Confirmed and presumptive cervical vertebral compressive myelopathy in older horses: a retrospective study (1992-2004).
Authors: Levine Jonathan M, Adam Emma, MacKay Robert J, Walker Michael A, Frederick Jeremy D, Cohen Noah D
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Cervical Vertebral Compressive Myelopathy in Older Horses Whilst cervical vertebral compressive myelopathy (CVCM) is well documented in young horses, considerably less is known about its presentation and management in mature animals. This retrospective analysis examined 22 horses aged 4 years and older (median 8.4 years) diagnosed with confirmed or presumptive CVCM between 1992 and 2004, comparing signalment data with 210 control horses to identify predisposing factors and lesion patterns. Male horses and warmbloods were significantly overrepresented amongst cases, whilst the caudal cervical region—particularly the C5–C6 and C6–C7 articulations—emerged as the primary site of pathology, with articular process osteophytes being the predominant compressive lesion identified on radiography and myelography. Medical management incorporating corticosteroids and non-steroidal anti-inflammatory drugs proved most effective, though eight horses requiring euthanasia had compression confirmed at necropsy, five of which involved osteophytic involvement. For practitioners evaluating ataxia or paresis in mature horses, CVCM warrants serious consideration as a differential diagnosis, particularly in older males and warmblood types, with degenerative joint disease rather than developmental malformation being the expected underlying pathology in this population.
Read the full abstract on PubMed
Practical Takeaways
- •Include CVCM in your differential diagnosis for older horses presenting with cervical myelopathy signs, particularly males and warmblood-type horses—this condition is not limited to young animals
- •Articular process osteophytes are the primary lesion causing compression in older horses with CVCM; myelography is needed to confirm diagnosis and identify exact lesion location
- •Medical management using corticosteroids and NSAIDs should be the first-line treatment approach, with prognosis varying by case severity and lesion type
Key Findings
- •CVCM occurs in older horses (≥4 years) with median age 8.4 years, with male horses overrepresented compared to controls
- •Warmblood and Tennessee Walking Horse breeds are significantly predisposed to CVCM in older horses
- •Caudal cervical vertebrae (C5-C6 and C6-C7) are the most common lesion sites, with articular process osteophytes being the most frequent cause of spinal cord compression (5/8 euthanized cases)
- •Medical management with corticosteroids and NSAIDs resulted in improvement in the greatest number of affected horses