Equine Cervical Vertebral Compressive Myelopathy Flashcards
Define Equine Cervical Vertebral Stenotic Myelopathy
Wobblers
ataxia and weakness caused by narrowing of the cervical vertebral canal, compression of the spinal cord that often included malalignment and malformations of the cervical vertebrae
what are some of the main differences between type 1 and type 2 CVSM?
Type 1 (malformation): young horses, thoroughbreds, multifactorial, malformation of the vertebrae and/or canal
Type 2 (degeneration) : older horses, all breeds, degenerative, OA changes of articular processes, more gradual
describe common histories and clinical signs of horses with type 1 CVSM
Hx: recent rapid growth or weight gain, foals larger than similarly ages foals or acute onset of ataxia following trauma
Clinical signs: abnormally worn hooves, DOD
describe common histories and clinical signs of horses with type 2 CVSM
Hx: performance problems, lameness, reluctance to bend, neck stiffness, tripping, behavior issues
Clinical signs: abnormally worn hooves, signs of nerve root damage (pain/focal muscle atrophy), palpable bony abnormalities and reluctance to raise or lower the head head and/or bend the neck laterally
The neuro exam of CVSM will have ataxia and paresis localized to the __ that is generally __ except type 2 can be __. There is damage to the __ matter causing more severe __ limb signs
The neuro exam of CVSM will have ataxia and paresis localized to the cervical spinal cord that is generally symmetric except type 2 can be asymmetric . There is damage to the white matter causing more severe pelvic limb signs
list differentials for CVSM
EPM, trauma, equine degenerative myeloencephalopathy/neuroaxonal dystrophy, equine herpesvirus myeloencephalopathy
what are common radiographic changes seen with CVSM?
Bone malformations of the cervical vertebrae:
- flare of caudal vertebral epiphysis
- abnormal ossification of the articular processes
- mal-alignment between adjacent vertebrae
- extension of the dorsal laminae
- DJD of the articular processes
myelography for CVSM
contrast dye is injected into the subarachnoid space to confirm spinal cord compression only determines dorsoventral compression not lateral
describe medical treatment options for CVSM
Anti inflammatory drugs such as corticosteroids, NSAIDs and dimethyl sulfoxide are the most commonly used treatments
Type 1: restricted exercise and a diet with reduced protein and carbs intake and balancing nutrients.
Type 2: facet injections that are most effective if the horse doesn’t already have minimal neurologic deficits
describe the prognosis for a horse with CVSM
depends on the age and severity of signs in each individual animal but no treatment has a guarded to poor prognosis:
young horses with med tx:
30-83% improvement
45-60% return to use
80% improvement with surgery
surgical treatment of CVSM
goal is ventral stabilization of vertebrae but final results can take 6-12 months with the horse expected to improve 1-2 grades
