For years, Atticus was a top performing athlete, sailing over 3’6” oxers with ease. But in the summer of 2022, the 13-year-old Dutch Warmblood gelding experienced two terrifying collapses while cantering around courses.
Alarmed, owner Crystal Dumas says she immediately knew who she wanted on Atticus’ case: Jose Garcia-Lopez, VMD, DACVS, DACVSMR, associate professor of Large Animal Surgery at the University of Pennsylvania School of Veterinary Medicine’s (Penn Vet) New Bolton Center. Garcia-Lopez had treated another horse in Dumas’ care.
“As soon as I understood the situation was serious, I got a hold of Dr. Garcia-Lopez. I trust him completely. I can call him. I can text him,” says Dumas, who travels between New England and Florida. “Some vets will talk to you like you’re not going to understand what’s happening. He’s not like that. He puts the animal first. “
Garcia-Lopez became Atticus’ primary clinician, leading a care team that included Amy Johnson, DVM, DACVIM (Large Animal; Neurology), the Marilyn M. Simpson Associate Professor of Equine Medicine and section chief of Internal Medicine and Ophthalmology, and Kyla Ortved, DVM, PhD, DACVS, DACVSMR, associate professor of Large Animal Surgery at Penn Vet’s New Bolton Center.
To begin, the gelding’s clinical team conducted a series of rigorous diagnostic tests, including a myelogram that revealed the problem: a vertebra in Atticus’ neck was putting pressure on his spinal cord.
Still, the team of cross-disciplinary specialists needed further confirmation before moving forward with a treatment plan.
“Before we recommended he undergo an invasive surgical procedure, we had to be absolutely sure it was in the horse’s best interest and that this was the problem causing the horse’s physical signs,” Johnson says.
To get definitive confirmation, Atticus was placed under standing sedation. His clinical team then used New Bolton Center’s robotics-controlled imaging system to conduct a cone-beam, myelographic CT of the area identified by the preliminary myelogram. The tests confirmed the diagnosis of cervical vertebrae stenotic myelopathy (CVSM) – otherwise known as Wobblers Syndrome. Only surgery could solve the problem.
While there was no guarantee the surgery would be successful, Dumas was determined to save Atticus.
He’s just a great horse, a loveable horse. He does everything to please us, to do his best,” Dumas says. “My husband and I couldn’t let him go without trying. We had to try to save him.”
The robotic CT scans showed a single compression point between the C6-C7 intervertebral disc space, offering hope. “Repairing one or two sites of spinal compression is fairly routine; any more than that could have permanently ended Atticus’ professional career,” says Johnson.
“Horses can accommodate for a single site of fusion fairly well and usually maintain a normal range of motion in neck. It’s harder to predict if they’ll regain all of their neurologic function,” Johnson says. “Fortunately, Atticus was in the mild to moderate range of disfunction. If we could stop the damage to his spinal cord, we could allow neurons that were inflamed or damaged, but not dead, to heal and the remaining cells to take over.”
Two weeks after Atticus’ initial diagnosis, Garcia-Lopez and Ortved performed the life-preserving surgery. The surgical team applied a custom-made, 3D-printed titanium alloy intervertebral spacer and spanning ventral plate – similar to those used in human medicine to fuse and stabilize back bones – near the base of Atticus’ neck.
Garcia-Lopez had performed similar surgeries before, but “there’s always a certain level of risk when dealing with the spinal cord,” he says. That’s why Atticus initially recovered from surgery in New Bolton Center’s unique pool-raft recovery system – designed specifically for horses to awake safely from anesthesia – which kept pressure off his spine and avoided any natural “fight or flight” response the horse may have had, Garcia-Lopez says. He was moved safely to a stall after the anesthesia had fully worn off.
A year later, Atticus is on the path to recovery, working to rebuild his strength for a potential return to competition.
“He’s doing so well and I’m so proud. You can tell he wants to (jump) again,” Dumas says. “The issue is gone. He’s not going to fall. It’s not going to happen.”