Treatment
The patient was sedated with acepromazine (0.02 mg/kg bodyweight intravenously), detomidine (0.01 mg/kg bodyweight intravenously) and morphine (0.1mg/kg bodyweight intravenously) with the horse restrained in stocks. A C1-C2 ultrasound guided injection was performed. A total of 120mg of methylprednisolone sodium succinate (Solu-medrone 40mg/ml, Pfizer) was injected into the cerebrospinal fluid. In addition, 40mg methylprednisolone sodium succinate (Solu-medrone 40mg/ml, Pfizer) was injected into the atlanto-occiptal joint under ultrasound guidance.
The following day a repeat neurological examination showed that the patient was grade 1 ataxic in all four limbs, the tail pull response was markedly better with only some weakness on tail pull to the right whilst the patient had an increased range of motion of the neck.