Diagnosing the Equine Neck and Lameness Connection

Lameness can be a difficult issue to pinpoint in horses, but the veterinarians at Palm Beach Equine Clinic (PBEC) in Wellington, FL, can help with an overall examination of the horse that includes a full body review. Lameness is not always caused by issues in the legs or hooves; with increasing frequency, the horse’s neck is being diagnosed as the root of the issue. Thanks to the incredible diagnostic imaging suite at PBEC, veterinarians can get a clearer look at all equine body parts to diagnose and treat lameness.

The Anatomy of the Equine Neck and What Can Go Wrong

The equine neck is composed of seven cervical vertebrae running from the head to the thorax, named C1 through C7, and each articulating with the other. The primary purposes of the neck are to move the head and to protect and transport the spinal cord and nerves, which run through the middle of the vertebrae.

Such a major role as the protection of the nerves and spinal cord can also come with some major risks and complications, with clinical signs of these problems generally presenting themselves either neurologically, as neck pain, or as lameness in the front legs. These more specific symptoms may include ataxia/clumsiness, which is generally an indicator of a neurological condition or damage to the spinal cord itself, caused by either developmental issues, trauma, or an infectious disease such as equine protozoal myeloencephalitis (EPM).

Issues such as nerve impingement from the spinal cord, arthritis of the articular facet joints of the vertebrae, neck trauma, or inflammatory diseases can easily translate to lameness in the forelimbs.

Diagnosing the Problem

Neck problems, particularly those related to lameness, are generally diagnosed through a process of exclusion, first performing nerve blocks to or ruling out lower regions of the horse’s body. Palpation of the neck, testing of the neck’s movement, and full neurological exams may also be performed in addition to a full lameness exam, depending on the horse’s symptoms.

Once other regions of the horse are ruled out as the location of the problem, veterinarians can use PBEC’s other imaging modalities, including radiographs, ultrasound, MRI, and nuclear scintigraphy, to get a clear picture of what’s wrong, make a precise surgical plan if needed, and design comprehensive treatment plans. PBEC is the only facility in South Florida with a Canon Aquilion LB Exceed CT scanner, and it is available for referring veterinarians. PBEC’s new CT scanner makes that process easier, faster, and more precise.

The new CT scanner at PBEC is able to show elements such as soft tissue detail that are not detectable on routine imaging modalities. In addition, the Canon Aquilion LB Exceed CT scanner helps veterinarians examine areas of the equine body that were previously difficult or impossible to see, such as the pelvis, sacroiliac, hip joints, stifles, entire limbs, and the neck.
“The neck is a really difficult area to image,” Dr. Karen Beste, a board-certified surgeon at PBEC and the head of the imaging team. “Routine radiographs don’t provide 3D detail. We can add contrast for myelograms, which allows us to look for dynamic compressions in the spine. We can see detailed changes that may impact a horse’s ability to perform and be a safe horse to ride. The new CT scanner allows us to get full neck CTs, all the way to thoracic vertebrae, even on really large horses. Additionally, because the acquisition times of images are so fast, horses are under general anesthesia for a very short time, which is better for any horse but particularly for a neurologic horse.”

While PBEC’s Canon Aquilion LB Exceed CT scanner has incredible technology, it’s nothing without the experts that manage the scanning process and those that read and interpret the scans, including board-certified radiologists Dr. Sarah Puchalski and Dr. Stacie Aarsvold, who look at every scan.

Treatment

Once a solid diagnosis is reached, the proper treatment protocols can be prescribed. Depending on the root of the problem, possible treatments may include shockwave therapy, regenerative therapies such as interleukin-1 receptor antagonist protein (IRAP) therapy or platelet-rich plasma (PRP) therapy, or one of the most common treatments, injections of the facet joints.

In the case of facet joint injections, veterinarians at PBEC can medicate under ultrasound guidance, guiding a needle into the joints and delivering corticosteroids or similar medication. Surgery is also an option as a final approach to severe complications.

In milder cases, treatments may also simply call for increased time off, chiropractic treatments, or the administration of non-steroidal anti-inflammatory (NSAID) medications.

If you suspect any issues with your horse’s neck, contact Palm Beach Equine Clinic any time by calling 561-793-1599 to schedule an appointment.