Abstract
Simple SummaryNeck pain and dysfunction in the horse is becoming an increasingly important topic among riders, trainers and veterinarians. Some horses may present for a subtle performance decline, while others may show dramatic, dangerous behavior. It is important to recognize how to carefully evaluate the horse in an effort to understand the different types of pain that may be contributing to the different behaviors. The musculoskeletal and nervous systems may both play a role in the development of clinical signs. Recognizing that there are many diagnostic options as well as several treatments choices is important. This synopsis covers the disease processes that may contribute to the development of neck pain and dysfunction in the horse, as well as several possible diagnostic and treatment options.Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous structures, soft tissues and the central and the peripheral nervous system may all play a role in these various clinical presentations. After completing the clinical evaluation, several imaging modalities may be implemented to help determine the underlying pathologic processes. There are multiple treatment options available and each must be carefully chosen for an individual horse. Provided is a synopsis of the current knowledge as to different disease processes that can result in cervical pain and dysfunction, diagnostic approaches and treatment strategies. Improving the knowledge in these areas will ideally help to return horses to a state of well-being that can be maintained over time and through the rigors of their job or athletic endeavors.
Highlights
It is becoming increasingly recognized that many horses presented to equine practitioners for poor performance have underlying cervical axial skeletal lesions that result in pain syndromes and an inability to meet athletic demands
With increased attention to cervical disease in the horse, the demand for magnet configurations that allow for examination of the entire cervical region may increase the viability of magnetic resonance imaging (MRI) to be used in ante-mortem assessment of the cervical spine, including the intervertebral foramen (IVF) and cervical nerve roots
In horses presented for declining performance or behavioral issues, it is of paramount importance to first determine whether the horse may be experiencing pain, and possibly what type of pain
Summary
It is becoming increasingly recognized that many horses presented to equine practitioners for poor performance have underlying cervical axial skeletal lesions that result in pain syndromes and an inability to meet athletic demands. Human physicians struggle to identify the source of neck pain even after employing advanced imaging modalities or other diagnostic techniques and obtaining verbal feedback from their patients This underscores the challenges that we face in equine practice to understand and diagnose this frustrating and potentially debilitating condition in horses. As information is being added to the literature at a rapid rate, it is important for veterinarians presented with these types of cases, to stay abreast of new material It is the authors’ opinion that as more and more practitioners and riders begin to recognize the complexity of these cases, we can work together to improve the clinical outcome of these challenging cases
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