Thank you, RAyers, I was hoping you would chime in. 
Practical and straightforward as always!
9 Likes
FWIW, my trainer doesn’t even x-ray backs at this point when doing PPEs on OTTBs. She had one running 2* before they figured out he had KS and finding that was incidental to something else. Trainer had to sell him for personal reasons and he’s kicking around as a hunt horse now.
My horse (also an OTTB) had back soreness and we imaged both his neck and back only to find absolutely no issues with the bone (apparently he has great vertebral spacing). His soreness was actually due to having significant NPA in his hind feet and the soreness (and his suspensory issues) went away when we corrected that. NPA would honestly be my primary concern with an otherwise asymptomatic KS horse because I’ve seen it cause so many other problems in so many horses and it definitely isn’t conducive to managing KS.
10 Likes
Plenty of fluffy pros out there too. But even if you do not consider people who are overweight- humans are getting taller, stronger, bigger in developed countries with almost every generation. Better nutrition and improved health care means the current generation is much taller, therefore overall larger, than their great-grandparents were. I don’t think there is an older junior at my barn shorter than 5’8". The one boy is 6’2".
3 Likes
Grade 2 would be moderate. These rads lean towards moderate to severe. With four processes affected and significant remodeling, I’m surprised at the cavalier attitude of your vet. It may be your vet is looking at it from the experience that KS is treatable – which it is. But it’s not cheap and it’s not curable, and you only have so many years of Osphos or Tildren or Mesotherapy and chiro before those therapies do nothing at all.
It sounds like you really like this horse and want positive affirmations. Remember that human spines cannot be compared to quadruped spines and what we ask of riding horses. We thankfully do not have to carry around 1200lb of meat on the equivalent of a poorly designed suspension bridge!
Rads like the one you posted are not typically asymptomatic. I say this with hands-on and clinical experience. Two things impact prognosis: location, and number of affected processes. T14-15-16 are most common. Five or more affected processes have a negative impact on long-term positive prognosis. KS presentation in the wither and lumbar has a poorer prognosis than thoracic.
The KS horse I own now only has two affected processes and his remodeling is less severe – he’s 15. If I saw these rads on a younger horse I would likely walk. Every horse is different. Some horses are more stoic than others, especially ex-racers. If you decide to move forward with this horse, I agree with others that your first start will be making sure the feet are balanced. KS horses do not seem to tolerate poor farriery.
This is your journey and your money, just go into it prepared that you will likely have to go above and beyond in terms of management this entire horse’s life. If you are like me, you will always second guess and question if what you ask is fair of the horse.
I am happy to share with you what has worked and what hasn’t with the KS horses I’ve managed - including my current one. That would probably be a topic for another thread, though.
19 Likes
That would be a Hard No for me, with no second thoughts. Factoring in the horse’s age, cost of treatment, cost of feeling like you’re walking on eggshells for the whole time you’re riding him, and that it appears that there has already been remodeling… I just couldn’t do it.
16 Likes
They aren’t. But that also means there is just about fuck all or research and the work done so far is absolutely insufficient to make the claims you are. There are no 20 year outcomes studies for treatments. There are no GWAS studies on genetic factors. There are only insignificant samples that imply something.
Even you are using your own anecdotal experience as some form of definitive explanation without any sort of statistical analyses.
The reality is we went hundreds of years riding sound horses with KS but we will never know because there was no capability to do the imagining or even what is the definition of KS.
I much more appreciate lackadaisical attitude providers have because it means they are looking at the actual physical capability of the horse. We see tons of athletes/military/normal humans with blown backs and they still have no pain while we have heathy folks with no radiologic evidence in debilitating pain. Again, if we made judgment on the rads the malpractice would be astounding.
19 Likes
I would not describe any of the vets I’ve consulted as cavalier - They are all partners or founders of some of the top practices in their area, which is why I’ve sought their opinions out, which were not provided for free. So I will take their assessments over yours of the clinical findings.
5 Likes
Huh? There is research on KS being genetic. There is also research on treatment and prognosis. I referenced my knowledge of that research in my post[s].
You are right I am using my experience as an example. However, here is where you and I are different.
I am putting my money where my mouth is and I am bankrolling someone else’s KS horse for the rest of his life, early retirement and all.
It’s not a bad thing to warn people of this reality. I have put my competitive aspirations on hold. This is very common with KS horses, if you would only bother to listen to the people who actually own a horse with KS and have actual experience caring for horses with the disease.
In any event, good luck @AAHunterGal - I get the very clear message that I am not sharing what you want to hear, therefore my input is unwelcome. Best of luck, I do hope he works out for you. It’s the best possible outcome for me to be wrong.
22 Likes
Here are the studies I referenced in my post, @RAyers:
Research finds KS is genetic:
Research on therapies and prognosis:
It’s a lot to read. Dig in. 
14 Likes
Soooo…the first study is the one that I mentioned, where they found a gene that predicts potential severity of a horse that might be homozygous for it, but that is not the same thing as genetics always playing a role.
The rest of the studies make cases that argue more against your point than for - the majority of the horses in those studies make a full return to work, with most of the rest of the horses at least improved. The only study I didn’t take a close look at was the Malaysian study, because I’m not keeping my horse in Malaysia and don’t ride/train in Malaysia so it doesn’t apply to my situation.
The first study in particular: “Four thousand four hundred seven horses were evaluated for lameness or poor performance between February 1, 2004, and January 31, 2011. Back pain was identified on clinical examination in 310 horses (7%). Two hundred twelve of the 310 horses (68%) were diagnosed with kissing spines. Seventy horses that had never shown any signs of back pain had their backs radiographed, of which 27 had overriding spinous processes (39%).”
That says to me that if 39% of horses they radiographed with no back pain had KS, if you extrapolate that to the remaining 3700 horses in the study (it’s said that 35% of ALL horses most likely have it), then about 1400 horses in the study probably had KS clinically but showed no symptoms. This to me is more statistically significant than the 212 horses with back pain who DID have KS.
There is also a chart in there that shows of the horses who presented with back pain between the ages of 6-10, the majority of them did NOT have KS. The only age groups where back pain + KS was represented to be showing more often than not was those 5& under and those over 16.
Look, I’m not trying to get into a pissing match with you. I’m just saying that, to me, this research does not present a doom & gloom outlook.
12 Likes
I bought a green 3 year old, by age 6 he was unsound and unrideable and despite numerous, expensive interventions including surgery, still not sound - he is now 10. So I too am heartbreakingly funding the retirement of a horse I adored and hoped would fulfill all my wildest athletic aspirations (3’, stuff of wildest dreams!). He had a truly lovely canter too.
Numerous amateurs that I know have unrideable or questionably rideable KS horses - I also believe they are never actually asymptomatic. I will never get a KS horse again.
ETA I was less than 120lbs when I bought him, and he was around 16h, so. I’m definitely not too heavy in any way.
10 Likes
I’m amazed you read and digested the full length of the study in 15 minutes.
You are right that there is a positive correlation in the study after therapies, but the study is quick to point out several therapies didn’t work and a multi-faceted approach is necessary for optimum return to work. I look forward to a follow up study in 5-10 years time to see if any of those horses are still in work. 
I only provided a handful of studies. There’s many more out there, including one that tracks prognosis and combined therapies in TBs and STBs. It’s up to you to do the work finding them.
Something to consider with many studies and anecdotes is, we all know everyone’s interpretation of sound is different. The same goes for asymptomatic.
If you go back to my OP, it was hardly “Doom and Gloom”. I provided my experience. I have a rideable KS horse. It’s possible. I also pointed out the opposite is true and more likely. I actually didn’t advise you one way or another, because I felt it was really your decision to make. You have to live with the consequences, not random internet people.
You ask in your OP “What Would You Do” – literally asking advice. Don’t get your back up when people give you the advice you asked for, it’s just not the answer you hoped.
My advice? If you don’t want people giving you advice - don’t post on COTH asking for it. 
17 Likes
No. Not really a lot to dig in. They barely have even looked at what is happening. To do a true genetic correlation for a condition you need tens of thousands of samples, not just hundreds. As I said, there is still a very small and limited amount of equine spine research. For example, we have identified 1400 genes that cause a variety of spine bone diseases such as osteoporosis, OI, disk degeneration, using 20 MILLION patients worldwide and we still don’t know.
You have 2 surgical technique papers and the rest have minimal statistical testing for significance in the data. These are very preliminary type studies equivalent to where we were in knowledge in humans 20 years ago. A lot of this work is going to be modified or disproven as we get more and more large sample sizes.
For example, our latest spine degeneration study to figure out why disks degrade has two groups with 1 million patients in each so we can see the effect of omega 3 and 6 fatty acids. Preliminary data there shows that while those nice fatty acids help your heart those molecules are toxic to joints and disks in the spine.
One can not make definitive statements from a few studies. That is what science is about.
15 Likes
FWIW, I’ve already found and read most of these studies - this one a few days ago.
3 Likes
Maybe you can point out where anything I said isn’t corroborated in the studies I linked, since your hang up seems to be about how there isn’t enough equine-centric studies (which I agree with) versus the topic at hand, which is about whether or not OP should buy a horse with KS.
For the record, Reed, a study with 200+ horses is a big sample by veterinarian standards. I know you are used to human medicine, but you really cannot compare expectations. Vet med is light years behind in a lot of ways.
12 Likes
Just wanted to say thank you for posting this. I have a teenager who was dx with kissing spines 12 years ago. He has been increasingly tripping and unraveling and I had it in my head that it was connected but didn’t know anyone else thought this to be true.
My teenager has been fairly successful despite pretty severe KS. He has myriad other issues, and I really wouldn’t even begin to guess how they are all interconnected, or guess which one caused the other. It has been a long and near constant battle to keep this horse sound, and it def has made me question my sanity - the constant game of wondering if he’s fresh or in pain is EXHAUSTING.
While I’m a bit of a skeptic about how much we really know from rads taken in a field (not in a clinic) setting, I think I would pass on a horse with this level of findings too. There are so many nice horses out there, there will be another one - I promise. This one may have a great life, and you can be happy for him to be proven wrong.
That being said, I took a horse a few years ago with a big ugly knee and arthritis at 7. So I get it! My vet looked at this horse and I felt like I knew what I was getting into with him. I was ok with it, because he was that special to me. He died from colic later that year. It’s all a crapshoot.
6 Likes
OP you haven’t answered the most important questions yet - how old is the horse, and has he been sound in full work? Imaging and vet opinions of the scans are only worth so much compared to assessing the horse in front of you. Without these factors the conversation can only devolve into the hypothetical “is kissing spine bad or not” and you probably won’t get useful answers for your specific scenario.
12 Likes
I’d also pass on these findings. I bought this horse 7 years ago. Nearly identical rads, unbelievable canter, 10 jump. He’s now retired in my field because he’s been impossible to keep comfortable in ridden work. I tried. For years.
FWIW I have a very high risk tolerance and no fear of maintenance. But I would not knowingly walk down the path of trying to manage a KS horse again.
12 Likes
I don’t think anyone is trying to argue you have no chance to keep this horse serviceably comfortable and enjoy a full career in your sport of choice. KS just throws another wild card into the deck of possibilities. A lot of people wouldn’t take the gamble for various reasons, most being cost or time, in that they realistically can only get one horse going.
If you love this horse and can commit to the cost of treatments, if/when needed, it seems like you’re going into this with clear eyes.
And nobody will fault you for that. The horse would be lucky to have you!
11 Likes
Raises hand I have one too! (The same horse I posted above). The tripping used to be only if he missed a farrier appointment. Then it was when he got to the end of a cycle. Now it’s constant despite fanatical attention to his feet and I’m digging deeper.
OP, here’s the thing - if this horse has been doing the job for years, is sound, and isn’t young, you have a lot stacked in your favor that he’s going to be manageable with these findings. He may be one of the sound and truly symptom free KS horses.
If he’s younger, hasn’t been doing the job you want, or has been sitting a while, that’s a much bigger risk. Having a KS horse has me connecting IRL with people who also have them - many do just fine until around age 10. It seems like that’s the age things start to catch up to horses and they stop being able to compensate - I’ve heard the same story with other issues like PSSM, ECVM, even just things like bad footing or farrier care.
So is this horse 15 years old so? Jumping around doing all the things? Or is he young and green? Otherwise we are all just rehashing the same KS arguments that have played out repeatedly over the years.
7 Likes
