Can someone interpret these x rays please?

[Birker2020]

Left fore and right fore coffin joints. With regards to the second photo as this is the limb the horse was apparently lame on, are there serious changes showing? TIA

 

[Birker2020]

Withers towards tail of spinous processes - the first two affected after the first coin (slide 2) have been medicated, the two before the second coin not. Slides 3 and 4 overlap somewhat. TIA.

 

[ycbm]

One of the ones which has not been medicated looks to me as if bone is filling the gap and still touching in spite of your rehab work. Was there a reason for only medicating 2 when others show clear signs of having impinged as well?

I can't see much on the coffin joints but I think I can see negative coffin bone angles, (the back should be higher than the front), and corresponding bull noses. I would try to resolve those by building the heels barefoot.
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[Birker2020]

One of the ones which has not been medicated looks to me as if bone is filling the gap and still touching in spite of your rehab work. Was there a reason for only medicating 2 when others show clear signs of having impinged as well?

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I think he chose where to medicate based on palpation of the back and because the saddle was sitting in that area. EDITED TO SAY I also only showed him the photo of the xray of that second photo (after the first coin) so I may have deliberately misled him. This was when he came out and medicated it at the yard. The third photo I've literally only just seen today! That said the saddle is an 18" saddle so probably is also touching that area too as well as the fact that the saddle sits a little further back because the horse has high withers and the saddle fitter said I was placing it too far forwards. I think that I need to speak to the vet that's coming out on Friday and see what he says as now I've seen all the xrays I am curious too.

Compared to my friends xray of her horses coffin joints in terms of arthritic changes, his look pretty decent. I did think when I looked that the pedal bone/coffin bone seems to be pointing down rather more than Baileys xrays of her feet (from memory). But not sure about the joint.

Thanks for looking.

 

[Goldenstar]

Did they give him Tildren ?

 

[sbloom]

The pedal bone is actually pointing up/forwards, it needs to follow the line of the pastern

https://www.facebook.com/hoofscanandhoofcarecentre/posts/7327730513967025

 

[ycbm]

I think he chose where to medicate based on palpation of the back and because the saddle was sitting in that area. EDITED TO SAY I also only showed him the photo of the xray of that second photo (after the first coin) so I may have deliberately misled him. This was when he came out and medicated it at the yard. The third photo I've literally only just seen today! That said the saddle is an 18" saddle so probably is also touching that area too as well as the fact that the saddle sits a little further back because the horse has high withers and the saddle fitter said I was placing it too far forwards. I think that I need to speak to the vet that's coming out on Friday and see what he says as now I've seen all the xrays I am curious too.

Compared to my friends xray of her horses coffin joints in terms of arthritic changes, his look pretty decent. I did think when I looked that the pedal bone/coffin bone seems to be pointing down rather more than Baileys xrays of her feet (from memory). But not sure about the joint.

Thanks for looking.

Where the saddle sits is only loosely related to kissing spines pain. All my horse's impingements were behind the saddle but they still hurt!
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[AlpacaTeddySJ]

Left fore and right fore coffin joints. With regards to the second photo as this is the limb the horse was apparently lame on, are there serious changes showing? TIA

View attachment 93109

As already stated, these x-rays are showing a negative PA.

Another vote to go barefoot if possible - otherwise/also farrier should advise to build up heel and increase to a positive angle. Has the farrier seen the x-rays?

 

[SEL]

Where the saddle sits is only loosely related to kissing spines pain. All my horse's impingements were behind the saddle but they still hurt!
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My pony seems to be preferring a saddle which is technically too long rather than one which comes in front of where her KS was on x ray. I guess it's how it spreads the weight.

 

[Birker2020]

As already stated, these x-rays are showing a negative PA.

Another vote to go barefoot if possible - otherwise/also farrier should advise to build up heel and increase to a positive angle. Has the farrier seen the x-rays?

No he's not. I will show them to him.

 

[Birker2020]

Where the saddle sits is only loosely related to kissing spines pain. All my horse's impingements were behind the saddle but they still hurt!
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That might explain why he is still resistant when ridden. Thank you.

 

[Birker2020]

Did they give him Tildren ?

No it wasn't offered. It might be worth considering as it will target all areas of inflammation which would work out cheaper and possibly more effective than individual injections.

 

[SEL]

That might explain why he is still resistant when ridden. Thank you.

Resistance might also come from the feet if he's NPA. If the angles are off their posture changes and has a knock on effect elsewhere.

I know you've put your heart and soul into this horse but if you're up for a final shot then I wonder if tildren and sorting out hoof balance will give you a stab at a functionally sound horse - or a final answer as regards retirement

 

[sbloom]

There is little acceptance of how to deal with KS via saddle fitting, different schools of fitting will approach it in different ways but essentially if you have no direct pressure, and space for the spine/TS to lift then it matters not, potentially, how that is achieved. It's ALL about posture, if you don't lift the TS, through preparatory groundwork, the feet and bodywork being right, and then the saddle/rider's seat not allowing continued lift, then you don't "fix" the KS.

 

[sbloom]

Resistance might also come from the feet if he's NPA. If the angles are off their posture changes and has a knock on effect elsewhere.

I know you've put your heart and soul into this horse but if you're up for a final shot then I wonder if tildren and sorting out hoof balance will give you a stab at a functionally sound horse - or a final answer as regards retirement

I would fix both body and feet, and both can be done without massive vet cost, all the links I keep sharing. I personally would not do tildren.

 

[quizzie]

I assume these have been diagnosed by a vet...although the bony changes at the front of the coffin joints are not excessive (right is worse than left), if the new bone interferes with or irritates the overlying tendon, or indicate damage at its point of insertion, then despite the bony changes being small, they can cause significant lameness in some horses.

In relation to both the feet and the spinal changes, it is worth bearing in mind the old saying that "Radiographic changes do not necessarily correlate to the clinical picture".

 

[I'm Dun]

I would fix both body and feet, and both can be done without massive vet cost, all the links I keep sharing. I personally would not do tildren.

I agree. I would bet any money that this horse has posture issues and if those were fixed then the rest may well slot into place

 

[ycbm]

I would be concerned that one of those process gaps appears to be closed by a bridge of bone, and I'd want reassurance about whether that needs to be shaved or not.

And I would wonder whether the back is causing the feet, the feet are causing the back or if it's one giant compensatory circle.

But with feet like that I'd maybe be wanting a 6 month barefoot rehab (and maybe one process shaved) before writing him off. But I still wouldn't blame you if you called it a day.
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[Birker2020]

I would be concerned that one of those process gaps appears to be closed by a bridge of bone, and I'd want reassurance about whether that needs to be shaved or not.

And I would wonder whether the back is causing the feet, the feet are causing the back of if it's one giant compensatory circle.

But with feet like that I'd maybe be wanting a 6 month barefoot rehab (and maybe one process shaved) before writing him off. But I still wouldn't blame you if you called it a day.
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Sometimes I feel positive and other times I feel its all too much to cope with. I certainly won't pts if the vet thinks he can be retired, i feel I owe him a few months of fun, out in a herd but if it comes to winter and he's not faring well weight wise and if he can't cope barefoot then I have my answer.

Realistically i know i owe him nothing. But I'm finding such a momentous decision extremely overwhelming. The decision with Bailey in comparison was so much easier. Poor horse. I'm annoyed with myself now that i gave him so much time off to rehab him if work was the glue that kept him together.

 

[sbloom]

Glue keeps them together...until it doesn't and then they can break catastrophically. I just think that a lot of rehab doesn't address the real root issues.

 

[Goldenstar]

I would be concerned that one of those process gaps appears to be closed by a bridge of bone, and I'd want reassurance about whether that needs to be shaved or not.

And I would wonder whether the back is causing the feet, the feet are causing the back or if it's one giant compensatory circle.

But with feet like that I'd maybe be wanting a 6 month barefoot rehab (and maybe one process shaved) before writing him off. But I still wouldn't blame you if you called it a day.
.

Tbh I would want a opinion of a KS expert on those xrays I would think they are a prime candidate for shaving .
I also would that foot pain is more likely than not to be driving all of these issues .

 

[Birker2020]

Tbh I would want a opinion of a KS expert on those xrays I would think they are a prime candidate for shaving .
I also would that foot pain is more likely than not to be driving all of these issues .

Please can you suggest anyone I could send the xrays to? I don't have unlimited funds so how would i find out if the insurance would cover this operation as I just can't finance it myself?

 

[Goldenstar]

I don’t know any one but I can ask my friend (a vet ) she away for a few days atm .
Where abouts are you .

 

[Birker2020]

Glue keeps them together...until it doesn't and then they can break catastrophically. I just think that a lot of rehab doesn't address the real root issues.

I know but the vet said at least 8 weeks due to the acute si strain and then i just continued as I needed to build him up, his topline and his core and the rider started riding him in Feb, i continued to do ground work until another saddle check and I got on April. I was led to believe he'd be hard to fit due to his conformation - high withers. Whereas he's in a normal Ideal GP saddle, its just that its been altered to lift off him and needs to be put back a little more than i was doing so its well off his withers.

I'd give anything to get him fixed so we can go out and have fun but ultimately if I have to retire him its not the end of the world.

I am annoyed he passed the vet with all these issues. But most of all I'm annoyed he's been seen as a problem to dump on someone else without disclosure, for a hefty price tag too. Although I'm glad he's mine too as i think the world of him.

 

[Birker2020]

I don’t know any one but I can ask my friend (a vet ) she away for a few days atm .
Where abouts are you .

West Mids/ Warks border. Thank you

 

[Marigold4]

Sven Kold is an expert vet specialising in kissing spine. This is his website. Hope he can help you find some answers.

http://www.svendkold.com/clinical/

 

[sbloom]

I know but the vet said at least 8 weeks due to the acute si strain and then i just continued as I needed to build him up, his topline and his core and the rider started riding him in Feb, i continued to do ground work until another saddle check and I got on April. I was led to believe he'd be hard to fit due to his conformation - high withers. Whereas he's in a normal Ideal GP saddle, its just that its been altered to lift off him and needs to be put back a little more than i was doing so its well off his withers.

There is NO blame on you, there are at least 3 lifetimes of learning with horses I swear, but like I say, a horse in a compensatory movement pattern can be kept going longer if kept in work but it doesn't mean it will stop them breaking. I wish vets would talk about these patterns and posture, instead it's isolate the issue, treat it, work back sometimes in case it's "secondary" (to me the movement pattern is the primary issue) to other symptoms, "fix" them, then fitten (with some strengthening, but again even some of the core strengthening doesn't really address movement patterns and lifting of the thoracic sling).

 

[Birker2020]

There is NO blame on you, there are at least 3 lifetimes of learning with horses I swear, but like I say, a horse in a compensatory movement pattern can be kept going longer if kept in work but it doesn't mean it will stop them breaking. I wish vets would talk about these patterns and posture, instead it's isolate the issue, treat it, work back sometimes in case it's "secondary" (to me the movement pattern is the primary issue) to other symptoms, "fix" them, then fitten (with some strengthening, but again even some of the core strengthening doesn't really address movement patterns and lifting of the thoracic sling).

I'm going to see what the vet says tonight, I think I might be on a hiding to nothing with the PSL and the KS but we will see. It's very hard to interpret by nerve blocks if the horse is more comfortable or not because I am not at the stage where I want to sit on him again and unless the benefits of nerve blocking the PSL can be seen its hard to know what to do.

Thank you.

Referring back to the x-ray of the KS (third on top line) I do know that only one process was medicated so I will be speaking about this to the vet as well and see if we can get all three medicated and then try and formulate a plan from there.

I'm a realist and I don't think he can be helped, he's already lost so much top line again, I feel like we are back to square one. But until I've done everything I can within my insurance money I won't know. I also was wondering about seeing if a chiropractor could help him at all.

 

[ycbm]

B I would also ask about the shadow between the one that the back coin is sat over and the one in front of that, because it looks as if that bone might have bridged and will need shaving to recreate the gap. I'm no expert on x rays but there is a definite shadow there.

 

[Birker2020]

B I would also ask about the shadow between the one that the back coin is sat over and the one in front of that, because it looks as if that bone might have bridged and will need shaving to recreate the gap. I'm no expert on x rays but there is a definite shadow there.

Yes I agree, thank you. I will point that out.