Follow up 4 months post treatment (October 2018)
Physical examination findings included no evidence of neurologic abnormalities within either the fore or hind limbs and no cranial nerve deficits. A reduced range of motion within the neck both laterally and dorso-ventrally remained, although this was improved compared to previous examinations.
A standing sedated CT examination was performed of the poll region which found continued remodelling of the comminuted fracture of the atlas and similar degenerative joint disease within the left atlanto-occiptal joint.
Repeat ultrasound guided injection of the atlanto-occiptal joint was performed with 80mg methylprednisolone (Depo-Medrone 40mg/ml Injection, Pfizer) under standing-sedation.
The horse resumed ridden exercise and remains on a controlled ascending exercise regime.