Page 1115 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

1090 CHAPTER 10

VetBooks.ir 10.46 10.47

Fig. 10.46 Stallion with sacral trauma. Note the bony
protuberances on the sacrum.

Fig. 10.47 Paraphimosis in a stallion secondary to sacral
trauma. The paraphimosis never resolved.

under standing sedation. CT may be of significant and should include bladder and rectal evacuation as
value in establishing the true extent of pathology in necessary.
suspected neck lesions. If the spinal fracture appears stable and the ani-
Fracture-induced changes in the CSF may be mal can stand with assistance, they may be placed in
useful for ancillary diagnosis. These changes can be a water tank and supported for long periods. Other
classified as acute (<24 hours) or chronic (>24 hours). methods of support include slings (Fig. 10.48), but
The acute changes include diffuse blood contamina- these should not be used for animals that cannot
tion, a high red blood cell (RBC) count, a normal to support themselves, as severe respiratory compro-
high white blood cell (WBC) count and a high pro- mise or compressive myopathy may result. Slinging
tein concentration. Chronic CSF changes include a of animals with mild neurological signs may help
normal to slightly increased WBC count, normal to minimise secondary complications, improve exten-
increased RBC count, increased protein concentra- sor tone and hasten recovery.
tion and xanthochromia. None of the changes, how-
ever, are specific for vertebral fracture. Prognosis
The prognosis for horses with spinal cord trauma
Management associated with luxations or fractures of the verte-
It is arguable whether drug administration hastens bral body, arch or articular processes must remain
recovery, but recommendations are similar to those guarded to poor for return to use. Healing of these
for cerebral trauma (see p. 1080), with many authors fractures frequently results in vertebral malalign-
recommending the administration of DMSO and ment. Delayed callus formation and degenerative
dexamethasone, although the efficacy of these is changes in adjacent articulations can result in delayed
unknown. Pain should be managed with NSAIDs. permanent spinal cord compression even after appar-
Caution should be used when administering analge- ent resolution of clinical signs. The prognosis is best
sics or tranquillisers to ataxic patients, because the judged on the basis of repeated neurological exami-
animal may fall and worsen the lesion. Good nursing nations. The longer a patient remains recumbent and
care is essential, especially for recumbent patients, neurologically impaired, the poorer the prognosis.