Trauma with Neurologic Sequelae

Spinal cord injury (SCI) in horses may arise from rearing and falling backward, collisions, kicks, and slipping. The pathophysiology of SCI comprises a primary mechanical injury followed by a cascade of secondary events. These secondary events include microvascular ischemia, oxidative stress, excitotoxicity, ion dysregulation, and inflammation. It is often the severity of secondary injury that limits the restoration of neurologic function. Clinical signs after SCI depend on the location of the lesion and the relative amount of damage to the gray and white matter. Acute management of SCI should include optimization of oxygen delivery to the injured tissues. A brief discussion of some of the more promising medical therapies that have been investigated in human medicine and may be applicable to equine patients is included.