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Experiences with neck injections in an ataxic horse?

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  • Experiences with neck injections in an ataxic horse?

    Hey folks - has anyone done neck injections on their horse with neck arthritis who was having neurological problems due to the arthritic changes?

    We injected my horse's neck yesterday morning (combo of betamethasone and predef). He is most definitely sore today. The plan is a couple days of stall rest, and then back to light handwalking. In my discussions with our vets, my understanding is that it will take a few days to see any improvement (if we're going to get improvement at all) and at least a week for the 'roids to take full effect.

    I am curious to hear about others' experiences with the procedure and how their horses responded.

  • #2
    I know a friend's horse was having issues w/ arthritis in her horse's neck. I know that it was causing her pains and issues particularly when working in collection. I don't believe she had any neurological problems, but I believe she had it injected and now knowing what she was working with adjusted her training and riding slightly. The horse is back to competing..


    • #3
      Yep, did it twice. No soreness following, though--did your vet use the ultrasound to guide the needle?

      We got six great months after the first set of injections. Only a few weeks out of the second. I retired the horse at that point.

      That was several years ago now, and Blush has not progressed further, but still does not swing evenly from behind.

      There is a very long thread in this forum detailing my experiences that might be useful to you.


      • #4
        Depends on how you define neuro problems. Star passed the neuro exam, but was having tripping incidents. The vet said that his neck arthritis (facet joints) could temporarily and briefly affect the spinal cord so that a packet of information did not make it from the front of the horse to the back of the horse. That temporary loss of info could lead to a trip, or just a enough temporary loss of proprioception that the horse would take a harder step.

        Neck injected a bit over a year ago with IRAP. Got a good year, but did not return the horse to jumping as there is still a tiny periodic glitch on a circle at the trot to the right. Had to tripping incidents after a year and had neck re-injected recently.
        The Evil Chem Prof


        • Original Poster

          Mostly I am looking to see the timeline for response and potentially being able to start rehabbing a horse after the injections.

          The backstory is long and complicated, and we are working closely with a number of equine internal med specialists - horse is a 15yo TB gelding. Starting at the beginning of Sept, he has had urine dribbling, muscle atrophy, weakness, and ataxia starting in the hind end and progressing to more severe hind end signs, with the start of front end signs (stumbling, etc). He has been tested for EPM, lyme, (both neg), had multiple CBC/Chem blood panels run (all normal), urinalysis (normal), rectal ultrasound of the bladder (normal), CSF cytology (also normal) and we have ruled out all infectious causes of neuro disease. When the signs worsened we did neck rads and found arthritis in the caudal cervical articular facets. No signs of narrowing in the canal from the rads, but doing a myelogram is not an option at this time. We injected his neck with a combo of steroids last week and I am hoping to see some improvement, but I would love to hear from people with personal experience with this procedure.

          At this point I have accepted that if he is still alive by Christmas, we are doing well, and getting back to riding would be a minor miracle. He has been my hunter show horse for 7 years, and 3 months ago we were jumping courses, doing fabulously in lessons, and my heart is just breaking watching him go downhill. I am trying to be pragmatic about his chances until his re-eval at the end of the week and we can go forward with a plan.


          • #6
            I have a 22 yr old gelding; last fall was quite ataxic, also tripping and generally not happy. Had injections done c5 thru c7, both sides of neck. He was on stall rest a few days and I was told to wait I think a month before deciding whether to get on him. Now, exactly 12 months later, he is doing very well; has been back in light regular work since January, including a slow rebuild of muscle. Now doing training/first level type work. I'm watching him closely and hoping for the best. He had been an upper level schoolmaster but I had stepped him down from that type of work a couple years ago. Good luck, I hope he shows the same improvement as mine did.
            We don't get less brave; we get a bigger sense of self-preservation........


            • #7
              Originally posted by Whyevernot55 View Post
              Hey folks - has anyone done neck injections on their horse with neck arthritis who was having neurological problems due to the arthritic changes?

              I am curious to hear about others' experiences with the procedure and how their horses responded.
              I have a horse who scored 1/5 on the neurological exam, with the neuro deficit manifesting as mild uncoordination of her left hind leg, with the arthritis also causing obvious discomfort in her neck (developed a funny head posture when it was at its worst). She was eventually diagnosed as arthritis in c3-c6. I've had the vet inject her neck twice with corticosteroids (6 facets total, guided by ultrasound). Both times I gave her 3 days totally off, and worked up from hand walking to light riding on a long rein over the following week. Both times it took 2 full weeks to see any improvement from the steroids, with maximum effectiveness reached shortly (2-3 days) thereafter. No idea why it has been slower to "kick in" in the neck than most joint injections, but in our limited experience the delayed efficacy has been a consistent pattern.

              I've had good success with the injections -- the first round lasted almost 9 months, and the second round happened a little over three months ago. Between the gradual reappearance of symptoms and recovery from the injections, I did have nearly a month of down time between the two periods of steroid-induced soundness. I don't anticipate being able to institute an injection schedule to diminish the time off, so the periodic off times are just something I plan to live with as long as I can keep her sound.

              Good luck getting your horse back to health and comfort. It sounds like you have a great attitude about this whole disappointing business -- the suddenness with which c-spine stuff can turn one's focus from showing goals to just trying to keep the horse alive is really breathtaking. Hang in there and I really do hope you are able to keep him going!
              Evolutionary science by day; keeping a certain red mare from winning a Darwin award the rest of the time!


              • #8
                I took a horse to UC Davis and he was graded 3/5 on the neuro scale. He's a wobbler with severe changes to C 4-6. I was told that a neck injection usually improves them by 1 grade, so with him being a 3, it was not worth it. For a horse that's a 1/5, it's well worth trying!


                • #9
                  Originally posted by Peggy View Post
                  Depends on how you define neuro problems. Star passed the neuro exam, but was having tripping incidents. The vet said that his neck arthritis (facet joints) could temporarily and briefly affect the spinal cord so that a packet of information did not make it from the front of the horse to the back of the horse. That temporary loss of info could lead to a trip, or just a enough temporary loss of proprioception that the horse would take a harder
                  Agreed. Neuralgia/neurological issues and arthritis are two different things, caused by different issues. Ataxia isn't always caused by a neuro prob either- could be from EPM, drugs, etc.

                  Indeed, someone correct me if I'm wrong, but I've never seen cervical arthritis cause true ataxia.
                  And the wise, Jack Daniels drinking, slow-truck-driving, veteran TB handler who took "no shit from no hoss Miss L, y'hear," said: "She aint wrapped too tight."


                  • #10
                    LaChasse - I'm curious about the last sentence of your post; could you explain re "true ataxia"? Although I'm no vet, I was under the impression that the cervical arthritis could result in pressure on the spinal cord, leading to neuro symptoms. I saw my old horse go thru the usual tests, and I could see the problems he was having.
                    We don't get less brave; we get a bigger sense of self-preservation........


                    • #11
                      My horse had ataxia caused by cervical arthritis at C2-C3.


                      • Original Poster

                        2tempe, you are correct. Cervical arthritis can cause remodeling that compresses the spinal nerves as they exit the spinal cord. This is not "arthritis = ataxia" as La Chasses implied - arthritis in the c-spine can result in neurological deficits such as ataxia. There are plenty of research papers on the subject if you do your homework. Ataxia is, by definition, a neurological problem.

                        In regards to my own horse, as was stated earlier, he has been tested for just about all of the possible causes of neuro symptoms that you CAN test for antemortem. Such as EPM. Again, we are working with boarded equine internal med specialists.

                        Thanks to those who have shared their stories. We are 1 week out from our injections and I waver between cautiously optimistic and horribly pessimistic. Checked in with his primary Dr today and hoping to see some improvement in the next week or two!


                        • #13
                          I did injections twice. First time horse was 2.5/5 and spent three days in the hospital on dmso drip and testing for epm. Test was negative and xrays showed moderate changes c-5 to c-7. Returned a few weeks later and injected. Got excellent results to where I could saddle up and hack lightly (walk and a little trot). Just enough to have those last few rides. Injections lasted about five months and went downhill. Returned to clinic and xrays revealed moderate to severe changes and we began to discuss euthanasia. Injected again. Found him dead in his paddock 48 hours later no signs of a struggle