Update - WWYD - PPE findings on young OTTB

Hey all - posting this in eventing since folks probably have more OTTB experience in this group.

I’ve been on the hunt for 3 months now for a horse. Show hunter, up to 3’ (though 2’6" is fine), quiet brain and nice balanced canter.

I’ve vetted two, both of whom had red flag issues for jumping (navicular bone cysts and advanced knee arthritis as a 4yo).

I found another one who I REALLY liked. Has such a gorgeous canter, fun to ride, light, balanced, sweet on the ground, all the things.

On an initial PPE that someone did before I could try him, they found some Grade 2 Kissing Spine. The back was only X-rayed because the potential buyer was buying for resale - horse did not palpate on the clinical exam. Horse had an otherwise “excellent” clinical from a very picky vet at a high level local practice. Vet was bummed about the findings b/c the horse was so nice and they knew their client’s business partner had zero tolerance for it in resales.

Now here’s where I’m at - I only X-ray the back if it palpates on clinic and/or the vet suspects something on the ridden examination, because I know so many have asymptomatic KS. So if I had done the first PPE, I most likely would not have found it. But, now I know and I can’t unknow.

Every horse is going to have something. Vets I’ve consulted have all been ranging from “I think this can be managed for the job you want it to do, it’s a nice horse,” (this was the vet who performed the PPE who I spoke with) to " All KS has a high degree of risk and you just need to decide if you’re willing to take the chance on an unproven horse" to “Sclerosis of the bone in research hasn’t been correlated with increased pain.” (he has space between all dorsal processes but some sclerosis in 4 places.

I can’t help but picture the scenario where I pass on this horse, find one I like but not as much and he doesn’t palpate on his back and passes the rest of the PPE, and then two years later he’s diagnosed with KS anyways and has it even worse than this one.

Would you investigate further, maybe get a chiro vet out to assess biomechanics/back health? Walk away now?

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Looking at the x-rays, I would pass because the KS were there, minimal, but the whole back shape as indicated there, can be conductive to KS, maybe ending up being a progressing problem.
How about another set of x-rays to confirm these, horse may have been standing funny.
It may not be affecting horse now, but under hard work and down the years, it may, may is the word.

Sorry, as some BNT used to say, “don’t buy trouble”.

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I view kissing spines as a symptom of something else. Generally unbalanced feet or hind end weakness causing said horse to not carry themselves correctly. Or horse never learning to use itself correctly can be added.

With that said, horses are a crapshoot. Horse can have the most perfect X-rays and break a leg running in the pasture as soon as you bring them home.

If horse is doing the job at the workload you want with zero issues, I’d buy the horse vs X-rays, zero issues.

If the horse isn’t doing the job currently, I’d make sure I had the budget to retire said horse if symptoms showed up, especially make sure you would emotionally be ok if you can only afford a single horse.

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If you know how to ride correctly, keep the horse on the aids with a lifted back vs. upside down against the hand, I’d buy the horse. I think like ulcers, most horses have it to some degree, “on paper”. But if asymptomatic, that is your biggest tell. We had an OTTB at my barn that 2 university specialists said were the worst case of KS they’d ever seen on film. They didn’t know how the horse was standing, let alone eventing successfully. He was asymptomatic and didn’t palpate.

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Is the horse currently sound and doing the job you want him for? If so I’d consider buying him if your vet is on board. If you’re shopping for a prospect that’s riskier, I’d probably pass myself.

Either way I wouldn’t bother paying for additional diagnostics. You have the information you need, you just have to figure out how much risk you’re willing to take.

KS is not a given - there are plenty of horses out there with clean back rads. Don’t buy this horse just because you might have to deal with KS anyway - decide if KS is something you’re comfortable with or not and then move forward accordingly.

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Yes, I was just going to post about the feet and what are the feet like.

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Feet are barefoot but probably need shoes - typical OTTB feet but not the worst I’ve seen. Tested positive on the front heels but not hind. He actually uses and carries himself quite well at the canter which is one reason I’m so interested in him - lovely long natural stride with suspension and flat kneed movement. Trot is a bit of a work in progress but once he’s goign forward it’s lovely.

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How do I say this nicely? If you are a lightweight, short rider and so is anyone else who might be on this horse regularly then I’d consider it. If you are not- then no.

I personally think one of the reasons we are seeing more symptomatic KS is that riders are much larger and heavier than they were in the past. Fox hunters were traditionally classified by weight carrying ability for a reason. I’m 6’ tall so it’s something I am very aware of for myself.

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Before there were portable Xrays that could get spine films lots of horses performed with KS. If you really like the horse and the horse is currently non symptomatic, I would make an offer. The value of this horse plummeted when those xrays were taken. Properly managed, many horses with KS can have good careers. It is a risk but he could do a suspensory the first day of turnout in his new home too. Good luck!

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It wouldn’t bother me if asymptomatic. I’ve known many horses with KS competing at the top of the sport.

There’s no harm in getting a second opinion. It’s inexpensive. If I were you, I’d seek that opinion from a vet/practice that is very used to looking at racehorse exams. Remember that lateral x-rays don’t always give you a perfect idea of what you’re dealing with. Something can look pretty much ok in a radiograph from the side and still cause problems. It’s not like an MRI.

When you’re asking a vet to predict future symptoms, the best they can do is give you their opinion based on their experience. I had three opinions on my horse’s knee radiographs before I purchased. One vet said “it is what it is”, another said that it would be devastating, and a third gave me a plan of what he’d do if this were his horse (which was turnout and lightwork before rechecking the images in 6months). All three were great vets who were giving me the best medical opinion they could. Everything looked significantly improved at that recheck. The thought that I may have passed this horse up is scary. You have to be comfortable with your choice though.

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Palpating is not a reliable indicator whatsoever that the horse is pain free. I own a KS horse who will not palpate despite it hurting him.

Where are the affected processes and how old is this horse? You would get more meaningful answers with that provided. There have been studies that show correlation between location, number of processes affected, and horse’s usability in riding careers.

Some palpate, but most don’t. The disease has to be progressed/unaddressed for them to palpate sore.

The more experience I have with KS, the more I realize there are no asymptomatic KS horses. There are just KS horses who hide their pain well. Most KS horses don’t even buck or bolt. Their symptoms are other things, like difficult to keep in contact, not enjoying dressage, becoming unraveled after a trip or jump, etc. Sometimes you find the KS incidentally when addressing a secondary complication like strained SI or suspensory.

KS progesses. In moderate cases it compromises the entire body, not just the back. It’s a lifetime of careful management and therapies at best. Young horses with KS can show little clinical pain. My experience is it’s not until the horse is 8-12 that the KS begins to interfere with their career.

My horse’s KS is moderate. I’m able to ride him. We are one of the outliers and I’m grateful for every day I have with this horse. His therapies are mesotherapy and injections every year. His management is very controlled - no stalling whatsoever, shoes on all four even though he grows great hoof (shoes help KS horses), and I’m careful what I ask of him. While I would not trade him for anything, I also recognize that most horses and people are not so lucky and they have to PTS or retire their friend over this disease.

My KS horse is expensive. He costs nearly three times what my mare costs a year to feed, treat, shoe, and care for. In a world where horse keeping is becoming more expensive, that’s a big consideration.

If I had to rehome or sell my horses, it would be difficult to rehome the KS horse. I’d probably. His rads aren’t objectively terrible but most buyers are terrified of clinical findings of KS. He’s expensive to keep. The trade off is he’s wonderful and honest, but his KS needs to be routinely managed for him to be comfortable. There’s the ethics question of if he even should be ridden, which I ask myself often.

There are surgeries for the disease with varying success, but keep in mind KS is “systemic” in that by the time there are treatable symptoms of this disease, it’s progressed to the point its negatively impacted other structures in the horse’s body, like their suspensories and stifles. For this reason, it is very common for owners of KS horses to struggle with PSD or other suspensory issues on top of the back. Shockwave is very beneficial and proven to help.

There is a FB group called Horses With Kissing Spines. I invite anyone unfamiliar with the disease to join it:
https://www.facebook.com/groups/101279456709105

One more thing I remembered - there was a study done on KS and soundness in future careers. AFAIK, once there were more than four or five affected processes the horse’s prognosis for sport declined. I’m sorry, I’m mobile now - but if I remember when I get on desktop I’ll drop the link. It was very informative.

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In fairness of the origin of KS — Race horses are ridden by the lightest class of riders in the world and come off the track with KS

KS is genetic. Some horses may develop it with hard or improper work, but they have to have the propensity to develop it genetically first.

To be clear KS is represented well in almost every breed for riding and driving. All modern breeds probably had a shared ancestor that had it. Maybe KS is what made those horses first tamed in the steppes easier to catch.

There is merit in keeping under a specific weight for your horse, though. I do that for my KS horse as well. I try to keep everything on him under 175lb. You’d be surprised how quickly pounds add up with eventing gear and a saddle. Even the bridle adds 5 pounds.

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It is but racehorses in the US are generally ridden upside down and inverted which is also vv bad. Once you have the bad conformation or the beginnings of arthritis? any extra weight, especially a rider that cannot consistently keep the horse stretching long through the neck and up in the back, is just additional stress on the spine. You rarely hear about a horse or pony with a lightweight child rider having back pain after all!

I ride a fair number of horses for other people and it boggles my mind that people will ask me to get on their 15hh horse with fine bone, a bad back and arthritic joints. At my height it’s impossible to keep everything under 150lbs, which is what those smaller, older horses need. Most of them need< 110lbs.

A certain amount of weight bearing strengthens, too much overwhelms.

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OP, everything beowulf said, and then some.
I have an OTTB mare, vetted clean clean clean. I’ve had her 6 years. I had one decent year on her, and after that it all went to hell.
NPA behind. SI pain. KS. Thousands of dollars spent to keep her rideable. I have done every single last thing that is available to me. At our last vet appt, 3 weeks ago, we did new rads of her hocks - to find they are fusing! W.T.F. She’s never had hock issues… and now this.
When I bought her, I thought I knew all the things to look for. Boy have I gotten a whole new education in that.

My advice… walk away. This horse you are thinking about isn’t even doing what you want yet. Oh, and you said they aren’t touching but are ‘just’ sclerotic? So is my mare. Same thing.
For the thousands you will spend keeping this horse “sound enough”, you can find something better.

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For reference, this is the area in question.

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That’s fairly significant. How old is this horse?

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Nope nope nope. I have one with similar X-rays - he was fine until age 9ish, when it started to catch up to him. He went from a very nice moving horse to… not that. Perhaps if I’d been better educated I could’ve gotten ahead of it with expensive therapies on the regular, but if I’d been better educated I wouldn’t have bought him.

If this horse is 12, 13, 14 years old and currently doing the 3’ job (and had been consistently for years) when they had this vet finding, maybe it would be worth the risk. But if he’s young, green, or unproven I really wouldn’t do it.

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Race horses everywhere are ridden that way. It’s not US specific. There’s no study correlating that inversion to KS. There are studies showing that inversion and hyperflexion does lead to cervical arthritis, though.

I agree with your other points about weight concerns on a compromised horse, but just wanted to say that KS isn’t the fault of ‘fluffier’ amateurs. This is not a comment on your character in specific Amberley, but I see this sentiment thrown all over the internet and it does a huge disservice to the riders who are left holding the reins on a broken horse. Those riders are usually not pros, who are more likely to muscle a horse into working so it can be resold, or pros who are good at ‘holding’ the horse together and disguising any problems. In most cases these horses had KS the entire time they were in a pro’s barn, but the pro was a great rider and chalked it up to greenness, lack of strength, etc. Then an amateur buys the horse, and concerned for the horse’s welfare, start investigating when the wheels come off. While they may discover clinical arthritis, by the time it is visible on x-ray the horse has been dealing with that KS for years.

It starts on a genetic level. Blaming the amateurs absolves breeders of the blame of continually breeding horses with devastating genetic disorders that the fat, overweight amateurs have to pay for.

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I am going to chime in from the perspective of somebody who medically and scientifically studies spine.

KS is not anything new. For it to become a recent genetic phenomena it would have had to go back 50 or more generations. It is more likely that KS has always existed and is simply the latest “disease du jour” in vet medicine simply because vets can image the spine that they could not 20 years ago. There as still a massive lack of research in equine spine compared to human, and in human we STILL don’t know what a “normal” spine is. The most simple classification system that exists is Roussely and there a 6 distinctly different spine types.

Thus, I ascribe to if the horse is sound and shows no issues, KS on rads doesn’t mean anything. You don’t ride the rads. As a sports surgeon once said, “If I did surgery on the rads, very few top athletes would be able to play.” Given they are part of the medical team here who are the team doctors to 4 pro sports teams (Super Bowl, Stanley Cup, World Series winners) and 3 universities, I realized how right they are. It is too easy to want to point to a single thing and say “yes” or “no” but that is not how biology, physiology, and medicine work.

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It can have a genetic component, but while they have found one gene that can predispose a horse to having worse grades of KS, there hasn’t been any other genetic connection found that’s been statistically significant.

It can also have a working component, but there also isn’t a statistically significant correlation b/w working a horse vs not working one.

As far as the rads, no vet has given it above Grade 2 (out of 4). One vet gave it a Grade 1, and one vet said that since there are technically no touching DSPs, it’s not KS at all. So it’s not as severe as some folks might be thinking.

I think I’ll move forward with getting the chiro out and maybe take some another X-ray of that spot with the horse in a better position to compare, and go from there. It’s also possible of course that I’ll get to a good spot on the KS piece (which I think I’m almost there) and he’ll have a chip in his knee when I get those images taken. So who knows.

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