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UPDATE now it’s hoof/suspensory/stifles. Holy kissing spine Batman!

Those who have done a KS rehab - either just the conservative route or surgery, what did your rehab routine look like?

Long story as short as possible here - pony has been out of work due to moving back and forth across the country, work schedule, and lack of saddle. Had some concerns about his feet and am currently chasing fixing them with the new farrier (we JUST suddenly moved back to the south so everything is still in the early phases). I also have some concerns about his back besides general weakness, he’s got these two “bumps” on his spine as well as nonspecific back soreness. I want to start getting him back into shape to see what is simple weakness vs something more, but I want to do it right.

Thing is, I’m a bit short on diagnostic cash at the moment - I ultimately want X-rays of his feet and back but with moving and higher board the spare change just isn’t here yet. So, I’ve been researching the “back to work” protocol for a suspected kissing spine diagnosis. I figure that even with a dx, cash for the surgery will be a while coming so I’d be trying the conservative approach in the meantime anyways. All I’m finding is “lots of long and low to build topline” but nothing specific otherwise. This is a horse coming out of the pasture with zero fitness.

I’d love to hear what y’all did!

My vet provided me with a 6 week rehab program for KS, with each week including 3-5 days of work. For all the lunging exercises below, it is suggested they are done in side reins or a pessoa rig. I bought an Equiband system to use as well. In addition, I am to be doing “dynamic mobilization exercises” - this includes back lifts, carrot stretches, etc. I personally am not even going to try and ride her until end of week 6 (or longer) because this has been an ongoing problem for years and will require serious rehab. Before this rehab begun I also got her back injected and shockwaved to hopefully kickstart the progress.

Week 1 + 2:

  • 20 minutes total. Introduce walking/trotting over 1-2 ground poles. Basic lateral work in hand (leg
    yield), spiral in/out at trot on the lunge.

Week 3 + 4:

  • 30 minutes total. Exercises can be done in combination of lunging/pessoa and
    ridden work (including trot poles under saddle).
  • Continue with pole exercises (2-3 poles in a row and add elevated poles 8”) and
    basic lateral work at the walk and trot.
  • Lazy bending lines (3 loop serpentines, whole arena figure 8s) are ok

Week 5:

  • Total time 30-40 minutes. Continue with pole exercises. Increase use of lateral work and
    small circles. Lazy bending lines (3 loop serpentines, whole arena figure 8s) are ok.
  • Introduce canter work on the lunge line focusing on canter-trot transitions

Week 6:

  • Total time 30-40 minutes. Continue working canter on the lunge line along with the
    other exercises. Ridden work should reflect a normal walk/trot school.
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Thanks so much!! This is exactly what I was looking for. Something tangible I can do in the meantime. Can’t hurt, might help!

If you do a search on here for Equiband, I think you’ll find some helpful comments also.

Yes I have the Equiband system! I will definitely search through those results though to see if anything I missed pops up

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So, pony has had a few sessions of hand walking and light lunging in the Equibands (no riding - haven’t sat on him since November) and he looks decent, not tracking up or really moving out though. He’s let me groom and curry him (didn’t before), the mouthiness is 75% gone.
That is, until today. Nippy, very angry at the curry on his neck and chest. We just had a cold snap and he’s had his blanket on (which I think he hasn’t in a bit). That seems like a correlation to me - but he’s still been backsore and not working as well as I know he can.
So I called the vet. He will be here Thursday to take some rads and do a work up. Fingers crossed for a diagnosis and good prognosis (and for my bank account to survive).

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My pony is also nippy in that area when she has been wearing a blanket :frowning: She associates it with the blanket being pulled up her shoulders/withers to fasten at the front. I 100% think its connected to her back soreness. Interested to hear how the vet appt goes!

Huh, interesting. He’s never been a fan of the blankets but I have many different styles (high neck, closed front, gussets and leg arch styles), and I always make sure to put the blanket on his neck and pull it back, not up. But he’s boarded and there’s a lot of different staff so who knows what they do. Also in the winter before we moved he lived in layered blankets 24/7. I wonder if that’s contributing to his general stiffness - but I have no idea how to help!

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I am also super careful about how I put a blanket on her but regardless she gets very grumpy about it. Might just be soreness from how it sits when its on her, I have always suspected something going on in her withers. I also had an ulcer-y horse that was very blanket cranky.

One exercise given to me by a DVM/Chiro/LMT person was a “walking turn on the forehand”. A TOF is a useful tool to loosen up the hips, in stepping under they must engage the abdominals in order to get the hind leg under the belly. By walking thru it - bringing the outside shoulder around and the outside foreleg crossing over the inside, while the hind is stepping under/over, creates a whole body (cross body) stretch. It has been extremely helpful in getting my mare looser. The circle needs to be rather small.
I also use a version of this over poles, altho on a larger circle. My mare has a habit of forgetting her hind legs. Using poles while bending, she has to “remember” (lol) her hind end.
Also trot poles - right now they aren’t spaced as far apart as an actual trot stride (for this horse) but a little closer together. A smart walk, or a thoughtful trot stride is how I describe the distance. Anyway, at a walk, she needs to reach out to get over each pole. I needed a minimum of 4 to get her to truly pay attention and get benefit from the exercise. Once she learned to “hunt” the pole at the walk (think trail horse class) I asked for a trot. When I spaced them for an actual trot stride what I found was she wasn’t strong enough to stride that big while keeping a correct body posture. Shortening that distance has allowed her to learn to go over correctly. I’m gradually increasing the distance between poles as she gets stronger. This I am doing from the ground. In the saddle I only walk poles.

I bought these books and have found them very helpful: https://www.amazon.com/gp/product/1570768048/ref=ppx_yo_dt_b_asin_title_o04_s00?ie=UTF8&psc=1
https://www.amazon.com/gp/product/1570769389/ref=ppx_yo_dt_b_asin_title_o03_s00?ie=UTF8&psc=1
https://www.amazon.com/gp/product/1570769788/ref=ppx_yo_dt_b_asin_title_o02_s00?ie=UTF8&psc=1
https://www.amazon.com/gp/product/1570767998/ref=ppx_yo_dt_b_asin_title_o02_s00?ie=UTF8&psc=1
https://www.amazon.com/gp/product/1570767211/ref=ppx_yo_dt_b_asin_title_o01_s01?ie=UTF8&psc=1

Hopefully the links work.

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You know, I used to do TOF with my jumper at the suggestion of his chiro. Someone seems to have done natural horsemanship style lunging with this guy so he “yields” his hind end at Mach 3 (and drives me bonkers with the slam on the brakes and turn in on the lunge) so I haven’t done it lately with this one. I may try again.
Poles are on the list too - I’ll have to try that set-up!
I got the core conditioning book for Christmas but haven’t devoted a ton of time so maybe I’ll start taking that to work to dig through on breaks - can’t wait to see my coworkers’ faces :joy:

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Teach him to walk forward and bring the shoulder across when he does this. Infinitely more useful as a body work tool than doing it the NH way. Mine was taught same thing. Slowing waaaaaay down and asking her to come in towards me (a really big no no in her book) while bring that outside foreleg around has helped.

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Vet came today. This vet is new to me but not the barn, and works really well with our farrier. He did a lameness exam and

  1. Back palpated SORE SORE. Vet commented “yeah he’s not just being a sensitive baby that HURTS”
  2. Right hock flexed off 3/5. Not loading that side nearly as much as the other, even just at the walk.
  3. Bare hinds are definitely footsore (plan is and has been to put hinds on next week when he’s due).

Took 3 back rads, 2 of the bad hock, and lateral views of all 4 feet.

Hoo buddy we have 6, maybe 7 places where his spinal processes are either super close or touching, definitely some remodeling on most of them. We also have two spots of mild-moderate arthritis in the hock, and both fronts had either negative or 0 palmar angles. One worse than the other. Both hinds are 0-maybe 2 degrees angles as well.

I’ll post pics of the rads but yikes. Poor guy. I haven’t been pushing him or working him hard but I know he’s been hurting!

Here’s a link to the rads. Scroll down for more. I THINK I have the rights and lefts correct :joy:

Treatment plan is to put him on Previcox and Robaxin for a while, get the hinds on, put him to work and reevaluate in a couple weeks. Sent the front rads to the farrier and will ask him to take the toes way back and get breakover set back. No wedges but might do pads.

Vet will be back out in a few weeks and I may inject the hock then. I also have been given pricing and a quick overview of mesotherapy and shockwave for the kissing spine. No mention of surgical options but I’m not sure I’d want to go down that road either. For now, we will be lunging and hand walking in the EquiCore, and I’m getting him trained on the treadmill to hopefully start doing that 2-3 times a week.
Vet says I can ride and just said “work him” but he’s so sore I don’t want to get on him at this time. Maybe the meds will help, and I’ll reevaluate riding then. Stretches, mobility exercises and lots of walking are the plan for now.

(Edited: spelling)

You’ve got L and R backwards, at least on the fronts—there are little markers on there from the vet that say L or R.

He’s definitely got a lot going on! I think it’s a good plan to stay off of him for now. Correct the feet, address the hock, and work on the strengthening and posture changes from the ground for a bit and see if that helps his back.

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Thanks! Fixed those. When they send me the rads in my email I’ll know which is which for the hinds.

Yeah I’m not getting on him for a while. I’ve got a lot to process though - I’m already stretched pretty thin just paying board here (the care is fantastic and the facilities are top notch) so now staring at some expensive therapies and not a lot of extra money. I’m not upset at the findings, more just relieved to know what’s going on, but it’s still disappointing to know this horse might not be rideable.

He’s got a forever home with me as long as I can afford it - somewhere - but I do miss actually riding and bopping around the local circuit.

So as far as the KS goes, you know that core strength, topline, and posture will help. There is an inexpensive way to help with this, although treadmill work and the Equicore are great tools. Properly executed carrot stretches…several repetitions, daily If possible, especially the forward bending with straight legs, have been shown to increase cross sectional area of the multifidus muscle that supports the spine. The study involved a lot of these exercises but the horses were otherwise laid up.

I might be inclined to space out the shockwave and/or meso until after you have made progress with the feet. It should be more cost effective that way assuming you’d like to avoid a lot of repeat treatments. Because his posture won’t be great until those angles are corrected, and neither therapy is very long lasting. They will help break the pain cycle he is in—but his feet can’t put him right back into it or you’ve gotten nowhere. Robaxin is pretty inexpensive in comparison and could provide some relief in the meantime and help with the stretches.

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I personally had zero luck with meso. Shockwave was great, but as IPEsq said above it’s not long lasting. It just gave my horse a “boost” into being able to do the hard work. Glad you at least got some answers!

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Oh I remember reading that study. That’s a great reminder! I’ll go find it again to see exactly what/how many/how long they did the stretches. He LOVES his carrot stretches but I’ll admit I often am not a stickler for doing them right (I let him get sloppy. And he leads with his teeth :roll_eyes:, I might need bigger treats), all of which obviously doesn’t help. I’ll have to be more careful about them.

I plan to have the farrier reset him, and I’ll try to get before and after photos. Maybe retake rads after a few cycles. I have pics of the old farrier’s work and… not great. Farrier before that was worse (couldn’t get him out more than every 6,7,8 weeks, and other general geometry issues). I just like documentation.

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