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Long term management for kissing spine/back pain - what works for your horse?

Eventing
#1

(Posting here because I am an eventer, but will try Horse Care forum as well)

Hi all,

I have a 10 y.o. TB gelding eventing at the Prelim level who has mild to moderate kissing spine. He was diagnosed when he was seven, and we have been experimenting with different treatments and techniques to keep him comfortable, with a huge focus on conditioning and strength and topline development, in addition to injections and Robaxin as needed (I’m lucky to work with two great trainers and a fantastic sporthorse vet). Overall, he manages quite well, and we have been able to compete with it for the most part. However, he does still get sore from time to time, so I am trying to work out the best plan to make sure he stays comfortable. He’s a pretty stoic horse so I don’t always get warning signs until his pain is quite bad (as just happened recently, two days before an event, of course!)

So, for those of you working with horses with a similar condition, what do you do? Regular injections, or only as needed? Alternative therapies (shockwave, FES, tildren/osphos, anything else)? Particular conditioning schedules or riding programs that seem to work well? Obviously I also have my saddles regularly checked.

I should add that I have been very clear with my vet that I will not ask this horse to do something that is beyond his physical limits. We are both in agreement that right now it is worth continuing to manage him so that he can compete comfortably at this level (and hopefully beyond) but will call it when the time is right. I also know there are tons of threads on kissing spine, but I’m curious specifically about long term maintenance of a horse who can be made comfortable enough to compete, and if there are new therapies/treatments that others are using.

Thank you!

#2

I am just chiming in to say I’m following, as I am going through a similar thing. For mine, I am taking it one day at a time. He is also very stoic, and I have not competed him yet this year. For him, keeping on top of saddle fit and the angle of his feet is incredibly important. My farrier went through a rough time and it affected the quality of his trims - I let it slide for too long and it really affected my horse’s comfort. Too long toes and underrun heels exacerbates their soreness in the back. A lot of people I’ve spoken to do a regime of mesotherapy (6mo to once a year) with shockwave and/or injections. Working-wise, pole-work, lunging in pessoa-type work, and lots of hills. Keeping on top of their shape and encouraging true work across the topline is (as I’m sure you know) encouraged. I’ve done and seen robaxin/estrone used to help build muscle for proper carriage.

So far a lot of people I have spoken to have opted for a new horse if their goals are competing… isn’t something you can really fix, even with the snip surgery. It sounds callous, I know, but it isn’t something that gets better. I wish you the best of luck.

#3

It must be in the water up here in Massachusetts :no: Beowulf and I have talked at length.

I’m just chiming in because my OTTB was recently (March 30th 2017) diagnosed with KS as well. I am interested in seeing how others have successfully managed the condition in the long term

So far, we have done back injections, added shoes (he was barefoot when diagnosed), plus 6 weeks of Robaxin. I also changed saddles from a 2005 Butet (which was really bugging him far more than I realized) to a 2014 CWD with Pro-panels. So far the Robaxin and saddle change seem to have made the most difference. And I have been lunging in the Pessoa or in Vienna reins.

I have watched a lot of the Art2Ride stuff online to understand what kind of stretch I should be looking for. I also reached out to Kristen Rozycki who events her mare Phyllis (recently featured in COTH and by the RRP) at the Advanced level. Kristen was super helpful and nice to take the time to respond to a random internet stranger (me) who reached out to her for suggestions.

Here is the link to the article on Kristen and Phyllis on RRP. The feature on them starts on Page 2 of the PDF.
http://www.retiredracehorseproject.o…TTBinsport.pdf

Edited to add the COTH link:
http://www.chronofhorse.com/article/full-circle-defied-the-odds-with-kristen-rozycki

1 Like
#4

You have to find what works best for your horse. Some respond well to shockwave, others acupuncture or injections. In working…it is really important to have a strong topline. I did a lot of work out of the saddle either longlining or lunging in a de Gogue (see here http://www.doversaddlery.com/de-gogue/p/X1-30059/) It really puts them in a nice long and long work…which is what you want. I might try a pessoa system (http://www.doversaddlery.com/pessoa-training-system/p/X1-3026/) as I have heard from a few how well it works.

Good luck! I did do the new surgery on one horse…and if your horse is a candidate, do recommend it.

#5

Thanks, all. I tried mesotherapy for the first time when he got treated for this latest bout of pain last night, so really interested to see how that works. I do lunge in a Pessoa regularly, which I find very helpful.

Beowulf, not to be a stalker, but do I remember you as being the person with a Say Florida Sandy son, and is this the one with KS? This is my SFS baby - do wonder how much of this is genetic (I’m sure it is, just an interesting connection!)

#6

Lady B, that sounds like my horse almost to a T! He (usually) comes out swinging for the first several events of the season, falls apart in July/August (physically) and then I get him feeling good for the end of the season. I’ve always chalked it up to different things (he also is a poor sweater and very sensitive to bugs, so the summer is really rough on him in generally). This is the first season where we’ve missed the early part of the season, as his pain reared up (no pun intended) quite early, but I think this may have been an acute “tweak” from one bad step, as he went from good to bad literally overnight. I do wonder if the summer issues are because (a) the ground gets harder, and that can manifest itself in the back, like Beowulf said, and/or (b) our training regimen changes to more gallops/jump schools and less lunging/flatwork over his back than in the off-season. These animals are so tricky, but when it comes together, it is all worth it!

1 Like
#7

100% think the ground and more work causes a lot of it, which the banamine can help.

I used to think I was the problem, not him. My coach never thought it was anything else, so we kept pushing. I feel bad looking back now. But it’s hindsight. He never showed serious signs, to me at least. It’ll be interesting to see how this season goes, knowing that I need to be more aware of his back.

#8

Lady B, that’s such a tough one. I’ve been there too. I know that if I ride like I’m protecting my horse, I don’t give him the positive ride he needs. I’ve made up my mind that I need to be 100% certain that he feels good before I leave the box, or I scratch. I’ve also learned to trust my gut (much through trial and error). I know him well enough, and know now that “flukes” aren’t flukes. It really sucks, and I feel like every time I think I have it figured out, I learn something new.

#9

Story of my life! Just when you think you’ve got it all figured out, something happens to make you question it. I’ve had my guy 10 years, and I’m am insanely in-tune with him. I can tell when he’s NQR and most people say ride through it but I don’t. I know it’s not him and it’s not right. Although he’s also NOT text book when it comes to injuries or other small things. Any bumps or blemishes seem to always need a vet call because I wait and they never get better. In the end he’s always ok and knock on wood he’s pretty damn stoic!

#10

LadyB,
Happy to share my experience. The hocks and the back (and even the SI) all inter-relate in terms of performance. Hocks support the through-ness required of the back. So it’s hard to pinpoint a diagnosis and not throw the book at them. I have found that as soon as you know something is NQR to address it with whatever seems to help your horse. There is no magic formula for that … only you can tell what makes him feel good and by experimenting. Clearly Banamine is part of that equation from what you mentioned. IMHO, stopping at jumps seems more like a hock issue but I am no vet. You have the good data of knowing that he needs a break toward August so I would simply plan on that.

I have a 14-year-old OTTB competing at Prelim/CIC*. Perfectly sound but had some minor lower back/SI issues when I got him 3 years ago, and because I was moving him up and placing more demands on him I took this approach over time:

  1. Saddle fit.
  2. Acupuncture/chiro with occasional Robaxin and bute. No longer needs this per se as I replaced with maintenance myofascial bodywork after the acupuncture got the initial stuff dealt with.
  3. Amazing farrier who also put pads on the front because ground can get quite hard.
  4. Lots of cross-training and in different (but good) footing – agree with other posters that lunging can make a huge difference. The more they round their backs, the more they release the pressure and use their core to support the work. I lunge with elastic side reins and try to get him really forward. Sculpt that topline all the way through the tube in the neck.
  5. Back injections every 6 months in lumbar region between L 3/4 and L4/5 with triacinolone and methylpred; sarapin gets injected in epaxial muscles L and R. Translation: Basically Traumeel and sarapin with some steroids (the good news about steroids here is that because you are not injecting into cartilage, there is no degeneration risk as there would be if you injected steroids into a joint like the hocks).
  6. If I feel him getting sore from collected work, I go out in a big field and do long and low canter in half-seat to loosen the back. Lots of hacking, roading, some trot poles and some hills.
  7. Belly lifts, occasional Previcox.

At one point I did inject the SI and hocks (along with the back) to aid in strengthening the muscles around and through the back and to support the CIC* prep. Right now he gets myofascial body work every month or so. I wouldn’t even say he has kissing spine because like yours it is so minor – I would wager that many of us have places in our backs with less space between the vertebra than others. The whole horse is a system that works together and it takes time to find the collection of maintenance routines that work for your horse. Some like Adequan and Legend for overall functioning which isn’t a bad idea for these guys as they get older. Always the question of where the money drain goes! If I had the cash I would redo all the injections and throw Adequan and Legend in there on a regular basis.

Hope that helps and good luck!

2 Likes
#11
  1. Adequan every other Sunday.
  2. Custom Antares Saddles
  3. Robaxin (5 2xday)
  4. 1 degree pads
  5. Previcox as needed
  6. Turmeric – 2 Tbs per day.
  7. Legend as needed
  8. Chiro as needed

And I never hack her out under saddle. She gets ponied for fitness and hills. She feels great. Her kissing spine is a result of having been born very windswept with a real wave in the spine. Considerate warmup is key as well, always thinking about what stretches the topline makes her feel better.

Good luck!

1 Like
#12

that’s so weird, my KS horse also got worse (and was diagnosed) around august (also happen to be more work). i attributed it to less turnout time (12+ hours to ~4 hours per day).

not much help on the treatment front, i tried time off, osphos, 2 different chiros, massage and decided to basically retire her to live in a pasture with the occasional trail ride.

#13

@flaxenmane Very fitting, my guy is 14 and I’m attempting Prelim for a 2nd year. I definitely think it’s more his hocks then his back, but they are all connected and of course they all work together.

I took him off a joint supplement for all of one month and put him on Pentosan, but he has one knee that fills up when the weather gets muddy. It was so large, after I took him off the Triacta HA and switched to the Pentosan, it was shocking. I put him back on the Triacta and it took a little bit but his knee is back down. His knee does not bother him, and I will not drain it because there is no irritation and draining it, the fluid most likely comes back. But there is little to none right now because of his awesome joint supplement.

I want to inject his hocks, but they are quite costly. Obviously you do what you can, he gets massages, and I don’t jump a lot, as I don’t feel he needs to, with his age, he knows his job.

I’ve had chiro work done, but felt there was nothing beneficial to him with it. I find massages are more beneficial to him.

I have 2 fitted saddles for him, that are checked twice a year. He’s never moved better, he used to sit down when I first got him, crazy! I’ve had him for 10 years now… so I feel like I know him very well.

I spray Sore no More on his back and hocks every so often, no clue if it actually does anything, but I like to help him out any way I can. I have ice boots for after xc as well. Hoping all these little things will help.

We’ll see how this year goes now that we know he goes wonky in August.

#14

My situation is a little different but similar- my gelding wasn’t diagnosed with kissing spine per say, but had vertebrae in danger of collapsing on each other due to a supraspinous ligament tear.

To treat the tear, we did shockwave, mesotherapy, robaxin, and a careful rehab schedule with a Pessoa system. The shockwave helped tremendously. Now, I manage with Back on Track, carrot stretches, belly lifts, chiro, Robaxin as needed, and try to ride off his back as much as possible/only do short stints of full seat at the canter or sitting trot when he’s not as fit as he should be.

He’s also got a longer back and straighter hocks, + dealing with bringing his heels back up right now, so those contribute too. I have a custom Black Country saddle + a full sheepskin Thinline, but have toyed with trying other half pads. The Back on Track pad + Thinline seems to be the best combo for him that I’ve found, although I don’t use a BOT if it’s too hot.

Has anyone found a therapeutic saddle pad that CAN be used in warmer temps? (Rambo Ionic, Draper Therapies?)

#15

My chiro just put my guy on Previcox which we will start next week.

#16

Hey all - reviving this thread for an update, in case it is helpful for others. About one month out from the latest flare-up, and injections, mesotherapy and osphos seem to have taken care of the most acute pain, but he still is NQR, jumping and on the flat. Talked to my vet again and she brought up the snip surgery. She said she was skeptical of it at first but has now seen several horses come through it quite well with no limitations post rehab. She doesn’t think it is the answer for all horses, but thinks my guy could be a good candidate. In any case, we’ll do a bone scan and then see what the surgeon says. I’ve done some reading on the new procedure and am intrigued by the results.

1 Like
#17

Did you end up doing it?

#18

I have one that has been competing for five years (now 17) at prelim since the initial diagnosis. I use the Equicore system 1-2 times a week, do lots of stretching in the warmup, and have used shock wave in the past, although she doesn’t currently need it. She has a run attached to her stall and also goes on the Eurocizer for two short sessions a day, I think that really helps keeps her looser. I do hillwork and have her on Equithrive. I also use a Sedelogic pad. No one believes she’s 17.

1 Like
#19

So my story ended up having an interesting turn. Went in for the bone scan (with a plan for surgery immediately after) and while noticeably sore on palpation, horse didn’t show any active remodeling in any portion of his spine. Vet (who is top sport horse vet) told me that while he has close vertebrae, he wouldn’t call it a case of true “kissing spine” without remodeling, and that really a bone scan is the only true way to diagnose (as opposed to x-rays, which is what I’d been going off of). Ended up ultrasounding spine and finding two lesions, one on supraspinous ligament at about T16 (right behind saddle) and one on the dorsal-sacral ligament over the SI. So, while the symptoms pointed me in the right direction, it turned out to be a soft tissue injury.

Horse was rehabbed successfully over the course of nearly a year, with shockwave treatments and a lunging only (with a Pessoa, per vet’s orders) exercise program until healing had progressed enough to carry weight again. I still manage his back carefully with proper work, exercise, saddle fitting, robaxin as needed, etc.

I’m thankful I didn’t need to do the surgery, but based on what I learned about it at the time, I would have done it had that been the issue.

2 Likes
#20

What an amazing update, thanks! And congrats!

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