Long term outlookk for horse with arthritic changes in the neck
A year ago my horse I took my horse to a clinic and he was diagnosed with high hind suspensory lesions. I was told to go ahead and ride him, w/t/c, with no jumping. I did that and for a year have not jumped him.
This past Monday I took him back to the clinic for areeval on the suspensories and for a look at some other issues. He has some problems in his right front, but he trotted out sound on that and no reaction to the hoof tester. He's still slightly of behind, more on the left but maybe some on both sides.
Now here's the kicker. He's got clinical swellings in his cervical c4-5, c5-6 regions and radiographical changes in all 3 caudal joints, including c6-7.
Its a bittersweet report, because he goes on to say that he's improved enough on the suspensories to start some jump training. But then says if he gets sore again that surgical treatment of his left hind high suspensory and intraarticular therapy of his cervical joints might be necessary.
Right now, he's sound enough to ride on the flat. But the arthritic neck changes are a new twist. I had got a vet do to chiro on his neck because its always so stiff,and when he reacted strongly on his neck, where there are bulges, the vet said you should get xrays here. So at the clinic I did.
I've been reading up on people's experiences with cervical arthritis and it doesn't look promising.
I am so depressed about it.
Does anyone have any long term experience with a horse with arthritic changes in the neck?
I'm having a hard time wrapping my mind around a vet saying to ride a horse with bilateral hind suspensory lesions....yikes.
I've known a couple of horses with cervical arthritis. Pain was managed in various ways (Tildren, injections, etc), and they've all continued on as useful riding (and jumping) horses. None were super duper high level athletes. Just good, lower level kid or amateur horses. So, I wouldn't write the horse off. That being said, I would possibly consider a second opinion, especially based on the care of the suspensories!
I would inject those facet joints NOW, and not wait. Calm down whatever inflammation is there and hopefully prevent more bony changes. Put the horse on natural vitamin E to support the nervous system. If he looks like he is in wind-up (overly sensitive to touch, overly upset about being groomed, etc) gabapentin can be useful, as can supplementing with lysine. And make sure that you have a very thorough neuro exam performed by a vet who is used to interpreting them done and on file, so you have a baseline and also so you understand exactly what sort of deficit exists now.
I would say the prognosis for future soundness with three joints affected is really not that great. I think the best way to set yourself up for the most success is probably to address it aggressively now.
I don't have long term experiences but I do have a horse with arthritic changes in C5, C6, and C7 seen on radiographs. He is older (24!) but was starting to experience some hind end weakness that was uncharacteristic--I know, he's 24, but you have to know this horse to understand this wasn't just "old age". He flexed fine and was not lame behind but was also having trouble with coming into the bridle--this is a horse that is normally a little bit of a runaway who was not just sort of floating above the bit. After injecting the three sites he was back to his old self--jumping around the CH/AA jumpers easily--and running away with me on a regular basis.
That being said OMG PLEASE DO NOT RIDE YOUR HORSE IF IT HAS HIND SUSPENSORY LESIONS. At anything faster than a walk. PLEASE get a second opinion.
Originally Posted by EquineImagined
My subconscious is a wretched insufferable beotch.
I'm of no help in regard to the cervical arthritis but I have to agree with everyone saying to get another opinion on the hind suspensories. My horse had bilateral hind suspensory lesions and things were not pretty--I can't imagine having continued to ride him once they were diagnosed--jumping or not. They're not going to heal if the horse remains in work and they very well may get worse.
And "improved enough" wouldn't have me resume working said horse over fences. H*ll, "improved as much as they're going to" wouldn't necessarily get me bringing the horse back to jumping unless he proved (via performance and ultrasound) he could hold up and remain sound on the flat for some time. I really hope this is somehow a mistake and that they were healed before you returned riding. JMO. Good luck with him.
Originally Posted by RugBug
Don't throw away opportunities because they aren't coming in exactly the form you want them to.
My horse has arthritis of the facet joints in the the C-7,6,5 area diagnosed via scintigraphy followed by neck radiographs. We did the scintigraphy because we had no idea what was going on; if we'd suspected the neck we could have gone straight to radiographs of it.
Treatment consisted of IRAP injections followed by bringing him back to work slowly, being careful to keep him stretched out over his topline, as opposed to inverted. We also canter before we trot. He is sound most of the time. When he isn't it is trotting to the right in a circle or through the short side of the ring. I had the injections re-done about a year after they were first done (in September) since the stumbling that was one of the indicators had returned to some extent. Since then and moving to a new facility with a larger ring with better footing, he looks pretty darn good most of the time.
The last time I asked the vet about jumping, she said that as long as he was off occasionally to the right that it wasn't a good idea. I do poles and brush boxes.
The long term prognosis is somewhat dependent on your expectations. I have a 23 yr old TB, former Prix St Georges dressage horse - at 20. Was leased to lower level rider, I got a call that he wasn't right 1.5 years ago. Long story short, injected c-5, 6 and 7, both sides in Nov. 2011. Gave him a month, started back very slowly. He is and has been quite rideable with the following qualifications: Long and low is his friend. Collection is not. He is pretty darn fit for his age, and happy. He is not tripping. One stifle a little slippy - likely nerve damage rather than muscle related. We monitor his breakover on that foot and ride him so that he does not get strung out in the back. Its been 14 months since the injections, and no sign yet that he needs redone. I've been told that the second time will not last as long, so every day is a blessing. If he gets more neurological, I'm prepared to deal with it but hoping its not soon...
We don't get less brave; we get a bigger sense of self-preservation........
Simke - I read the thread about Blush. What a long and frustrating road for you. Like you, I never suspected the neck, always thinking it was due to something else, until we did the chiro. How he reacted to the little tool the vet used was the the definite sign, although looking back I now see so much that fits. I hope Blush is living comfortably now, but it must have been crushing to lose such a beautiful prospect.
Peggy and 2tempe - Your input was invaluable and spot on. It is good to know he could still be rideable with this. I have been intuitively riding him long and low and I see that it does help him. I will continue to exercise him like that, my only concern is that he not get too on his forehand and trip. He does tend to be trippy but I had always thought it was due to his break over in the front. So I've had him shod with a rocker toe and we keep his toes pulled back. I keep him on a 5 week schedule. He also does some tripping out behind from dragging his toes which I also attritubed to the suspensory issue. Now I wonder, although both conditions would cause a horse to drag his toes. One other thing he does he to drop his shoulder and miss a beat, which I thought might also be his break over, but now I think it's more likely the neck. So many signs were missed, I wonder how many other horses have cervical arthritis and its totally over looked.
As for the issue of riding him with suspensory lesions. His are very high near the origin. It was not an acute injury, the diagnosing vet said it might be a chronic thing. He was never 3 legged lame on it, I brought him in because he's always been so stiff and hard to get forward, (until he's warmed up or revved up about something). The vet said many horses never even show lameness and its not something you can palpate easily. Since the history I gave him was that the horse had improved over the previous summer when I had stopped jumping him, he felt keeping him in light work was over all better than not. It has been over a year since the original diagnosis and he has been ridden on the flat, light hacking, no jumping. The fact that he is presenting much better than he did(all flexions were negative)was proof enough to this vet that he had improved and could try some jumping. That part I was very happy with. I've had 2 other vets involved and neither of them felt I should stop riding him, and believe me I've revisited that question again and again.
Yesterday, I put up a couple of low (as in 18" and 2') cross rails and we jumped for the first time in over a year. It was great, and he enjoyed doing something different. I will probably not pursue much jumping with him, keeping it low, but it is nice to be able to pop him over something now and then. As long as he is sound enough, I see more low level dressage type things and trail riding, with a bit of jumping thrown in to keep it interesting. It's sad because this is a horse who loves to jump and has all the fire and heart a TB should have. It's hard to see his body betray him.
Did the vet tell you that over 50% of horses over 10 have arthritic changes in their neck? (there was a study release, I think last fall about this, I am pretty sure it was 50% over 10, If I can find the study again I will double check) I seriously would not worry to much about it. It is very common. Just have regular chiro done.
FWIW -- you might want to check with your vet (i.e. the person who has read the x-rays and done your neuro exam) before pursuing chiropractic. I'm admittedly not a believer in chiropractic, but in any case when my horse was diagnosed with c-spine arthritis (with some mild associated neuro symptoms) one of my vet's instructions was no chiropractic adjustment.
My experience is similar to 2tempe's in many other regards, except that the horse was a 12y.o. and only did lower level dressage. We've done 2 rounds of injections and so far all is still well.
OP - not wanting to sound like a nervous nellie here, but be very careful re the tripping when you are riding! And yes I understand what you mean re not on the forehand- fortunately mine is pretty easy to keep correct - all those years, I guess he doesn't know any better lol.
We don't get less brave; we get a bigger sense of self-preservation........
My older guy has arthritis in his neck. Didn't find out exactly where because he was also diagnosed with epm that day and we actually retired him because he tripped a lot and would drag his feet. It was just a little dangerous IMO. Did epm treatments retired him and now over 3 years later with new epm trial meds he is coming back under saddle. That said he had arthritis in the neck but really doesn't seem to other him now. We don't asfor much at the moment because he is just coming back to work but he wants to find contact and will carry himself ia dressage frame, tracking up etc all on his own with no one asking for it. So IMO his neck can't be bothering him to much if he offers it himself. I would discuss with the vet the right course of action with him depending on how bad the arthritis is and go from there.
Horses aren't our whole life, but makes our life whole
So IMO his neck can't be bothering him to much if he offers it himself.
I just want to address this since we make so many false assumptions about our horses and what their behavior means. This does not prove whether or not your horse's neck arthritis is bothering him. I have known at least half a dozen dressage horses personally that had severe neck and/or neurological issues and none of them said "owe my neck hurts". Several were out showing and winning at dressage competitions. Most horses exhibit either tripping in front, or dragging behind, and a lack of push or throughness, none had problems going in a frame.
OP, cervical arthritis can present in a variety of ways (or not at all) and depending on how it is affecting your horse, the long-term prognosis is going to vary greatly. If it were my horse, I would be hauling to a vet school or specialty referral clinic to get a thorough work-up for both the suspensory lesions and the cervical lesions. I would also absolutely not be doing chiropractic on this horse, as others have said. Just because he seems comfortable right now doesn't mean he is safe to ride - tripping is a huge, scary issue, and it is easy to get hurt riding a horse with neuro issues causing tripping.
I also have personal experience with C-spine arthritis in my 15yo TB. He presented with some seriously bizarre symptoms and his neurologic status degenerated extremely quickly. His condition has been complicated by previous stifle injuries and ongoing stifle problems clouding the issue, but we did facet injections as soon as we had neck rads and within a month, he had regained almost 200lbs lost to neurogenic muscle atrophy and stopping tripping. His injections were just over 4 months ago and he is currently back under saddle and very comfortable doing W-T-C, although I don't think he's ever going to jump again, and certainly not at the level he was at previously. I am not going to lie - it is a LOT of maintenance between oral jt supplements, Vit E, Adequan, and constant re-evaluation, and prior to doing the injections I was convinced I would be putting my horse down. Even now that he is reasonably stable he is never going to be a normal horse again. If you have specific questions, feel free to PM me.
I agree that preventive antiinflammatory treatments may extend the career and usefulness of your horse. You would be suprised how many horses have cervical spondylosis/arthritis and no one would ever know. But, I would be sure that is the thing causing the problems and not the suspensory. Many horses show no symptoms, while others do - and tripping, falling etc. is dangerous. One thing I will recommend is NO MORE chiro treatments on the neck,this can certainly exascerbate inflammation in the area.
I had a 15yo Dutch/TB cross who was diagnosed via radiographs with cervical facet arthritis at c4/5, c5/6 and c6/7. I had taken him in to the vet school at UC Davis for a lameness workup prior to putting him back to work after several years off. When I longed him I noticed he looked a little off on the right hind, was dragging it a little. When the faculty vet watched him he told me he thought it looked more neurologic than lame, and we proceeded to a neuro exam. When they pulled his tail to the side as he walked and he almost fell down, I nearly threw up. I had thought he was a little lazy behind but this degree of ataxia was a complete surprise. We did ultrasound guided injections at that initial visit, started him on high dose of vitamin E, Adequan and continued his oral joint supplements. The vet told me the prognosis was guarded; some horses do fine for years while others decline in a matter of weeks or months. He was quite adamant about NO chiropractic.
We went back in about 60 days and his symptoms were slightly worse. We did another set of injections, but sadly I lost him a few days later to a bad colic/peritonitis.
I hope your horse is one of those that responds well to the protocol and is happy and comfortable for a long time, but I strongly advise getting a neuro exam done by someone who does a LOT of them. These are really big animals we are around every day and we don't always realize changes when they happen slowly. Good luck!!