After a bunch of mysterious Grade1 lameness issues, we did a full lameness work up of my guy. It seems he may have C6/C7 arthritis. Does anyone have experience and/or words of wisdom? Looking at getting his neck injected soon, and starting him on adequan.
Yes, last summer…c6-7. I have an incredible vet client that came to me… Dr. Carol Holland out of Palm Beach. We did Pro-Stride injections and 2 weeks later he jumped the best he ever had (at 20yrs)! I wish I had treated him earlier! This is something so under treated. I work in the industry so I do see this a lot. Try to find someone who has done these a lot… they will ultrasound to find the joints to treat and ultrasound guide the injections. I only use biologics but I’m sure they’ll offer other injectables. Good Luck!! My horse would tell your horse to do it!
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Thank you! My horse is a GIANT… 17.2 big WB that has had some strange unresolved lamenesses. I have a great vet hospital that is about 2.5 hours from me. My vet is sending the xrays to a radiologist for review then I am going to contact the clinic. Just wanted to hear good or bad stories about treatment! Thanks for the thumbs up.
Yes. I had a good performance horse vet* do a lameness exam, but I knew the horse’s way-of-going pretty well and she had some weird, high-up issues that needed some diagnosis. I was pretty damn sure this horse wasn’t sore in her legs. Some of this had to do with not wanting to bend to the right and, all things being equal, choosing to carry her head to the left, from the base of her neck. What he noticed was the way she held her neck like that and a shortened extension of her RF. I always noticed this mare leaving the RF on the ground too long and I thought that was about not wanting to reach under and push with the RH.
*Lameness vet was also a very expert ultrasound guy, so beside the lameness exam, he diagnosed the OA by ultrasounding the joints in her neck from C7-T1 all the way up. He showed me where the should-have-been-smooth lines of joint capsule were disrupted; those were the images of arthritic damage. We stopped up by her poll because neither of us thought she had clinical signs of pain or inflexibility there.
Treatment was joint injections for the worst ones with Betamethazone, some form of HA (Stride right? I don’t remember brand names) and the usual prophylactic antibiotic, Amikacin. In addition, he recommended Adequan year round (his protocol is different from other vets; I’ll share if you want), and Tildren. The Tildren was there to help with the subchondral bone that was involved in some places. I injected a few joints, so we spaced those out over time.
I might get 6 months from the injections, with Tildren lasting a year and supposedly making the joint injections more effective (probably by addressing any bone pain).
This is very much my first rodeo with neck OA, and the DX plus treatment started in November. It took long enough to do all the stuff and have the Tildren soak in that the vet said I’d notice the full effect this month. I don’t know if all that $$hi$$le will work well enough to give this horse her career back (as a dressage horse) and/or be worth the cost for me to make a habit of it. She is quite comfortable right now and she is back in work and happy.
Joint injections were by ultrasound-guided needle. I’m not sure there is another way to get into those deep, complex joints. Also, they are at a 45-degree angle, on both sides of the neck, so when we ask a horse to flex to the side and with his neck in a relatively up-hill posture, he’s going to close those joints. You can see why a horse with arthritis low in his neck might not want to bend to one side or really reach with his scapula or carry himself uphill. It’s some kind of complicated anatomy to learn, at least for me.
I also don’t know what ultrasounds of neck joints usually look like on horses who are clinically sound there, so while I know enough anatomy to appreciate the disturbance in the cartilage layer that the vet pointed out, I couldn’t tell you if that DX was definitive.
I do think, however, that you have to spend the money to look at the candidate joints that could be contributing to the pain. My guess would be that that neck OA accretes slowly and that horses probably have spent some time holding other joints stiffly before they finally get diagnosed, so I think you really have to go up and down the neck (on both sides) to see which joints you don’t need to inject.
I hope this helps. Ask other questions if you think I can help.
BTW, there is some literature out there about some malformations of the spine that, IMO, probably contribute to instability and that, in turn, contributes to OA. In my mare’s case, I think a train-wreck of a casting incident in a stall about 5 years ago probably set up this relatively assymetrical OA. I can tell you more about this mare’s way-of-going that lead me to get here. That’s its own essay, though.
This is EXACTLY what I was looking for and I appreciate your detailed account.
I have an 11 yr. old DW who did the job of a big eq horse for a few years. We got him as a green 7 year old and made him up. ALWAYS wanted to go a little downhill, even though he looked like he was built up him. The horse was tough and very strong, always wanted to lay right and hang on the left hand. When we got him, he could barely hold the right lead canter. Stopped showing fall 2019 (kid didn’t want to show any more.) Last Spring we had some issue with his feet (side walls blew out and had a glue on shoe for a bit) and everything went down hill from there. Horse got WILD and spooky. Literally tried to buck me off every ride. Vet came out. Injected stifles, which needed to be done. Stopped the bucking but was still fresh and now quite tense under saddle once you got him on the bit. On the buckle… not so much. Still had some weird shifting lameness. Sometimes behind, sometimes up front. Then the horse had an anaplasmosis flare up and was on minocycline for 6 weeks. Back to steady work but had intermitten strange lameness up front (grade 1 RF) but would work out of it. Still tense at the canter (teeth chomping tense and he was never like that before- sensitive yes, chomping no.) Did full lameness exam last night and could not get the horse to trot lame up front with flexion, even though he looked lame on the longe. Flexed positive RH Fetlock and LH hock and stifle… but nothing on the xray. Did a neck sort of flexion and the horse struggled (a little) turning left and didn’t really want to raise his head all the way. Under saddle, REALLY dropped the right him while tracking right and counter bending left. Wants to completely swap off the right lead to the counter canter. xrayed his neck and looks like C6-7 arthritis but my vet wants to refer it out.
There are a few of us here who have been through this, and you might find search useful.
For my horse: 6 great months following steroid injections, regression, 2 good weeks with repeat injections, regression, retirement. She’s been stable for about a decade but doesn’t swing evenly from behind and doesn’t quite know where her hind limbs are in space.
Following on Simkie’s comments, I did cervical injections c5-c7 on a 22 yr old horse who had already stepped down from PSG level dressage. In my case the benefits lasted over a year at training/first level type work before regression. I did not do a second round because my vet said they often do not work as well as initial treatment and I was happy to retire him. I also have read some other comments on other threads as to second injections not working so well.
re Tildren, I’ve not heard of others using it for cervical arthritis but that doesn’t mean much at all…
have a read about the c6/c7 malformation. if you google sharon may davis you’ll find her work on equine complex cervical malformation. it should be evident in your neck xrays if they took shots at particular angles.
Thanks! I actually came across her website and was looking into her.
I came across your thread OP and was wondering how your horse is doing?
I’ve recently come into some neck issues with my own horse. Maybe my only advice to your situation is make sure your vet can find someone GOOD to analyze your horse’s rads. Mine doesn’t necessarily have changes at C6/C7 (my vet didn’t get quite that far down) but I contacted the gal with the ECCM and even she didn’t / couldn’t comment on the rest of my horses neck so I think she is very specifically just looking at that one spot.
My horse was determined to have a structural abnormality of all the vertebrae in his neck which orientates them tipped cranially and also sideways, which narrows the canal for the spinal cord, so he most likely is having compression /pinching of the cord. So sadly, he is now retired from his very successful career of barrel racing and AQHA ranch horse, and several other things. I’m amazed at his talent despite having this his whole life. I’m sad to make him “just” a trail riding horse but his symptoms all made perfect sense, knowing this new diagnosis.
Up until my vet found this person, everyone else she found to send his rads were like her saying “well, he could have some mild arthritis”. But she and I knew there was something else going on, so I am grateful for the good vet I have and she found someone that knew the answer.
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Oh I am sorry to hear about your guy. Mine is sort of a similar story. One vet looked at the rads and recommended injections. So, I had three levels injected (C3/4, C5/6, C6/7) with little to no improvement on soundness. Then he went to New Bolton (UPenn) for eye surgery to laser corpora nigris cysts in both eyes. The neurologist there looked at the rads and said C6/7 spinal cord compression, which makes complete sense why the injections made no improvement. So, he’s retired from his job as a big eq horse and is now trail riding and walk trotting around on the buckle a few times a week. Sad part is that he is only 11 years old this year. Thanks for reaching out.
And sorry about your guy too. Mine is only 10 this year. Far too young for issues of that magnitude!
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