Update p98: E/Se normal, trying sucralfate. Kissing spine and neck issues - a thread

[fivestrideline]

@LadyB

What is the degree of your horses KS?

Here are the X-rays from when I got the diagnosis ~2 years ago:

Update on the OSPHOS/prednisolone regime: I think he’s less back sore! I usually test it by using my Posture Prep curry on either side of his spine from withers to croup. Today he was reactive (dropping/tilting the pelvis forward) for the first pass on the right, though less than before. The second and third pass on the right were MUCH less reactive, and no reaction on the left at all. That’s something! He’s still not “sound”, and I haven’t done any other tests, but that’s an improvement in my mind.

[DMK]

I don’t want to rain on your parade, but I went through a deterioration with my early retiree starting at about 5 and culminating somewhere around 7. My suspicion was somewhere in the neck, although he did constantly present as backsore. But the fact that even a surcingle caused him to be girthy and reactive made me feel there was more than just the back going on (this was before kissing spine sx). We threw everything at him in a last ditch attempt, osphos, mesotherapy, neck injections and back injections over the course of 10 days. And for 4 months he was amazing. I was shocked at how much the suspension in his trot had slowly deteriorated without me noticing it, because even without the suspension he was a hack winner.

And then just like that it wore off, and he was worse than before. I gave him a couple months off to see if that would change anything and the last two times I worked him were disastrous. Day one was me lunging him with the tack on. He took about 8,000 steps to go 50 yd to get to the arena and then just did that horrible girthy walk trot and canter. He finally loosened up a little bit when he was cantering to the right and then he heard a noise in the woods and lifted his head. Not in spook or alarm but just general interest, and went from zero to bronc in one step. I truly believe that it was like an electric shock, and that was the moment I realized that this horse had no intention or control over when he would bronc, and he would kill me one day. The next day I took him out and just tacked him up in the arena just to finish on a different/good note. As soon as I slightly tightened the girth he buckled down and then reared up and buckled and reared a couple times, and then fell over. I made him get up so I could safely remove the tack and that was both the first time he did that in his entire life, and the last time he’s had tack on him!

But, to put a happy end on the story, if that hadn’t happened, I’d probably still be slogging along in the hunters and instead I pivoted and moved to combined driving and I’ve never enjoyed myself so much as when I made that change. So I like to think that these things happen for a reason

[LadyB]

His is very minor, we were shocked he was as reactive as he was. And still is at times.

For years we didn’t do anything with his actual back but massage and chiro. When he started showing more uncomfortable signs in 2021, we re-x-rayed and there was minimal change. We opted to Inject with Cortisone and Mesotherapy instead of the surgery since he was already 18. Still rocking at 21 and eventing at Training level.

[fivestrideline]

Update on this guy:

He’s been off the pred for almost a week. We have noticed a big improvement in his attitude and movement! He’s still back sore, but maybe a bit less?

In general he has been sharky to people in his space (not dangerous, but you wouldn’t want a kid or non-horseperson handling him), as well as a bit of a tyrant in turnout. Since the OSPHOS and pred, he’s actually been a bit snuggly, and we saw him doing some mutual grooming with his pasture mate for the first time! He’s still The Boss, but I did see him cantering around the pasture yesterday with far more reach and push than his usual “bunny hop” style.

I’m cautiously hopeful that we may have found something to make him more comfortable. My money is on it being the OSPHOS, but I’m also not sure what I was looking for the prednisolone to do.

Older pic of the chunky boy - he really doesn’t look like he should be as NQR as he is…

[IPEsq]

Neck and back problems tend to love steroids. Which is I assume why your vet wanted to do the trial?

[2tempe]

Re the Pred - I have a horse diagnosed with cervical arthritis (mild changes upper neck, moderate in lower neck) and resulting spinal compression. Neuro symptoms - mostly tripping. He was retired after diagnosis, shoes pulled and out with a buddy 12 hrs/day. We put him on a permanent low dose of Pred - after starting high and working down. The belief was that it will provide general inflammation help. Understand there are risks to this long term, but better a few years of feeling realtively ok. Its been quite helpful - he still trips some but generally seems physically comfortable.

[fivestrideline]

Oh good to know! Yeah I know about OSPHOS but wasn’t familiar with pred. I need to call my vet for an update chat on him anyway, but they didn’t give me a ton of info on the pred and what to expect!

[IPEsq]

It’s kind of like doing a Bute trial, only it’s usually longer with loading and tapering. And a different kind of anti-inflammatory. So if there is improvement, usually means there was some inflammation that it helped relieve. When you have a lot of problems, you can’t go injecting steroids everywhere. Pred is fairly low risk and gives you a broader effect. You can also do something like that as part of the legging up process for a horse with back or neck pain to help them unlearn associated negative behaviors because of the broader pain relief. For neck and back stuff, NSAIDs aren’t all that effective, but steroids can be.

[2tempe]

Yes, good description and why we skipped injections!
That all said, and I presume this would be obvious, but you wont be horse-showing on this…

[fivestrideline]

I won’t be riding the horse at all actually - he’s incredibly backsore even now

[beowulf]

People do show on Osphos/Tildren - whether or not it is ethical or not is another story. I think it’s a wonderful short-term pain management tool, but as other posters mentioned, it’s not appropriate long-term.

My gelding with neck issues did fantastic on the prednisolone, until he didn’t. He also hated the chiro - I think this is common for symptomatic neck problems. Your guy’s condition looks great and I agree for his level of pain he sure looks in great condition… I’ve seen enough neck cases now that I think chronic neck pain has a very specific muscle wastage “tell” sometimes.

It sounds like something pain related was addressed by the Osphos + steroid combo since you mentioned his behavior has become sweeter. It sure would be easier if they could talk, wouldn’t it? I really hope you get some solid answers; did you hear anything yet from your vet about what they expected the steroids to address? Refresh my memory, do you have ultrasounds on hand for the neck? I was shocked when I saw the degree of bone spurs in one of my horse’s necks - injections made all the difference for him.

[fivestrideline]

@beowulf

Refresh my memory, do you have ultrasounds on hand for the neck?

Just X-rays. He has, at the least, narrowing spaces. Likely congenital but not so bad that it’s obviously The Problem!

I can ultrasound his neck once my bank account recovers

ETA: it’s the neurological part that’s the scariest. If you cross his front legs, he just stands there. He also failed the walking downhill with his head up and blindfolded - ironically the blindfold didn’t change anything but he still “failed” it.

[IPEsq]

It sounds like the narrowing has become a problem if he’s having those neuro deficits.

[fivestrideline]

I agree. Hence why he’s not being ridden 🫠

I’m not sure what I will do going forward. I’ll talk to the vet, but it’s a question of comfort at this point. Clearly something was bothering him, but if you run your hands down his spine he still drops. He’s letting his BFF groom him all along his spine though so… who knows!

[2tempe]

@beowulf

My gelding with neck issues did fantastic on the prednisolone, until he didn’t.

@beowulf - can you tell me a bit more - ie how long was he on it and then what changed? My horse is roughly 8 months into this. My vet is doing periodic bloodwork, and I she mentioned some risk of laminitis

[SBrentnall]

Have you done the ECVM series of C6 - T1? These sound like stereotypical ECVM symptoms. I’m attaching the PDF of the specific angles to take, in case you haven’t already done them.Ros et al_2023-.pdf (12.8 MB)

If it does turn out to be ECVM, my horse was massively improved by daily 10,000 IU doses of Vitamin E.

[fivestrideline]

No, I haven’t. Field X-rays and a vet who doesn’t do them often - while it might be ECVM, at this point I don’t know if that would change my treatment plan.

He’s on 2500IU E, plus what’s in his feed. I could trial 10,000 IU, but honestly I’m not sure it’s in the budget for him long term. I could definitely do a month, maybe two. How long did it take your horse to show a difference?

[rockymouse]

@SBrenthall, I can’t say thanks enough for sending me down the ECVM rabbit hole this afternoon. My mare was not quite right in attitude and body for most of her life, a weird constellation of behaviors that could not be reliably replicated for vets. She had KS surgery in 2022, which somewhat improved matters, but did not eradicate it all. My vet and others - especially post surgery - thought that I was a timid owner with a mare that had my number. Yet all along, I knew they were wrong. My husband believed me. Reading about ECVM, she exhibited every one of the behaviors that is listed. Every one. I feel vindicated.

We lost her in June. She suddenly developed pemphigus foliaceus and we euthanized her. I wonder now if one begat the other somehow.

I love COTH.

[IPEsq]

So sorry for your loss @rockymouse. I’ve been totally gaslit by vets and trainers and people who just felt the need to tell me their unsolicited opinions when I have dealt with neck and back stuff. Things like ECVM we now know to be pretty common. I think we have unintentionally bred for it. And some vets will swear up and down it has no clinical significance. Not all horses are affected the same way, and some horses do live with it just fine, and some can perform at a high level. But you can’t just ignore the symptoms when they are staring you in the face either. You could say a lot of the same things about KS. It’s so sad when we have to go through this as owners. Sad for us. More sad for the horse. Hugs to you.

[rockymouse]

Oh, thank you for your kind thoughts and words. I read aloud the ECVM signs to my husband and we talked it out - he, who is not natively horsey, said, Well, now we know we did absolutely everything we could for her. Which we did know, anyway, but this really sent it home to us. Regardless of her difficulties, we gave her a great life.

My country vet is great at treating colics or abscesses and palpating cows. I’m grateful to him, but, candidly, I’m the one who figured out her ulcers, who thought something was going on with the mare globally, who insisted she must have KS (and she did), who said that the mare jumping clear out of her skin when her tail brushed her hocks was not a gap in training or my own timidity. I also figured out the pemphigus foliaceus at the end. Hopefully the vet’s gonna be more keyed in now. Maybe that’s why the mare and I were put in his path - to be his teachers, in part.

Thanks again.