kissing spines in 4 year old - what would you do?

[wynnwith]

Hi there - id really like your opinions on what you would do if you were in my situation!

I have a 4 rising 5 year old who has been diagnosed with kissing spines (lumbar area) she has 4/5 spinal processes severely impinging, several that are close, cysts and sclerotic changes. I imagine that it would be a big op. The kissing spine was an incidental finding when diagnosing hind limb lameness (she also was found to have bone chip in her fetlock which was successfully operated on today).

She had only been in work for 10 weeks before she went lame but was never very happy about girth being done up, not particularly forward going and also hates picking back legs up. All this could be down to her temperament, though if anything i expected her to be very forward as she is a spirited little thing!).

My question is this!

she is insured and i could have it operated on. Does anyone have any experience of this problem in such a young horse and if so what happened? were they operated on with success?

From the x-rays and bone scan she has had i really can't see that this is a problem that will not be affecting her or causing her pain although she has not reacted badly to the start of her ridden career just not enjoyed the girthing and not particularly forward but again this could be put down to her being young?? (tho incidentally she only started to pull faces when being girthed up about 8 weeks into work)

I really don't know what to do, is it worth putting her through all the pain, should i just call it a day?

any thoughts or experiences would be greatly appreciated.

 

[Miss L Toe]

When you say call it a day, do you mean that it is OK to put to sleep with insurance covering the costs, or is it that you feel that it is the best thing in the long run.
It is not a good start.
Is your vet willing to talk, I find it easier to talk on the phone about serious matters, but you need a senior vet.

 

[wynnwith]

not thought about PTS - when i said about calling it a day i meant am i kidding myself that she will ever have a decent ridden career.... tho saying that i really don't know what i'd do with an unrideable 4 year old.. as much as i love her i would have to think seriously.

 

[loverly]

I've PM'd you wynnwith

 

[bluehorse]

Your vet will have the best view of what the true prognosis is - talk to him.

If he thinks there is a positive outlook then I'd recommend having the op (having put my 6yo though it). At her age she will heal well and will just have a late start to her ridden career.

 

[xxMozlarxx]

Have the op no question, my horse had it at 6 and in his and every other case I have known it has been successful, where it's not its usually because there are other issues, for instance my horse also has suspensory damage. His back however is really sound. I cant see any reason why you wouldn't give such a young horse every option possible.

 

[Ladydragon]

In addition to any replies/PMs you get from this thread Wynnwyth - it might be worth PMing Wagtail or pop on her thread in the Lounge section... Her horse has fairly recently had KS surgery...

http://www.horseandhound.co.uk/forums/showthread.php?t=521410

 

[Wagtail]

Hi there - id really like your opinions on what you would do if you were in my situation!

I have a 4 rising 5 year old who has been diagnosed with kissing spines (lumbar area) she has 4/5 spinal processes severely impinging, several that are close, cysts and sclerotic changes. I imagine that it would be a big op. The kissing spine was an incidental finding when diagnosing hind limb lameness (she also was found to have bone chip in her fetlock which was successfully operated on today).

She had only been in work for 10 weeks before she went lame but was never very happy about girth being done up, not particularly forward going and also hates picking back legs up. All this could be down to her temperament, though if anything i expected her to be very forward as she is a spirited little thing!).

My question is this!

she is insured and i could have it operated on. Does anyone have any experience of this problem in such a young horse and if so what happened? were they operated on with success?

From the x-rays and bone scan she has had i really can't see that this is a problem that will not be affecting her or causing her pain although she has not reacted badly to the start of her ridden career just not enjoyed the girthing and not particularly forward but again this could be put down to her being young?? (tho incidentally she only started to pull faces when being girthed up about 8 weeks into work)

I really don't know what to do, is it worth putting her through all the pain, should i just call it a day?

any thoughts or experiences would be greatly appreciated.

Yes, the operation has a very high success rate. My 9 year old TB had really bad KS all along his back from the withers to the lumber region. He had ten spines impinging and like your mare was reluctant to go forward, especially in canter, and hated being girthed up so much he would be explosive! Finally, he became unridable. In November, he had five spines removed at Rossdales under standing sedation. He had a total of 4 weeks box rest, the last two of which he was walked in hand twice daily. After that he had two months turn out. I started work with him six weeks ago. I started riding him two weeks ago and started trot work yesterday. He is a changed horse. Lets you pick all four feet out (wouldn't before the op), can tolerate girthing like any other horse, and his paces are much looser. I am really pleased with his progress. He also has hind limb problems and had to have a bone chip removed from his hock 18 months ago.

 

[wynnwith]

thanks for all your replies, at the moment (or before she went lame 5 months ago) she was still completely rideable but just not very forward and had started to pull faces when being girthed up but is that due to the kissing spines or is it just her personality? its really hard to tell, my vet said that x-rays can look terrible but they can tolerate it a lot better than you think but I'm just wary that if they are that bad now, surely they will get a lot worse in time and then my insurance will have run out and i would have to fund this op myself. Do i really want to wait to the point of her showing extreme symptoms and being in acute pain?

My biggest problem is whether i put her through the op at this stage even though her mild symptoms may be just due to her temperament rather than her kissing spines. Though again could she just be generally grumpy (was a lovely foal and yearling but started to get grouchy from 2 1/2 3 yrs onwards) because she's in pain?!!

I really don't know what to do, she has a very good prognosis from her fetlock but its going to be realistically 4 months before i can ride her enough to see if her K spines are causing a problem, then i will only have 6 months left for KS operation and rehab under insurance.

does anyone have a horse out there that didn't have the surgery and is still fine??

 

[Wagtail]

We have another two horses at the yard with KS who have not had surgery. One is totally unridable, 7 year old TB, although his owner is going to attempt to reback him this summer. He has 4 impinging vertebra and has had steroid injections into the spine and shockwave therapy 18 months ago. He appears generally more comfortable but we will not know for sure until the backing. Another is a cob who started bucking 4 years ago (he was 5) and objected to having his girth tightened etc. He was found to have very mild KS with two impinged vertebra. He had the steroid injections. They worked at first but only for 2 months. His owner was not schooling him properly over his back. He had further injections and this time his owner took more care to school him correctly. Three years on he is absolutely fine with no further problems.

 

[applecart14]

Had a friend whose horse had KS but he had other issues as well. He had the steroid injections and shockwave but they didn't really help. As he was only young she decided to send him to the blood bank and he is living the life of riley out in the fields in the summer as part of a big herd and then housed in huge indoor barns in the Winter with ad lib hay.

She didn't opt for the operation for her horse as I think he was too badly affected. This was about six years ago and things have moved on a lot since then in terms of research and the experiences gained from the procedures done on horses since.

 

[opinionuk]

I had the same problem with my 4 year old mare, now just turned 6. She had hind lameness and nothing could be found, so X-rays were taken and found she had kissing spine only 2 vertebrae were affected but I was devastated as I bought her to bring on and event, she had cortisone injections in her spine and we worked with the physio once a week for a month, not riding her but a lot of long reining and Pessoa work to make her work long and low, I also bought her a magnetic rug called ' back on track' which she wore, I also brought an equimassage as the physio said this would help.
The vet said she would prob need injections into her spine every 6 months but touch wood its been 14 months since she was injected.

 

[TicTac]

If you search for my posts on kissing spine you will see that my mare had the op 18 months ago to remove 4 spinous tops are being diagnosed at the age of 10 with 7 impinging vertabrae.

I would say if your horse is insured then go for it. The operation has a high success rate these days and your horse is young. The rehab is not as bad as people think with a reletively short period of box rest before turnout is allowed. IMO if you dont give your horse a chance then it is highly likely that she will only get worse as she gets older at which point your insurance wont cover it.

 

[BethH]

My horse was difficult at 4, after 2yrs of trying to work out the problem, KS was diagnosed. He had scintigraphy which confirmed there was KS but no other problems so we went ahead and operated when he was 6yrs old and 6yrs later he is still sound and being ridden, I wish I'd known what the problem was earlier it would have saved us both so much heartache.

My thoughts from the experience are this; if I had known at 4yrs old what the problem was and been brave enough to operate then I would have saved my horse 2 years of huge discomfort whilst I was trying to persuade him to behave with 4 legs on the floor whilst being ridden, he was just backed when I bought him and started off relaxed, but as we gradually asked for correctness he started to flare up and throw himself around, he then muscled up correctly which supported the back and he became a gem for about 12-18mths although would have flip outs every now and again completely randomly especially when asked to walk downhill on a hack, when I became pregnant he did less work, lost some muscle and when I started riding him again started flipping out again and eventually we could see lameness which was when the vet finally managed to diagnose the problem, I have to say after a brilliant chiropractor spotted a vet was needed, as it was not muscular or fixable by her, so it is possible that your horse will start to become more upset at being ridden and is probably suffering from low level niggling back pain.

I also feel that if you leave the op, the back will continue to deteriorate and your horse will struggle a little more as you go along and that is where my horse developed huge behavioural issues, panic attacks & anxiety. Also, because they compensate for not moving correctly the longer you leave it the higher the risk that your horse may develop other problems like spavins, splints etc etc.

I would get a scan to confirm no other issues and if clear then operate, if there are other issues lurking, that will allow you to think carefully and more clearly about the future. It is hard to make a decision like this without full info and support from an equine vet, the scan is expensive but if your insurance covers it then at least you know what you are dealing with. If you are to ride this horse, I would think it's better to prevent riding being an experience that causes your horse discomfort, on the other hand to completely contradict myself, many horses have KS and it doesn't bother them so be sure it is this causing the problem.

Hopfully, this info will provides some food for thought, but I couldn't have got throught it all without my fab and very unstanding specialist equine vet. The very best of luck to you, a tough decision to make so I feel for you.

 

[Goldenstar]

My experiance with KS with a a young one was before they did surgery for it it was of our homebreds suffered this and we PTS as a six yo we could not get her comfortable I became convinced her had low grade pain all the time not just when ridden and decided to PTS.
It's a sad situation for you have a proper discussion with your vet think out before the main points want to ask and write them down so you don't forget and decide, the KS surgery I knew turned out to be an expensive waste of time it did not help the horse who ended up PTS anyway but that's one horse you will find people on here whose horses are back to work after the op.
It's a big descision either way ,good luck with it.

 

[Rebecca1988]

At such a young age you've got to give your horse a shot at it. Get the op done whilst under insurance cover and then only time will tell if it has worked. I'm sure you'll be much happier knowing you did everything you could if it didn't work out. But by the sound of it the op has a high success rate.

 

[blue eye]

i to am confused by kissing spines last year i brought a horse in poor condition that had passed through a dealer on tracing her history found out she was a very well bred show jumper that had been written off with 3 fused vertebrates behind withers and unless operated would only be light hack or companion she was 13yrs she then spent the next year in a very unsuitable home on a yard where she was ridden by lots of differant people most of who could nt ride before feeling sorry for her i brought her after 6 months of weight gain and building her up she is back working with no problems and hoping to take her out jumping again some say just rest and working long and low can help who knows have spent hours and hours googling kissing spines and still none the wiser

 

[BethH]

Hi Blue Eyes, just to clarify, the palliative route & training long and low can work for a ks horse as they all deal with discomfort in different ways and show different levels of pain, it sounds to me as though she has been ridden very correctly by you which has allowed her to build correct muscle which in turn supports her back and has allowed her to feel comfortable with a rider which is wonderful, from what you mention in her previous history, it was unlikely this was the case and showjumping would probably put pressure on her in just the wrong place to cause pain without having correct muscular support to help her deal with it.

Often the palliative route doesn't work long term because the back can continue to deteriorate so the operation ends up being the solution especially if the training routine changes at all which can result in lost muscle (like my horse when I was pregnant) but if you continue to keep her correctly fit and do plenty of ground work like long reining, anything to encourage her to come through from behind and lift her back (not with gadgets as usually false outline and for a ks horse much stress!) you have a good chance of keeping her going, many horses cope in this way for years. It sounds as though you have a lovely horse for your efforts - congratulations no mean feat!

 

[Rollin]

Goody Goody I am in France also, Maine et Loire.

I would be interested in your opinion. My CB stallion arrived aged 3 unbacked after a five stage vetting for his stallion licence and a pre-purchase vetting.

I sent him away to be backed and only started to have trouble when he was asked to canter. He was seen by three more vets and an equine physio, only the physio suspected some neck problem. As my vet was sure it was my bad riding!! a specialist orthopaedic vet said he had an inflamed tendon. We sent him to one of the top dressage riders in France who agreed with me. His canter is tres joli but he does not want to canter with a rider.

At her recommendation we took him to see Prof. Geoffroy at Nantes who is an FEI vet. He found KS on two spinal processes and an old badly healed fracture in his neck. Not congenital but likely due to elevage.

Here is the question? The French recommendation is spinal injections to help with the pain. I do not want to go down that route as I think it only deals with the pain not the problem. If we opt for surgery it means going back to the UK. Currently he is a pasture ornament and also at stud. He does produce quality youngstock.

What do you think of the French suggestion of spinal injections?

 

[muff747]

thanks for all your replies, at the moment (or before she went lame 5 months ago) she was still completely rideable but just not very forward and had started to pull faces when being girthed up but is that due to the kissing spines or is it just her personality? its really hard to tell, my vet said that x-rays can look terrible but they can tolerate it a lot better than you think but I'm just wary that if they are that bad now, surely they will get a lot worse in time and then my insurance will have run out and i would have to fund this op myself. Do i really want to wait to the point of her showing extreme symptoms and being in acute pain?

My biggest problem is whether i put her through the op at this stage even though her mild symptoms may be just due to her temperament rather than her kissing spines. Though again could she just be generally grumpy (was a lovely foal and yearling but started to get grouchy from 2 1/2 3 yrs onwards) because she's in pain?!! QUOTE]

I think you've answered your own question here in the last sentence of your first para. IMHO, I wouldn't blame her temperament for her being grumpy, and again I think you know the answer to that question.
I have heard nothing but success stories with this op and her being so young, I wouldn't hesitate, even tho it is a big operation. From what others have said, it sounds like the recovery is not too horrendous so in your shoes, I would go for it definitely.

 

[BethH]

Whilst I agree that there are muscular issues with this and a physio can keep a horse ticking over, it doesn't resolve the issue and generally the palliative route is in the main riding extremely correctly and long and low (a lot of very classical dressage really). A physio can help ease muscular tension whilst you are building correct muscle to support the back and I did go down this route for quite a while but then when I was pregnant my horse wasn't ridden so stringently for a few months and his back deteriorated and I had to operate to remove his source of pain.

It is hard for most normal riders to be able to ride to this standard the whole time and I had to pay my instructor to try and keep my horse ticking over by exercising him a couple of times a week and boy did I have to learn to massively improve my riding which is tough when you aren't a natural. The operation is the main solution although again the rehab can be very tiring and you have to be committed to it, it does mean that I now don't panic so much about going on holiday etc etc. The op can now also be done bystanding surgery.

So many people try the palliative route and in the long term end up still operating, it would be wrong to dismiss surgery as an option, I accept it depends on the horse and the rider but my horse was recommended to be PTS and would have been had it not been for my fabulous surgeon! 6yrs on my horse is still doing really well, is happy, relaxed and most importantly pain free, I am pretty certain this would not have been the case without the op.

 

[GoodyGoody]

Hi BethH, I am not talking about palliative care but about sorting out the root cause of the problem. Muscular pain in horses is rarely cured by physio or massage. In your case the KS may have been the root cause. My point is only that a correct assessment should be made. If you read the literature on KS you will see that in many cases horses with severe KS appear to be completely normal and others with far less severe KS are not. The clear implication is that there is something else going on.

 

[BethH]

I absolutely agree that correct diagnosis is key and that many horses have and cope with KS and that this isn't always the cause of their problem, that it could easily be another issue which is clouded by KS showing up, as lets face it a very high percentage of horses would show this if they were x-rayed. In my case, mine was genetic and my horse became super over sensitive as a result of 24/7 low grade niggling pain which made him feel very vunerable and over time he became increasingly dangerous as his back deteriorated. He can still be hyper sensitive at times and I think he will always be a worrier, but the danger bit vanished the second he was operated on. He was problematic at 4 and it took 2yrs for correct diagnosis, (hence I fully understand your hesitation about finding out the correct underlying root cause) and he was operated on as a 6yr old.

I also agree that these days a lot of people jump on the KS bandwagon and a lot of other limb issues are blamed on KS, but a decent equine vet should do a thorough investigation and scintigraphy and in my case it showed there were no other hot spots on my horse and therefore this could be the only cause. I hasten to add that had my horse had any other issues or been older I would have been unlikely to operate as I believe it severely reduces the ability for a successful recovery, but I also believe that KS can cause many secondary symptoms and problems because of the way a horse learns to carry itself to reduce the pain and it is also these secondary symptoms that can cloud the main problem.

I am all for anything to avoid an op but sometimes it really is KS, I have to say my vets were brilliant once they took the problem seriously, lets just all hope that we can get a correct diagnosis for our horses quickly - if only they could talk to us and tell us the problem!

 

[xxMozlarxx]

Hi Rollin,
There is no doubt that KS can be a painful condition but in our experience the CAUSE is muscles in spasm and it is this which needs to be sorted out. If he had a bad fall then it is even more likely that he has significant muscular pain. My own opinion of surgery is that it is rarely attacking the root cause. I'm not sure there are many human athletes who have their bones shaved down to prevent them rubbing! It surely makes logical sense that, if we trust that nature has designed a horse to work, then barring abnormalities, there is something else causing the spinal processes to touch which is likely to be the muscles and not just the muscles closest to the spine. The horse is a complete mechanical structure and like any physical structure if you damage a part of it repercussions can be seen throughout the structure. I am a trained human Bowen therapist and we were trained to start at the point FURTHEST from the symptoms in order to find the cause.
Stephen

So you are a human Bowen practitioner and you feel that gives you authority to comment on equine orthopaedic issues?? Have you ever actually owned a KS horse? A human athlete would have a similar operation if they had a similar problem with any bone in their body. Your comments are exactly the reason why I now steer clear of any 'alternative ' treatment for my horse, you are not medically trained and should be very careful of the claims you are making.

 

[GoodyGoody]

Hi xxMozlarxx, instead of being insulting you might want to find out more. I am only interested in results, alternative or otherwise. I agree with you with what you feel about 'alternative' therapies but why don't you include conventional 'therapies' too? I have done better than own a KS horse, I have successfully treated one earlier this year which was condemned as unrideable by 3 different vets. Your attitude is precisely the reason why horses have so many problems which only wait to be solved until the poor thing can no longer move. My stallion, Vigo (Concorde & Voltaire) was last year bought by Cian O'Connor after a successful rehab at our centre. Personally, I don't care what potty theory someone has, just that it works and works properly as opposed to covering up the symptoms. I am more than happy to stand by what I say by showing results. I am in the UK in June and would more than happily meet up with you to talk about what we do. Perhaps we could both learn something?

 

[xxMozlarxx]

Actually there is nothing insulting in what i posted unlike your reply. I asked you how as a Bowen therapist you feel you can comment on an equine condition, I also asked whether you had owned a KS horse. I hear that you feel you have treated 1 horse successfully, but I'm sure you must be aware of the fact that working with 1 horse cannot give you the experience to make the claims you are. I'm asking what your background, training and experience is to make statements about KS which are simply inaccurate quite apart from the advertising you are doing on here. For your information my horses condition was not picked up by a Chiro, in fact what she did would have caused him more pain, she certainly didnt pick up the muscular 'damage' you speak of that's because there wasn't any. My
horse is fully recovered from KS surgery alomg with so many others I know..he has had no further treatment from any 'back' person but is comfortable and moving fluidly. My attitude ensured that he was treated quickly and appropriately..and wasn't left until he couldnt move. Who were the 3 vets who said the horse was unrideable, seems a strange thing for 3 vets to do when there is an operation which could cure it, if the horse had the op and was still affected how could you know it was what you did that cured it, it may have happened anyway? What you are attempting to promote is worrying

 

[Meowy Catkin]

There is no doubt that KS can be a painful condition but in our experience the CAUSE is muscles in spasm and it is this which needs to be sorted out. If he had a bad fall then it is even more likely that he has significant muscular pain. My own opinion of surgery is that it is rarely attacking the root cause. I'm not sure there are many human athletes who have their bones shaved down to prevent them rubbing!

Wow! You have certainly demonstrated your ingnorance Re the difference beetween human and equine anatomy. I'm also quite amazed by your claim that muscle spasm can deform the spine to such an extent that the dorsal spinal processes touch.


Anyhoo, the OP may be interested in this research.
http://onlinelibrary.wiley.com/doi/10.2746/042516402776181259/abstract

The surgical treatment of impingement of dorsal spinous processes (DSPs) at 2 equine veterinary hospitals following a similar diagnostic and surgical protocol is described with special reference to the diagnosis and case selection. The diagnosis was made from clinical examination and results of radiography and diagnostic analgesia of the affected sites. Scintigraphy was also used as an aid to diagnosis at one hospital. Surgical treatment was generally recommended when conservative treatment, which included 3–9 months rest, intralesional corticosteroids and physiotherapy, had failed. The DSPs were approached through a midline incision in the skin and supraspinous ligament. They were resected using an oscillating saw. Postoperatively, horses were returned to lungeing work after 2 weeks and riding commenced at 3 months, in most cases, and by 6 months in all successful cases. From one to 6 DSPs between thoracic vertebra (T) 11 and lumbar vertebra (L) 3 were resected in individual horses. T15, 16 and 17 were the spines most commonly treated. Long-term follow-up information was obtained in 209 horses. Seventy-two percent of these horses returned to full work and a further 9% improved sufficiently to be used for some athletic work.

 

[opinionuk]

thanks for all your replies, at the moment (or before she went lame 5 months ago) she was still completely rideable but just not very forward and had started to pull faces when being girthed up but is that due to the kissing spines or is it just her personality? its really hard to tell, my vet said that x-rays can look terrible but they can tolerate it a lot better than you think but I'm just wary that if they are that bad now, surely they will get a lot worse in time and then my insurance will have run out and i would have to fund this op myself. Do i really want to wait to the point of her showing extreme symptoms and being in acute pain?

My biggest problem is whether i put her through the op at this stage even though her mild symptoms may be just due to her temperament rather than her kissing spines. Though again could she just be generally grumpy (was a lovely foal and yearling but started to get grouchy from 2 1/2 3 yrs onwards) because she's in pain?!!

I really don't know what to do, she has a very good prognosis from her fetlock but its going to be realistically 4 months before i can ride her enough to see if her K spines are causing a problem, then i will only have 6 months left for KS operation and rehab under insurance.

does anyone have a horse out there that didn't have the surgery and is still fine??

I really feel for you I had exactly the same diagnosis as you, she was also a 4 year old and like you went in with hind leg problems, her KS wasn't overly serious but she didn't like going forward, didnt like girth being done up, she still doesn't!

I decided to try an alternative to the op, the vet gave her a cortisone injection in her spine which she said I would need to inject her every 3 months, I spent a lot of time with her on the Pessoa, getting her to stretch her back long and low, I got a physio to come and see her every week for a month, I brought her a magnetic stable rug and a equi massage pad and put this on her every day, during this time I didn't ride her but did a lot of long reining her, this went on for about 8 weeks, i also put her hay on her stable floor to encourage her to stretch.

I did get on her she was ok, still not great behind but I wasn't expecting a miracle! She hasn't needed injecting since which was 2 years ago, I got to know when she was sore so rather than ride her that day I'd turn her out, I also put her on supplement called agnus cactus, it's hardwork to maintain but just goes to show touch wood that it can be done

 

[DanaHart]

My RI events a horse with Kissing Spines, and his partner competes at Advanced Medium Dressage on a horse with Kissing Spines...... neither horse has been operated on.

They work their horses in an exagerated long, low outline at all times (unless competing), using a Pessoa whilst lunging...... by working them long and low, they are stretching over their backs, therefore, 'opening' the discs reducing the pinching of the spinal cord.

This may not work for eveyone, but surely, it is worth giving it a try.....??

 

[Hoptoit]

Have a look at the surgery being carried out at www.cottsequine.co.uk. It's a new less invasive technique that seems to have fairly consistent results. There's a lot of info about it on their website. I know that if I had an affected horse this is the root I'd go down in the first instance.