How to assess horses with suspected spinal cord disease

The most common request for a neurological consult is because of gait abnormalities. If onset is abrupt and not subtle, the neurological deficits are quickly recognised as such. However, if gait problems develop gradually and the changes are mild the presentation will often be mistaken as lameness, back or neck pain, and not necessarily recognised as a neurological problem. A neurological examination of subtle gait anomalies requires careful attention to the owner’s complaint. The common denominator is inconsistencies and irregularities, stumbling and tripping, during riding, or worsening towards the end of exercise. The information from flexion test results and whether a course of nonsteroidal anti-inflammatory drug treatment changed the presentation is extremely valuable.
The most important information on neurological gait evaluation comes from your physical and hands-on examination. Ample time should be spent on this examination. It has to be complete and should follow a head-to-tail approach. The combined information from this examination will help you to determine a neuro-anatomical location, and allows you to make proper choices of further diagnostics or diagnostic referral. The key, especially with subtle abnormalities, is to spend sufficient time on the examination. Watch the horse move – over and over again. Take a look at the horse on a lunge line and under saddle (if possible), but re-focus on the walk. It is the gait that will tell you the most about neurological abnormalities. Describe in terms of ataxia or incoordination, dysmetria and weakness. What’s abnormal – is it in all 4 limbs, only in the hindlimbs or is the problem lateralised to the left or right side? And, can the problem(s) be graded on a pre-set scale?  […]