Efficacy of mesotherapy for Kissing Spine

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Is it even worth it for KS? My gelding has mild impingement of 3 processes. The diagnosis was actually by accident, we were looking for something else.

My vet did not think the process impingement was bad enough to warrant ligament snip operation but he did suggest mesotherapy to “break the pain cycle”. To me that sounds like rubbish, shouldn’t you treat the cause and not the symptoms? He actually hardly seemed concerned about the KS at all. I’m very happy with this vet otherwise, he is an incredible vet but he just did not seem phased by the KS diagnosis.

Our spring was nasty and wet and the gelding was out of work for a few months. He’s back into work now and I just can’t tell if he is uncomfortable because of the KS or if it is just him, he’s always been sensitive and a mental ride. Would a bute trial help, or previcox trial? Basically he starts out very wonderfully but after we canter he gets tense tense tense… but he is a TB… I’m tempted to try the bute trial but worried about gastric upset.

I’ve already sent a msg to the vet to ask him to come out and go ahead with the mesotherapy, I just want to know if there are other options out there.

[Tee]

My gelding (in my profile pic) just had the spinous process removal for KS - he had 3 involved as well. I never found that bute or previcox made a bit of difference with him. We did a couple rounds of injections which worked great, until they didn’t this last time. I went ahead with surgery rather than continue to guess if he was sore or just being a booger. His surgery was just on Tuesday, so it’ll be awhile before we know how well it worked but his vet is very optimistic.

[caryledee]

The key to KS in a lot of cases is keeping them fit. So the break in training probably did aggravate it to an extent. What my vet suggested to me was a round of robaxin and NSAIDs along with therapy in the form of lunging on a Pessoa system (or something like an equi-ami if you don’t like the Pessoa). Build up strength in his back before riding again. Other things like hill work and cavaletti were also options.

Surgery did not work for my horse. It is not a cure-all; you still have to constantly work on keeping the horse’s back strong. I jumped into surgery too quick I think (hind sight is 20/20) and maybe should have tried shockwave or mesotherapy. My new vet keeps high level competition horses with KS going with therapy and recommends surgery as a last resort. She is a surgeon herself so I think that says a lot. Shockwave is pretty popular around here as a treatment option.

Your vet probably was not phased because it is found in so many horses. Many horses have no symptoms whatsoever.

Overall this condition is a pain to have to deal with; there is no one right treatment option that works for them all and it is expensive because you often have to try a lot of different things.

[TWH_Girl]

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. To me that sounds like rubbish, shouldn’t you treat the cause and not the symptoms?

Much of medicine is treating the symptoms because often times, you can’t fix the cause.

I’ve never used mesotherapy myself, but it would not be my first choice for KS, which is the vertebrae are too close together and can cause impingement. Steroid injections, or Tildren/ Osphos would seem to be better choices. Honestly, KS may require treatment of both the bony issue and secondary muscle soreness, so maybe meso can be an adjunct therapy.

[LookmaNohands]

What are you doing training-wise to teach him to lift and use his back correctly?

[joiedevie99]

IMHO… no. Why not inject the facet that has the issue directly? I know several horses that have seen major improvement from that.

I like mesotherapy for muscular pain, like pain from poorly fitted saddles.

[IPEsq]

@joiedevie99

IMHO… no. Why not inject the facet that has the issue directly? I know several horses that have seen major improvement from that.

I like mesotherapy for muscular pain, like pain from poorly fitted saddles.

Kissing spine is not a facet problem. Depending on which processes are overriding, the problem can be quite far from the location of the facet.

I think that mesotherapy could help when used in conjunction with injections between the processes (if possible–with severe impingement it’s not possible) and shockwave. It could help through this period of getting the muscle support back that was lost during the period of rest. I can understand why you wouldn’t go to surgery if this was an incidental finding, because there are so many KS horses out there who are not symptomatic.

While it doesnt target the pain site directly, mesotherapy can calm down associated neuromuscular pain. It’s more invasive than shockwave but cheaper. I’d pick shockwave to treat over the supraspinous ligament area, though, which you wouldn’t hit with the meso.

[2tempe]

Some useful exercises at the end of this article:

​https://www.horsetalk.co.nz/2015/02/04/help-horse-kissing-spine-goodbye/

[joiedevie99]

@IPEsq You are correct. I meant injections between the processes, not facets.

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This post is longer than I intended and it covers the four/five year history I’ve had with this horse. Prior to me he was green broke.

At the moment I’m not asking him to “lift and use his back” because there is legitimately a mental road block there, and I think it hurts him. He is perfectly happy walking, trotting and cantering on the trails but the second I pull him into the ring and ask some real work out of him over his back, things fall apart. He’ll get very tense. He will canter on a loose rein but trying to get him soft, supple and round at the canter will cause him to lock his neck and take short, choppy strides. I had a dressage trainer try to help me get through the canter and the trainer could not get him to canter quietly… and this is a good trainer too. We wondered if it was physical but he trotted and cantered on the lunge sound.

I really thought it was me not being a strong enough rider despite being a trainer by trade, but he completely gets unglued in the grass ring. Or, his version of unglued. The odd thing is he is perfect when the footing is perfect AKA a dressage ring… so I thought it was hooves or tendon possibly? Had my vet x-ray and ultrasound his legs bow to sternum, his hoof rads were pristine, nothing on pasterns, knee, hocks, stifles or leg. He has some mild arthritis in a pastern but I have the rads from his PPE five years ago and the arthritis is unchanged. Just for good measure we put shock absorbing pads on him to see if he was possibly just ouchy on uneven footing but it did not change his way of going. He always had a saddle reflocked to him but at this point I consider going custom and get him a new saddle. It’s reflocked every 6 months.

So then I figured it had to be me, right? So I did a month of lunge work to see him on the ground, with poles, cavaletti and side reins off of his back to try to get him to really work correctly. He was already doing daily poles in the ring undersaddle so it was not necessarily a big change in work out routine. I thought we were doing well but was thought he still seemed a little tense even without a rider. One day of this, he had just come down from a canter and all of the sudden he checked out mentally, hit the end of the sidereins and panicked and went right through the gate like he did not even see it…

Vet came out and I thought for sure vision? My vet is intimately familiar with eye problems and he came out and did a neuro and vision exam with no results.

Then I thought for sure it was PSSM, or maybe EPM? Lyme? It has to be physical. I had titers pulled for everything, he had a hair biopsy done, and just in case we changed his feed to a PSSM type diet. I added Vit E and oil. Everything came back negative. I had three different vets out to try to unravel this. They all said nothing was wrong and to continue working him and that maybe he was just a tense horse. I continued to do light hacking on the trail (walk only) and he never once ‘misbehaved’. The thing is, this horse is unflappable on the ground and hacking… he has never bolted with me hacking out, has never bucked or reared or misbehaved. Yet when you put him in the ring and send him forward and ask him to come round something gets stuck up front and I know something is wrong physically. I waffled between “it’s a strength issue” to “no, it’s pain” many times. My trainers encouraged me to work through it but I felt it was wrong. He bolted on me three times over the span of three years and it was not the “I’m getting you off” bolt but the “this hurts I need to get away” bolt. He stopped but not without gaining terminal velocity first :eek:

Chiro had been involved since day one, he has a history of mild soreness in his neck and over his hip, but the chiro at the time thought it was associated with the amount of work we were doing. It seemed to wax and wane depending on workload.

Thought maybe he had a micro-injury we couldn’t detect, so he had the winter (4month) off. I had his back and neck x-rayed during this time because I was certain it had to be his neck and boom, cervical arthritis and kissing spine. In hindsight maybe the back and neck should have been the things I looked at first, but because he never bucked or misbehaved and it was always a tension/stiffness issue I went down typical avenues first: feet, teeth, saddle, hocks, etc.

I’ve gone to the moon and back with diagnostics to try to fix this horse and I think I’m just at the end of my rope from a financial standpoint. He has a place with me for the rest of his days but I guess I’m just so frustrated and needed to witch.

My vet is really pushing mesotherapy but I just don’t see how it treats the underlying condition, if it is indeed kissing spine. I actually suspect now that I know what I know that maybe the neck is the actual issue and that we should be looking at the neck instead.

[IPEsq]

Thank you for the history. What’s interesting is that he has issues lifting his back. Rounding the back should help the KS impingement problem. I am thinking this is more neck and a contact problem. Have you injected the arthritic areas of the neck yet? If not, I’d do that. Give it a good month or two, and if he’s still NQR, you can try meso on the neck and back.

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@IPEsq

Thank you for the history. What’s interesting is that he has issues lifting his back. Rounding the back should help the KS impingement problem. I am thinking this is more neck and a contact problem. Have you injected the arthritic areas of the neck yet? If not, I’d do that. Give it a good month or two, and if he’s still NQR, you can try meso on the neck and back.

The more I think about this the more I’m convinced it’s the neck. Thank you for being my sounding board. I called the vet last week asking to look into neck injections. I’d rather do it first than the meso but my vet is pushing the meso and says most horses have some form of cervical arthritis. He said he will put us on the schedule for it.

I know it sounds like a contact problem, and I know if I was reading what I wrote and from an outside perspective I’d roll my eyes at myself as a poster. It’s a weird feeling under saddle, he feels like he “locks” from the withers to the poll. I had an easy time in the beginning getting a training level outline out of him. He actually has been one of my easiest horses to start… but once the work increased to first level expectations he started to have little problems. I had a few different riders with different styles of riding get on him so I could see this behavior on the ground and see if it was something I was causing. One thing I noticed is that he never gets behind the vertical with any of them. Not that you want him to, but it almost looks like he physically cant.

To me it kind of feels like he gets stuck and can’t elongate/drop his neck and step under at the same time. It’s like he can’t stretch his outline. His mouth will suddenly go hard and lead-like and feels like a sack of bricks, and he is a horse that is very light on the bit. For a long time I was convinced it was just a training problem or jockey problem but he’s so compliant in other ways that I think it’s an objection to something that causes him physical discomfort.

He sees a lot of hills and hacking, is out 24/7 and we live in a mountainous area. His warmup every ride whether or not we are doing ring work is to walk up and down the bridlepath I made, which is on the face of a hill. I am not sure I could do more hill work with him, honestly.

For a while I do the tail pull and other chiro exercises including the tummy-tuck where you poke and hold their stomach up. I did not see a difference after a month of doing these exercises. One really weird exercise my chiropractor had me do that I did see a difference in was the tongue pull. He would be much looser and softer in the jaw.

I know his family well and they are all stoic horses, which doesn’t make this any easier!

[IPEsq]

Oh, I didn’t mean to imply that the contact problem wasn’t rooted in his physical issues. It’s just that you’d expect round carriage to help with KS because it would encourage widening between the dorsal spinous processes. But the freak out in side reins and the reluctance to go on the bit coupled with also finding cervical arthritis makes me think that (not the KS) is likely your primary problem.

If you search my threads, I’ve got some long sagas on here about my horse and his cervical issues. When we were going through diagnosis and treatment options, one thing the vets wanted to know is whether he had any behavioral changes with different degrees of contact. My horse does not, at least not really. Instead, his manifests as problems turning left on the longe line, completely refusing to go forward in any fashion, sporatic bolting at things out of his left eye, and using his neck such as to jump (he wants to root down at the base and then will go high with his body and fling his front legs out where I can see his feet sticking out and forward…some of this is his M.O. when he’s being a green doofus, but when you add in the rooting down before take-off, that locked from poll to withers feeling…that means his neck needs treatment).

Anyway, BTDT, inject the neck. To help support the injections, mesotherapy can work. So can acupuncture and electroacupuncture. As well as shockwave, although I personally have not found the duration of help from that to be nearly worth the expense versus the other therapies.

[CindyCRNA]

I have a thread on my TB’s KS and treatment. The last entry addresses mesotherapy.
https://www.chronofhorse.com/forum/forum/discussion-forums/horse-care/314377-the-i-m-rehabbing-my-tb-with-kissing-spine-thread/page2

[mpsbarnmanager]

My horse was just diagnosed with KS as well. We injected his SI and did 2 rounds meso. IMO the meso was not effective.

[mpsbarnmanager]

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This post is longer than I intended and it covers the four/five year history I’ve had with this horse. Prior to me he was green broke.

At the moment I’m not asking him to “lift and use his back” because there is legitimately a mental road block there, and I think it hurts him. He is perfectly happy walking, trotting and cantering on the trails but the second I pull him into the ring and ask some real work out of him over his back, things fall apart. He’ll get very tense. He will canter on a loose rein but trying to get him soft, supple and round at the canter will cause him to lock his neck and take short, choppy strides. I had a dressage trainer try to help me get through the canter and the trainer could not get him to canter quietly… and this is a good trainer too. We wondered if it was physical but he trotted and cantered on the lunge sound.

One day of this, he had just come down from a canter and all of the sudden he checked out mentally, hit the end of the sidereins and panicked and went right through the gate like he did not even see it…

.

The thing is, he HAS to lift and use his back, or he is making things worse. When he hollows his back it makes the spaces between the spinal processes smaller. When he lifts and rounds his back, they spread apart. He HAS to learn to work this way. It will fell better to him! I would not ride at all until you spend a good month in a pessoa building his back up. I am just on the other side of this with my horse. Today was the first ride since APRIL that he let go of his mental block and used his back. He trotted around BEAUTIFULLY. He had been inverting, prancing, breaking into a canter, stopping, anything to avoid trotting. I know he feels better because he is finally sound on the lunge, and he was acupunctured last week. The whole ran through the gate thing screams pain to me. He might have been inverted and in the transition pinched something and it was very painful, making him run “away” from the pain.

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@mpsbarnmanager

The thing is, he HAS to lift and use his back, or he is making things worse. When he hollows his back it makes the spaces between the spinal processes smaller. When he lifts and rounds his back, they spread apart. He HAS to learn to work this way. It will fell better to him! I would not ride at all until you spend a good month in a pessoa building his back up. I am just on the other side of this with my horse. Today was the first ride since APRIL that he let go of his mental block and used his back. He trotted around BEAUTIFULLY. He had been inverting, prancing, breaking into a canter, stopping, anything to avoid trotting. I know he feels better because he is finally sound on the lunge, and he was acupunctured last week. The whole ran through the gate thing screams pain to me. He might have been inverted and in the transition pinched something and it was very painful, making him run “away” from the pain.

Thanks. I completely understand that, but it’s the actual working over his back that is causing the pain. We already tried a month of correct lunge work, he was working over his back to the best of his physical abilities, but a horse that is in pain cannot genuinely work over their back and improve their core and condition while doing so.

That is the problem I have with the Art2Ride people, who think that it’s just a matter of “not working correctly”. A horse can’t work correctly if they are in pain.

For that reason I am not keen to try another month of lunge therapy as I don’t think the KS is the root of the problem and something happened while he was lunging that caused him so much pain that he went through a gate. He is normally a very sensitive, not explosive horse. I am not keen to repeat that experience.

For the record, he has been very good the past few weeks. We have continued the hacking conditioning at suggestion of vet with 2 days of very brief (20m or less) ring work getting him long and low. I put him on 55mg of Previcox as a bute trial to try to isolate if it was behavioral or physical, it is definitely physical.

The vet is coming to do neck injections this week, possible spine injections if he feels it is warranted. Not sure about the mesotherapy anymore. I will let everyone know…

[IPEsq]

I’m interested to hear how the neck injections go. You’ll want to give it at least a month to see the full effects.

[TWH_Girl]

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That is the problem I have with the Art2Ride people, who think that it’s just a matter of “not working correctly”. A horse can’t work correctly if they are in pain.

That is so very true. I hope the injections do help! I did a bit more reading and it does sound like meso does help with some aspects of kissing spine. Like most horse problems, there are compensatory issues and you end up having to address those and the original problem.

[Blkarab]

Oh Wow, OP…I just found this thread (I was googling KS) as I have been having very similar problems with my mare.

Today took the cake…full blown rear during our lesson! :eek: Last week, I came off after she stumbled in the canter while throwing her head back and forth. It was like she was trying to shake away pain.

I have an appointment to take her in on Monday for x-rays of the back and neck. My trainer wanted me to x-ray the hips as well, but we’ll see what the vet thinks. It’s been a long saga of some days good behavior to some days just horrible. It’s been going on for a few months now.

We also started First Level work with her…and it seems that asking her for more connection causes her to become more tense, tight and resistant…along with lifting her back. She has always had a weak back and dropped, so asking her to strengthen and lift has always been our mantra. Her back has improved a lot…but the past couple of months, it has become more and more difficult for her to sustain it.

For those injecting…how long do the injections last?