Any thoughts on the usefulness of a cervical CT without doing a myelogram? How about bone scans for cervical issues? My horse tripped and fell with me the other day. We are both okay but the trip and fall did not have a good explanation. Vet workup today found nothing, completely sound and passed his Neuro tests. We did neck and back x-rays which were completely normal. My vet is very skilled with x-rays so they were high quality and if she said they were clean, they were clean. We discussed the idea of a CT/myelogram. I’m on the fence because I don’t want to subject him to risky tests. The fall was very odd but also his clinical exam was very unremarkable.
I discovered that New Bolton now has a standing CT scanner so you don’t have the risks of laying them down. I also know there are real risks associated with seizures etc from myelograms. Is there any point in doing a CT without myelogram? I will of course be calling and talking with vets on Monday, but super curious to hear experiences and opinions here.
Also, my vet said bone scans are not very helpful for cervical issues (ie. they can look clean, just like x-rays and there can still be underlying pathology)? Thoughts or experiences?
Yes, there is some utility in doing a cervical CT without the myelogram. I just spoke about this with Mid-Atlantic the past week; they also have a standing CT. Apparently in Europe they are finding that they can do cervical evaluations with good results and diagnostic quality without the myelogram. The myelogram is recommended to assess true spinal cord impingement via the contrast; if your horse truly is not neurologic (which they would likely recheck at NB anyway), the myelogram may not be needed. Definitely worth asking about!
A bone scan is unlikely to be super helpful in this case; it’s a different type of diagnostic/way of evaluating and yes, can look normal (or there can be crazy update in areas of remodeling that don’t necessarily correlate with the clinical picture) and a CT may be needed anyway.
