Kissing Spine surgery thoughts

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18 June 2020
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My 9yo mare has just had a full body work up done due to loss of performance, and its found moderate to severe impingement of the dorsal spinous processes between T12-13, T13-14, T14-15, T15-16, T16-17, T17-18 and T18-L1.
The deep epaxial musculature including the multifidus muscle was medicated with 120mg
methylprednisolone acetate(steroid) and she is now home and being ridden 20 mins in walk over poles for 2 weeks, then 4 weeks with walk and trot pole exercises.
After 6 weeks she is to return to vet and they will consider ISLD(ligament snip surgery)

If you have a horse that has had a similar experience can you please share your story with me
 

paddi22

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I had one with 6 spines impinging. I got the injections and with correct work we didn't need the snip. I think vets are too quick in their rehab schedules. I'd def give longer than 6 weeks for rehab, the back has to learn a completely different way of moving.

I did months of proper rehab and groundwork with one of mine after his injections and it really built his back up properly. I'd do way more groundwork before getting onboard. I'd get a decent physio and work with them on a rehab programme so you can avoid the snip if possible. my horse worked for years and it was only another issue that ended his ridden career. vets had suggested the snip but he didn't need it. every horse is different but my advice would be to chat to a physio and just look at the horse in front of you and what it needs.
 

sbloom

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As paddi22 says, I'd want to talk to a specialist rehabber, such as Dan Wain Equestrian, or other yards that Tom Beech uses, and there are other in hand specialists. Rehabbing for posture, and KS is essentially the results of poor posture in so many cases, is involved and more than polework, and likely to be much more groundwork than ridden. Again I'd be leaving ridden work until the posture is improved. My experience as a saddle fitter doing a lot of remedial work is that vets see this work as fittening/strengthening and don't see the important of the thoracic cling which is what you need to work on.

I'd want to be 100% sure that this sort of work wouldn't be enough before opting for surgery.
 

Darkly_Dreaming_Dex

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Thanks, the vets were very blase about surgery, the more I am researching the more worried I am about making the decision, I will have a look into the rehab specialists you are mentioning.x
10yearsago had four snipped on our ISH with congenital KS -we’d tried rehab for a couple of years and got worse, not better . worked really well but over time it’s allowed the spinal processes to sag sideways and he’s no longer sound unless you ride on a loose rein - then he moves on 3 tracks and is ok .. not sure I’d do it again & my vet agrees
 

ycbm

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I had one with five snipped in the loins where he had been born with no space between very thick DSPs. He recovered well but was PTS for multiple self inflicted head fractures and untreatable pain a short time after. This wasn't connected, he had always smacked his head. But I would not have another operated on for exactly the reason given in post 5, I believe it destabilise the spine - and why wouldn't it, if you are going to cut the ligaments that hold it in place?

I don't think we have enough information available about the long term effects of KS operations.
.
 
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Ive got time to decide, I was walk hacking her few weeks prior to injections whilst awaiting referral appt, Im now walk trot canter long and low, polework, but no circles yet, and she is definitely more energetic and happy(trying not to humanise). She doesnt ride hollow but is on the forehand, she had hunted and has a few BE90's under her belt, I was hoping to continue at this level but TBH I can inherit her form my daughter and potter at riding club level if she is happy to do so, but I def don't want to wreck her completely with surgery.
 

paddi22

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I've had a few with kissing spine who got injections come through here and one of them happily evented 1 10 with it. the main thing is to really learnt ow work them properly, get them off the forehand and strong behind, to help carry strengthen the back as much as possible. I take my lad once a week to a pro who really gives him a proper workout to strengthen his back.
 

catembi

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Mine had ks surgery in 2015. 4 processes reshaped in the saddle area and a lig snip further back. Follow up xrays were perfect but he has never come right and I think his spine isn’t stable as his back end isn’t great. He can only work in walk and is more or less retired. I wish I had looked into rehab by exercise instead of surgery, but at the time the vets were pushing the surgery 🙁
 

sbloom

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Mine had ks surgery in 2015. 4 processes reshaped in the saddle area and a lig snip further back. Follow up xrays were perfect but he has never come right and I think his spine isn’t stable as his back end isn’t great. He can only work in walk and is more or less retired. I wish I had looked into rehab by exercise instead of surgery, but at the time the vets were pushing the surgery 🙁
This is what really worries me, surgical intervention as more or less the first or only option just can't be the way forwards for so many cases.
 

Trouper

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Thanks, the vets were very blase about surgery, the more I am researching the more worried I am about making the decision, I will have a look into the rehab specialists you are mentioning.x
Yes - so was my vet. I now wish I had taken longer to work through a comprehensive programme with her as @sbloom suggests before considering surgery. She never came right and I had to pts.
 

Andrew657

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Having had mine PTS a month ago with KS I thought I would share.

He had surgery prior to me owning him and was sucessfully rehab'd.

But since then he had a couple of unrelated field injuries and an illness each of which required box rest/ extended periods off work. After each incidence he needed to be carefully rehabbed - and each time his back was weaker.

So sadly a downward cycle over a five year period.
 

Bellaboo18

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My experience has been vets seem to think it's a simple, non-invasive surgery with great success rates but I think that's because they see the short-term benefits and probably dont follow those horses through to retirement.

I've not seen any long-term success stories. I wouldnt put one of mine through the surgery and I was very close at one point. I'm glad I didn't go through with it.
 

BethH

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My horse is now 22 and was recommended PTS at 6yrs old unless he had surgery as he had genetic kissing spines. It took 2yrs to diagnose and he had developed many behavioural issues. However, I found a fabulous surgeon called Svend Kold at Willersley in Gloucestershire who was clever with the op in that he cut 1 bone to prevent the crossing rather than taking the whole lot out.

This was before the ligament snip was invented/used and I have to say that I don't like that idea as i would imagine it would leave the back weaker and I can see that the horse would eventually break down, mine had his supaspranius ligament (not sure I've spelt that correctly) cut in 3 places but then re-stitched once the bone was removed.

We tried to go down the palliative route of correct work beforehand but he found it so hard to hold on to the muscle and I spent the whole time panicking about him ever having a week off work, I still feel that the op he had was the best solution. He is and will always be a little quirky and does have some issues now he is in his 20's with a touch of arthritis here and there but it saved his life and I have had the privilege of enjoying him for 15years longer than I thought I would. The key to KS horses imho is to ensure you do a solid rehab to develop decent muscles especially through the hind end, we spent at least 6 months long reining including some ground poles and also ridden a lot in a decent walk with plenty of uphill work to persuade the back legs to push through. Every time he has been not quite right I've reverted back to this way of restarting him and it has always helped, not pushing too hard or to fast when they start work again is really important, I've seen a lot of horses initially do well and then break again because they haven't been strengthened enough initially before they do more.

My horse is still being ridden albeit a little creakily these days but he still has a good quality of life and is only on an odd bute here and there when he has a bad day usually when it is warm and damp. He is part of the family though rather than a competition horse but the op did give him a future.

I just wanted to post a success story in the hope it might help, but I do think the type of operation you decide on is vital and I am still to be convinced that the ligament snip is a good long term solution.
 

sportsmansB

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Mine is 16 now, I got him 3 years ago knowing that he has close processes and got yearly injections. He was eventing at 3* at that time.
I have continued with the injections
He is a very 'round' horse all the time, thats his natural way of going, and I think that has made the difference to him to be honest.
This year has has been double clear at 2 events (90/100) and shows absolutely no signs of discomfort.

I don't give him time off / holiday - (hes not great not in work anyway, he likes routine and hates having to fend for himself in a field!) he stays fit and muscled up all the time. He is at least 2* fit currently for his life at 100, and we do a lot of pole / cavaletti type work, use a VIP pad and a well fitted saddle, and crack on as though there is nothing wrong except I always, always warm his back up and down before and after riding by stretching, lunging, walking with the saddle on before mounting, etc.
I do think that it is worth seeing if you can manage it by making sure their way of going and routine is as supportive as possible, and using injections if appropriate, before resorting to surgery.
 
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Hey any updates on what you decided to do ? Im
Going through it with mine she doesn’t show any issues when saddled other than being a ball of tension and was wondering if rehab before surgery was better
 

Dynamo

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Worst thing I have ever done to a horse, having a KS op. I felt bullied into it by the vet and have regretted it ever since. Pony re-habbed ok at first, but 18 months later, despite doing everything to keep him fit and strong, his back completely sagged and he's now worse than ever. A different vet who x-rayed him recently and to whom I showed the original x-rays from before the op agrees with me that it was absolutely not the right thing to do and that doing the rehab work without the op would have been much better in the long term. Would never do it again.
 
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Worst thing I have ever done to a horse, having a KS op. I felt bullied into it by the vet and have regretted it ever since. Pony re-habbed ok at first, but 18 months later, despite doing everything to keep him fit and strong, his back completely sagged and he's now worse than ever. A different vet who x-rayed him recently and to whom I showed the original x-rays from before the op agrees with me that it was absolutely not the right thing to do and that doing the rehab work without the op would have been much better in the long term. Would never do it again.
Would you mind me asking which op your horse has was it the lig snip or the bone shave ? Xx
 

Errin Paddywack

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I remember the great steeplechaser 'Mill House' having a back operation. I 'think' they removed one of the spinal processes. He had a history of falling at fences which was attributed to kissing spine only they didn't call it that back then. He ran in one race afterwards at Wincanton and by a stroke of luck I was down there on holiday and was there that day. He was a huge horse, nearly 18hhs and he won easily but never ran again that I heard of, think they retired him so no idea how he was long term. I was very much a fan of his so seeing him was something never to be forgotten.
 
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