Peer-reviewed veterinary case report
Fistulous withers causing spinal epidural abscess in a Thoroughbred mare.
- Journal:
- Journal of equine veterinary science
- Year:
- 2025
- Authors:
- Ceriotti, Serena et al.
- Affiliation:
- Department of Clinical Sciences · United States
- Species:
- horse
Plain-English summary
This case involves a 15-year-old Thoroughbred mare that developed a serious condition called fistulous withers, which led to a spinal epidural abscess (a painful infection in the spine). Initially, she was treated with antibiotics and anti-inflammatory medications, but she soon showed signs of trouble, like difficulty walking and weakness in her back legs, indicating that her spinal cord might be compressed. Imaging tests showed that she had fractures and an abscess in her spine, but it was unclear if it was affecting the spinal canal. Despite aggressive treatment, her condition worsened, and she was ultimately euthanized. A post-mortem examination revealed a large abscess that had severely compressed her spinal cord, and the bacteria found was a common cause of this type of infection. This case highlights the need for careful diagnosis and treatment of similar infections in horses, as early intervention may lead to better outcomes.
Abstract
This case describes a 15-year-old Thoroughbred mare with fistulous withers that progressed to vertebral osteomyelitis and spinal epidural abscess (SEA), a severe complication that has yet to be reported. Initially treated with antibiotics and anti-inflammatory medication, the mare developed acute hindlimb ataxia and spastic paresis, suggesting spinal cord compression at T3-L3. Diagnostic imaging revealed vertebral fractures and abscessation, but vertebral canal involvement could not be confirmed. Despite aggressive medical therapy, including antimicrobials, corticosteroids, and neuroprotective agents, the mare's neurological condition deteriorated, leading to euthanasia. Post-mortem findings confirmed an extensive paraspinal abscess that had extended into the epidural space, causing severe spinal cord compression. The isolated pathogen, Escherichia coli, is commonly associated with chronic fistulous withers. This case underscores the importance of considering SEA as a diagnostic differential in horses with chronic paraspinal infections that develop acute neurological decline. Due to diagnostic and treatment limitations in equine medicine, prognosis remains guarded, with early surgical intervention and targeted antimicrobial therapy likely being crucial for better outcomes.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/40889728/