My suspicion is that this is a case of two different radiographic techniques. If the beam is not correctly aligned you can either create an image of something that appears to be kissing spine or you can miss kissing spine because the beam alignment passes thought the processes so they look separated. An un-anthesitized horse is a bitch to keep perfectly aligned and different radiologist (techs) have different methods.
As one who served as an expert witness in medical device failure, including the need to read x-rays, this case is fairly easy to dismiss if the same vertebra were x-rayed and labeled correctly.
Since starting this thread I have had two additional 3rd party vets review all xrays. The vertebrae where the Kissing spine is apparent is simply missing from my original views. To be clear, this isn’t the case of two or even three vertebrae that are “close” or “almost touching.” There are 5 total vertebrae with arthritic changes that have already developed. Both vets said that when xraying for kissing spine that they would have taken the view I am missing.
To the person who asked about leasing. The horse is showing no signs currently (no lameness, no pain), but he only just turned 4 in april. He was started right before I bought him, I have since had him in training working on steering, going forward, pole work, and small cross rails. He’s young, big, and extraordinarily talented. It’s not exactly a lease situation, and he hasn’t been pushed or tried enough to know if it will ever bother him. The thing is I wouldn’t have bought the horse to begin with if this rad was taken, because it’s not a matter of a couple of close vertebrae. The Rad itself is not good. Really not good.
So your x-rays show something but there is nothing wrong with the horse? This happens in people too- x-rays or an MRI look horrible, but person is fine/no pain.
For the legal part- I agree with what G said - but also- did you have a contract/agreement in writing? If you paid bill at the time of service and now are charging that improper images were taken or are missing, why was that not brought up at the time of the PPE and the bill disputed?
For medical part- how has horse been ridden or worked since you have had him? KS is degenerative and I am not sure how long it takes for changes on x-rays to show.
Found this article on The Horse- so maybe the x-rays are not as meaningful with regard to pain/lameness. Idk. I am in insurance and do know that the longer a person waits to assert an allegation, the harder it is to prove and the more questions there are as to why was this not disputed at the time? Not sure where your case will go or if you have one…
Radiography — Denoix was one of the first researchers who didn’t use general anesthesia in radiographing the equine spine. “Under general anesthesia,” he said, “you have to put the horse down, and control anesthesia and recovery. This increases time and cost. X rays in the standing horse began at Alfort (the veterinary school at Alfort is the parent university of CIRALE).”
Denoix had the strong feeling that back pain and injuries don’t necessarily result from injury to the superficial surface of the spinal vertebrae, as many practitioners believed, but that clinical signs of back injuries are caused by lesions deep within the spine.
With computerized radiography at the Center, Denoix is able to view X rays immediately after capturing them, changing the exposure and resolution so that certain areas of the vertebral column can be seen in the most advantageous way. It is not uncommon to see Denoix showing a horse owner a radiograph of the horse’s back, while illustrating with specimens how two vertebrae should fit together and how they are abnormal in the owner’s horse. CIRALE has a complete spinal column in the radiograph viewing room, which is used for illustration with clients and students.
You really can argue it either way (which is why we have the court system!!!).
While yes, a lay person is not trained to read an x-ray and you should TRUST your vet that you are hiring to do the job you ask them to do – but at the same time, the client needs to ASK QUESTIONS. If you don’t understand what you are looking at, you have to ask. If you wanted a full set of the entire back, then I would have the vet go through it, piece by piece, of what part is where so I can be confident I did indeed get x-rays of the entire back.
From what you have described, I do feel like you have a case against the original vet, but that doesn’t always mean you would win. If you specifically asked them to check for kissing spine and they most likely missed it…
I am not a vet. I am not an attorney. I am an extremely infrequent purchaser of horses and therefore not a consumer of or participant in many pre-purchase exams.
But. I have over the years tried to learn a bit about horse anatomy, and I have looked at radiographs of horses with kissing spine. I have an impression of how many vertebrae/ribs form the spinal column of a horse and how they connect together. If I had seen OP’s original set of rads, I might have been savvy enough to realize that “the part in the middle” was not pictured. OP did not pick up on that, but she shouldn’t have needed to - she asked for a full set of back xrays and thought she had gotten them. At the time of the PPE, she probably should have had a known and trusted vet review the rads in which case the omission likely would have been caught. Chalk that up to another hard lesson from the great teacher of almost all things horse-related, Hindsight.
I think the fact that the PPE vet does not have an image of the area of greatest concern based on palpation is highly suspicious - as well as his discounting the mid-back as an area of likely kissing spine when the horse palpated sore in that area. Something smells rotten. It’s one of those situations where intuition strongly suggests something is wrong, but whether it’s worth making an effort to take it as far as a malpractice action is another thing entirely.
As I sit here typing this in tears (again), I did ask questions. I stared at the radiographs and asked if he was sure the horse didn’t have kissing spine. I asked him if he thought he would have potential to have kissing spine because he was so big and so young. He said there was good spacing in the vertebrae and the back looked good.
I bought the horse as an investment. Now I know all of the risks that go with an investment horse, and have done this many times over pluses and minuses. The horse hasn’t been tested enough to know if it will bother him. He’s 4, and he’s hardly been under saddle 6 months. When the jumps get to 3’ or 3’3 or 3’6, then we’ll know, and I’ll be tens of thousands of dollars in to him (more) by that point. And as you said it’s degenerative, so it will just get worse.
At this point there have been a total of 5 vets look at the rad with the kissing spine. None of them have a good outlook for what they see. None of them think this appeared in the last 6 months. 5 vertebrae with arthritic changes. Sure it may never bother him but he will also never get past a ppe exam.
I was following along with very little skepticism until the above. If you do this often and had a horse with kissing spine prior to this one, why were you not a little more skeptical of the PPE vet’s rads or findings? I get that you are not a vet, and it’s not your job nor area of expertise to read rads, but I would have expected a little more healthy skepticism if you weren’t using a vet known to you for the PPE.
Whether or not you pursue any legal recourse, I hope that you can find a situation for the horse that suits his capabilities and that he will have a long and successful career.
I think its pretty hard to sue for malpractice.
You would have to prove that the vet knew and mis-advised you. From what im understanding you asked for full back xrays to rule out kissing spines, your vet has then radiographed the areas of the back he understands to be common for kissing spines, showed you the films and everyone has carried on.
You had opportunity at that stage to ask why there were missing films.
By your own admission there was no sign of impingement on the films he took, so therefore nothing to alert the vet to investigate further.
It seems like a case of everyone was doing what they thought was right and have missed the issue.
This happens a lot BTW, unfortunately PPE arent really great for picking up some issues, and a quick squizz through here shows all the undiagnosed issues available to vets in the first place.
The vet may settle with you to avoid the publicity, but I would be surprised if you could win this case.
My understanding is the new PPE has picked up the KS due to palpating sore in the area, this is the OP selling the horse.
The origional PPE from the OP buying the horse is where the missing rads are, and no indication that the horse palpated sore then, in fact im quite sure he didnt or OP likely wouldnt have bought him going on her previous experience
Apparently the OP thought the sore part of the back was done. I don’t know how many rads it takes to do a whole back but I would assume three and would have asked, what parts of the back the images were showing if there were only two films.
OP I think this might be an expensive lesson learned for you.
your attorney will be able to evaluate the strength of your position. Keep in mind— as far as the law is concerned, as far as the court will be concerned—it is not “common knowledge” for anyone to know horse skeletal anatomy or read xrays, or know what constitutes a set of xrays representing such—this is why we hire professionally trained / passed their boards vets to provide us this specialized service. You can think of it as a bit like OJ Simpson and “if the glove doesn’t fit you must aquit”…sort of. We all know he did it right? But the bloody glove wouldn’t go on his hand. You aren’y a trained vet—you don’t know what the inside of a horse or xrays look like even if you’ve had the 50 years… From a legal standpoint— this is why we hire vets, doctors etc. To tell us things they are specially trained in and we are not. Things that require 4 years of professional post grad education and board exams to be able to provide a service for.
Law looks at horses themselves as property worth a dollar amount. And your expenses incurred as a result of someone elses’ negligence.
Your attorney will have to advise based on the evidence at hand/privy but-- I find usually it settles best with a monetary figure that adequately compensates you for your costs, the cost of the “damaged” horse, the fees, legal fees…tally it up to a fair figure you are willing to live with vs. what it’ll be to duke it out in court. The costs of duking it out are what everyone is afraid of and will leverage. The other party often flatly stone walls hoping you will die on the vine via attrition. This is where the weight of your evidence will need to be very good—do other experts state that the PPE xrays and locations fall within what is accepted given the horses presenting back pain and your request to fully xray or not. If other expert vets say uh no??? this is not the norm given symptoms of the horse and client specific request for exam/xray—then I think you have pretty good leverage to try to get them to settle out of court. If other experts say yeah this is normal…that tells you you may be SOL.
You will have to decide with your attorney what the cost to pursue will be vs. potential gains—and I strongly suspect a out of court settlement/negotiated solution will be the most attractive.
Realistically, it may be too much to expect full recoup of your losses/expense, given the prickliness of this being horses. I would think carefully what you could live with to at least dent your losses without risking/ spending great deal more and coming away disappointed. There is likely a dollar amount that vet will pay (if you have good supporting evidence for your side) —to pay you to just go away and sign a non disclosure. And you and your attorney may need to be ballsy enough to put it to them up front . —but of course, your attorney will advise you as they feel is best.
Nothing ventured nothing gained. You can be certain of one thing, not pursing more info/ exploration at this point is assured zero compensation. Looking into this, maybe putting a dollar amount to them to settle is at least 50/50 shot at some compensation! LOL Your attorney will advise you best though.
Negotiated settlement is my gut instinct here. …But I am not a attorney! Just a all around hustler in horse biz LOL
As stated above, I sat there and asked the vet after the rads were taken if there was any indication of kissing spine and what the risk was of potential future development. I did everything I knew to protect myself at the time. It didn’t work, clearly. I seriously and honestly thought that I had seen the entire spine, I had no reason to think otherwise. This was my second set of spinal rads to review with a vet ever. The first was a single rad where the horse palpated sore, not the entire back, so I really had no comparison.
But I had no idea they were missing, at all. FWIW this evening I spoke with a Kissing spine expert. He stated that the PPE vet was vastly misinformed as 99% of Kissing spine occurs where this horse has his. Which makes it even worse for me. I feel sick.
Yes, I thought the part of the back that palpated was sore was radiographed. I asked for the whole back to be done, I asked afterward if anything was amiss, was told it was not.
Id take the 99% with a grain of salt, ive seen plenty have them towards the sacrum, and less but still have seen a few up behind the withers.
And because ive seen so many of them, I am extremely wary of a sore back, IME 99% of those have an underlying physical issue.
I would have handled it differently based purely on my own experiences (nothing with a sore back would be considered for a start) so its hard for me to imagine your position, but i really hope you get some resolution.
Its a crappy position to be in.
I had a friend sucessfully sue for malpractice after she was informed by the vet to Euth a warmblood that severed an exttensor tendon, they were specifically told there was zero chance of recovery. However its a different situation as they were wronly informed of something the vet knew of, in your case, the vet also didnt know, so the best you have got is him not providing a service you asked for and thats still going to be arguable.
edit Actually sorry, my friend settled out of court in the end, but it went pretty far to get to that point
What are the damages you or the horse has suffered? That will need to be proven. Duty owed, breech of duty, breech is the proximate cause, damages incurred. This appears to be a poorly executed PPE but I’m not sure you have a legal argument for recoverable damages. Let us know what you find out. Sorry this has to happen.
I believe everything you say regarding your (lack of) experience with xrays of the equine spine. It’s another hindsight thing, but it’s too bad you didn’t ask the vet to specifically show you the vertebrae in the area where the horse palpated sore. In this case, it certainly seems the vet doing the PPE for you was either grossly ignorant re kissing spine or deliberately omitted (or deleted?) the most critical view.
What surprises me is that someone who purchases horses with the intent of reselling them doesn’t have an on-going relationship with a vet that you would automatically ask for a second opinion on any xrays that any other PPE vet took. I understand that some experienced people who buy projects for resale often don’t do a lot of rads unless something seems suspicious - but if you’ve been doing this for a while and not had previous occasion to wish you had gotten a second opinion, I think you’ve been pretty lucky.
Well, presumably the first investment (purchase), the training and board for the last year, and lost profit on the sale. I think that’s the easy part to demonstrate.
The hard part will be whether the fact that the vet obviously sucks is enough to sue for malpractice. I agree that it’s worth trying - the OP asked to rule out a specific problem, the vet did not use his medical knowledge properly to do that - whether it was because he is not experienced enough, or because he deliberately didn’t xray part of the back. Advised the client that the xrays ruled out the problem, which led to the purchase of the horse.
The other question will be whether the settlement - even if she wins - is enough to go forward, and/or cover her loss(es).
I hope so. Well, this is a good lesson for any of us reading too. Definitely work with a vet you trust, even if it means incurring additional costs to have the PPE vet send all records to your “home” vet.
