Cervical Epidural and Subarachnoid Catheter Placement in Standing Adult Horses.
Authors: Hurcombe Samuel D, Morris Tate B, VanderBroek Ashley R, Habecker Perry, Wulster Kathryn, Hopster Klaus
Journal: Frontiers in veterinary science
Summary
# Cervical Epidural and Subarachnoid Catheter Placement in Standing Adult Horses Administering medications directly into the cervical epidural or subarachnoid spaces offers potential therapeutic advantages for horses with spinal pathology, yet the technical demands and safety profile of placing indwelling catheters in these locations have remained largely unexplored. Researchers placed catheters into either the cervical epidural space (six or eight-inch Tuohy needles using hanging drop technique) or subarachnoid space (following dural puncture and cerebrospinal fluid aspiration) at the C1–C2 interspace in seven standing horses under deep sedation and local analgesia, with ultrasound guidance for needle placement and radiographic confirmation of final catheter position. All horses tolerated their catheters throughout the 72-hour study period without signs of discomfort or behavioural changes; cerebrospinal fluid parameters remained stable (P > 0.9), though postmortem examination revealed mild meningeal inflammation in one horse and haemorrhage consistent with needle trauma in another. For practitioners involved in managing horses with cervical myelopathy or other spinal conditions, this work demonstrates that catheter placement is technically feasible and well-tolerated in the standing horse, establishing a foundation for future investigation of therapeutic drug delivery to the spinal cord—though the inflammatory changes observed warrant consideration of minimising trauma during placement and careful monitoring of catheterised patients.
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Practical Takeaways
- •Cervical epidural and subarachnoid catheterization can be performed safely in standing horses with appropriate sedation and ultrasound guidance, offering potential for therapeutic drug delivery
- •Ultrasound visualization is critical for identifying anatomical landmarks (dura, spinal cord, CSF) and ensuring correct needle placement between C1-C2
- •Horses tolerate the procedure and indwelling catheters well with minimal complications, though post-placement monitoring for meningitis signs remains important
Key Findings
- •Seven horses (2 cervical epidural, 5 subarachnoid) successfully tolerated indwelling catheter placement in standing, sedated animals under ultrasound guidance
- •All horses remained comfortable throughout the 72-hour study period with no signs of discomfort or behavior changes
- •CSF parameters showed no significant changes over the study period (P > 0.9), with only mild meningeal inflammation in one horse and hemorrhage in another
- •Ultrasound guidance was essential for safe placement confirmation, with radiography confirming anatomical location