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Horsekaren

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He gets to come home tomorrow which is good as i have missed him like mad, my day has zero structure without the big man to dote on.
Vet has been amazing, literally couldn't be more grateful for her persistence and thinking as we expected he didn't want to show his issues but they kept going and made good progress. He worked beautifully long and low i was told, they then after a while of not seeing anything wrong pushed him to lift his head and there it was, he started to do it. I couldn't believe it when she called to say they have a inkling and want to look at his neck and neuro tests. He sadly didn't do so well on a few of the neuro tests, particularly walking down hill with his head up. They xrayed his neck and found a few lesions (very unclear on the xray but they couldn't get any better as its understandably tricky to xray the neck). So the assumption is that these lesions are possibly effecting his spinal cord when his head is in a certain position.
We have been given options of trying oral steroid medication and a months rest to see if that helps bring down any inflammation or a referral to a bigger hospital with a CT myelogram machine... but that has risks with GA and injecting dye around his spinal cord. A lot to think on and really trying to only think positively for now and think along the lines of it can hopefully be managed so no negativity please, i understand this is pretty big.
Out of curiosity has anyone had the CT myelogram? i really wish there was another way to see his neck :(
 
It's good that you're closer to an answer and I'm so sorry it's not one that you wanted. I don't have any experience of the CT myelogram but I think in your shoes, if you have enough left on your insurance to cover it, I'd give it serious consideration. The more you know about what you're dealing with, the better the chance you have of managing it, if it can be managed. Sending both you and Strawberry big hugs.
 
glad you are on the way to getting some answers for him, even if it’s not what you really wanted to hear.
I have am no help with the CT, but hope you can get this managed for him one way or another.
 
I am so pleased for you that you've got an answer. I have two friends with horses being treated for neck arthritis right at the moment. Both are being given shockwave so you might ask about that possibility. Also steroids injected into the neck and one has had tildren. That one is seven years old, was bucking badly, and is now being placed in dressage competitions. They have been told that fifty per cent of horses will show neck changes on xray, so there is hope that reducing inflammation will sort Strawberry out. Fingers crossed!

I would want to see how the steroids go before doing the myelogram, but possibly add shockwave and tildren, if possible, and if that does the trick see if a low level of bute will keep him comfortable and in work. I'm uncertain about the suggestion that he should be rested, I'm not sure I understand how that will help versus work on a loose rein to keep things moving.

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Sorry it's not better news, but this diagnosis does seem much more in line with the variety of symptoms you've seen him over the last couple of years, so at least you may be making progress x

Neuro/neck issues are notoriously difficult to deal with so if you have the money and you're sure that you want to keep trying to work him then go for the CT to give the vets as clear a picture as possible to work with.
 
Well that makes sense in explaining the look at bush then it happening situ. I am very pleased they managed to replicate the behaviour there.

Re. the CT, I would discuss with them whether it will likely change the treatment protocol/outcome or just give you a better idea of what is going on. Is there a reason you cannot do the steroids + months rest first (insurance for instance) and then do the further diagnostics if needed.
 
I'm so sorry that the results are not something simpler.... If you are thinking of going for the myelogram, first ask the vet whether it would make any real difference to treatment or prognosis to have a clearer picture.
 
ester said:
Well that makes sense in explaining the look at bush then it happening situ. I am very pleased they managed to replicate the behaviour there.

Re. the CT, I would discuss with them whether it will likely change the treatment protocol/outcome or just give you a better idea of what is going on. Is there a reason you cannot do the steroids + months rest first (insurance for instance) and then do the further diagnostics if needed.
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no reason, its A) whether the insurance will cover this as its not the area i was expecting. B) the CT really does worry me, what if he is one of the unlucky ones. Dont get me wrong i really want to get to the core but not sure at what risk.

There isnt a prognosis as they cant see enough, at the moment its like a human having a sore leg and unable to walk, just looking at the outside and trying to decide if they can walk again. So im getting somewhere but we are still very much in the dark as to detail.
 
Being blunt my concern is that your treatment options might be limited, so I would want to know what the likely possibilities are on the basis of their current working hypothesis that those areas are affecting the spinal cord when the head is raised.

There may well be many but this info would help you make an informed decision
(while I am also a would like to know exactly what was going on person ;) )
 
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Having gone through very similar with my 6 year old mare I am sending much love and support. My mare was 6 and showed neuro symptoms but they would come and go. She was treated at Liphook and lesion was found on x-ray at end of neck- the worst place. She was given a year off in a field and was better but quickly declined following attempting to ring her back into work. I believe Liphook have a special neck imaging now but they didn't have it when my mare was diagnosed. I am glad you have a diagnosis and wish you all the best with your lovely pony. I also has a bone scan done but actually it just reviled the same hot spot on neck and secondary hot spots in the hocks where she was compensating. This actually bumped up insurance at nearly £2000 and wasn't necessary as diagnosis was already done.
 
I would be imaging further if you still have in the back of your mind you want to ride him again. I’d want a definite opinion on whether this is an option for him moving forwards.

I’m sorry, but not wholly surprised, you are at this point. Such a lovely horse.
 
Sounds like you are now a big step forward with understanding what has been the problem, so that is a good thing and I'm pleased for you to have found that out. I've no experience of the further assessments which have been suggested to you, so can't be of help. Did you mean that a CT scan needs a general anaesthetic? If so, that does need quite a bit of thought.
 
I don't see what help the myelogram is going to be. It will either show that there is insufficient room for the spinal cord, or that there is enough room but inflammation is causing obstruction, or that there seems to be enough room and no reason for the neuro symptoms.

If removing the inflammation stops the symptoms, then there's surely no point in doing a myelogram? Because even if it showed that there was too little room, if he is moving fine then you would just carry on, perhaps with bute/occasional steroid injections to keep the inflammation away.

And if it shows there's enough room, but reducing the inflammation doesn't take the symptoms away, then you would probably have to retire him anyway.

So where does the myelogram get you, exactly? Unless your vets can tell you clearly what difference it will make, I would not take the risk.


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Glad you are getting somewhere with regards an answer OP, but so sorry that it’s not great news. It definitely sounds like the explanation for the strange symptoms. I’m assuming this is sort of an equine equivalent of MS in humans?
 
ihatework said:
I would be imaging further if you still have in the back of your mind you want to ride him again. I’d want a definite opinion on whether this is an option for him moving forwards.

I’m sorry, but not wholly surprised, you are at this point. Such a lovely horse.
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agree with this.
My neuro horse was very clear on x Ray but I was expecting to do the myelogram and I would have done if it hadn't been so clear. Because I would have wanted to know the extent of the problem and what our options were, as well as the prognosis with as much certainty as is possible. I'm not very good with what ifs and maybes, I like to know as much as I can, so especially if you have insurance funds for it, I would use them.
 
I would go ahead with it as then you know exactly what is what.

If you run out of the insurance and then need to do it you would be faced with a huge bill.

Having as much information as possible is my preference. They know the area now, it's just looking a bit deeper to know the more intricate details.

Well done in getting him seen, they sound like they have really listened.
 
I'm sorry, I have no similar experience but I would do as much as your insurance will cover if the vet thinks it would be helpful. I am glad that you are now some way to getting some answers, even if there are still more questions.
 
I am very glad for the both of you that it looks as though the problem has been identified but sorry that it isn't a simple thing. Keeping everything crossed for you both.
 
I have zero experience of these kinds of issues, but given how long the problems have been going on, I'd think it would be in your interest to get as much detail as possible. If the myelogram can give you a much clearer picture of what's going on and what you can do treatment-wise, I'd go for it. Give your boy a big cuddle and a carrot or three tomorrow x
 
scats said:
I’m assuming this is sort of an equine equivalent of MS in humans?
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Much more likely that the neck vertebrae are squeezing the spinal cord bundle. The nerves to the back end are on the outside of the bundle, which us why neck arthritis and congenital narrowing of the channel through the vertebrae causes back end symptoms.


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I am wondering if people recommending the myelogram procedure have looked up the risks? This from a 2015 study:

"Of the 278 horses observed in the study, approximately one-third experienced adverse effects from a myelogram, the team found."

If want to be damned sure it was going to change the treatment before I subjected a horse to that level of risk!

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What level of risk? What were the adverse effects?! Does whatever you googled document the risk of serious adverse effect?

I would most definitely subject my horse to the risk. Because I would want to identify the extent of the damage, the safety and ethical considerations to keep the horse under saddle and know which areas of the neck warrant injecting if that was an option.

For me the alternative is retiring the horse.
 
ihatework said:
What level of risk? What were the adverse effects?! Does whatever you googled document the risk of serious adverse effect?

I would most definitely subject my horse to the risk. Because I would want to identify the extent of the damage, the safety and ethical considerations to keep the horse under saddle and know which areas of the neck warrant injecting if that was an option.

For me the alternative is retiring the horse.
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What ycbm googled went on to say, in the same sentence, that in the majority of cases those adverse effects were "mild and self limiting", but that some were more serious.

Everything I've found says a myelogram is an essential diagnostic tool in cases like these.

I'd certainly want clear imaging, full diagnostics and a professionally considered prognosis if this was my horse.
 
Rowreach said:
What ycbm googled went on to say, in the same sentence, that in the majority of cases those adverse effects were "mild and self limiting", but that some were more serious.

Everything I've found says a myelogram is an essential diagnostic tool in cases like these.

I'd certainly want clear imaging, full diagnostics and a professionally considered prognosis if this was my horse.
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It also said 2% died!
 
I have no experience, but I really must commend you on your determination to do the right thing with him. I take my hat off to you.

Like others say, if your insurance will cover, surely further investigation is worthwhile? I'm also a want to know sort.

Fingers crossed & so relieved that they managed to replicate the move.

C'mon Strawberry tell her what's up! She wants to help!
 
I have nothing to add to what's already been said (personally I would go with doing the myeleogram as you've got this far).
Just wanted to send hugs and say what a lucky boy Strawberry is to have such a dedicated owner xxx
 
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