Primary phenotypic features associated with caudal neck pathology in warmblood horses.
Authors: Dyson Sue, Zheng Shichen, Aleman Monica
Journal: Journal of veterinary internal medicine
Summary
# Caudal Cervical Pathology in Warmblood Horses: Clinical Features and Diagnostic Differentiation Radiological findings of caudal cervical disease in horses are well documented, but the associated clinical signs remain poorly characterised in the literature. Dyson and colleagues conducted a prospective case-control study of 223 Warmblood horses (96 cases with caudal cervical pathology, 127 controls) to establish which clinical features reliably distinguish horses with caudal cervical lesions from those presenting with other causes of gait abnormality. Key pathognomonic signs included focal muscle atrophy (48% of cases), hypoesthesia (40%), pain on palpation over the articular processes and transverse processes (60%), and hopping-type lameness in the thoracic limb (32%)—none of which occurred in control horses—whilst restricted sideways neck flexion was significantly more common in cases (49% versus 32%, relative risk 1.5). Notably, 42% of cases with thoracic limb lameness deteriorated following diagnostic anesthesia, suggesting nerve root compression rather than primary lameness pathology. These findings provide equine practitioners with a structured clinical framework for identifying caudal cervical involvement, particularly distinguishing it from forelimb orthopaedic disease, though systematic lameness and neurological examination using the described methods is essential for reliable differentiation.
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Practical Takeaways
- •Systematic palpation for focal muscle atrophy, hypoesthesia, and pain over caudal cervical joints combined with assessment of neck flexion can reliably differentiate cervical pathology from other causes of gait abnormality
- •Hopping-type thoracic limb lameness is a relatively specific indicator of caudal cervical lesions and should prompt detailed cervical evaluation
- •When diagnostic anesthesia worsens lameness in a horse with suspected thoracic limb lameness, consider caudal cervical pathology before pursuing distal limb investigations
Key Findings
- •Focal caudal cervical muscle atrophy (47.9%), hypoesthesia (39.6%), and pain on palpation of caudal cervical joints (60.4%) were significantly associated with caudal cervical pathology (P<0.001)
- •Hopping-type thoracic limb lameness was observed exclusively in cases (31.6%) and not in control horses
- •Restricted sideways neck flexion was significantly more common in cases (49%) compared to controls (31.8%, RR 1.5, P=0.009)
- •Deterioration in lameness after diagnostic anesthesia occurred in 41.9% of horses with thoracic limb lameness, suggesting cervical involvement