crease in activity is often noted at C5-6 as well, but to a lesser extent.” In some cases, Dr. Marti- nelli has treated C4-5 also. He says that if the problem goes further up the neck, into C3-4, the horse prob- ably had an accident that caused it, such as crashing into a jump, with his nose hitting the ground and compressing his neck. Proper treatment will vary with
each case. Injection of anti-inflam- matory medication such as cortico- steroids or autologous conditioned serum (ACS) has proven helpful. That is
the
treatment that worked with Gabby and Harvey’s jumpers, and for them the results were quick and long-lasting. Corticosteroids are often used because the anti-inflam-
matory properties of the medication can work on the nerve root, spinal cord and facet joint at the same time, explains Dr. Martinelli. If the condition becomes chronic, corticoste- roids might be used once or twice before switching to ACS, sometimes known as IRAP (interleukin-1 receptor antago- nist protein). In a paper Dr. Martinelli co-authored with Drs. Rantanen
and Grant and Dr. L.A. Walker, they demonstrated the im- portance of multiple diagnostic techniques when using these types of injections. They noted that client satisfac- tion rose to 92% when the facet joints were injected based on history, clinical examination, radiographs and bone scans. Without a bone scan, the client satisfaction dropped to 63%. Sometimes a horse may have concurrent difficulties with his neck and topline. Dr. Martinelli and his co-authors noted that injection of facet joints in the back and into the sacroiliac region is less common because other treatments, such as massage, acupuncture and different exercise regi- mens, can be used to manage those areas.
In Conclusion The bad news with neck problems is that they are hard to diagnose because symptoms can manifest themselves in different ways. The lameness can show up in parts of the body far from the neck, and sometimes the horse isn’t even lame. Instead, his performance is “off” in some way, which a rider might attribute to other factors. The good news is that veterinarians are learning more about the role the neck plays and how to treat it. And in some cases, such as those experienced by Gabby and Har- ley, that treatment allows the horse to return to work at his previous high level and continue to have a long and healthy career.
Warmbloods Today 39
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