Page 8 - Equine Matters - Summer 2012

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7
EQUINE MATTERS
N E C K PA I N
Case Study:
A neck condition treated by medical
management -
‘A real pain in the neck’
Veterinary Surgeon
Richard Sutcliffe
XLVets Equine Practice
Bishopton Veterinary
Group
Over a year later Hurly Burly's owner
noticed that when bringing him in from
the field on an evening after a day at
grass, Hurly Burly could not flex his
neck when negotiating the corner which
led to his stable. Each morning the stiffness
had improved and his ridden work
was unaffected.
When examined on the stable yard
Hurly Burly was tied up but held his
head and neck over to his left. He was
very reluctant to either straighten or flex his
neck to the right - when requested to do
so he preferred to pivot his body around
his forelegs. After another brief period of
unsuccessful treatment with 'bute' he was
referred for investigation of the neck pain
by nuclear scintigraphy or 'a bone scan'.
The bone scan images produced by the
radioactively labelled marker show areas of
higher bone metabolism as 'hot spots'. His
bone scan showed high levels of radiation
in the lower neck vertebrae especially the
upper joints between the 5th and 6th and
the 6th and 7th cervical vertebrae.
As a result, once Hurly Burly was less
radioactive, x-rays were taken of his lower
neck vertebrae which confirmed arthritic
changes in these areas. The affected
articular facet joints were medicated with
corticosteroid (anti-inflammatory) injections
guided by an ultrasound scan.
After a two week rest period we decided to
supplement this treatment with a drug called
Equidronate
®
(formerly Tildren
®
) with the aim
of improving the long term prognosis. This
medication is licensed for the treatment of
osteoarthritis of the small hock joints (bone
spavin) but it has also been used in the
treatment of a range of arthritic joints. It
acts by modifying the disease process by
inhibiting the cells within bone called
osteoclasts. These cells absorb the bone
matrix during the arthritic disease process
and are thought to contribute to the pain
experienced with the disease.
Hurly Burly was additionally given a course
of Cartrophen-Vet
®
intramuscular injections
which have good anti-inflammatory
properties in arthritic joints and prescribed
a daily glucosamine joint supplement
in feed.
This investigation took place two years ago
now, and since then Hurly Burly has been
happily grazing outdoors without signs of
neck pain and has continued to enjoy his
normal ridden exercise.
6. Injecting Hyaluronic acid and
corticosteroids into Alfie's fetlock joint.
Richard Sutcliffe BVM&S MRCVS,
Bishopton Veterinary Group
H
urly Burly, a grey 16 year old Connemara x gelding who was used for pleasure
riding and local competitions presented to the practice with a ‘stiff neck’. A clinical
examination revealed nothing obviously abnormal and after a short course of 'bute' pain
killer anti-inflammatory and a period of rest things returned to normal.
Bone scan showing a 'hot spot' in the upper
(facet) joints between the neck vertebrae
X-ray of the neck vertebrae showing arthritis
of the upper (facet) joint
Hurly Burly relaxing in his stable at home