Kissing Spines - my poor boy

[arabiansrock]

Well after addressing major dental issues (movement got slightly better), injecting every joint in all 4 legs (movement got slightly better), my horse suddenly went backwards. 2 weeks ago vet injected his SI because it palpated sore. Helped a little but not much. Today vet agreed with me that it was time to xray spine and neck. Bingo! Kissing spines. We decided to start with intr spinous injections of sarapin and corticosteriods along with an Osphos injection. Well the oddest thing I have ever seen happened while vet was injecting the spine. He literally did the entire length from base of withers to start of SI area. He started at withers and worked his way towards the rump. About halfway there (basically right under rider seat area), my horse woke up from sedation and started nickering or woofflying as vet was injecting the fluid. It was a happy kind of sound, kind of like you makw when someone rubs a sore spot on your back and you go “oooh ya right there!”. Then at the next spot he would jump when the needle went in, but as soon as vet started pushing fluid in, my boy started making that happy nicker sound. My vet said it very much sounded like he was saying “you finally found the right spot”. fwiw, vet injected both sides of spine.

Has anyone had a horse make a sound like that during injections, expecially when they were quite nicely sedated? My trainer was there also and she agreed, it was a “that feels good” sound. My vet thought maybe he hit an accupuncture spot, but my trainer and I are wondering if as the fluid went in, it pushed the spinal processes apart and that is what my boy was reacting to. Anyway just curious about others experiences.

Also would love to hear any sucess stories of treatment with long term relief and horse successfully returned to work.

Another question I had was I have heard that there is a new form of joint injection that is more of a semi-solid that stays in the joint for a much longer period and apparently greatly extends the time inbetween injections. I was wondering if that would work to help keep facet joints from making bone on bone contact?

[beowulf]

Oh no, sorry to hear about your boy’s diagnosis. That is very interesting about him making noise – it could be a release-of-tension noise. I had a horse that made similar noises during acupuncture, interestingly, when the needles were being put right under his eyelids.

What are your goals, long term, for his riding career? And do you have the x-rays, what severity did the vet describe the presence of KS as? How about a video?

My experience with KS is that you look at the horse first versus the x-rays; there is not a reliable correlation between severity of KS and presence of symptoms in clinical settings. So I let the horse tell me; some are symptomatic with barely remodeled facets – some are asymptomatic with moderate remodeling.

Osphos is a good start, but keep in mind it completely masks pain for a short amount of time… If the horse is on Osphos regularly, you will never get a clean read of whether the KS is getting worse. It will disguise deterioration/further remodeling.

I own a horse with KS, although the KS was found incidentally when we were x-raying his spine for a catastrophic fall. Vet found moderate remodeling in T5-6. I manage him very carefully, and I don’t kid myself that the KS finding is insignificant. He is my competition horse and is ridden from February to late fall – he hunts, hunterpaces, events, and does a lot of long distance trail riding – he is worked harder than the average amateur horse. He is only symptomatic in fall/winter, which coincides with the end of our working season. I inject him with mesotherapy every spring at the beginning of leg up season, and have the vet perform a routine soundness exam each visit to have a paper-trail baseline. His symptoms are not behavioral - he has never bucked or bolted - but I can tell it’s time to reevaluate when he steps away from the mounting block or starts to grind his teeth. Thankfully, this has only happened twice in the last 5 years and both times films looked unchanged but we injected with meso and gave him time off. He is very honest and stoic, so I try to evaluate each day and let him tell me when it’s time.

He has taught me there are a lot of symptoms of KS besides misbehavior - and unfortunately I think a lot of people get so wrapped up into thinking KS symptoms are obvious like rearing or bucking. There’s a lot of silent pain signals out there too – like a horse who is perpetually tense under tack, has a pinched expression when moving, or gets unsettled/unraveled if you abruptly shift your seat, or doesn’t like being blanketed, or doesn’t like being saddled, or is suspicious of any sort of object being brought along their flank. Some of these are symptoms of other issues, too – so it’s really worth knowing your horse and watching for what changes.

The things that have made the biggest difference in managing my current KS horse’s comfort is keeping him out 24/7 and keeping him shod on all four. He could go barefoot, he has fantastic feet – but I noticed some SI soreness that I think was related to posturally protecting himself. It’s not uncommon for KS horses to develop secondary issues in their SI and their suspensories, because they compensate for their KS by standing under themselves and move sorely, putting strain on their SI and suspensories. So it is always a good idea to be on top of their shoeing/trim angles. I have yet to see a clinically symptomatic KS horse that had perfect angles behind – YMMV. I am starting to be convinced that KS symptoms are significantly exacerbated by trim style.

My KS horse is ridden in a sheepskin saddle pad and one thing I really have to stay on top of is his saddle’s wool flocking. I found out he went best in a sheepskin saddle pad with a saddle with serge panels (non-leather). Something about the contact and impact absorption seems to really jive with him, but every horse is different – and I’m not sure, honestly, if it is something that would be outwardly perceptible to people who weren’t familiar with him.

I’d be curious to her of this joint injection your vet was talking about. I haven’t heard anything new yet. My vet is reserved about surgery for KS, and prefers management changes first. He didn’t feel my horse’s clinical symptoms matched the KS on film, so didn’t think he would be a good surgery candidate.

[arabiansrock]

Beowolf - thank you for all that information. That gives me hope honestly that with good maintenance my boy can still have a long useful time riding and being comfortable.

My boy has (knock on wood) never misbehaved. I’ve written about him before, when I first got him he pulled back bridling and broke his nice new bridle. So I had my vet look in the mouth more extensively. That was a nightmare in there. 2 abscessed/broken molars got removed, then 6 months later he started pulling back again so we xrayed the front teeth, and all 12 front incisors had to come out. EORTH, 4 teeth had huge calcifications on the roots that was eating at the jawbone, the other 8 had no roots left, they had just dissolved. poor boy must have been in agony. So I blamed the tight sore muscles and stiffness/lack of freedom of movement on the pain and tgrying to protect his mouth.

We had slowly gone through and started injecting all his leg joints (he was a low level jumper and I suspect his original owner was not a very skilled horseperson), and every joint we injected definitely had very degraded joint fluid for it was def needed. And each set of joints done he got a little better. Then we did the last 3 sets of joints, hind coffins, pasterns, and fetlocks (they palpated sore so I said lets just do it to make hime feel his best). RIGHT after that set of injections he had 6 days off, got his new set of shoes (he was already scheduled) and started back to work. From that first work on, he just was not right. Short striding behind but switching sometimes left, sometimes right. Not rotating well thru his shoulder in front, again switching randomly sometimes left, sometimes right. Now the farrier DID change the type of shoe he had on his hinds that day, and didn’t put on his trailers. He just got re done last week, and farrier put him back the way he has been doing him. My farrier is very careful to keep his hind angles as perfect as he can and is very careful with side to side bal also.
We tried giving him bute, another chiro visit, I even called in the animal communicator I know of. Vet was unavailable for 3 weeks so…

When vet came out I said mouth or KS. Vet said SI or neck. We both agreed SI was def sore so he injected that and came back a week later to check on him. Very slight imp rovement, so we pulled out the xray. The back xray showed several overlapping areas with tighter spaces than desired but only 2 areas with significant signs of bone lesions. But based on his reaction to the spinal injections, I think my boy is a case of he feels worse than you would think based on xrays. But he is very stoic and solid and he has never done anything under saddle no matter what to say “hey knock it off that hurts”.

I bought him to be my confidence builder. I have no idea why but about 10 years ago, I started to get fearful for no reason when riding and it got worse and worse, until I hit rock bottom one day. Got on and was too scared to ride, and too scared to get off. That was about 5 years ago. I have been battling back ever since. My boy has got me riding without fear (for the most part, some days I just have anxiety off the chart), riding alone, riding in twilight almost dark, and enjoying every moment of it. My goals for him were for me to get back to being a strong confident rider, get my seat/core solid again, and try to may be get him to 2 cd level (he is 20 so I need to be reasonable).

I use a sheepskin half pad with my boy also, although now I am thinking about trying a prolite half pad (most horses I have used them on love them) and seeing if he likes that better, or maybe a sheepskin with thinline. Unfortunately we do not have a saddle fitter in the area that I trust. Although the Antares lady has at least a couple of very happy customers that I know, so she might be worth a try. Stubben tried to sell a friend a saddle that in no way, shape, or form fit her horse. Same with Trilogy and a different horse, and there are so many arabs in my area going around in Custom saddles with big long honking panels up on their croups that I won’t even talk to that one. Oh and JRD (Mehrdad) has flooded the area with his saddles, they are literally a dime a dozen on the used market. People sell them off so fast because they just dont fit the horse and after sale support is lacking.

The serge is nice, I have a saddle with serge panels, but it was built for a round wide no wither arab. def not going to fit my boy. I would happily buy a saddle with serge panels again tho.

I did ask my vet about KS surgery. He had a one word answer NO. He has used shockwave though on KS horses and apparently had some luck with that. Reading on line it described teh typical KS horse as being fairly tall, high withers, short back, ex jumper, tb or warmblood. Bingo on all accounts.

It sounds like your boy is being very well managed if he can work that hard during the riding season and be sound. You are def doing a great job taking care of him. Hopefully you will alwasy b e able to control his discomfort and he can have a long happy career with you.

[Obsidian_Fire]

@beowulf

I inject him with mesotherapy every spring at the beginning of leg up season,

What is mesotherapy? Thanks.

[beowulf]

Mesotherapy is a series of transdermal injections — usually sarapin but not always — aimed to treat localized pain and inflammation. It’s most commonly used over the back but I have seen it used on the croup and hindquarters before too. It’s very effective in treating and stopping the pain cycle, so is often used in conjunction with other therapies (like shockwave, PEMF or acupuncture/chiro) to reduce pain and strengthen the area. I use it in the spring because he gets the winter off and we leg up every spring, so I think want to make sure he comes out of his vacation at 110%.

It is very interesting to watch, and a horses reactivity to it is usually a good indication of how much the area previously bothered them. The needles are extremely small, but you do about one hundred to three hundred injections. The horses have to be sedated because the treatment itself is not pleasant, but the results are typically very positive.

[findthedistance]

A friend’s mild KS horse was successfully managed for years with long-and-low work, bodywork (which he RESENTED but it helped noticeably), BOT products in winter, and Equioxx.

My personal horse did not turn out to be a success story, though I think that was more about additional pathologies (facet arthritis in her back, SI arthritis) than the KS. We did one meso treatment as part of the initial shotgun approach and Miss Mare tolerated it so poorly (came through the sedation) that the fancy-clinic-vet counseled against ever trying it again. Mine also strongly preferred a very wide-fitted saddle with a thick sheepskin ThinLine half pad underneath over any other fitting combination. Shockwave and fitness were the things that worked best for her.

Good luck to you! It certainly sounds like you’re pulling out all the stops for your boy. He’s lucky to have you.

[leheath]

My horse has KS. His x-rays look surprisingly bad, yet he is 100% sound, comfortable and successfully competing in eventing and dressage. He’s only had one osphos injection and no other injections or surgery. However, he is very particular about saddle fit - he had two saddles, both fitted twice by a professional, competent fitter, and he wasn’t comfortable in either of them. His KS is along the back and base of his withers (T9-12) which is more forward than most horses’ KS. He now has 2 new saddles that have a totally different design (the panels go over the shoulders rather than sit behind them) and he is very happy. He also lives out 24/7 on hilly terrain, which was a prime recommendation of my vet and made a big difference. I also do a lot of dressage work (50-66% of our rides) to maintain his topline and strength. I palpate his back after every ride to catch any problems early and he gets PEMF every 6-8 weeks.

Research has suggested shockwave with mesotherapy to be very effective for KS horses, and that is what we will try if his back causes problems in the future.

There are 2 types of KS surgery and both can be very successful, but not always (usually, it is less successful if there are multiple other issues either caused by compensation for the KS or just that were actually more active than the KS in the first place). The ligament snip is the least invasive, while the bone shave is very invasive, but either would be a last resort for me and my horse. Also remember that many vets are not particularly familiar with KS or the surgeries, so if more conservative treatment doesn’t work, and you want to consider surgery, I would definitely seek a second opinion for a KS surgeon/expert (although given his age, I’d be rather hesitant to go through surgery with him).

[NaturallyHappy]

What brand of saddle did you find that went over his shoulders?

[mdp9]

My 6 year old Eventer has grade 4 kissing spines all along the thoracic vertebrae. He is going Training level quite well. We do shockwave and mesotherapy every 5ish months, with chiropractor visits in between, and this keeps him happy. @beowulf is totally right about looking at the horse and his behavior rather than the radiographs. Some don’t complain even with pretty bad rads, others display pretty dramatic symptoms with not-so-bad rads.

Also- I flat him in the Equiband system, and we do a lot of dressage and cavalletti work to help him develop his topline.

Time will tell with my guy! But I’m optimistic. Best of luck with your horse, it really can be a manageable situation.

[leheath]

@NaturallyHappy

What brand of saddle did you find that went over his shoulders?

EQ Saddle Science - I have 2 now (jumping and dressage as we are eventers) and he loves them. They are great for me too - comfortable, put me in a good position and balance, and they offer a great feel so I think my aids go through to my horse more clearly.

[LazyA1]

I am leasing a horse with KS.

Be very careful about saddle fit. He did not like the saddle I was riding in at all. I did not know at the time he had KS. He did not like his left lead and wanted to swap off of it. I had the vet out several times and she xrayed to find mild to moderate KS right under the saddle.

My saddle seemed like it fit him and I tried various half pads.

But then I switched to an Antares, and the difference was night and day. I had injected his back about 2 weeks earlier, but the thing that made the night and day difference was the saddle switch. Problem completely resolved and he rides like an angel.

[SolarFlare]

@arabiansrock

Another question I had was I have heard that there is a new form of joint injection that is more of a semi-solid that stays in the joint for a much longer period and apparently greatly extends the time inbetween injections. I was wondering if that would work to help keep facet joints from making bone on bone contact?

I think you may be describing Noltrex or Arthramid, which are polyacrylamide hydrogels. I’ve used Noltrex very successfully in several joints. It definitely lasts longer than your standard HA/steroid injections. I haven’t used it for KS as thankfully I don’t need to deal with that. It originally was only for use in motion joints (ex. knees, fetlocks, etc) but last year-ish was also extended for use in non-motion joints. I just used it for lower hocks this year so will see how long it lasts, but so far the results have been very good.

[LadyB]

My 18 year old OTTB has KS.
Became aware of it 7 years ago after having 2 vets out with two different opinions. Ended up treating the hocks as the first vet found his KS was so mild it shouldn’t be effecting him, hence having the 2nd vet out.

Managed his KS best with a properly fitted wool flocked saddle and cranial sacral massage therapy. He absolutely hates Chiro but I do have it done every so often, but the massage therapy he seems to respond best to. Which is done every 3 months.

This past March 2021 he started showing extreme signs of resistance. Never have I felt this before, added head shaking and inverting. It was extreme. Unlike him, and disheartening. Took a month of poking and prodding as I personally didn’t think it was his back, felt it was more wither-like. Had the vet out, re-x-rayed his back. His KS progressed about 20% worse since the original 2016 x-rays. Still fairly mild, but clearly enough to cause some discomfort. His hocks are done yearly, we had done them prior to this vet appointment, which clearly did not improve his pain.

In April 2021 we did cortisone shots in 4 sections and mesotherapy. My horse feels absolutely amazing. We continued to show at Prelim this whole season. I’ve been working him long and low for warm ups and then bring him up throughout the ride.

With winter around the corner, I will blanket him a little warmer than the average horse to keep his back happy. He will get a heating pad prior to a ride. I am a little concerned as his issues always seem to rise in March every year. I’ve tried more work, I’ve tried less work, I’ve tried being ahead and injection prior. We will see what happens this March, he will be 19 next year, so we’ll see!

As for supplements, he is on a joint supplement. I do red light therapy when I can, which I personally find beneficial.

[arabiansrock]

Just a quick update on my boy. Vet injected the spinal facets almost 3 weeks ago and gave osphos at the same time. He had a week and a half of just turn out then started back with light riding. He is def improved under saddle, however it is def not a miracle in terms of changing his movement. He is even front and back and much more willing to go. He has a little more suspension than he did before. I suspect there will continue to be small improvements as he starts to get his back topline stronger now that he is not in pain. What is MUCH improved however is his general attitude. He acts like a 10 yr old now. Lets go!!! I wanna buck and play!!! He even tried to take off with me five min into my first ride on him. There was a “LITTLE” and I mean little, noise and he thought it was a good excuse to try something. Luckily I was able to just shut it down and ride on and he was fine the rest of the time. But before he would never even have tried it.

I have ordered a joint supplement for him that pretty much has everything including the kitchen sink in it, so will see if that helps also. It is just good to see him feeling so much more comfortable.

[LadyB]

Curious, how are his feet angles? This can play a big role as well on his comfort. If not done right, it will cause more pressure on his KS.

[arabiansrock]

LadyB, feet angles are very good, my farrier works with my vet to make sure all his “special” cases are getting what they need. I dread the day he retires, hopefully it won’t be anytime soon!

My boy continues to improve in his movement behind, he is pushing more and nicely willing to move forward. I suspect I will need to have vet inject his lower cervical vertebrae once I get the back paid off. Now that he is good behind trainer is noticing he is not moving as fluidly in front as he should, and vet did find arthritic changes on c5-7 but he did not want to inject at same time as spine because he wanted to see what kind of improvements and where the spinal injections brought.

Thank you everyone for your kind thoughts and ideas! I will report back as Buddy moves thru this journey.