KS and ethics

[rextherobber]

As title really, have a KS horse, back has been injected and on a rehab plan, but it's not going well. I'm struggling with the ethics of continuing with surgical intervention- I know it's successful in many cases, and my vet is quite keen for this as a next step treatment (though we haven't discussed this in depth yet) . Horse is quite happy as a field ornament and seems in absolutely no discomfort at all, charging about, sound as a pound. Unfortunately, riding is not going so well, just started after weeks of groundwork, the back injections have made little difference. The recent post about a horse having huge issues post op hasn't done much to convince me...I have other horses, and my own land, so an early retirement isn't a problem, but I particularly like riding this horse, even if my sports horse was to become a happy hacker...What would you do? How often is KS the only problem and not secondary to another issue? Horse is 10. TIA.

 

[Boughtabay]

this will be such a personal decision but for me, the lynchpin would be a) how I thought the horse would cope with surgery/post-surgery maintenance & b) whether I could alternatively afford to keep an ornament & run another horse if wanted/needed to.

 

[ycbm]

Difficult one. I know it can work, but I've had one done and still lost him not long after from self inflicted head trauma. I wouldn't have another done and if a core strength rehab didn't work and I had land I would retire it.
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[ycbm]

To add, I'm really not certain about the ethics of multiple cuts into a ligaments that should be stabilising the spine and I'm unhappy about the lack of research into long term outcomes.
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[AmyMay]

It’s not an operation I would put any horse through. I actually do think it’s unethical.

 

[rextherobber]

this will be such a personal decision but for me, the lynchpin would be a) how I thought the horse would cope with surgery/post-surgery maintenance & b) whether I could alternatively afford to keep an ornament & run another horse if wanted/needed to.

That's a good point, I don't think the horse would cope at all well if post surgery care meant being stabled/confined for any length of time.

To add, I'm really not certain about the ethics of multiple cuts into a ligaments that should be stabilising the spine and I'm unhappy about the lack of research into long term outcomes.
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It’s not an operation I would put any horse through. I actually do think it’s unethical.

I think you have both reinforced my own feelings.
Thank you all.

 

[myheartinahoofbeat]

In the cold light of day, I wouldn't put a horse through this sort of operation. I'm sure I might feel differently if it was my only option but I hope I would stay true to what I believe to be the right thing to do for the horse and not get too emotional. I have 2 field ornaments at home now( not KS) and if you have the land, I would definitely retire.

 

[Abacus]

With regard to how things are going now: you haven’t really said why the rehab isn’t going well but is it possible that your horse is reacting in this way because of pain memory rather than a continuing physical problem? If so then surgery might not actually help anyway (regardless of the ethics).

How long have you been rehabbing and how long was he out of work? It can take quite some time to build the muscles that will support the back and create distance between the vertebrae. I’ve known horses ‘recover’ from a KS diagnosis once properly back in work, including my 25 year old horse who was diagnosed probably 13 years ago, and is still working now.

 

[ownedbyaconnie]

I’ve done it and 1 year on she’s the best she’s been in years. But the surgeon that did it is very highly regarded and was the BD team vet for a bit I think. I trust my vet wholeheartedly so tbh I didn’t really know much about the surgery before she went through it and I had already seen a few horses go through the rehab and look fab at the end of it (I’m on a yard that specialises in rehab).

It did open up a bit of a Pandora’s box of issues as she actually started to work properly and that highlighted other issues she’d done a pretty good job of hiding but it was worth it.

Only thing I’d say that maybe worked in our favour is my in hand rehab was a lot longer than other rehab plans I’ve seen and I also didn’t do the lunging that was recommended. I’m also not bothered about working into a contact so i didn’t put any pressure on her working before she was ready. My aim was straightness and pushing from behind. All my rehab was straight lines hacking, didn’t set one hoof in a school until maybe 6 months post op and then we built up from there.

Only time will tell re the long term but she wasn’t happy in the field so I had to do something. I think it’s probably become a bit trendy and some vets recommend the surgery when it’s not a one size fits all? But for mine I think it definitely was the right decision and I bristle a bit at the implication it was an unethical decision But each to their own!

I’ve got a thread on here that I updated during the process if you did want to see a start to finish (I think finish, not sure when I last updated it!).

 

[ycbm]

That's a good point, I don't think the horse would cope at all well if post surgery care meant being stabled/confined for any length of time.


I think you have both reinforced my own feelings.
Thank you all.

If you need any more reinforcement I can show you my x ray of the ligament "snip" operation, which shows a chisel buried deep in my horse's spine. I have pretty much campaigned against the desmotomy operation being referred to as a "snip" ever since, it's nothing like as simple or harmless as the tiny word snip implies.

 

[ycbm]

I’ve done it and 1 year on she’s the best she’s been in years. But the surgeon that did it is very highly regarded and was the BD team vet for a bit I think. I trust my vet wholeheartedly so tbh I didn’t really know much about the surgery before she went through it and I had already seen a few horses go through the rehab and look fab at the end of it (I’m on a yard that specialises in rehab).

It did open up a bit of a Pandora’s box of issues as she actually started to work properly and that highlighted other issues she’d done a pretty good job of hiding but it was worth it.

Only thing I’d say that maybe worked in our favour is my in hand rehab was a lot longer than other rehab plans I’ve seen and I also didn’t do the lunging that was recommended. I’m also not bothered about working into a contact so i didn’t put any pressure on her working before she was ready. My aim was straightness and pushing from behind. All my rehab was straight lines hacking, didn’t set one hoof in a school until maybe 6 months post op and then we built up from there.

Only time will tell re the long term but she wasn’t happy in the field so I had to do something. I think it’s probably become a bit trendy and some vets recommend the surgery when it’s not a one size fits all? But for mine I think it definitely was the right decision and I bristle a bit at the implication it was an unethical decision But each to their own!

I’ve got a thread on here that I updated during the process if you did want to see a start to finish (I think finish, not sure when I last updated it!).

I would have far less of an issue if everyone rehabbed like you, ObaC. My rehab plan included lunging on a pessoa and I told my vet that wasn't going to happen and there was no way I was going to attach my horse's mouth to his hind legs.

When I think of the ethics of it, it's in continuing to do these operations without publishing any (?) studies about the long term outcomes, because anecdotally there are a lot of failures; the snap that many vets seem to make straight to the operation with no suggestion of a postural rehab first; the snap to the operation without first investigating the hock/psd/SI issues that so very often seem to have caused it, and operating on what look to me and other experienced horse owners as completely unsuitable horses.

The ligament desmotomy also works at least in part because it denerves. We now pretty much frown on denerving feet, a lot are uncomfortable about denerving PSD, and this falls in the same boat, for me.

I don't mean to criticise anyone who's had this operation done, we all do these things for the best of reasons guided by our vets.

There's no doubt, ObaC, that you've done your absolute best for yours under the best guidance and I'm really pleased that with your regime and what you want for your pony, it's working for you.

 

[Trouper]

Many of us on here have experience of having this operation done but I would guess that every case was different. Mine was not successful and I have reflected long and hard on it all and whether I would ever consider doing it again.

My concern is that I would need to be very sure that that was the only issue affecting the horse and that is very difficult to do. I think it is only when the horse is moving differently after the op that you begin to find out what other problems are also present and then you are almost back at the beginning having to decide what to do in the best interests of the horse.

As a veteran of two back operations and other procedures myself, I know that surgery can help a great deal. Do I go back to doing all the heavy duty work and lifting that I used to do before - well, no of course not. So why would we want a horse to go back to carrying our weight around and expect it to be able to cope with a full ridden career.

I think my conclusion is that if a KS op gave a young horse the chance of a pain free existence as a field ornament then I might consider it but for no other reason.

 

[Jellymoon]

I would have far less of an issue if everyone rehabbed like you, ObaC. My rehab plan included lunging on a pessoa and I told my vet that wasn't going to happen and there was no way I was going to attach my horse's mouth to his hind legs.

When I think of the ethics of it, it's in continuing to do these operations without publishing any (?) studies about the long term outcomes, because anecdotally there are a lot of failures; the snap that many vets seem to make straight to the operation with no suggestion of a postural rehab first; the snap to the operation without first investigating the hock/psd/SI issues that so very often seem to have caused it, and operating on what look to me and other experienced horse owners as completely unsuitable horses.

The ligament desmotomy also works at least in part because it denerves. We now pretty much frown on denerving feet, a lot are uncomfortable about denerving PSD, and this falls in the same boat, for me.

I don't mean to criticise anyone who's had this operation done, we all do these things for the best of reasons guided by our vets.

There's no doubt, ObaC, that you've done your absolute best for yours under the best guidance and I'm really pleased that with your regime and what you want for your pony, it's working for you.

I also would not have the op done, for the reasons YCBM has stated above. I’m not sure it is ethical, but I completely understand why people have it done, there’s not judgement there. It’s the vets I’m unhappy with actually, not the owners.

 

[rextherobber]

With regard to how things are going now: you haven’t really said why the rehab isn’t going well but is it possible that your horse is reacting in this way because of pain memory rather than a continuing physical problem? If so then surgery might not actually help anyway (regardless of the ethics).

How long have you been rehabbing and how long was he out of work? It can take quite some time to build the muscles that will support the back and create distance between the vertebrae. I’ve known horses ‘recover’ from a KS diagnosis once properly back in work, including my 25 year old horse who was diagnosed probably 13 years ago, and is still working now.

Thanks for your reply - been rehabbing for 12 weeks, horse was out of work for 6 weeks. Its not going well in that horse appears well, good top line, stretching forward, until you get on, was ok for 5 mins, and is generally OK in walk but hollows and is tense in anything other than walk. Have tried ACP trial in case it's remembered pain, but that is random, sometimes better, sometimes not, and I don't want to have to drug a horse in order to ride it, unless it's very, very short term, of course. Am now suspecting there may be more going on.

 

[rextherobber]

I’ve done it and 1 year on she’s the best she’s been in years. But the surgeon that did it is very highly regarded and was the BD team vet for a bit I think. I trust my vet wholeheartedly so tbh I didn’t really know much about the surgery before she went through it and I had already seen a few horses go through the rehab and look fab at the end of it (I’m on a yard that specialises in rehab).

It did open up a bit of a Pandora’s box of issues as she actually started to work properly and that highlighted other issues she’d done a pretty good job of hiding but it was worth it.

Only thing I’d say that maybe worked in our favour is my in hand rehab was a lot longer than other rehab plans I’ve seen and I also didn’t do the lunging that was recommended. I’m also not bothered about working into a contact so i didn’t put any pressure on her working before she was ready. My aim was straightness and pushing from behind. All my rehab was straight lines hacking, didn’t set one hoof in a school until maybe 6 months post op and then we built up from there.

Only time will tell re the long term but she wasn’t happy in the field so I had to do something. I think it’s probably become a bit trendy and some vets recommend the surgery when it’s not a one size fits all? But for mine I think it definitely was the right decision and I bristle a bit at the implication it was an unethical decision But each to their own!

I’ve got a thread on here that I updated during the process if you did want to see a start to finish (I think finish, not sure when I last updated it!).

Thanks, will hunt down your thread. Totally get that it's a case by case thing, and obviously right for your horse. I am not a fan of lunging anyway, so all my rehab has been straight line, long rein work too.

 

[rextherobber]

If you need any more reinforcement I can show you my x ray of the ligament "snip" operation, which shows a chisel buried deep in my horse's spine. I have pretty much campaigned against the desmotomy operation being referred to as a "snip" ever since, it's nothing like as simple or harmless as the tiny word snip implies.

Thanks, I believe I've seen that on another thread, it's not an image that's easy to forget!

 

[LEC]

In my experience it’s just not successful. If I had a young horse that needed it then I would just quit. Too many issues especially with secondary problems which then need fairly hard intervention. I am more open if the horse is older, become a bit uncomfortable and has been a successful performer for years. I don’t think failure rates are discussed enough and I think they are high. Saying that I had a horse with KS but quite far back and it has never been an issue - never needed back injected etc it was a field accident years ago which caused her issues for eventing but she is in work and has a lovely life at low level.

 

[rextherobber]

I would have far less of an issue if everyone rehabbed like you, ObaC. My rehab plan included lunging on a pessoa and I told my vet that wasn't going to happen and there was no way I was going to attach my horse's mouth to his hind legs.

When I think of the ethics of it, it's in continuing to do these operations without publishing any (?) studies about the long term outcomes, because anecdotally there are a lot of failures; the snap that many vets seem to make straight to the operation with no suggestion of a postural rehab first; the snap to the operation without first investigating the hock/psd/SI issues that so very often seem to have caused it, and operating on what look to me and other experienced horse owners as completely unsuitable horses.

The ligament desmotomy also works at least in part because it denerves. We now pretty much frown on denerving feet, a lot are uncomfortable about denerving PSD, and this falls in the same boat, for me.

I don't mean to criticise anyone who's had this operation done, we all do these things for the best of reasons guided by our vets.

There's no doubt, ObaC, that you've done your absolute best for yours under the best guidance and I'm really pleased that with your regime and what you want for your pony, it's working for you.

Our rehab is straight lines, poles and raised poles, walk-halt- walk transitions, walking up hill, and backing a few steps uphill. We started about 6 weeks in, building up from a few minutes at a time to 15 minutes doing the above but with physio bands, that go from a special saddle pad under the belly, and one that goes round the quarters, but they are both only attached to the saddle cloth not the bit. No lunging, no pessoa, and some passive physio stretch exercises as well. The Vet and Physio worked together on this, and I'm happy that I'm not asking the horse to do anything uncomfortable. So long as I don't get on, that is! Hence the suggestion of surgery. I think you've hit the nail on the head for me with the likeness to denerving...
And no, absolutely no criticism of anyone who has had the operation - all horses and stuations are different. In my own horse's case, I'm pretty sure there's something else involved , (despite no issues found on a full body bone scan) and I think if we can achieve a comfortable retirement, we'll have done well. Thanks to everyone for their replies.

 

[maisie06]

I would have far less of an issue if everyone rehabbed like you, ObaC. My rehab plan included lunging on a pessoa and I told my vet that wasn't going to happen and there was no way I was going to attach my horse's mouth to his hind legs.

When I think of the ethics of it, it's in continuing to do these operations without publishing any (?) studies about the long term outcomes, because anecdotally there are a lot of failures; the snap that many vets seem to make straight to the operation with no suggestion of a postural rehab first; the snap to the operation without first investigating the hock/psd/SI issues that so very often seem to have caused it, and operating on what look to me and other experienced horse owners as completely unsuitable horses.

The ligament desmotomy also works at least in part because it denerves. We now pretty much frown on denerving feet, a lot are uncomfortable about denerving PSD, and this falls in the same boat, for me.

I don't mean to criticise anyone who's had this operation done, we all do these things for the best of reasons guided by our vets.

There's no doubt, ObaC, that you've done your absolute best for yours under the best guidance and I'm really pleased that with your regime and what you want for your pony, it's working for you.

I agree wholehertedly with you on this, I has a wonderful welsh D who had PSD we tried various rehab plans and nothing really worked, the PSD was a catch 22 with other issues too - chicken and egg sprang to mind, vet was VERY keen for him to go for surgery, but ethically I couldn't do it, I would have been riding a de nerved lame horse who couldn't feel he was lame, on chatting to the farrier who agreed with me and said he'd seen so few of these cases ever really come right the decision was made to PTS as he wasn't really happy retired and began losing condition, he was 15 at the time. The thing that annoyedme the most was despite being told no the vet's still reffered him for surgery and rang to confirm the op was booked for 3 days AFTER he'd been PTS...

 

[rextherobber]

I agree wholehertedly with you on this, I has a wonderful welsh D who had PSD we tried various rehab plans and nothing really worked, the PSD was a catch 22 with other issues too - chicken and egg sprang to mind, vet was VERY keen for him to go for surgery, but ethically I couldn't do it, I would have been riding a de nerved lame horse who couldn't feel he was lame, on chatting to the farrier who agreed with me and said he'd seen so few of these cases ever really come right the decision was made to PTS as he wasn't really happy retired and began losing condition, he was 15 at the time. The thing that annoyedme the most was despite being told no the vet's still reffered him for surgery and rang to confirm the op was booked for 3 days AFTER he'd been PTS...

OMG - I'm so sorry, that must have been devastating!

 

[blood_magik]

I had one that had the surgery and he’s absolutely thriving now. It did take a long time to rehab, to be fair… much longer than expected as I basically had to re-back him.

The injections did nothing for him and things had progressed significantly by the time he actually had the op done.

as I said above, he’s absolutely loving life and has gone from strength to strength. Just wanted to give you another perspective as it’s not always doom and gloom…

 

[rextherobber]

I had one that had the surgery and he’s absolutely thriving now. It did take a long time to rehab, to be fair… much longer than expected as I basically had to re-back him.

The injections did nothing for him and things had progressed significantly by the time he actually had the op done.

as I said above, he’s absolutely loving life and has gone from strength to strength. Just wanted to give you another perspective as it’s not always doom and gloom…

Thank you, it is great to hear the positive stories too!

 

[Indefatigable]

My niece recently gave up being a vet because of the profit motive. I'll just leave that there

 

[SEL]

My niece recently gave up being a vet because of the profit motive. I'll just leave that there

That's very sad - trying a different practice or one of the medical schools might be in order. I've known someone who has spent virtually her whole career at one of the medical schools (they train vets as well as do horspital stuff) & although the salary is less the £££ drive isn't the same

 

[Sossigpoker]

If you have to cut into /around the horse's spine just so you can ride , I'd say that's selfish. A lot of what we do to our horses for our benefit is questionable, I think cutting into /around the spine for me would be the line I wouldn't cross

 

[marmalade76]

My niece recently gave up being a vet because of the profit motive. I'll just leave that there

The difference in attitude when you tell them your horse isn't insured says a lot.

 

[catembi]

Mine is 19 & he had 4 processes reshaped & a ligament snip in 2015, so I guess he would have been 11 at the time. Ex racer. The post op x rays were perfect but his performance never improved. It turned out that he had PSSM/MIM all along, p3/px. I wasn't aware of the hair test in 2015. He is still going and I ride him every day, but it's only 20 minutes in walk in the arena & he doesn't want to trot.

 

[Widgeon]

My niece recently gave up being a vet because of the profit motive. I'll just leave that there

I know this is tangential to the purpose of this thread but I think that's a very sweeping insinuation - my horse IS insured, but our vet has always been excellent at providing information and supporting my fairly pragmatic and minimal-intervention approach to problems. So I don't think it's fair to suggest that all vets are entirely profit driven.

 

[ycbm]

Mine is 19 & he had 4 processes reshaped & a ligament snip in 2015, so I guess he would have been 11 at the time. Ex racer. The post op x rays were perfect but his performance never improved. It turned out that he had PSSM/MIM all along, p3/px. I wasn't aware of the hair test in 2015. He is still going and I ride him every day, but it's only 20 minutes in walk in the arena & he doesn't want to trot.

I'm sorry Catembi, but I feel compelled to point out for others readers of the thread that the test you describe is not approved and is widely mistrusted by equine medical and scientific experts.

Your point that the horse"s real problems weren't found before operating is sound.
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[Nasicus]

Whilst I've thankfully not had to make the decision myself, I know personally of a good handful of horses and ponies that had the ligament snip done, and none of them ever stood up to any long term work or a return to their previous levels of soundness, regardless of how closely the rehab plan was followed. That is enough for me to think I wouldn't get it done and just retire if sound in the field or PTS if not.