Kissing Spines (again) - can anyone recommend a vet for a second opinion?

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LucyDT

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Please can anyone offer advice?! I live in Sussex and my horse has been diagnosed with kissing spines. Initial investigations in Dec last year showed that she had OCD in her right hock (which was subsequently operated on in Feb this year). At the time, although the spinal processes looked 'close' on xray, my vet put the back tenderness down to referred pain from her hock.

To cut a very long story short, she has recently come back into work and things haven't been going well. She's incredibly reluctant to go forwards, does not want to be tacked up or mounted, and when we're out or in the school she'll suddenly stop dead. When I ask her to go forward she rears and/or bucks.

Took her back to the vets yesterday, she had a 'deep' ultrasound scan of her back, which combined with the xrays and bone scan she has already had, showed kissing spines at T12-T15 levels. She also has boney changes in that area, which even I (in my ignorance) could see very clearly on the scan. Not only that, but as soon as the vet put mild 'targetted' pressure on her back in that area, she reared. They have ruled out any pain from the hock/stifle and are now sure that she has specific back pain.

He injected her back with a mixture of steriods and local anaesthetic and told me to take her home and ride her before the local wore off. She was a totally different horse - much more forward going and much more relaxed. He then told me to carry on riding her for the next 'few weeks' (he's now away on holiday until 15th Sept) to see how we got on.

I took her for a hack this morning and we're right back where we started. Reluctant to go forwards, very tense etc although thankfully no major fireworks. But I don't feel safe riding her, and I feel that she is in pain.

So what do I do? In 2005 my (now retired) horse had unsuccesful surgery for KS at the same practice that have been treating my girl. So I am worried that we're facing a repeat performance. The streroids clearly have made no difference (yet) - do I swallow my fear that she's going to 'explode' and carry on riding (I am also recovering from back surgery so this isn't a great combination!)

I would really like a second opinion on her from another vet. I trust my vet totally but I want to explore every option and a second opinion can't hurt? Please can anyone recommend a kissing spines 'expert'!? As I said, we're in Sussex but I'd be happy to travel for the right man (or woman!)

Many thanks and sorry for the mega-long post.
 
I use Sue Dyson at the Animal Health Trust at Newmarket, but you have to be referred by your vet (I believe that to be the case, we've had three horses go there, all via our own vet).

Completely understand your concern. All crossed that things go well for your her.
 
No personal experience but the general consensus of opinion seems to be that Sven Kold is the man to talk to when it comes to KS.

I'm sure there's a few peeps on here who have had horses operated on by him.
 
any clues as to practice you are with or vet initials? Would guess you are with same prac as me as one of the bigger ones in the area. Mine has a back problem too. Not ks (as thought) but arthritis in joints of spine has had two lots of meds and doing ok. from what you have said and from what i know about ks op would be next step esp as blocks and scans are showing that to be the issue. Just because it didn't work last doesn't mean it wont this time. Why chat with vet if you are with same as me yes he is hard to get hold of but will always go through options in detail. I would trust them 110% with my horse. But if you do want another opinion either get diff vet at same practice or go to one of the other big practices such as bell? And if your not with same prac as me maybe try them. I know its hard but good luck with what eva you do
 
Thanks for the replies. I do trust my vet totally, I suppose I'm just nervous after last time... and also having back trouble myself I know how valuable it can be to get a second opinion. I would really like to speak to a 'specialist' in this area too, who will have seen it all before. I will speak to vets on Tuesday, thanks.
 
My mare is having her op for KS next week but I am bedforshire/cambridgeshire based so it might be too far away however, however, here are our vets. you can try, Rossdales, Newmarket. Fellowes Farm Equine, Abbots Ripton, Cambridgeshire or AHT Newmarket. I have heard of Dr Sven Kold of Willersley Practice, Gloucestershire.

Incidently, you mention that your other horses operation for KS was un succesful. In what way please?
 
my other horse had KS surgery in 2005 (and his xrays didn't look as bad as my mares!), he got an infection immeadiately after surgery (in the muscle-layer of stictches) and he was at the vets for 4 weeks on intravenous antibiotics. The complications and subsequent treatment blew our £5k insurance limit - final bill £9,000.

He came back into work and all went well for a few months, then he became reluctant to ride again. He was referred to Liphook, they said he probably had nerve damage and to give him time in a field "to be a horse" and then give ridden work one final try. We turned him away for over a year, then tried again. It was very slow progress but we did quite well and got back to low-level dressage competition. Then over Christmas 08/09 he just lost his sparkle. Lost weight, seemed depressed and didn't enjoy even the shortest hack. Vets did blood tests which showed nothing. I just knew he'd had enough, and rather than bute him right up and keep going I decided enough was enough. So he's now retired and looks amazing as a field ornament!

I suppose because the op wasn't the answer for him, and having been through the heartbreak once already, I need to be absolutely 100% sure that I make the right decision for my girl. I do realise that 5 years is a long time in the science world though, so perhaps things are a bit different now!?

I really hope all goes well for you, I have heard of incredible success stories following KS surgery!
 
Absolutely no question about who to go to- you must must try Svend Kold at Willesley equine, he is the leading expert in the country/world for treating kissing spine and has operated on many very successfully. Dont touch any other vet with a bargepole to treat KS, only use Svend!
 
seabsicuit2 said:
Absolutely no question about who to go to- you must must try Svend Kold at Willesley equine, he is the leading expert in the country/world for treating kissing spine and has operated on many very successfully. Dont touch any other vet with a bargepole to treat KS, only use Svend!
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Sorry but I don't agree with your statement. I know that Sven is a leading surgeon in this area of surgery but my mare has just been operated on for KS and I have absolute faith in the vet who performed her operation.

Incidently the re-hab that Sven advocates is very intense and there is no indication that his method has any more favourable results than that of turnout and then start to lunge 3 months post op. I have spoken to several people who have put their horses through this operation and most have said that complete paddock rest and time to heal have lead to happier horses with less issues.

Personally I think it's all about gut instinct and knowing what's best for your horse.
 
Everyone has their own opinion but I do think that paddock rest and no exercise is absolutely the worse possible thing you can do in the preceding 3 months following surgery. The back muscles needs to maintain and build up its elasticity and exercise prevents scar tissue forming. If you rest them , too much scar tissue builds up which then can lead to a back that will never have real suppleness and elasticity.
My horse was walking out in hand for ten mins twice a day immediately after surgery building up to an hour twice a day by week 6. 6 weeks post op he started a lunging program in the pessoa and over the next 6 weeks built up to walk, trot and canter over poles on a fairly tight setting. 3 months post op he was well muscled, could walk trot and canter on both reins balanced supple and collected then some time later he was out winning elementary dressage and Showjumping.Physio was amazed at what good physical condition he was in and how good his back muscles are.He then passed a 5 stage vetting and was sold as a dressage horse.
Of course everyone has their own way of doing things but Svend has experimented with both methods of rehab- lots of exercise Vs no exercise and an intensive regime is the best thing and lots of top performance horses that he's done have returned to competition and done well.
I'm sure that every surgeon/vet has their own success stories to talk about.
 
My 6yo is going to Willesley this afternoon for a kissing spine op tomorrow (all vibes gratefully received ...). Svend is not performing his op but I have total faith in the practice and the recovery regime is as outlined in the post above, walking out in hand, lungeing in a pessoa from 6 weeks onwards, ridden excercise starting at 12 weeks. I will be following it to the letter - one of my friends horses was operated on at Willesey and her horse works up to medium level dressage now, and she also followed this plan.

Still, I guess different vets may have different ideas...I'm just going to be listening to what mine tell me!
 
MrsMozart said:
I use Sue Dyson at the Animal Health Trust at Newmarket, but you have to be referred by your vet (I believe that to be the case, we've had three horses go there, all via our own vet).

Completely understand your concern. All crossed that things go well for your her.
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I know of a couple of people who have been referred to Sue Dyson, she is very knowledgable and will tell it how it is. She can be a bit blunt so I've heard and doesn't suffer fools gladly but if you want an honest answer even if its not the one you wish to hear then ask your vet to refer her there. Otherwise I would suggest Liverpool
 
The equine hospital at Lambourn has a KS specialist, they were very good when my horse went there and did a thorough investigation, I can't remeber the surgeon's name but I think she was originally from Canada, good luck with everything though.
 
Thank you everyone for the responses. I spoke to my vet and Svend Kold's secretary first thing Tuesday morning, my vet is sending the Xrays over to Svend - I'm hoping I will get an opinion from him on Friday or Monday. I just really hope he can help her!

As for different methods for rehab.. my gelding (whose KS op was unsuccessful) had box rest for 6 weeks, then turnout, for 6 weeks, then 3 weeks of lunging. Then I was back on board. In hindsight I think that one of the problems with him was that his back was (understandably) very, very weak. He lost so much muscle and condition during his rest period that when I got back on, even though I took it very slowly, he couldn't cope. So I'm ready to try another method this time and if Svend thinks he can help, I too will follow the rehab schedule to the letter - although not sure how I'd manage 2 long walks a day, plus my full time job, in winter!! Will cross that bridge if and when we get there though, it's the least of my worries at the moment!

Thanks again and good luck to everyone else who's going through, or has been through, the trauma of KS!
 
I would go with your instink - a vet wouldn't be qualified if they couldn't carry out the procedure.

Sayin that, from a personal experience I would edge away from Svend Kold. He operated on my mare in 2007 - she had to have just one dorsal spine removed due to a spur of bone on the back of T17 - she did not have a kissing spine. After months and months of prescribed, stressful Pessoa lunging for up to 40 minutes at a time she was rideable, but 3 months later we were back to square one and after x-rays and ultrasound scans it turned out that her supraspinous ligament was damaged in surgery.

To cut a very long story short; she had 2007 off, 9 months of 2008 off, all of 2009 off to recover - She even had a foal in 2009. In 2010 we started working her again and she went very well for 4 months - winning dressage, jumping, xc etc - but then we were back to square one again (a week to the day after losing my other mare) and in a worse state than ever. Very sadly a combination of surgery, rehabilitation, time and regular physio could not save her and she was put down 6 days ago.

During the 3 years of post-op problems Svend did not want to know - he was contacted by my vet who advised him of the Mare's condition, but he never even acknowledged it.

Another horse I worked with did have a full KS op by Svend and was also put down as he ended in a worse state than he started.

Although Svend maybe a very good surgeon and yes, probably does have a good success rate, it was devastating and disapointing to find that he had no interest what-so-ever in my mare, post-op, when problems came back as "his job had been done".

Everyone is obviously fully entitled to their own opinions and to judge from their own experiences and I fully respect that - this is just what I know and from these experiences I wouldn't go back to Svend.

I wish you all the luck in the world and hope that the surgery and post-op journey is a million times better than we experienced.
 
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