Comparison of 2 collection methods for cerebrospinal fluid analysis from standing, sedate adult horses.
Authors: Chidlow Hayley, Giguère Steeve, Camus Melinda, Wells Bridgette, Howerth Elizabeth, Berghaus Roy, McConachie Beasley Erin
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: CSF Collection Methods in Standing Adult Horses Cerebrospinal fluid analysis is essential for diagnosing neurological disease in horses, but the choice between lumbosacral (LS) and atlantoaxial (C1-C2) collection sites has lacked direct comparative evidence. Researchers conducted a prospective study in 24 horses (15 neurologically normal and 9 with neurological signs) to evaluate both collection methods performed under standing sedation in randomised sequence, analysing collection duration, cytology, and equine protozoal myelitis (EPM) antibody titres. Atlantoaxial CSF demonstrated statistically and clinically meaningful advantages: lower mean protein concentration (49 versus 52.1 mg/dL) and substantially fewer red blood cells (6 versus 33 cells/µL), indicating reduced traumatic blood contamination during needle placement. Critically, collection time, total nucleated cell counts, and EPM serology results—including serum:CSF antibody ratios important for EPM diagnosis—were equivalent between sites. For practitioners managing horses with suspected neurological disease, C1-C2 collection offers a viable alternative to traditional LS centesis with the advantage of cleaner samples less likely to be obscured by blood contamination, potentially improving diagnostic accuracy without compromising clinically relevant parameters.
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Practical Takeaways
- •C1-C2 centesis is a viable alternative to lumbosacral collection and may be preferred when minimizing blood contamination is important for accurate cytology interpretation
- •Both collection sites yield equivalent diagnostic information for EPM titers and nucleated cell counts, allowing clinicians to choose based on patient factors and operator expertise
- •The lower protein and RBC values at C1-C2 suggest this site may be more suitable for horses where sample quality and freedom from blood artifact are critical for diagnosis
Key Findings
- •C1-C2 CSF collection yielded significantly lower mean protein concentration (49 mg/dL vs 52.1 mg/dL; P = .03) compared to lumbosacral collection
- •C1-C2 collection resulted in significantly fewer red blood cells (6 cells/μL vs 33 cells/μL; P = .02), indicating less blood contamination
- •Collection time, total nucleated cell count, EPM titers, and serum:CSF EPM titer ratios showed no significant differences between C1-C2 and lumbosacral sites
- •C1-C2 CSF collection provides a clinically acceptable alternative to lumbosacral collection with reduced likelihood of blood contamination