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Management of the Severely Ataxic / Collapsed Horse
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Both ataxia and collapse are challenging problems for the clinician from both diagnostic and therapeutic perspectives. Theoretical instruction and knowledge will seldom prepare the clinician for all the problems that may be encountered with either situation, because almost every affected horse will be different. However, in broad principle ataxia is usually an indicator of spinal injury or disease while collapse can be related to many metabolic, organic and neurological conditions.
An acutely recumbent horse should be examined as an emergency – even though some conditions are necessarily urgent, others are critical and decisions may have to be made even when there is inadequate clinical evidence. There are several circumstances when an acutely collapsed horse is examined. Circumstances, when a horse is found recumbent having collapsed often cause considerable distress both to the owner and the animal but the circumstances, are of real clinical relevance. Most cases are traumatic injuries of various types but others such as toxicities for example botulism, tetanus and bracken fern poisoning as well as infections are usually less dramatic in terms of onset but no less serious in terms of prognosis. The same principle applies to ataxia – genuine acutely ataxic horses often have a traumatic incident even though some have an underlying problem that is exacerbated by mild or severe trauma. For example, a horse with cervical vertebral instability may suffer trivial ‘trauma’ and instantly become severely ataxic and possibly even recumbent. Infections such as viral encephalitis, rabies and equine protozoal myeloencephalitis also induce ataxia but the onset is very different and often the progression is a major clinical signal.
Collapse with weakness and or flaccid paralysis might occur in botulism or equine motor neurone disease, carries very different implications from collapse with signs of seizures or spasms. It is vitally important to establish the precise circumstances of the collapse and whether any previous episodes or potentially related events have taken place. This should enable the clinician to differentiate cases of neurologic collapse from those that collapse for non-neurologic reasons. [...]
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