Rick Mitchell, DVM, MRCVS, DACVSMR, an owner of Fairfield Equine Associates and a founding member of ISELP, talked about a Grand Prix jumper with a stiff neck focused in the cervical articular process joints in a presentation based on a 2021 AAEP Sunrise Session on Redefining DJD Diagnosis, Refining Treatment and Mastering Client Communication. (You can watch a video of that presentation with Drs. Mitchell and Kyla Ortved here.)
Mitchell said a successful Grand Rrix jumper was having some issues jumping and was “losing his shape” in the air over a jump. He also wasn’t using his front end as well as he had in the past.
Case Notes About Horse Experiencing Neck Mobility Issues
Mitchell shared a few case notes on the horse, along with his approach to arriving at a diagnosis.
- He did a normal physical exam.
- Mitchell noticed that when the horse was lunged, he carried his head out and away from the person lunging him.
- He would not “release and relax” while being circled, noted Mitchell.
- Mitchell said that was also typical of how the horse moved when he was ridden. “Achieving poll flexion with this horse had become quite a challenge,” said Mitchell.
Insights From Evaluation
Upon evaluating the horse’s neck mobility, Mitchell noted:
- In the physical examination, “I prefer to allow the horse to show me how mobile it is rather than force mobility on the horse,” Mitchell noted. “I find very often that just getting the horse to reach for a treat can tell me a lot about their range of motion.”
- To the right, the horse had a pretty good range of motion when asked to flex his neck significantly and laterally (back and up toward his tuber coxae).
- To the left, the treat-induced motion was repeated.
- Then when Mitchell moved back to the right side of the horse and asked it to do the same motion, the horse told him, “That’s hard for me to do, Doc!”
“So, there is some dynamic going on there that when he flexed laterally—right, then left, then back to the right—that induced pain and reduced his range of motion significantly,” said Mitchell. “That was a good indication that there was something going on in his neck.”
Radiographs to Diagnose Neck Mobility Issues in Horses
Mitchell radiographed the jumper’s neck in the field. “These images were taken with a 15 MA machine at 76 kvp
at 0.18 seconds,” he said. “I think they are very diagnostic images and can be done with digital systems in the field very effectively.”
What Mitchell saw on radiographs was enlightening:
- On oblique views, they showed the horse had significant osteolytic changes and some proliferative changes along the margins of the facets.
- “I think oblique images can oftentimes tell us a lot that simple lateral images may not always show us. I think it is a useful technique,” stated Mitchell. Mitchell treated the horse’s articular process joints in the regions of C4-5, 5-6 and 6-7 with corticosteroids.
He said the horse responded nicely to intra-articular injection and achieved a degree of comfort that improved his way of jumping. This horse concurrently started an Adequan i.m. (polysulfated glycosaminoglycan) program on the 7-dose regimen, noted Mitchell.
Veterinarian quoted is a paid consultant of American Regent, Inc. PP-AI-US-0845