[FineAlready]

I know there are a few really informative threads out there on this topic and I have read them. However, could those of you who have had horses with c-spine issues please provide a concise list of the symptoms your horse(s) experienced and how the ultimate diagnoses was made (x-rays, ultrasound...other)?

Thank you in advance!

[Simkie]

Diagnosed via bone scan, with ultrasound followup.

Initial Symptom was hind end lameness that looked like a standard hock issue, but did not respond to injections (horse was really actually worse after injections.) Horse was also super sensitive to touch--hated to be groomed, twitched the saddle pad right off her back and was unreasonably annoyed by flies and such. She had also gradually become more and more withdrawn. Zebra symptom that I cannot confirm is related but suspect that it is is chronic tail rubbing, especially in the summer time. It started about the same time as all her neck stuff, went away when neck injections were successful and returned when neck injections were no longer successful.

[wizard]

Mine just wouldn't canter to the right but happily would to the left. He cranked his head and jaw to the right. Vet went straight to neck xrays after watching him lunge. he had arthritis at 4 levels which improved with injections that lasted a year. Vet says he has had good experience with annual injections into horses' teens. It is hard for me not to wonder if he has nerve impingement that could affect sensation and/or strength in his legs. I guess it depends or exactly where the bone build up is as to whether it pinches a nerve. oh well, so far, so good.

[x-halt-salute]

Mine was diagnosed by x-ray and ultrasound imaging. Treatment has been corticosteroid injections in several facets plus a daily dose of firocoxib.

Symptoms were:

• General stiffness and "NQR" under saddle
• Increasing reluctance to stretch through topline and work through to bit (she is used for dressage)
• Mysterious lameness-like unevenness in gait (looked to me like some sort of front end issue, but she responded remarkably little to flexions everywhere except 1/5 in upper limb both hinds, which is not too bad for a 13 y.o.)
• Breaking to trot in the canter in conjunction with topline and bend issues, especially on the right lead
• Eventually a sort of stabby/choppy front end movement in the trot
• Eventually complete refusal/inability to bend to the left and evasion of bit contact
• Eventually began carrying head/neck in a twisted posture when moving faster than walk and was noticeably uncomfortable (This was awful -- I wish I had found the right vet sooner!)

Injections took about 3 weeks to become 100% effective. After 9 months she is beginning to show symptoms again and will be re-injected. There does not seem to be any diagnostic process for determining the interval of injections other than the re-occurrence of symptoms. Our long term outlook is full of uncertainty because there is some spinal cord involvement and hind end weakness.

[Rickys Rider]

I went through this with my 5 y/o TB two years ago. It took 10 months and four vets to finally diagnose what was going on, but x-rays eventually confirmed Cervical Vertebral Stenosis.
Symptoms went something like this:

- Intermittent lameness - switched from front to back, side to side. It started as a few lame steps once or twice a month at the start of a ride, then progressed to daily lameness
- Heel pain in both front feet - tried to treat with wedge pads and Isox; rads of front feet showed early navicular developments, likely due to overloading from the underlying cervical instability
- Neurological symptoms - general hind end instability, significant tripping developed; my horse also became very spooky and sensitive to touch. He had enjoyed being groomed but once the neuro signs developed he hated it, once he even tried to buck in the cross ties when I used a soft brush. Failed all general neuro tests (leg cross, tail pull, etc.) but tested negative for EPM (truly unbelievable in this area). Cervical x-rays were taken and mis-read by a major vet hospital (still really bitter about this!); I treated him for EPM because it was the "fixable" option for any neuro diagnosis.

Finally after so many nerve blocks I can't even count, I had a fantastic lameness vet re-read the cervical x-rays. We did a consult with Rood and Riddle and they confirmed CVM with mild to moderate narrowing of the cervical channel in multiple areas. He was treated with cortical steroid injections and that made a huge difference. Neuro symptoms cleared up and lameness went away. However, given his prognosis and what I wanted to do (jumping), I retired him and he's got a nice home as a light riding/trail horse.

Getting a diagnosis was the hardest part, at least in my experience, because no one thinks to look at the neck first. It was so difficult at first because I'd have the vet out and suddenly have a sound horse! I had to resort to video taping him so that I could show vets that I wasn't crazy and that something was actually wrong. If you're going through something like this, best of luck to you. I did a lot of research and had to learn a lot because I'd never known anyone who had a horse go through this. Hopefully you'll get some good info on this board, I know I did!

[Simkie]

Just out of curiosity, and certainly not meaning to hijack your thread, FineAlready, but could everyone with a c-spine diagnosis post the pedigree? Here is mine:

http://pedigreequery.com/blushing+maiden

[2tempe]

Simkie - my gelding (TB) is not on Pedigree Query but both his dam and sire are: Jest Beautiful and Sun Power.

He is 22; last fall showed signs of lameness, neuro in the back end, tripping and wouldn't hold the canter. First did EPM test (negative from blood test); then brought in a different vet, full lameness evaluation, EPM standing spinal tap test, neck xrays. Injections done several weeks later-after receipt of 2nd EPM results - in November; he went back to light riding in January w/ more consistent riding in last two months. He is doing great at training level-first level type work w-t-c w/ a little leg yielding and a little shoulder in. Bending is limited to be sure, and his carrot stretches get his mouth only about to his elbow, but he LOVES to stretch down, and when he gets his weekly viewing in our round pen, he does it himself at the trot and a bit of canter. He also has a new found love of grooming w/ those rubber bumpy mittens. Previously he just put up w/ grooming, never got the sensitive skin symptoms, but didn't care one way or the other.

[x-halt-salute]

Simkie, my mare is a Morgan and her pedigree is not online.

FWIW her dam is Indigo's Chantilly Lace (http://www.allbreedpedigree.com/inde...mall_font=1&l=)

Her sire is Moonrose Kee Haux (http://www.allbreedpedigree.com/inde...mall_font=1&l=)

Amen to Rickys Rider commenting that diagnosis is the hardest part. I spent 8 months and thousands of dollars, consulted 4 different veterinarians (plus sent xrays to big vet school neuro folks), and anguished over the situation between the time my horse first became unrideable and getting an actionable diagnosis. Wish I had known about COTH back in those dark days!

Has anyone noticed their c-spine diagnosed horse becoming more and more distraction-prone in the arena as c-spine arthritis symptoms creep (back) in? I certainly lack focus on my work when I'm in pain so it makes a certain amount of sense, but I can't tell whether I am imagining a correlation between neck pain symptoms and reactivity to things in/near the arena or whether it is real. (Again sorry to hijack the thread)

PS my mare is as bendy as Gumby -- carrot stretches past her hip even in the worst of times. She really only seems to be uncomfortable when she is moving. Just a caveat to FineAlready that c-spine stuff doesn't always present in the most obvious ways!

[Rickys Rider]

Here's the pedigree for my guy: http://www.pedigreequery.com/and+a+gentleman

I'm so glad to know that others had the same experience as me regarding getting a diagnosis. I spent thousands of dollars and stumped numerous vets before someone finally figured it out. All for a horse that I had bought two months earlier with a clean PPE!

FWIW, my horse seemed more comfortable with his head low as well (e.g. stretchy trot). It was great until he needed to have his nose on the ground to be comfortable. Prior to the neuro signs he was a very laid back, non-spooky horse. X-Halt, I do think distractability comes into play when they're not totally in control of their body. They are a little more apprehensive about what's going on around them and where their body is in space, hence the spookiness.

[2tempe]

I actually was lucky - my diagnosis didn't take terribly long. My gelding was out on lease when all this happened; that vet pulled the first epm test before they sent him back to me. I called one, highly recommended vet who came to our farm, spent almost 4 hours w/ the horse and was fairly certain even before xrays. (he also did a heart ultrasound on the horse, who has a-fib and a murmur, to get updated status of that situation. )

[FineAlready]

Thanks for the input so far, guys, and keep it coming! My horse has an odd handful of symptoms, some of which improve with "traditional" treatment like hock injections, and some of which don't. He is certainly NQR in the hind end, especially the right hind. He does work out of it to a very large degree. The lameness is not consistent, and not present every day. Lately, he has also become a bit resistant about bit contact, and has had some issues with having his hind feet trimmed by the farrier. I do actually hear his neck crack from time to time, but more than one vet has told me this is normal. (?) He has also, recently started stumbling in front sometimes and/or putting a front limb down, loading it, and then buckling a bit at the knee (when walking - mounted and unmounted).

I think exploring the c-spine is the next step (we've been chasing down other diagnoses for a while now), but I'm trying to decide if I should start with neck x-rays or ultrasound...or?

[spotnnotfarm]

I went through this with my 5 y/o TB two years ago. It took 10 months and four vets to finally diagnose what was going on, but x-rays eventually confirmed Cervical Vertebral Stenosis.
Symptoms went something like this:

- Intermittent lameness - switched from front to back, side to side. It started as a few lame steps once or twice a month at the start of a ride, then progressed to daily lameness
- Heel pain in both front feet - tried to treat with wedge pads and Isox; rads of front feet showed early navicular developments, likely due to overloading from the underlying cervical instability
- Neurological symptoms - general hind end instability, significant tripping developed; my horse also became very spooky and sensitive to touch. He had enjoyed being groomed but once the neuro signs developed he hated it, once he even tried to buck in the cross ties when I used a soft brush. Failed all general neuro tests (leg cross, tail pull, etc.) but tested negative for EPM (truly unbelievable in this area). Cervical x-rays were taken and mis-read by a major vet hospital (still really bitter about this!); I treated him for EPM because it was the "fixable" option for any neuro diagnosis.

Finally after so many nerve blocks I can't even count, I had a fantastic lameness vet re-read the cervical x-rays. We did a consult with Rood and Riddle and they confirmed CVM with mild to moderate narrowing of the cervical channel in multiple areas. He was treated with cortical steroid injections and that made a huge difference. Neuro symptoms cleared up and lameness went away. However, given his prognosis and what I wanted to do (jumping), I retired him and he's got a nice home as a light riding/trail horse.

Getting a diagnosis was the hardest part, at least in my experience, because no one thinks to look at the neck first. It was so difficult at first because I'd have the vet out and suddenly have a sound horse! I had to resort to video taping him so that I could show vets that I wasn't crazy and that something was actually wrong. If you're going through something like this, best of luck to you. I did a lot of research and had to learn a lot because I'd never known anyone who had a horse go through this. Hopefully you'll get some good info on this board, I know I did!

Oh my goodness!!! My horse is having all these problems except for the grooming issues! I am taking him back to the vet clinic in a few weeks for a new lameness exam. Thank you for this! I may ask them to check this out!!!!

[Rickys Rider]

Cervical x-rays can be difficult because the horse needs to be laid out, but the other option that was given to me was a myelogram. There are serious potential complications with a myelogram and for a horse with narrowing of the cervical column it can sometimes make things words. Anyway, the x-rays weren't bad and surprisingly not super expensive relative to a lot of other diagnostics. Good luck figuring out what's going on...even though I ended up with a diagnosis that ended my horse's career, it was a relief to finally know what was causing all his problems.

[Simkie]

Cervical x-rays can be difficult because the horse needs to be laid out...

No, they don't. We have plenty of c spine films with the horse standing. I would be reluctant to lay down a horse with suspected neck issues, as I think there's risk there when you put them down and get them back up.

A bone scan can be useful to diagnose--that's how we found Blush's issues. We chose not to do the myelogram because basket surgery wasn't on the table and I did not want to take on the risks of the test.

[Perfect Pony]

No, they don't. We have plenty of c spine films with the horse standing. I would be reluctant to lay down a horse with suspected neck issues, as I think there's risk there when you put them down and get them back up.

A bone scan can be useful to diagnose--that's how we found Blush's issues. We chose not to do the myelogram because basket surgery wasn't on the table and I did not want to take on the risks of the test.

I think xrays and a bone scan are most useful. I know of a horse that had clean xrays, but the bone scan showed the damage was just below where you would see with them. It's very important that one have a vet that is familiar with neck/neuro issues so they know how to diagnose and what tests to do and when.

[x-halt-salute]

For me it was easier and cheaper to do the x-rays, so that's where I started.

Nuclear scintigraphy (bone scan) requires the injection of a radioactive isotope, and because of this I would have had to travel to the nearest big-name vet school and have my horse stay in a quarantine stall after the procedure so they could collect the (radioactive) waste the horse produces. The cost would have been well over $2000, plus unpaid time off work.

My vet got great x-rays using a high-quality portable x-ray machine. We needed several people for the imaging -- to hold the plate, position the highly sedated horse's head and neck, and operate the x-ray, but it required a lot less time and money than the bone scan would have. My horse's issues were very obvious from the x-rays, though we followed up with ultrasound to get a second look at the osteophytes on the margins. No need for scintigraphy in my horse's case, but had the x-rays not been conclusive I would have probably had to give it a go.

Myelograms are not on the table for my horse, even though there seems to be some channel narrowing at one spot. They are invasive and risky and the diagnostic information would not lead to a different treatment plan, so there is no point in putting the horse through that.

[FineAlready]

Thanks guys. I'm thinking I may just start with the standing x-rays and see what they show. I certainly won't be doing anything that puts his life at risk (i.e., myelogram). His life is much more important to me than his rideability. I might consider a bone scan depending on what x-rays show.

[xitmom]

All of this is fascinating reading for me as my horse has been going through a mystery lameness since I got him 3 years ago.

Symptoms: NQR in the front, but it would move from the LF to the RF depending on the week or month. Some tripping up front. He does NOT like to walk down hills, with rider on or off. Will place feet very deliberately. He used to love to jump and then started refusing. He's very stiff in the shoulder, resistant to reach out in the trot and always an effort to get him to really push from behind. He can be resistant to bending in one direction or the other depending on which side is bothering him. He also frequently scoots (different from bolting) -- often randomly such as when walking out on a loose rein with no external stimulus that would make him spook, and sometimes upon landing from a jump. It's a brief but intense scoot, like someone hit him with a cattle prod up his hind end. Then he's back to his calm self. The NQR lameness became most apparent when we did shoulder in work to one direction which would make him clearly off... after warming up just fine.

What I've done: I had his hocks injected several times over the 3 years and it helped, but not really resolved the problem. Use Adquan on a monthly basis after the loading dose. We did a lot of corrective work with the farrier to adjust hoof angle, then ended up trying wedge pads, and then back to flat with foam under the pads. My vet has done many blocks over the years trying to find the mystery cause but could never come up with anything consistent and conclusive. I took my horse to a regional specialist for a bone scan, xrays, ultrasound and a myriad of other tests last fall. They found mild to moderate arthritis in the C6/7 and in the hocks and also noted a slight tear in the biceps tendon. They thought that the bicep tear was causing the front end problems and hock arthritis causing the back end issues. We treated the biceps tear with PRP, stall rest, and then brought back very slowly. Still lame.

My last resort has been to have his C6/7 injected with steroid which was just done a few days ago. FINGERS CROSSED.

[kcmel]

My guy started with a very stiff neck--not much lateral movement. He also started refusing jumps and cross-cantering. His major symptom later was knuckling under with his right front. Diagnosis was x-rays and bone scan.

http://www.equineline.com/Free-5X-Pe...number=4023391

[Frizzle]

Oh dear. This sounds a LOT like my horse. Looks like I need to start saving some money for diagnostics/treatment (and, no, he is currently not being ridden).

Just yesterday, my vet (who is also my BO) said he looks good and I should start riding him again and see how he is, but I don't feel right about getting on him again until I know it won't cause him pain. He's stiff through the topline, short in the LH, very grumpy/sensitive about grooming, and NQR in the back-end. He moves up-and-down at the canter, bucks frequently (especially on the right lead), is very spooky/reactive, and when I was riding him he was always above the bit, hollow through the back, short behind, etc. That doesn't sound like a sound horse to me. I am not saying anything bad about my vet, as he just happened to be outside while I was longeing my horse and certainly didn't spend a lot of time watching him go (and I don't expect him to, as I didn't have an appointment and wasn't paying for his time/expertise).