Talk to me about your results of coming back from proximal suspensory injuries and/or kissing spine and what your rehab process looked like…
My guy was recently diagnosed with kissing spine which we are dealing with day by day, AND two suspensory injuries - one in each hind leg. After ultrasounds and x rays, our vet believes that the suspensory came from overcompensating for his back. He has received PRP and shockwave for them. In the left hind, the issue is acute but the right hind is chronic. For the KS, he has received a set of injections and was put on bute for the first week. The pain has returned in the back and we are now looking into surgery.
I could definitely use some advice as I am anxious and wearing thin from this whole process. sigh
The challenge here is you have one issue requiring more rest (suspensories) and another issue requiring a fitness plan (kissing spines). And of course, that fitness plan needs to be one where he can quit the compensatory patterns that led to the ligament issues in the first place.
I’d be not very optimistic, but I would plan to take it very, very slowly. Do you have access to a water treadmill?
Boy, that’s definitely tough because as IPEsq said, one benefits from work, the other from rest. But I would assume that surgery for the KS would require some rest, so there’s that.
How bad are the suspensory issues? Many of them which are not too bad benefit right away from controlled walking, and that would also benefit the KS issue when you get to that point. Walking and walking some more, using poles to encourage a head down/back up posture, even ground driving and encouraging a very forward down and out back lifted position, will help the entire body.
But it all comes down to the severity of everything.
As others said you have 2 problems with opposite solutions…you can help alleviate some of the discomfort in his back with massage, stretches, linament(sore no more stew…just apply LIBERALLY and put a turnout sheet on over it, keep that back extea warm, folded human blankets or throws work if too warm to cover the rest of his body), back on track sheet, roboxin, previcox, a chinese supplement called Body Sore. Serve hay off the ground/floor if at all possible. Let him move as much as the suspensories will allow,tranq the snoot out of him for turnout hand walk ground drive what ever vet allows. You will have to get creative, best of luck. Try to enjoy nice long therapeutic grooming sessions. Dealing with a similar situation KS and fetlock joint bleed, so i totally sympathise and offer some hope about how much just getting your hands on his back and all those other things above you can do with him hardly moving can help. I would ask about banamine rather than bute.
Are you in the PSD Discussion group on Facebook? Lots of good info there, including discussion of how PSD and KS are often related to/exacerbated by NPA in the hind feet (so def want to radiograph those).
Check your horse’s feet. The more clinically diagnosed KS I witness, the more I see a correlation between poor hoof angles/NPA and suspensory involvement, as well as more clinical KS signs.
Check out the KS groups on FB. It is unfortunately common for horses with clinical signs of KS to have PSD. Imbalanced hooves make everything worse.
Thanks so much! I’ll check up on his feet angles. Vet and farrier didn’t seem to think this was contributing factor but I need to ask more questions about this for sure…
Just hopping in to say I have a KS horse, with lameness behind, that popped a suspensory. Four vets and three farriers (we moved states) all were unconcerned about his feet in general and in relation to the issues, promoting injections/shockwave/surgery. If I posted his feet and rads, anyone with a basic understanding of geometry and anatomy would be AGHAST. I had to learn all that as we went, while being told I was worrying about the wrong thing.
I posted pics of my horse’s feet here when I started to wonder and got some great info and questions to ask. I’m now working with a vet and farrier team that are treating the whole horse, and also pretty sure the years of poor trimming + TB conformation caused our issues. Fingers crossed that once we have good feet and rehabbed the soft tissues, the KS may not even be an issue outside of needing a particularly well fitted saddle.
This seems to be a very common story, and closely mirrors mine. Super fancy sports medicine specialist kept thinking it was KS, since you can see the mild impingement on radiographs, and the horse presented as back sore. Seems straightforward enough, right? Not so fast. We treated with steroids, shockwave, and physical therapy, which helped some, but every time I’d start to put her back in “real” (i.e., collected, upper level work) she get uncomfortable a few weeks later (I now know it’s because the suspensories would rest while we were doing PT, then get inflamed again after a few weeks of work).
All this time we knew the hind feet were NPA, but multiple vets weren’t that concerned about it. Eventually, I realized it wasn’t the back (or at least, not only the back), got a second opinion, and we found the PSD. Vets are still not that concerned about the NPA (which has improved over the last year, but I’m still hoping for more angle), but current sports vet at least hears me when I say the mare’s comfort changes dramatically when wedged up, so she’s deferring to me on the shoe front. But there is so much contradictory info about how to fix NPA, and even though everyone has “the best farrier”, most of them are AWFUL and are willing to let the horses walk on the bulbs of their feet with toes a mile long. (For what it’s worth, I’m in a similar boat to FiveStrideLine - I think once the feet & suspensories are resolved, I’m pretty sure the KS will be a non-issue.)
My advice to the OP: get rads of the hind feet, at the very least. Then don’t hesitate to get a second opinion - you can get one from any large hospital’s podiatry department remotely if needed, because chances are your vets will say the NPA you will probably find is not a big deal. But your horse will probably disagree.
Good luck. It’s like the wild west out there as far as opinions go, and you will be the only one who cares about your horse as much as you. It’s a journey, for sure.
Re: hoof balance, it is so frustrating that more vets don’t key in on this. I had a new, well-reputed soundness vet out for a checkup recently. He dismissed my concerns about negative plantar angles by saying that a CSU study had shown they don’t cause lameness. I was like hmm interesting so I went looking and found this: https://pubmed.ncbi.nlm.nih.gov/30472759/
So yeah that type of study can’t prove causation but it certainly found a correlation! Not super confidence-inspiring.
Another thing I seem to hear fairly often is that increasing plantar angle only puts more strain on the suspensories. Which may be true at a certain point, but doesn’t seem like a good excuse to let the angle stay negative.
