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Everything to know about Kissing Spine, please!

Well my horse that I’ve been dealing with stifle issues was recently diagnosed with Kissing Spine. It makes A LOT of sense now. It’s T16 I believe. I think t18 is close as well but not touching.

I was hoping the wise group in COTH could tell me some of their learned wisdom about kissing spine. Finances are an issue this year due to some family stuff earlier in the year. So really going to try to at least hold off on surgery for now. But still want him comfortable and of course ideally back to work if possible but if not at least comfortable!

His symptoms: lameness behind that would switch from left or right with no rhyme or reason. Mild to moderate back pain in the lower back region, behind where the kissing spine is. He was very full and lazy acting but can be spooky (but not dramatic.) Always had a pain face in my opinion. Would drag is hind legs especially at the walk although again he was very lazy and slow moving. He was very resistant to belly lifts and pelvic tilts. Occasionally after working for a bit he would toss his head although not in a rude way. It seemed like all of a sudden he struggled with pole work. He has been mostly out of work with just some groundwork for the last 7 months due to life outside of him and me thinking he never seemed quite right.

He just got injected 2 1/2 weeks ago. He was on robaxin for 2 weeks and I just did groundwork. Trying to get him to stretch down at his head actually walk (he was more forward) and stepping over single poles. A little bit of walking up and down hill. Carrot stretches and massages. Unfortunately a few days after we stopped the roboxin, he was lame going to the left. So it’s back on the robaxin and we are doing mesotherapy in 2 weeks and some massage.

What else is there to know or do that has worked for people? I’ve heard shockwave can help, Osphos, checking on feet balance, equiband (I own one), lots of turnout (he goes in a turnout with others most of the day but lives in a 31 foot long outdoor pen at night.)
Obviously saddle fit is important. Oh back on track and keeping the back warm as well.

I’d love to hear anything else that might be helpful. I’m struggling a bit with knowing how much work to do to build muscle but also not hurt him. So for now it’s very very light ground work.

Did you get his feet xrayed? It doesn’t “start” with the spine.

I fixed close and touching processes in my young mare with a year of correct work. Surgery is not always the answer.


We have x-rays from his front feet but not hinds yet. I’m suspect of an injury personally because when he originally injured one of his stifles he was sore in his lower back and there is some talk about whether it was a stifle or the SI. But he improved a lot for a little.

But yeah I did put in my post that I know that foot balance seems especially important. Especially NPA. His hind feet don’t look NPA to my eye but we might need to xray at some point to double check.

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I also wanted to say that’s so awesome that you were able to help your mare. It’s nice to hear some inspirational stories!


The current “standard” for a lot of more minor KS now is physical therapy and injections into the area (like a steroid to reduce inflammation), before surgery as a last resort. Back on Track sheets can help keep muscles supple. In-hand work to start, working on all the things that encourage a lifted back and engaged hind end, will strengthen all the muscles needed to support rider weight, and then ridden work to continue that (so essentially, solid dressage work).

I’ve seen some use thigns like EquiCore (I think that’s it?) bands to really encourage use of the hind end. I know some swear by a Pessoa rig type setup, but I’m such an anti-fan of that because of its impact on the mouth that I’m not sure I’d ever try that. I don’t see how that could do anything that the bands couldn’t do, along with proper in-hand/ridden work

It actually can start with the spine, as shown by the fact that some breeds are much more prone to it than others (TBs, WBs for example) and height and weight seems to play a role as well


Thank you. Yeah my vet is confident that we can get away without surgery although it does seem like if too much is maintenance needed that sometimes it is the best route. But I’m really not in the position to do that at the moment and I think the conservative route is worth a try!

He already had steroid injections and I did see an improvement but not 100% yet although it’s only been a few weeks… Hopefully the mesotherapy will help us as well (and massage!)

I already own the equiband so I definitely will incorporate that.

My vet was of the personal opinion that it was either genetics or injury caused. If we don’t get things under control I definitely will go to x-ray in the hind feet which is about the only thing I think we don’t have X-rays on. He does have one of the top farriers in the area, whenever any vet (like CSU or any consulting local ones ) ask me who I’m using they are very happy to hear. I know that’s not a guarantee but there’s no obvious in NPA to my eye. He is barefoot behind right now. I’ve had him shod behind I didn’t think it ever made a radical difference but it is something we could try again.

He’s a quarter horse but has a pretty large amount of TB blood in his pedigree. He’s got barrel racing and cow horse blood in there from what I’m told. But of course I’m a dressage rider lol.

Fingers crossed!!


He did have a sore spot on his neck on just one side… kind of mid neck. We did neck x-rays but my vet did not see anything. She did send them to CSU just to have their internal specialist look them over. She said neck x-rays are not her specialty. I just wanted to make sure there wasn’t anything in there that we were going to be dealing with unknowingly.

Since his back injection and being on the roboxin and it seems like his neck does feel a lot better.

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Also, retirement is on the radar. He’s young though and a good boy with a good attitude so hopefully we can get him working happily. But I don’t want to work an uncomfortable horse.



It actually can start with the spine, as shown by the fact that some breeds are much more prone to it than others (TBs, WBs for example) and height and weight seems to play a role as well

It absolutely does start with the spine. Researchers confirmed in 2021 that KS is Hereditary.

Researchers Confirm Kissing Spines is Hereditary – The Horse

Having said that, it is absolutely correct that having the correct angles in the feet is critical with a KS horse.

The biggest factor in successfully managing KS is turnout. 24 hour turnout, supportive therapies (back injections, mesotherapy, shockwave, robaxin, back on track), regular, correct work and properly fitting tack are all essential in successfully managing KS.


Is a 31 foot long outdoor pen enough? He’s turned out in a ground for about 7 to 8 hours a day and then he’s in his outdoor run.

I could probably arrange extra turnout by trading another boarder but no way to have him out 24/7 at this moment. That being said, he’s not ever stalled. He hasn’t been on a stall since i have owned him.

As far as everything else, I’m on it. Fingers crossed.

I live about 7 minutes from the barn so luckily I’ve been able to hand walk him everyday too.

I did have someone recommend mesotherapy and massage therapy every single month for him… But I calculated that and it’s about $500 a month for that maintenance program. Yikes. Hopefully he responds with just occasional mesotherapy and massages …

Honestly, you need to work him. Get him as comfortable as you can, but he will have to live with some level of discomfort to build the muscle needed to support the area. You can do all the injections and meso in the world, but handwalking isn’t going to cut it.

In an ideal world, he would be out full time on a couple of acres. If you have any way to get him access to a larger turnout, it would be beneficial, but I understand not every place has that luxury.


I said what I was trying to say wrong - you guys are correct that it has a genetic component, but there are tons of other things that factor into whether or not it’s manageable or not, as well as the severity of how it presents.

Again, I reversed it with correct work - she came off the track with it, clear as day on the xrays. A period of time of correct work and you can xray all you want and you won’t find it.


Given that the research was done by Etalon, it’s sketchy at best, at least for now, about how valid their findings are. That’s why I didn’t post that, because it’s not truly validated.

For now at least, I would do your best to arrange for as big a turnout area, for as much time as possible. Is all his food at or below chest level? Better yet, ground level is feasible.

Caveat, I haven’t rehabbed one of these, but have a few friends who have, and you’re right. It’s unfortunate they have to be uncomfortable in the beginning, but it’s reality. Hand walking and working in-hand on any holes he might have in his understanding of lifting and engaging (knowing the OP, this isn’t likely), and/or adding some extra level of unweighted strength, is where the horse has to start, so there’s some knowledge and strength foundation to start/continue more ridden work

Absolutely! One thing about ANY structural soundness issues is that it starts changing how the horse moves, which can impact the health of the feet. Asymmetrical movement will start causing some level of flaring, for example. And it’s 100% true that some forms of KS can be caused by long-term compensations and poor posture due to hoof issues and outright poor, upside down, hard riding for long enough.


Well I was walking him all over the property not just like in the arena or anything… there’s a couple hills that we would go up and down and then we would do walking over poles and serpentine’s and stuff. I just thought trying to hop back on him two weeks after injections seemed a little fast. I wanted to make sure that he was truly comfortable before getting back up on him.

I want to start using the equiband But I wanted to make sure that he was actually comfortable before asking too much… I have mesotherapy scheduled on the 26th. He’s back on the roboxin again now so maybe I can work him a little bit more.

I could get him some more turnout but I’m in Colorado in a dry area where space is becoming very limited and boarding facilities are shutting down at alarming rates…

That is so awesome!! These are the stories I like to hear. Although I do know multiple people that have had success to varying degrees. Some with surgery and some without .
His hind feet are definitely on my radar. I’m a bit tapped out financially at the moment for x-rays on anything else… But I will have a chat with my farrier in the mean time.

Want to add that my comment about hand walking was not so much that I think it’s hard work, but just that in the meantime when we’re trying to get him comfortable I’ve been focusing on keeping him moving to some degree. Not letting him sit.

I do have an admittedly hard time working a horse through discomfort though. I just didn’t want to do too much too early before the injections actually kicked in.

But maybe I’ve been too conservative. That is certainly possible!!

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I was thinking about looking into long lining or ground driving too. I’m not keen on lunging him much since he is prone to stifle issues and he did have a legit injury to the right stifle.

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I think everyone feels that way! Especially if you’re not comfortable (yet) distinguishing between “this is uncomfortable and hard but it’s manageable” and “this really hurts”, and that’s different for every horse.

I would think a few weeks is enough time to make enough improvement from the injections that he can start more purposeful work, but your vet will know more on that


I was discouraged that he was lame when we took the roboxin away. But maybe 2 weeks is not long enough on it. He did improve on the lunge in One direction and was actually stretching down and looking fairly well. But the other direction he looked pretty poorly…

There’s also the possibility that we still are dealing with stifle on top of the back. He didn’t flex very positive that has last vet check but he was really wonky and that’s how we discovered the back…

I think him having the majority of 7 months off prior to this definitely has not been a good thing. But I was dealing with the family crisis and I knew that he did not look right, I just didn’t know exactly what was going on. I’m definitely kicking myself a little bit for letting him sit but all I can do is focus on the here and now