Kissing Spines

[timbobs]

Ed was diagnosed with four Kissing Spines last week after a trip to Liphook for x-rays and had the steroid injections done.

Vet is back on Friday to have a feel and see how he's looking.

I'm not convinced that the injections will work as he has one where there is barely any space between them at all so I wanted to get people's thoughts and experiences on the ligament snip and rehab programs.

X-ray below- have circled the one which is very tight.

 

[ohmissbrittany]

Has the horse any issues with his gut, sensitivity elsewhere, feet, joints?

Here is some interesting reading: https://holistichorse.com/health-care/the-kissing-spine-disorder/ and also https://thehorse.com/148184/kissing-spines-horses-back-pain/ and https://www.horsetalk.co.nz/2015/02/04/help-horse-kissing-spine-goodbye/

I find kissing spines is often co-morbid with other issues, such as ulcers or hind end soreness, wich cause "poor posture" and the resultant back pain. It's hard to say because we don't x-ray the spines until they are lame, but for example there was a study done and the result was that a panel of vets could not reliably pick a lame horse based on navicular x-rays alone. All that to say, we don't actually know how many sound horses have close/touching vertebrae, and if that's even the main cause of the problem. My vet once told all of this information while examining a horse, and finished by saying he wasn't sure if it was actually the surgery or the time off and careful bringing-back that did the horse more good.

I personally have seen a handful of horses "develop kissing spines" from ulcers, foot issues, time off work due to unrelated issues.... and all of these resolved through physio, horsey "core workouts" and changes to feet/feed. None had surgery. Those that I know have had surgery (2), one recovered completely and one did not. The one that did not, I suspect has other hind end issues though because he moved a bit funny through his pelvis to one side. My personal opinion is that, especially when the affected vertebrae are around where the rider is sat, the issue is either a lack of correct back strength to support the rider/tack or there is something that is causing the horse to carry them incorrectly (IE, ulcers making them not want to engage thoracic muscle, or sore shock preventing them from keeping their hind legs engaged in carriage). Take that as you will- I'm a biochemical engineer and not a vet though I've had/trained/ridden horses for myself and others for over 20 years.

 

[timbobs]

Has the horse any issues with his gut, sensitivity elsewhere, feet, joints?

Here is some interesting reading: https://holistichorse.com/health-care/the-kissing-spine-disorder/ and also https://thehorse.com/148184/kissing-spines-horses-back-pain/ and https://www.horsetalk.co.nz/2015/02/04/help-horse-kissing-spine-goodbye/

I find kissing spines is often co-morbid with other issues, such as ulcers or hind end soreness, wich cause "poor posture" and the resultant back pain. It's hard to say because we don't x-ray the spines until they are lame, but for example there was a study done and the result was that a panel of vets could not reliably pick a lame horse based on navicular x-rays alone. All that to say, we don't actually know how many sound horses have close/touching vertebrae, and if that's even the main cause of the problem. My vet once told all of this information while examining a horse, and finished by saying he wasn't sure if it was actually the surgery or the time off and careful bringing-back that did the horse more good.

I personally have seen a handful of horses "develop kissing spines" from ulcers, foot issues, time off work due to unrelated issues.... and all of these resolved through physio, horsey "core workouts" and changes to feet/feed. None had surgery. Those that I know have had surgery (2), one recovered completely and one did not. The one that did not, I suspect has other hind end issues though because he moved a bit funny through his pelvis to one side. My personal opinion is that, especially when the affected vertebrae are around where the rider is sat, the issue is either a lack of correct back strength to support the rider/tack or there is something that is causing the horse to carry them incorrectly (IE, ulcers making them not want to engage thoracic muscle, or sore shock preventing them from keeping their hind legs engaged in carriage). Take that as you will- I'm a biochemical engineer and not a vet though I've had/trained/ridden horses for myself and others for over 20 years.

Thanks for your comprehensive reply- some really interesting reading in your links.

Ed had ulcers 18 months ago, scoped clear after 6 weeks treatment and was clear when scoped last week. He was diagnosed with arthritis in both hocks 6 weeks ago, so I wonder if this is a contributory factor.

 

[Jumoro]

Harry had injections into 4 spaces in June (one touching and 3 close). I was sceptical at the time and the rehab/remedial work (mainly ridden) was hard to start with. However, 6 months down the line he is like a different horse physically and mentally. Obviously every horse is different and what works for one may not work for another, however so far the outcome has been great for us and our vet is v pleased with progress.

 

[timbobs]

Harry had injections into 4 spaces in June (one touching and 3 close). I was sceptical at the time and the rehab/remedial work (mainly ridden) was hard to start with. However, 6 months down the line he is like a different horse physically and mentally. Obviously every horse is different and what works for one may not work for another, however so far the outcome has been great for us and our vet is v pleased with progress.

Thanks for replying Jumoro- how quickly did you see a difference in Harry after the injections pain-wise? Ed has the vet again tomorrow, but so far he seems grumpier and in more pain than before the injections.

What was your rehab plan after the injections? Sorry for all the questions, I'm just trying to put together my thoughts to discuss with the vet tomorrow!

 

[ohmissbrittany]

He was diagnosed with arthritis in both hocks 6 weeks ago, so I wonder if this is a contributory factor.
Read more at https://forums.horseandhound.co.uk/threads/kissing-spines.771624/#mpOYfTPKhmQQRfR1.99

I really would not be surprised. Sore hocks, he would not want to bring his hind end under him and push- he would keep more weight on his front and possibly "trail" the back legs. if you think about this from a mechanical perspective, posting the legs out behind would extend the spine medially (the "belly side") and compress the top processes (the top side of the spine)... think letting a slinky sag between your hands.

The first thing I would do is introduce core/hind end work. If he's uncomfortable on his hocks, inject them. Then when he's ready to get back working - usually 2-3 days off after joint injection IIRC - do the core/hind end stuff. Theraband (you don't have to go buy branded crap, you can get therapy bands from gym supply stores and attach to a surcingle or the girth). Give it up to three months of CONSISTENT buildup and then re-evaluate the back. (If it was my horse, I would even re-radiograph just out of clinical interest even if the horse was no longer symptomatic. It was fascinating to watch her HP angles change when I rehabbed the crushed heels. )

 

[Jumoro]

It's hard to remember thinking back - We gave him a couple of days off after the injections and then my instructor rode him at first before I got back on. We were not given a very rigid rehab plan, however I worked closed with my vet and instructor - nothing v fancy - we took him back to basics - getting him to work from behind (he was very on the forehand) and use himself properly - something he wasn't always entirely enthusiastic about to start with! Lots of work long and low to start with + suppling exercises, lots of transitions and working over poles, hill work out hacking, mainly walk and then canter to start with although we are now really working on his trot. As he has got stronger we have been working him more into a contact and reintroduced jumping & gridwork. Progress wasn't always linear and sometimes it felt like we were going backwards but the overall improvement has been huge.

 

[timbobs]

I really would not be surprised. Sore hocks, he would not want to bring his hind end under him and push- he would keep more weight on his front and possibly "trail" the back legs. if you think about this from a mechanical perspective, posting the legs out behind would extend the spine medially (the "belly side") and compress the top processes (the top side of the spine)... think letting a slinky sag between your hands.

The first thing I would do is introduce core/hind end work. If he's uncomfortable on his hocks, inject them. Then when he's ready to get back working - usually 2-3 days off after joint injection IIRC - do the core/hind end stuff. Theraband (you don't have to go buy branded crap, you can get therapy bands from gym supply stores and attach to a surcingle or the girth). Give it up to three months of CONSISTENT buildup and then re-evaluate the back. (If it was my horse, I would even re-radiograph just out of clinical interest even if the horse was no longer symptomatic. It was fascinating to watch her HP angles change when I rehabbed the crushed heels. )

Really useful description of the slinky- makes it very clear to visualise in my mind how the hocks will have been affecting him.

He had both hocks injected about 6 weeks ago now, and the change in his movement has been significant. It was about 10 days post injection that his back pain become clear so we initially thought the pain was muscular due to his changed movement (and the fact that he has lost a lot of muscle being on light-work only for the last few months whereas he was well-muscled and fit previously) Unfortunately the pain didn't reduce with physio, acupuncture or rest and he was spooky to the point of panic at times when ridden so we x-rayed and found the kissing spines. ETA: He is clearly sore on palpation over the KS area, but no reaction on other areas.

I have seen the resistance band systems and have been looking at those with interest! At the moment, he is so sore that I am reluctant to work him at all, but will discuss with the vet tomorrow.

It's hard to remember thinking back - We gave him a couple of days off after the injections and then my instructor rode him at first before I got back on. We were not given a very rigid rehab plan, however I worked closed with my vet and instructor - nothing v fancy - we took him back to basics - getting him to work from behind (he was very on the forehand) and use himself properly - something he wasn't always entirely enthusiastic about to start with! Lots of work long and low to start with + suppling exercises, lots of transitions and working over poles, hill work out hacking, mainly walk and then canter to start with although we are now really working on his trot. As he has got stronger we have been working him more into a contact and reintroduced jumping & gridwork. Progress wasn't always linear and sometimes it felt like we were going backwards but the overall improvement has been huge.

Thanks for sharing your rehab experience- lots to think about when we get started on rehab!

 

[Hormonal Filly]

Sorry to hear about your horses diagnosis but well done on getting him checked out. Please get a lameness work up done on the rest of him, hocks, stifle etc. My mare successfully had the KS traditional operation, she had 3 processes shaved down. I rehabbed her, all going well, for her to only go lame with hock arthritis then ulcers. The hocks were bad. We couldn’t keep her sound and happy. She also possibly had navicular, muscle wastage all across her back and suspensory looked like it had issues. Once she had her back sorted and was using her body properly the other joints were not coping well. She was so unhappy and hated the vets, plus all the scans etc. She was put to sleep at 9, bless her.

Ive seen so many success stories which is amazing, but I would get the full picture first. I wouldn’t go down the steroid injection route UNLESS I wasn’t insured. If you’re insured go for the operation (as long as you know nothing else is a problem) it cost my insurance about £3,500 5 years ago. The steroids don’t last long enough.

If I knew she had the other issues I would of probably not had her operated on, it was a long rehab process and box rest she didn’t copy well with.

 

[Jumoro]

Hope all goes well with the vet & good luck moving forwards.

We are still a work in progress, however consistent and appropriate work is doing the trick for us. We've also kept an open mind as we've moved forwards and been careful to keep and keep an eye on horse and rider as a whole rather than just fixating on the back if that makes sense (which I found very difficult to start with) - so as we've moved forwards we've found and addressed issues with his teeth, improved his bridle fit, experimented with different bits, worked on his feet/shoeing, I've worked on my riding ability, core fitness and straightness issues and of course kept a close eye on saddle fit....all basic stuff tbh but of course getting it all right and then keeping it right can be quite a challenge!

 

[timbobs]

Sorry to hear about your horses diagnosis but well done on getting him checked out. Please get a lameness work up done on the rest of him, hocks, stifle etc. My mare successfully had the KS traditional operation, she had 3 processes shaved down. I rehabbed her, all going well, for her to only go lame with hock arthritis then ulcers. The hocks were bad. We couldn’t keep her sound and happy. She also possibly had navicular, muscle wastage all across her back and suspensory looked like it had issues. Once she had her back sorted and was using her body properly the other joints were not coping well. She was so unhappy and hated the vets, plus all the scans etc. She was put to sleep at 9, bless her.

Ive seen so many success stories which is amazing, but I would get the full picture first. I wouldn’t go down the steroid injection route UNLESS I wasn’t insured. If you’re insured go for the operation (as long as you know nothing else is a problem) it cost my insurance about £3,500 5 years ago. The steroids don’t last long enough.

If I knew she had the other issues I would of probably not had her operated on, it was a long rehab process and box rest she didn’t copy well with.

Hi AimeeTess- Sorry to hear about your girl, sounds like a really tough situation.

He had a full lameness work-up at Liphook 6 weeks ago and blocked sound to the hocks. These were injected and he is now sound.

When he went back to Liphook to get the back checked out last week he scoped clear for ulcers and his neck x-rays were clear, so I'm hoping there is nothing additional going on alongside the hocks/back. Before Liphook would operate, I think the next step would be to block the back to make sure there are no other factors contributing to his pain.

He has already had his back injected, but it doesn't seem to have made any difference. He is insured, but the insurance are trying to put the hocks/back under one claim at the moment. If they do this, I'm not sure I will have enough money for an operation but we will see!

 

[timbobs]

Hope all goes well with the vet & good luck moving forwards.

We are still a work in progress, however consistent and appropriate work is doing the trick for us. We've also kept an open mind as we've moved forwards and been careful to keep and keep an eye on horse and rider as a whole rather than just fixating on the back if that makes sense (which I found very difficult to start with) - so as we've moved forwards we've found and addressed issues with his teeth, improved his bridle fit, experimented with different bits, worked on his feet/shoeing, I've worked on my riding ability, core fitness and straightness issues and of course kept a close eye on saddle fit....all basic stuff tbh but of course getting it all right and then keeping it right can be quite a challenge!

So many different things to think about, and it is so easy to fixate on just the back!

I am trying to take a holistic approach, as he is only 7 and I want to keep him as strong and healthy as possible, but I am nervous about him having these issues so young.