early January 2024. It was a disaster of a magnitude we hadn’t seen before. He couldn’t make it over small singles without a complete melt down and running through your hands. I absolutely knew without a doubt there was something very wrong beyond he back (which would not palpate sore). Midway through this 2+ week circuit, we scratched all his jumping classes.

I was playing around on the flat one day and asked him to bend and walk in fairly tight circles to see if I could identify where he was “locking up” (he would completely take his right side away during his melt downs). I isolated this issue to somewhere in his lower neck or wither or shoulder. I asked another client, who is a vet, to take a look at his neck for me. She agreed that he was tight and shock waived him. He softened quite a bit and was lovely to ride (flat).

I should mention that we had SEVERAL vet appointments at this point to try and identify the issue. I lost track of which appointments and when, because by this time, I had dropped somewhere in the 5 figures in vet appointments. The evaluations were NUMEROUS. With no conclusion.

I couldn’t justify keeping him in training and continuing with an unknown condition, taking him to shows when he feels good, with the hopes that he’ll make it though this time, just to be met with a melt down. I took him back to his owner.

She let me continue (trying to) showing him in the flat as we were qualified for the World Show and he seemed very content with flat riding. The first show I took him to (February 2024), we had a great first day. But the second day, he had a melt down in the same fashion that he had had over fences; he had never acted this way in the flat before. And his owner was there to witness. She agreed that there was something very wrong and scheduled an appointment.

It was quickly determined that he had severe OA and bone spurs at C6/C7 and was neurological. He had no idea where his hind legs were (which explained the issues with lead changes and anxiety over fences). He was given a poor prognosis and we were advised he wasn’t likely safe to ride.

She kept him around as a pasture pet for a short bit while trying to determine if he could have a long term quality life. At some point in the spring time, he had a “stinger” of sorts in his neck while in the wash rack and nearly went over backwards. He developed a lameness in a front leg, thought to be related to nerve damage that affected his shoulder. His quality of life was rapidly declining. This horse’s vet had a personal horse go through nearly the exact same thing. He was found one day down and paralyzed in the pasture after what was assumed to be a stinger in his neck, he reacted by flipping over, and broke his neck upon landing that unfortunately did not kill him. We did not want our giant to suffer the same. He was euthanized June 2024.

I’m sorry for the long and bleak story. Yours may not be at all the same. You mention nerve compression and OCD fragments, which would concern me in the long-ish term. It sounds like you have a good team on board though.

[Birddog1]

Oh wow thank you for sharing that story. There are eerie similarities to what I have gone through including that my mare tends to look pretty good for awhile (notably after a period of light work by your’s truly and a lot more longer/lower moving) and will rapidly progress to canter problems, spooking, and overall stiffness after a few months of training - I have cycled through this 3x in the last couple years. She has such an incredible ability to work and try, that it was easy to ‘ignore’ some of her behavior as they do wax and wane some.

I do have a very good team, but it is so hard to reconcile so many different opinions in a situation where there are a number of permutations and future scenarios. I do feel like the CT myelogram may be money well spent - My only hesitation is that I am nervous about having to make a decision real time about not waking her up if we see central cord compression. I know where I would land and I’m just not ready to schedule that appointment.

I am a MD and am good at looking at human medical things rationally, and using shared decision making with my human patients but BOY do these vets have their hands full trying to do the same with horses and their owners. If only she could tell me/us how she feels…

[Birddog1]

She was 4 during the PPE, and my heart sinks thinking that there was any funny business there. I was not present at the actual exam as I bought her out of town, but I used an independent vet and I have been involved with the folks I bought her from throughout all of this.

[RedHorses]

@2tempe

Regarding riding: this is a decision only you can make, but if you do, I would consider riding in a long/low frame. Any type of collection is not your friend

Be aware that a “safe” neck position very much depends on exactly what the individual horse has going on. No one can say what position is free of impingement without the spinal fluid dye and xrays procedure. I opted to not bother as my horse had clear neuro symptoms and nothing they could find would have changed anything I was going to do. Aside from the procedure requiring full anesthesia and the accompanying recovery risks being much higher for a neurological horse.

[BroncoMo]

It sounds like you have a generally pragmatic view of things, which I usually do as well…. Until it comes to my best friends. I’m not proud of how far I’ve gone to salvage a bad situation(s) in the past because I can get tunnel vision with them. I’ve learned in recent years, most notably with the aforementioned horse, to give someone else permission to tell me when enough is enough.

This horse was so stoic and tried so damn hard, it was easy to overlook the underlying condition and chalk it up to a training plateau or learned habits.

For what it’s worth, whether you believe in it or not, I had an animal communicator connect with him. While he didn’t express his pain as being the debilitating factor, that session was heartbreaking….

While I was the one that dumped a moderate fortune in to this horse, when I returned him to his owner, I became the voice of reason for her for which she has expressed gratitude. She got tunnel vision in thinking he could be salvaged as a pasture pet. But she was deathly afraid of him going down in a pasture incident and being alone/injured for hours on end. So she ultimately made the decision, in which she was questioning up thru the day of. I saw the horse a couple days prior and, despite his happy-go-lucky personality and trying to be happy to see me, his eyes told the truth. He was in agony. It was definitely time.

Perhaps if you have someone close who is also a bit more of a realist, maybe give them permission to help keep you in check. It’s so easy to take a horse down a rabbit hole. I’ve always said that if a horse has the try, I won’t tell them no. But at times I definitely need outside help in reminding me that I can and should say enough is enough.

Good luck with your mare, and hopefully she can have a long happy retired life.

[Birddog1]

Thank you, your words are very helpful. I go back and forth between feeling like I am being too cautious, and feeling like I am being too cavalier. A trainer I work with, but not this mare’s trainer, is a solid realist and she was on the side of euthanasia and cut your losses BEFORE I knew what was going on. To be fair, she has never actually met this horse but does know me well and trains another horse of ine. Whereas, my horse’s body worker, who does have an intuitive bend has shared that my mare is happy just being here with me.

Writing out all of this in this thread has been cathartic, actually. I see some of my own cognitive dissonance at play “she’s safe and happy, I can ride just her differently” AND "I’m slow rolling a CT myelogram because I’m afraid the answer will tell me that I might not wake her up.’

That catharsis alone has been so helpful to think through. Thanks to everyone for your stories and comments.

An additional thought I had re the xrays following my comment above, I do believe the PPE films were actually hers as I have looked at both and while I’m not a veterinary radiologist they are pretty clearly the same horse. One of the biggest concerns I have is just how much progression there has been from 2022 to 2025 without any clear insult or reason to have caused it. And, not know what that portends for future progression.