Diagnosis, treatment and outcome of cranial nuchal bursitis in 30 horses

Background: No large retrospective case series describing the treatment and outcomes following diagnosis of cranial nuchal bursitis have been published.

Objective: To describe the clinical presentation, diagnostic techniques, treatment and outcome of horses suffering from cranial nuchal bursitis and to determine their outcome after medical or surgical treatment.

Study design: Retrospective case series.

Methods: Medical records (1990-2014) of two referral centres were reviewed for signalment, diagnostic features, method of treatment (medical, surgical or both) and outcome.

Results: The median age of horses was 13 years (range 5-22 years) and follow-up time ranged from 12 to 108 months. Fourteen horses were treated medically and 20 horses were treated surgically. Of those horses treated medically, four horses had recurrence of clinical signs requiring subsequent surgical treatment. Overall, 41.7% of horses had recurrence of clinical signs following treatment and 66.7% of horses were able to return to their previous level of exercise. Five horses underwent more than one surgical procedure due to recurrence of clinical signs. Of those horses treated solely surgically, 28.6% of the horses had recurrence of clinical signs and 78.6% returned to their previous level of exercise. Of those horses treated solely medically, 33.3% had recurrence of clinical signs and 66.7% returned to their previous level of exercise. Of those horses treated surgically following failed medical management, 100% had recurrence of clinical signs and 25% returned to their previous level of exercise.

Main limitations: Retrospective design with small sample number.

Conclusions: Nuchal bursitis can be successfully managed with either medical or surgical treatment. Prognosis for return to work tends to be worse in horses requiring surgical intervention following failed medical management.