Kissing Spine symptoms? Surgery? Success?

[Eventer2483]

I have a now 5yr OTTB who I have struggled with since I got him with somewhat explosive behavior. I tend to think a lot of that originated from back pain, and he’s gotten back injections and has done long and low long line work for a year along with undersaddle work. He’s gotten a ton better on the lunge, and will stretch and maintain a connection, but when he goes undersaddle he is continually wanting to get heavy, break forward Into a canter, and from there often either bucks, bolts, swaps, or leaps in the air if you touch his mouth. He has a custom saddle. I am at my wits end with him. I’ve had him ridden by a professional (though I’ve brought a long a ton of green horses myself over the years so I am qualified to do the young horse stuff), and while he was better with her (ie no airs above ground) he still was a “very difficult” horse… no/very bouncy connection, hard left lead canter then bolted, etc.

I’ve never taken back radiographs of the horse and been thinking about kissing spine and the surgical options. Any experiences with this? I’m so frustrated. I’ve made a commitment to keep the horse long term, so I’ll either find a way to make him work or he’ll end up in a field. He has originally supposed to be a eventer/LL dressage horse and “passed” his post-purchase with my vet, who is the one that put him on the back injections and lunging therapy process.

[ghst13]

What kind of back injections did he have? When my KS horse got back injections the vet used x-rays to place the needles between the processes so I’m surprised you don’t have any views of his back.

I would definitely have your horse evaluated and get x-rays. If it is KS, surgery did wonders for my horse and was more cost effective than continuing to inject.

[Eventer2483]

@ghst13

What kind of back injections did he have? When my KS horse got back injections the vet used x-rays to place the needles between the processes so I’m surprised you don’t have any views of his back.

I would definitely have your horse evaluated and get x-rays. If it is KS, surgery did wonders for my horse and was more cost effective than continuing to inject.

They call it “prolotherapy”. It’s basically injecting something like an analgesic into sore muscle/nerve points. Followed by exercise physical therapy.

[ghst13]

@Eventer2483

They call it “prolotherapy”. It’s basically injecting something like an analgesic into sore muscle/nerve points. Followed by exercise physical therapy.

Gotcha. I also tried similar muscle injections with my guy, but saw more significant results from the injections between the processes.

Clinically my horse’s x-rays weren’t very severe but his reactions and symptoms were significant. Sore back consistently despite multiple saddle fittings, chiro, massage, muscle treatment and he grew more and more reactive and spooky under saddle.

I’d still recommend x-rays to get a definitive diagnosis on whether or not there is KS.

[mollymoon]

I just saw this article referred to on another thread the other day that reports on a study of different KS outcomes by age, breed, number of joints involved, and treatment type.

https://aaep.org/sites/default/files/issues/proceedings-11proceedings-424.PDF

Be forewarned: The results presented in this article will make it sound as if KS in a young horse is untreatable. It does seems like treatment is perhaps less likely to be successful in young horses presenting with significant disability, but the study only contains 6 horses from that population, and if I were in your position, I wouldn’t completely give up on my horse based on the outcomes in a sample of 6.

[Eventer2483]

@mollymoon

I just saw this article referred to on another thread the other day that reports on a study of different KS outcomes by age, breed, number of joints involved, and treatment type.

https://aaep.org/sites/default/files/issues/proceedings-11proceedings-424.PDF

Be forewarned: The results presented in this article will make it sound as if KS in a young horse is untreatable. It does seems like treatment is perhaps less likely to be successful in young horses presenting with significant disability, but the study only contains 6 horses from that population, and if I were in your position, I wouldn’t completely give up on my horse based on the outcomes in a sample of 6.

They didn’t investigate surgical intervention in that study either. Hmm. Well thanks!

[IPEsq]

It’s easy enough to shoot a few X-rays to see what’s going on. Depending on what it looks like, surgery may or may not be an option.

But the behavior you describe could for sure be from something like KS. Some other pain sources might cause a similar reaction, including congenital neck problems. But it’s hard to say without doing some more X-rays and/or ultrasound to start.

[J-Lu]

Get radiographs.

They’re not that expensive given what you’re dealing with. Radiographs will rule in or out kissing spines, and it sounds like you are at the juncture to know know what you’re dealing with.

[Elsari]

Just a different perspective since no two horses are the same. I have a horse that presented with back pain and hind end issues. The thought was that his back was throwing things out of whack for his hind end. He was an absolute saint under saddle (no bucking/bolting behavior) and did everything asked of him. No ear pinning, no swishing tail. His back x-rays were awful. My trainer was at our appointment and she couldn’t believe that he never tried to kill me with how bad his x-rays looked. Vet said he wasn’t a candidate for surgery because his lumbar vertebrae have fused together. He was put on a muscle relaxer for 2 weeks and re-evaluated. Vet checked him out again and determined he didn’t need his back injected (no longer reactive to palpation), but his hind end issues remained. Ended up x-raying his hocks (arthritis confirmed) and injecting them.

[beowulf]

I agree with the others, get radiographs.

One thing that you will not learn in discussing KS with a vet, is how to manage a horse with KS. Vets are all about treating the disease, but many don’t understand (or don’t push for a change) how management plays a huge part in a horse’s comfort.

You’ll need to stay on top of their hooves; their angles will make or break a horse with KS and I have seen now, much more often than not, that symptoms are exacerbated by poor angles (especially behind).

You’ll need to change their life style management too. Very few horses with KS are sound in a stalled environment. The more you can get them out, the better.

I have seen very good results (including in my own KS horse) treating the pain, and then addressing the management. My KS horse was another horse where he had very few of the classical symptoms of KS (no bucking, no tail swishing, a good horse under saddle but tense), but presented as clinically sore over his back. My horse was not a bone-shave candidate (moderate remodeling, no overlapping), and my vet opted for injections, mesotherapy to break the pain cycle, a few months of robaxin, a totally different style of shoeing – it’s been five years since diagnosis and he has completely turned around. I do have to be mindful of the clinics and shows I take him to - I won’t attend overnight shows as while he tolerates the stalling, he is often very tight over his back if he’s stalled overnight any length of time.

KS will cause many secondary issues, in my experience. Hocks, SI injuries, and PSD seem most common, especially if you cannot get the feet under control and change the management to a non-restrictive/movement scenario.

Every KS horse presents differently. I have one that never bucked or reared, never palpitated sore. I’ve learned it’s better to treat the horse in front of you and their symptoms rather than just go off of x-ray.

I am not personally impressed with the long term results of lig-snip surgery. I don’t see many continue to be riding horses three or four years down the road. Bone shave seems slightly more successful long term, but it’s my impression the wastage rate in horses that have gone the surgery route is quite sobering. However, I will enter this with the caveat - I think many of the failures are because the horses are still kept in management practices that exacerbated their symptoms in the first place.

I would join these FB groups -
Pferd Mit Kissing Spine
Horses With Kissing Spine

[SonnysMom]

@Eventer2483

They call it “prolotherapy”. It’s basically injecting something like an analgesic into sore muscle/nerve points. Followed by exercise physical therapy.

I looked into having prolotherapy done on my back about 20 years ago after a car accident. The particular doctor was a quack. However last time I researched it a few years ago there was not one major insurance company or Medicare that would pay for it. It is not a therapy with a proven benefit for people at least.

[LadyB]

My 17 year old gelding has KS, thought it was the reason for him refusing jumps. Ended up getting radiographs, turns out his KS was very minor, not causing the pain. It was his hocks, injected them and he’s been going great the last 3 years since starting the yearly injections.

I would say maintenance and keeping them fit/moving is key. Top line is their best friend, the muscle around the joints to help support. Plus abs, and no big gut weighing down on them, pulling on them.

I had a friend who did the surgery, her horse never changed, he didn’t get better, but the success rate is big. I think its per case on the quality of the surgery. There are many options out there for making them comfortable @beowulf Nailed it completely though, its a long term care that you need to think about and look at.

[ghst13]

@beowulf

You’ll need to change their life style management too. Very few horses with KS are sound in a stalled environment. The more you can get them out, the better.

I have seen very good results (including in my own KS horse) treating the pain, and then addressing the management. My KS horse was another horse where he had very few of the classical symptoms of KS (no bucking, no tail swishing, a good horse under saddle but tense), but presented as clinically sore over his back. My horse was not a bone-shave candidate (moderate remodeling, no overlapping), and my vet opted for injections, mesotherapy to break the pain cycle, a few months of robaxin, a totally different style of shoeing – it’s been five years since diagnosis and he has completely turned around. I do have to be mindful of the clinics and shows I take him to - I won’t attend overnight shows as while he tolerates the stalling, he is often very tight over his back if he’s stalled overnight any length of time.

KS will cause many secondary issues, in my experience. Hocks, SI injuries, and PSD seem most common, especially if you cannot get the feet under control and change the management to a non-restrictive/movement scenario.

I agree that you have to treat the horse in front of you considering both the diagnostic data and the horse’s reactions and symptoms.

I’m going to disagree with the generalization that KS horses aren’t sound if stalled. I’m sure full turnout benefits some horses, but my KS horse was never unsound. And I know someone who’s horse was evaluated as completely sound multiple times by an FEI vet before KS was discovered. From a management perspective many KS horses do benefit from being fed from the ground as opposed to hay racks or hay nets. Building up and maintaining the horse’s core strength is also important in KS cases.

I’m always interested in people who are told their horses aren’t surgical candidates as the reasons seem widely varied and dependent on each vet (other than cases where processes have fused our there are other significant known problems in addition to KS). My horse sounds clinically like yours - 5 impacted spaces, 2 with remodeling and 3 with reduced spacing, no overlap. He had the bone shave operation. While the surgeon probably wouldn’t have done surgery based on x-rays alone, the horse’s behavior and limited improvement with other treatments made him a surgical case. My surgeon won’t do lig snip as he doesn’t believe it is effective long term.

[beowulf]

@ghst13

I agree that you have to treat the horse in front of you considering both the diagnostic data and the horse’s reactions and symptoms.

I’m going to disagree with the generalization that KS horses aren’t sound if stalled. I’m sure full turnout benefits some horses, but my KS horse was never unsound. And I know someone who’s horse was evaluated as completely sound multiple times by an FEI vet before KS was discovered. From a management perspective many KS horses do benefit from being fed from the ground as opposed to hay racks or hay nets. Building up and maintaining the horse’s core strength is also important in KS cases.

I’m always interested in people who are told their horses aren’t surgical candidates as the reasons seem widely varied and dependent on each vet (other than cases where processes have fused our there are other significant known problems in addition to KS). My horse sounds clinically like yours - 5 impacted spaces, 2 with remodeling and 3 with reduced spacing, no overlap. He had the bone shave operation. While the surgeon probably wouldn’t have done surgery based on x-rays alone, the horse’s behavior and limited improvement with other treatments made him a surgical case. My surgeon won’t do lig snip as he doesn’t believe it is effective long term.

I would love to see a video of this horse - remember, soundness is more than how the legs move. :encouragement:

This is not meant flippantly, but truly, I see a lot of horses people say are sound that are not. At this point in my horse career, I take “sound” with a grain of salt. It’s been a long time since I have seen a truly sound horse.

There’s no evidence that stalling is beneficial for horses (besides those on layup for injury, of course). There is plenty of research now that proves the contrary: that stalling is directly detrimental to the horse’s mental and physiological health…

I know it’s an ugly pill to swallow, particularly when the industry standard revolves around stalling, and so many owners are caught between a rock and a hard place because they can’t control their horse’s management without sometimes voting with their feet.

The point being – if a horse is doing okay stalled, imagine how much sounder and better their health would be, if they were offered suitable turnout (20+ hours a day).

I might still have the rads of the non-shave candidate if you would like to see them. He had minor remodeling of two facets and it did not change from year one to year three; he presented clinically much worse than his radiographs suggested.

My vet, like yours, does not believe lig snip is viable long term. He also is very conservative about recommending bone shave, and will try to exhaust all other modalities (including the above 24/7 turnout) before he recommends the bone shave.

It works for some horses, but go in with your eyes and mind open.

[ghst13]

@beowulf

I would love to see a video of this horse - remember, soundness is more than how the legs move. :encouragement:

This is not meant flippantly, but truly, I see a lot of horses people say are sound that are not. At this point in my horse career, I take “sound” with a grain of salt. It’s been a long time since I have seen a truly sound horse.

There’s no evidence that stalling is beneficial for horses (besides those on layup for injury, of course). There is plenty of research now that proves the contrary: that stalling is directly detrimental to the horse’s mental and physiological health…

I know it’s an ugly pill to swallow, particularly when the industry standard revolves around stalling, and so many owners are caught between a rock and a hard place because they can’t control their horse’s management without sometimes voting with their feet.

The point being – if a horse is doing okay stalled, imagine how much sounder and better their health would be, if they were offered suitable turnout (20+ hours a day).

I might still have the rads of the non-shave candidate if you would like to see them. He had minor remodeling of two facets and it did not change from year one to year three; he presented clinically much worse than his radiographs suggested.

My vet, like yours, does not believe lig snip is viable long term. He also is very conservative about recommending bone shave, and will try to exhaust all other modalities (including the above 24/7 turnout) before he recommends the bone shave.

It works for some horses, but go in with your eyes and mind open.

I don’t have video of my friend’s horse and the horse has since been treated for KS.

Not looking to start a debate, but if you haven’t seen a truly sound horse in a long time I’m pretty sure any video I provide wouldn’t be satisfactory. Does that mean your guy hasn’t become sound either?

Yes, turnout is almost always beneficial just my opinion that it is still completely possible to keep a KS horse on stall board.

[beowulf]

@ghst13

I don’t have video of my friend’s horse and the horse has since been treated for KS.

Not looking to start a debate, but if you haven’t seen a truly sound horse in a long time I’m pretty sure any video I provide wouldn’t be satisfactory. Does that mean your guy hasn’t become sound either?

Yes, turnout is almost always beneficial just my opinion that it is still completely possible to keep a KS horse on stall board.

The more you learn, in general, about lameness, the less you see a truly symmetrical, evenly moving horse. My horses are no exception. My KS horse is still in work under vet jurisdiction (including routine soundness exams spring and fall), but a sharp eye can see the way KS has impacted how the rest of his body moves.

It is possible to keep a KS horse on stall board, but it is much more expensive for you in the long run as you(g) will pursue more treatment options to keep them comfortable, the horse is much more likely to develop secondary issues like PSD and hock problems, and the stalling is still detrimental to the horse - perhaps even moreso for a horse with KS.

That routine stalling is detrimental to a horse isn’t a debate - it’s factual, proven by years of research (not my own).

The take-away here being, do your(g) research on management practices that optimize a horse’s soundness and longevity, pursue treatment that you can, and go into it all with an open mind and the understanding that surgeries may not be the answer for your horse. My two cents being, I would never do the bone-shave or lig-snip without making sure the horse had access to 24/7 turnout once healed. It’s my experience any good that comes out of the surgery is made almost negligible if you don’t change your management. YMMV.

[SBrentnall]

My horse had the lig snip surgery after trying everything else first. It was a standing keyhole surgery with minimal downtime. He starting moving better very quickly. After 2 months of lunging in a pessoa, he had a big round butt and a topline better than I’d seen in years.

Then of course he ran around like an idiot during daily turnout one day and tore a medial collateral ligament. He’s a pasture ornament now, but at least his back doesn’t hurt!

[caryledee]

I had a lig snip done on mine after injections and other therapies didn’t work. I’m pretty sure the surgery would have been successful but after his back was fixed, he became lame up front and we found he also had cervical arthritis. My advice is to get a full workup done before proceeding with any treatment. It is always best to know up front everything that is wrong as there can be multiple issues going on.

It is hard to say what is wrong just off of the symptoms. I had another horse with no KS but with SI issues. His symptoms were much more severe than my KS horse ever was. Hock issues can also cause things like bucking and bolting, as can EPM. You really need a full workup done before jumping to any conclusions. Good luck!

[KnockedOut]

Definitely get radiographs first to make sure you’re treating the right problem. I also did the ultrasound guided injections between the processes. They helped his pain level but didn’t do a lot as far as riding was concerned. I’ve found that consistent chiropractic and massage/body work helped a ton. I also did a lot of work to strengthen his back muscles using a pessoa system. Seemed like chiro and fitness was really key for my guy. We diagnosed him at 17 and he’s 22 now and still going happily.