Neuropathic Pain - Case Histories.

HISTORIES - SPINAL PAIN with treatment by CVMUA

These are NOT selected cases. They are a representative series of ‘consecutive’ cases.

Cases 1 to 10 - Histories written by owners

Cases 11 to 13 - are via phone conversations -

 

1) MELODY 14.2hh mare 16 yrs (Treated 1/5/98)


History:- (as on 1/10/98) Bought as a 14 year old in Dec. 95 a Pony Club pony with a special talent for show jumping.

Dec.95

Behaved and performed all we wanted from her, though became rather excitable with a speciality for leaping and plunging. Became lame on near fore after a steady summer. We put this down to the very hard ground and rested her for two months. She became sound again and was lightly hacked during winter months.

Spring and Summer 97

We began to play polo cross and take part in all other P.C. activities, she won a cup and several rosettes for show jumping at local shows.

At P.C. camp Melody ‘exploded’ on XC course and from then on her jumping deteriorated as she seemed unable to stretch over spreads and finally began stopping at even small fences. She was eliminated at a O.D.E. and suggestions were made that maybe back trouble was the cause, We changed the saddle- still no change. All jumping was stopped but polo cross was continued. Immediately after P.C. championships Aug 97 she became very lame on the near side fore. We called the vet he could find nothing no swelling, no heat etc. He suggested a chiropractor to look at her back. The chiropractor diagnosed her muscles in her back were in spasm from ears to tail. After many treatments an improvement was shown but she suggested the winter off.

February 98

The chiropractor came to check her, gave all clear to start riding. Slowly we built up work and it soon became apparent all was not well she was lame again. At this point we began to think this was the end of her ridden days.

Then we met Dr Tom Ahern.

May 98

Since being treated, Melody is now perfectly sound, is a much calmer pony, no more plunging and leaping.

It took several weeks for the lameness to disappear, after 6 weeks she was still slightly lame. After 11 weeks there were no more bouts of lameness. She has completed a season of polo cross, several tournaments ending at P.C. championships where she played some very gruelling matches. There is no sign of lameness or the excitable behaviour.

In September we started jumping her, she was wary at first, presumably remembering the pain involved previously, but gradually her confidence has grown.


2) MOLLY 14.2hh 18yr old mare (Treated CVMUA 29/4/98)


History:- (as on 1/10/98) Bought in October 97, a first class P.C. pony aged 18yrs a special talent for XC and SJ. Her dressage was definitely not good as our Assistant District Commissioner said ‘always shown her teeth at the dressage judge’ ....she has been in our P.C. for many years. We tried hard with Molly’s dressage through that winter but had no success with bringing her head down to anywhere near acceptable levels! We took her to a well known dressage establishment for help but she totally resisted all methods employed.

When Dr Ahern came to look at Melody I asked him to look at Molly too. He decided her case was marginal, there was some sensitivity but not unduly acute. We decided to go ahead with treatment. She was discovered to be very stiff all down one side of her neck and it took a lot of effort to free her.


Since her treatment the first sign of success was an improvement in turning particularly against the clock in show jumping. But the more dramatic result which didn’t happen until a full 12 to 13 weeks later was her willingness to go onto the bit for short periods in the dressage arena - this has stunned the P.C. officials who have known her for many years! We still have a lot of work to do with her but at last my initial worries of, maybe she is in pain, are now gone and we can progress ‘with her co-operation’.


3) GYPSY 12.2hh 17yr old mare  (Treated 1/5/98 CVMUA)


History:- (as on 1/10/98) Bought in 1995 a 14 yr old P.C. pony. she always behaved well and we had no problems with her.

In January 98 this all changed, Gypsy had always been bottom of the pecking order in the field with the others, backing off and giving way. However she changed overnight into a fiery monster, any pony that came near her she crowded on and kicked out at many times, causing much distress to others, cuts and bruises but miraculously no broken legs! This behaviour then moved to kicking others when being led or ridden, in fact in March 98 I was riding Melody and leading her when she suddenly backed onto Melody and let rip on her. She (Melody) saw it coming and jumped out of the way. Unfortunately I didn’t, fell off between them and Gypsy still lashing out caught me on the side of the head, my hat was sent flying and I had a fractured skull.


Dr Tom Ahern suggested her problems could be back related having checked out any other possible causes eg. hormonal irregularities.


Since being treated Gypsy is a changed pony, but it took a full 3 months. There is no more lashing out in the field the others are no longer afraid of coming up along side her and the same when being ridden.

She is an acceptable pony once again.


4) PASCHAL ELIZABETH 13yr old mare TBX  (Treated 14/4/98 CVMUA)


History:- (as on 1/10/98)  We were lucky enough to be loaned “Lizzie” 18 months ago. She came with an awkward jump but we were never too worried about her back as it didn’t seem to affect her, although we had been told she had 5 years previously fallen from a bridge in an accident. Six months after we had her, I turned her out in to the field and as she galloped off she slipped and fell, which is when our problems really started. She was obviously in discomfort and put in some viscous bucks on landing over fences and then bolting. Her flat work was unbelievably tense.


Since we have had Tom Ahern to her we have noticed the following.

(1) Having always been a “fizzy” mare hardly knowing what walk was and continually changing legs at the canter her whole attitude has changed. Much calmer in all paces- Her dressage has improved dramatically. she always used to be placed last, but now her scores are midway!

(2) Her jumping is much rounder and she is not rushing so much after her fences.

(3) Before when I turned her out she always galloped away bucking, now she just walks.

(4) Having hated it, she now never flinches when her mane is pulled.

(5) Having been a bad traveller in a trailer she now never moves a muscle - a real pleasure to tow.

(6) She had a reputation for not being easy to catch. Now she actually approaches me to be caught.


We noticed some change in the 8 weeks after Tom had been but the real difference (especially points 1 and 2) came almost 5 months to the day. We now have a very talented and happy horse - and I am sure there is more improvement to come.


5) BUZZ 17 yr old pony mare  (Treated CVMUA 4/4/98)


History:- (as on 1/10/98) Buzz is a 14hh New Forest pony who before her back therapy was stiff on the right rein and had very sensitive feet. She was timid and wary of strangers and slow to make friends. In the early spring and summer she had a problem with head shaking, nodding her head up and down and trying to scratch her nose all the time she was ridden.


Since she has had the treatment the biggest improvement has been to her feet. They are not sensitive, she does not try to creep along the grass verges all the time and will even walk over gravel! The only drawback has been the treatment has made her feet grow faster and she has needed to be shod every three to four weeks, although they are settling down now and are a much better shape.

She seems much friendlier and more trusting and is supple on both reins.

Surprisingly the treatment has also helped with the head shaking, although it has not been a complete cure it has improved by at least 50% to the relief of both horse and rider as this has been a real problem during the summer months, just when you want to do the most riding, so we have been very pleased with the results of this back therapy.


6) WEASEL 6yr old 15.2 hh HolsteinX gelding (Treated CVMUA 30/1/98 & 20/4/98)


History:-  (as on 1/10/98) Weasel is a six year old gelding, 15.2 hands, Holstein cross. I have owned him for three years. He has proved to be intelligent and easy to train and has never presented any problems of lack of cooperation during his breaking and initial schooling. He is an exceptionally friendly and inquisitive animal.


Weasel has good paces and a particularly rhythmical trot. This proved easy to establish but after months of perseverance very little progress was made in canter. When asked to strike off in canter Weasel would hump his back and swish his tail and proceed in a sort of half buck. I changed his saddle to a wider fit with greater load bearing surfaces and this helped for a short while. During this period the muscles in his back, just under the very back of the saddle were in spasm, forming two hard lumps.


At the same time Weasel was generally very tense and volatile. He displayed stallion like behaviour and I had his blood tested to see if he was a rig. When tied up he would shift about constantly and no amount of chastisement had any effect. He found it impossible to stand still when someone was in the saddle and was prone to lashing out.


After treatment by Tom Ahern there have been changes in both his demeanour and appearance. He is generally less tense although when startled can revert to previous behaviour patterns. I can best describe that when he is suffering extreme tension he feels like a horse made of concrete to such an extent that my back is uncomfortably jarred. When merely startled by dustbins etc. I can feel a completely different level of tension. I no longer ride a concrete horse. He still has a high head carriage but we can work it through, I was able to achieve canter within a short time of beginning riding again and he has now begun jumping with a great deal of enthusiasm.


He has also changed shape, has a much more developed rear end and a well rounded profile along his whole back, from withers to pelvis. I have always had trouble maintaining his weight but no longer.


I am looking forward to maintaining the progress we have made so far.


7) BLONDIE 18 yr old 13 hh pony mare  (Treated CVMUA 3/2/98)


History:- (as on 1/10/98) Blondie is an 18 year old, 13 hand pony mare. I have owned her for five years. She is a highly strung animal but a good childrens’ pony, having excelled at cross country and polocrosse. During last summer she stopped jumping, would rush at fences with her head held very high and stop, sending her rider over her head.

After her treatment she slowly began to jump again and has recently completed a one day event and hunter trial, as well as taking part in several polocrosse tournaments.

She has also changed shape, which was a great surprise after, having owned her for so long. She has gained so much condition along her back and just in front of her hind quarters... Just before her treatment she had a new saddle fitted and the saddler remarked on the fact that the profile of her withers and back were the same. This is no longer the case.


She is slightly less sensitive to handle and I can now pull her mane without a twitch. We have also managed to load her into a trailer for the first time. She has become a dominant mare in the field but is a relaxed pony when ridden by my 10 year old daughter.


8) RHIANNON six year old Arab X Welsh Cob mare (Treated CVMUA 13/3/98)


History:- (as on 1/10/98) Until the summer of 1997 she had no major health problems, with the exception of a chest abscess following a routine vaccination.  She had no history of severe back trouble, but had experienced one episode of back pain. This was attributed to a very rigorous session of ‘skylarking about’ in her field with another horse. Her sore back resolved after rest and medication (Bute).


In the August of 1997 she had a bad accident when she fell into a drain whose cover had been dislodged when the field was ‘topped’. When we found her she had extricated herself  from the drain, and to judge by the scratches on her belly and upper hind legs, she had gone down into the hole some considerable way. She sustained severe lacerations to her lower hind legs, we presumed that as she scrambled to get out, one foot scraped over the front of the other leg. Her wounds healed (with the exception of one small patch), and, in time she appeared to return to normal. It was noted,  however, by her rider, that she was stiff when turning on one rein (to the right). It was not a severe response but it was consistent.


It was suggested by Dr Ahern that she may have hurt the upper part of her neck. On examination she demonstrated severe hypersensitivity at the pole, down the front of her neck and body on the right, and over the saddle area. She was manipulated under anaesthetic  (an experience that her owner found uncomfortable), and left to rest for one week.


When she came into work again a gradual improvement was noted, both in her flexibility and demeanour. A few months following this treatment she went out on loan to another rider. There is now no problem turning on either rein, and she is enjoying her riding and her new friends.


It is very difficult to be objective about behaviour in an animal as there are many subjective things that the owner may do, inadvertently, that will in themselves alter a horse’s behaviour. However, it appeared that she was less ‘skittish’’ following treatment, and, when the time came for her to be led into a trailer, ( a type she had never seen before) she went in after only a short protest. When introduced to her new home and field companions, she did not, as was her previous habit, turn and kick out at them, she was calmer and more sedate.


9) CHARLIE four yr old Welsh XHackney gelding (Treated CVMUA 20/9/98)


History:- (as on 3/10/98) Charlie was purchased as a ‘ride and drive’ pony. He was, when bought and for the first four days of his stay a model horse, a perfect ‘gent’. After this very short honeymoon period he underwent a sea change, and became excitable, fractious and very difficult to handle. As he had previously been grazing alone, at first his change of personality was attributed to his having a field companion.

His behaviour did not improve as expected, however, after eight weeks his owner was still perplexed, and not a little out of pocket as all the possible root causes were investigated. His being a ‘Rig’ was eliminated by blood test, his feeding was altered, many different methods of handling him were tried, all to no avail. One major problem was that he was very quick to bite, and to move his head when his bridle was being put on. Only once in the eight weeks was I able to comb his mane fully, the lower part he would tolerate - just, the upper part was definitely forbidden territory! Charlie seemed constantly anxious, uncomfortable, and unhappy.

Riding school was started and he was noted to be moving away from the right side, whilst he would turn his head, he moved his body out to the left, producing a sliding movement. Dr Ahern was consulted again, but was only told about the horses behavioural problems. Charlie was examined, and a sore area identified high in his neck, which radiated down the right side of his chest and into his hoof. He was treated, and, such was my difficulty with this horse, that I took full advantage of his soporific state to comb his mane, cut a bridle-way, and attend to any other tasks that he refused to let me do under normal circumstances.


It is too early to evaluate his treatment, as it is only two weeks since it was undertaken, and again it is difficult to be entirely objective about behaviour, but a few ‘gains’ have been made and have been identified. He is biting less, and seems less tense, and I have been able to comb his mane all the way to his ears - twice!

 

10) (Name Withheld- so owner doesn’t find out and ask for him to be put back into racing) 10 yr old  ex National Hunt   (Treated CVMUA late July 1998)


History:- (as at 13/10/98) I have had my 10 yr old 15.3hh thoroughbred for just one year after his very successful career as a racehorse. When he came to me I was told that he did have “a bit of a back problem”. The two main difficulties I found were cantering on the off fore - we would go sideways - which was very uncomfortable for him and myself, and a difficulty in walking down hill.

In July this year Tom Ahern manipulated his neck under sedation. This looked very dramatic. I was told that it would take a few months before seeing the results. Within a couple of months I noticed that he could canter leading on the off fore - now straight - without discomfort and also he can now walk down hill with ease. The other unexpected changes are that he will now stand still when putting on his saddle and rugs (doesn’t gig-gog behind or kick out with his back legs) and doesn’t constantly swish his tail. He also doesn’t flinch when being groomed. All in all I would say that he appears to be much less sensitive and a lot happier. The one downside is that he has become much stronger and a lot faster, both things I am having to learn to cope with.



11) PONY X 5yr old gelding (Treated CVMUA 23/1/98)


History:- (phone conversation) Presented short striding all four legs - unable or reluctant to turn left. Was to be sold but could not pass a vet test. Had been examined and treated on several occasions over a six month period. No joy - still lame. Was in front mostly / now behind.

Eight weeks and 3 days post treatment the pony was declared totally sound. Had been improving ‘steadily’ prior to this.

Has since passed a full vet examination for purchase - was sold- has competed Internationally - successfully.

P.S. - because of sale the identity of this pony will not be revealed!


12) WILLIAM 6 yr old TB gelding / dressage. (Treated CVMUA 4/2/98)


History:- (phone conversation) Presented with a two year history of persistent right fore lameness (lame at walk!). Diagnosed ‘navicular disease’- surgery-navicular ligaments - No change !. Post treatment very slow but discernible progress - When phoned in September the horse was back competing in dressage. The horses vet was amazed at the progress! The horse at presentation had been on 1gm of Bute / day for 3 mths - and was still lame. Presently the horse is on arnica and one quarter of a gram of bute every 4 days - and is competing.


13) National Hunt Chase horse- ..............(Treated CVMUA 20/7/98)


History:- The usual !!- fell - reluctant to jump - poor form - ? lame behind - For sale ! Since treated  - took about 6 weeks to really see the difference - raced late sept. jumped well - won by 7 lengths .


This is a fairly representative group of horses that suffered with ‘Neuropathic’ i.e.  spinal pain.  They give some idea of the vast variety of different presentations, that are all derived from the effects of  ‘ALTERED SENSITIVITY’. That is the sensory receptors,  (most often pressure-mechanical), send an exaggerated signal to the central nervous system and thence the animal in some way ‘OVER REACTS’!