Computed tomography confirms neck fracture in thoroughbred mare
September 23, 2021
Named after a “Game of Thrones” character, Daenerys, a 15-year-old gray off-the-track Thoroughbred mare whose stable name is Dany, visited the Equine Medical Center in late July for emergency evaluation of acute neurologic signs.
While being lunged, Dany had spooked and flipped over backwards with her saddle in place. She remained recumbent for several minutes and was minimally responsive. After lots of encouragement, she was able to stand, but appeared very unstable.
Alex Yerkes of Damascus Equine Associates was called in to evaluate Dany on the farm. Yerkes noted cranial nerve abnormalities, a large hematoma over the mare’s left shoulder, and a gait abnormality.
Dany was given medication to make her more comfortable, and cervical radiographs revealed no obvious abnormalities. For further diagnostics and treatment, the mare was referred to the Equine Medical Center.
Upon Dany’s arrival at the center, medicine resident Stephanie Hernandez, under the guidance of Emily Schaefer, clinical assistant professor of equine medicine, completed a full neurologic exam. The team noted that all cranial nerves were within normal limits; and although Dany had a bright, appropriate mentation and was responsive to stimuli, she appeared to have pain in her neck and was very reluctant to flexion bilaterally. The mare was not sensitive to palpation of the cervical spine or back and at a walk and, importantly, no ataxia was noted. When circling, she appeared to move appropriately with no toe dragging or interference; however, she was lame in the left forelimb with a short-strided gait. Repeat cervical radiographs revealed a fracture at a cranial articular process of the fifth cervical vertebra (C5).
Dany was placed in the center’s neuro stall within the center’s biosecurity level 2 isolation unit, which features padded walls and a hoist for the mare’s safety. Medical management with fluid therapy, strict rest, anti-inflammatories, and pain management was started.
Upon Dany’s third day in the hospital, a neck computed tomography (CT) was performed under standing sedation. The CT clearly identified an even more significant fracture than radiographs suggested: a complete, mildly displaced, comminuted fracture across the entire C5 vertebral body, including the articular facets. There was vertebral canal and cranial vertebral body involvement, but fortunately, the fracture into the spinal canal did not cause impingement of the spinal cord or intervertebral disc-space narrowing.
Dany was discharged from the hospital with detailed instructions for her continued rehabilitation and care. She will be on stall rest for several weeks to months and must remain calm to minimize excessive movement to enable her fracture to heal.
Bred and owned by Tara Farms Inc. in Maryland, Dany was foaled on May 1, 2006, and raced as Singingtothecrowd. By Pennsylvania-bred Crowd Pleaser (by A.P. Indy) out of a Prospectors Gamble mare, Singing Gambler, she ran 15 times between April 2009 and April 2010 in claiming races on the mid-Atlantic circuit, winning three times and finishing in the money six times.
“When we arrived, the wonderful staff at the Equine Medical Center met us at the trailer and took Dany to the Neurological Unit where she was fully evaluated and stabilized,” said Dany’s owner, Liane Kagarise of Mount Airy, Maryland. “I am so impressed by how competently the veterinarians took charge of the situation to save my horse. I received an update on her situation that same night, and twice every day she spent at the clinic, regarding her progress. The medical team has been, and continues to be, incredibly supportive.
“Dany spent six days at the clinic, where she received the best care to make her comfortable, while being monitored 24/7 for any changes in her condition. Because of the quick action of my friends, my local vet from Damascus Equine, and the expert care of the medical team at the Equine Medical Center, Dany was able to come home. I will be forever grateful to everyone who has helped her through this traumatic and painful experience. Dany still has a long recovery ahead of her, but thanks to God and to all the wonderful people who helped her when she was at her most vulnerable, she has been given a second chance.”