Kissing spines surgery, please give me hope.

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crazycorkey

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Hi all,
My 12 year old 17'3hh ish came back from Newmarket approx 3 weeks ago after having 6 dsp's operated on. (Went in for right hind lameness)
He also had hot spots in his sacroiliac joint and also in both hocks which was highlighted during the bone scan. X-rays were taken which confirmed arthritic changes in both hocks but more noticeably on in his right hind.

He has been on box rest with 2x daily in hand walks for the past 3 weeks and has now been allowed free access to a smaller paddock during the day. To my great surprise and relief he has for the most part been an angel and completed his time in horsey prison without too much drama.

However today for the first time he trotted away from me for a few strides and is now even more lame on his right hind than ever before!

Can anybody shed some light or even give me some much needed hope?
 
If he's got changes in his hocks and has been stood in I would put it down to stiffness. Whilst the box rest was needed for the back, it won't necessarily have helped with his other problems
 
Mine had six separated nine weeks ago and is going from strength to strength. I did not box rest mine or restrict him to a small paddock, because I did not think it was right for my horse.

I doubt if the issues with yours are as anything to do with the back surgery.

I've been told that Cotts, who pioneered the ligament resection I assume your horse had (because removing six dsp's would be quite unusual) say that sixty per cent of the horses they operate on have SI and/or PSD/hock issues. You are far from alone.

I hope the rest of his rehab goes better if he can get to move more.
 
Gosh I didn't even really consider it may be that he is stiff.
It's been one thing after another with him so instantly thought the worst.
Thank you all, from tomorrow I'm going to turf him out 24/7 but give him free access to his stable.
 
He will have lost a lot of muscle and will be very sore and tight , would get him moving and working properly ASAP ( you can do that 6 weeks post KS surgery, must work in a round and engaged way ) and give plenty of regular physio
 
I'd get him moving. My rehab recommended lunging at the stage yours is at, does yours? According to Cotts he can also be walked out for an hour in hand or led from another horse.
 
No actually I'm not due to lunge for another month according to my rehab programme. Seems along time

The rehab programme from Newmarket is basically: 1 month of walking in hand for 10 mins increasing to 20 mins twice daily during this period.

Small paddock turnout from 13/11/13 (he is already out)

Free paddock turnout plus lunging/long reining from 11/12/13.
The above is for a month minimum then I can think about riding.
 
TBH I would think this is more of an issue with the SI. Did the vet say anything about the possibility of issues with the hind suspensories?

My (then 13 yr old) ex-racer had 3 vertebrae removed, double neurectomy and injections into both SI joints. The KS and the PSD wasnt his issue; his limiting factor is the SI. He had the KS op and 2 days later the double neurectomy. He had 4 months box rest (he is a loon so couldnt even think of small paddock t/o or walks in hand as he just went around on 2 legs) and then he went for a check-up. Still lame. He then had the SI injections and box-rested for a further 4 weeks. He had a back x-ray as well just to check everything was settling down (he had quite a lot of swelling) and then we started lunging for a month and then started turning him out with my other 2 for an hour a day building up over time. After about 2 months of limited turnout he was slowly introduced to 24/7 turnout and then a month later I started riding him in walk for 10 mins at a time (after 30 mins lunging) building up slowly to trot. When we finally managed to get to trot the power was amazing - it was like having ridden a horse with the hand brake on before.

It might seem "extreme" and I took things slowly, but for my horse he lost a lot of muscle just being box rested for a couple of weeks so I took it slowly as I was scared of breaking him again. He has been off work twice since with 2 kick injuries and each time I have slowly brought him back to work. I just sat on him again yesterday for 10 mins in walk.

I would say that you need to find a system that works for you and your horse and ignore what everyone else is doing with their horses. Each one will be different in their rehab and what the vets tell you is just a guide. I would say though that with a SI injury you need to try and keep them in a level of a work that is going to keep the topline so that it holds the front end and the back end together. I wouldnt be surprised if he also had some damage to hind leg suspensories.
 
My boy had 4 processes removed and I did 1 weeks box rest, then small pen turn out for a week then normal turn out, I started walking him after a week, then at week 8 post op started lunging or long reining, started riding at 16 weeks. He is doing fine. Being out i think is better for them as they can gently exercise and stretch their back, plus if yours has arthritis then it's better to keep them moving and will help with any stiffness.
 
crazycorkey said:
No actually I'm not due to lunge for another month according to my rehab programme. Seems along time

The rehab programme from Newmarket is basically: 1 month of walking in hand for 10 mins increasing to 20 mins twice daily during this period.

Small paddock turnout from 13/11/13 (he is already out)

Free paddock turnout plus lunging/long reining from 11/12/13.
The above is for a month minimum then I can think about riding.
Click to expand...

I know each horse is an individual but mine did not have the additional issues that your horse had, so you would expect his rehab recommendation to have been less onerous. In fact, it's mixed, which makes no sense. In addition, the recommendation from Cotts where the operation was pioneered is one hour in hand from day one!!!

My rehab was box rest 3 weeks, small paddock for a further TWELVE weeks. Lunge at 3 weeks, ride at 6 weeks.

What I actually did was keep him in a big barn for 11 days (I ride in it, it's that big) and then turn him out on 11 acres of steep hill on day 12.

Neither your horse's sacroiliac nor his hocks are, I think, normally best treated with rest. So as long as they didn't find PSD, which might need rest, then I don't understand why you are not being told to ride at six weeks like Cotts and my surgeon do.

Did he have any dorsal processes removed? If you're not sure, check the holes - they will be tiny if not, no more than about a finger tip. If he had dorsal processes removed then it is longer before you can sit on them.

Mine demonstrated the new flexibilty in his back by launching me in to orbit yesterday. To be fair, the cat coming over the wall and landing in his feet did shock us all a bit.

Let us know how you get on?
 
Just checked my report from newmarket and he had the wedge ostectomy across 6 sites.

I have turned him out 24/7 now next to my other 2 and will continue with the twice daily walks in hand.

Will absolutely keep you all informed.
Thanks everybody.
 
OK they cut the bones out, that's the operation busybusybusy's horse had and it is longer before you sit on them with that operation compared with mine.

It is still extremely unlikely that the right hind lameness is related to the back operation in a horse with hock and SI issues, I think.

I hope you are insured for this? It seems a little unusual to me for Newmarket to have done the kissing spines operation when there was no confirmation that his issues were actually a result of his back. Did they suggest that it would resolve his hind leg lameness?
 
Yep I'm insured but went way over.
Other than X-rays and the scintigraphy the confirmation came only from me riding him at Newmarket and what I have told them about his behaviour changes whilst ridden.
They did tell me that whilst the arthritic changes were moderate the most likely culprit for the lameness was the kissing spines.
 
I'm so sorry for you, but it looks like they were wrong about that :(

It's a new one on me, I've not heard of kissing spines causing outright lameness in one leg. I presume they nerve blocked his back and the lameness disappeared, which led them to that conclusion?

Sorry to keep asking questions, ignore me if it's getting annoying but I'm finding everything about kissing spines fascinating at the moment. I've been riding my boy for three weeks today and he's a different horse :)
 
Im so glad it worked out for you, wish it was slightly more clear cut for us.

They didnt nerve block his back but my vets did nerve block his right hind from heel to stifle and drew a blank. They then referred me to Newmarket as we were all getting frustrated.
When I went down to Newmarket though to ride he was extremly tense and about to take off if pushed to work correctly. Sounds silly but because my father was going away I had to run our business unilaterally so couldn't afford to injure myself. Wish I had now!

I could perhaps send you my report from newmarket as actually there are a few things that have cropped up that I was not made aware of at all. Making me now feel that Iv made totally the wrong decision!
For instance there were 6 areas impinging however after reading the report more thoroughly today found they only operated on 4.
 
It's normal to take out one in three, which allows the other two to open up. So taking out four to cure six impingements is absolutely normal.

It sounds from all your diagnostics as if it cannot be the hock, but it is unlikely now to be the back, which leaves the sacroiliac as the most likely candidate. SI strain often goes with kissing spines, so hopefully curing the KS will allow him to resolve his SI issues.

I think maybe you should ask Newmarket what the optimum rehab would be for the SI joints, assuming that is now the main cause of single leg lameness.
 
crazycorkey said:
Im so glad it worked out for you, wish it was slightly more clear cut for us.

They didnt nerve block his back but my vets did nerve block his right hind from heel to stifle and drew a blank. They then referred me to Newmarket as we were all getting frustrated.
When I went down to Newmarket though to ride he was extremly tense and about to take off if pushed to work correctly. Sounds silly but because my father was going away I had to run our business unilaterally so couldn't afford to injure myself. Wish I had now!

I could perhaps send you my report from newmarket as actually there are a few things that have cropped up that I was not made aware of at all. Making me now feel that Iv made totally the wrong decision!
For instance there were 6 areas impinging however after reading the report more thoroughly today found they only operated on 4.
Click to expand...

They take out every other one - but it really depends on which processes are impinging. did they show you the xrays. Which practice did you use in Newmarket?

KS may cause the horse to appear lame behind as it tries to compensate its way of going - this is what leads to the SI problems. SI is very hard to predict; some horses come back into full work and others are constrained by it, such as mine who wont ever jump again (we are still yet to determine if he will canter under saddle - he is fine on the lunge and does not disunite now). Also, there is no "cure" for SI; you have to manage the condition and can use injections to help but the injections may or may not work and there is no guarantee on how long they will work for and how often they are needed.
 
The surgeon my vet uses takes out every third in cases like my horse, who had six impinging processes all in a row, so there must be more than one way they skin that particular cat. The way it was explained to me, I thought they were all done that way, but clearly not. I did wonder at the time why they would not simply take out every other one.
 
Cbanglo, yes saw the X-rays at Newmarket and I saw 6 impinging sites in the thoracic area. Will attempt to post the X-rays.
Not sure what department exactly but the vets name was Matt, unsure if I can give second name.
 
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