KS operation - SP removal. What are reasons for it going wrong?

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zoregano

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Continuing with my quest for information before deciding whether to operate.

When SP removal ops are not successful, what are the reasons? I would expect problems if correct work cannot be established so the horse does not work his back correctly post op. I am trying to establish what other reasons there are for things going wrong - such as horse not coping with the box rest or settling to in hand walking. What damage can be done? Any input gratefully received.
 
As above putting that aside I think the skill of the people doing the rehab Working on the ground and ridden is very very important .
I had one done his back was a terrible I felt sick when I saw the xrays he had five or six removed .
The inhand lunging part of the rehab was over the worst part of the winter five lots of work a day and it was a cold slog but I could see my horse was different so it was easy .
Once he was ridden I worked with a good trainer so I had great eyes on the ground
He was transformed sadly for me he got tumours on his bowel, so sad but that was that .
Other things are death under GA that a statistical risk your vet will fill you in on .
Injury caused standing when they come round is also a risk
Wound issues either the wound breaking down or more likely getting stuck , a Acpat trained physio will show you how to prevent this ( needs to be a people trained physio who has moved on to horses as they do a lot of that type of work in the NHS with people )
It’s a significant thing to put a horse through and you need time to care for them after we had a really full on couple of months here with mine and the rehab slog went on for months .
 
Thank you, Goldenstar, for raising some interesting points.

Firstly, I am sorry to hear your horse succumbed to tumours after you had transformed him. Heart-breaking for you. But he must have been so much more comfortable once transformed - they put up with a lot.

You raise a point I have not considered up to now. There will be significant scar tissue in the back which will tighten. I had significant surgery myself and the muscle is not the same - plus the area is tight as some muscle was removed and it is still uncomfortable now. Getting my horse to "work through" that post op will be difficult and he will strongly resist against any area of discomfort. I need him to push up through that area.

I re-backed him recently, after one of our many periods of rehab and it was the first time he felt like he was able to carry me (but not for long - we hit a brick wall very quickly. A sudden loss of all looseness and going solid instantaneously - must be when it touches. This was before the latest x-ray which showed the cyst. He is not going to be ridden now). I think that was because he learnt to compensate by pushing the rider up and so out of his pain zone. If he has muscle damage and tight scar tissue he most certainly will not be wanting to push up through it. Really good point you raise.

I am also interested to hear about your post op period being a couple of months and then a number of months rehab. Certainly a lot longer than I had in mind. Thank you for your input.
 
I agree with everything above. I had a lengthy battle with a KS surgery which resulted in loosing the horse during the rehab. In hindsight, I’m honestly not sure I’d do it again.

I think there were various other issues that hadn’t been diagnosed; vets identified the KS, but there must have been other issues. My advice would be to get all other areas checked; hocks, SI, suspensories, neck?! Basically, X-Ray everything and look very honestly at the whole horse before proceeding.

We ended up with gastric ulcers requiring several rounds of gastrogard and scoping and then hindgut acidosis which I ended up treating myself because the vets weren’t convinced (search my old posts, there are plenty!!)

We got into the rehab and she came back into work well, muscled up, felt great but we just kept on chasing issues around. We’d clear up one thing and then the ulcers would be back or something else would be happening.

The most frustrating part was that on the surface, she looked absolutely great, never took a lame stride, but had become aggressive, wouldn’t load (we were having to IV sedate to get her to hospital) and she was depressed, so 6 months and £10k+ down the line, I felt I’d exhausted every avenue and had her PTS. Even then, she took a long time to go, so although I didn’t have a PM, I and the preciding vet suspected some kind of tumour was present.

Perhaps I was unlucky, but I know others who’ve got through surgery to have them break down in a matter of a couple of years afterwards.

I have ready access to OTTBs but for the meantime at least it’s enough to put me off another one.

Sorry to be gloomy!!
 
I know of two, mine and one other, that started to have fits during the rehab. To be fair, mine had been bashing his head on things since he was at most four years old and was once seen to run blindly head first straight into a wall, so I can't claim either were definitely the result of being operated on.

A third I know closely was operated on in spite of having arthritis diagnosed in the hind fetlocks, and never came right and is now a brood mare (not a choice I would make myself, for fear of inherited weakness).

I would not operate on another, either the ligament snip or the process removal. I would treat with physio and steroid injections and PTS when I thought the horse was not coping.

I am increasingly frustrated that there doesn't appear to be any research being published to follow up horses which have been operated on.

.
 
I too would like to be able to access more material about the post op and rehab periods. Both of your inputs are really helping and I am sorry for both of you that you are in a position to advise having had heart-breaking experiences yourselves.

The issue of stress post caused by the op and the post-op period is at the front of my mind. My horse developed sarcoids in the last few weeks which I am putting down to the stress of being re-backed (as requested by the ex-vet who was not listening to me and wanted to see him ridden). Given that, and that he internalised it, I think the op will place too much stress on him which will manifest in other ways. I still believe horses put up with a lot before they start to shout.

I have heard of people who have had the op done and their horse is fine and back competing. Given that they all seem to sail through everything, I wonder if they are noticing the tiny detail and warning signs? I would like to see research on the progress of the horses a couple of years down the line too.
 
Yes, there are undeniably some horses back in full work going beautifully post surgery, but sadly I don’t know of many personally.

Horses that have returned to work that I have known have needed to be kept in work at a reasonable level to keep them that way and have broken down once work has stepped down (usually due to lameness from other problems). I’m not saying it’s not a possibility, but not one that i’d Personally entertain in a rush.

You might also want to consider whether you’re every likely to want/ need to sell in the future- buying a post op horse will entertain polarised opinions.
 
I had four vertebrae ligaments snipped on our gelding when he was 10,rehabbed well but started to take the odd wonky step ,would work through it but by the time he was14 we had a mechanically unsound horse, he also had strained his DDFT in his hind .

nerve blocks or bute didn’t make any improvements , further xrays etc showed the back had tilted out side ways so some vertebrae were out of line if you looked from the tail to the ears, we looked at various options including PTS then by chance, discovered he is 99% sound (no drugs) in a wykeham pad (flat felt panel) side saddle and hunts for hours with his ears pricked, in a snaffle, no martingale and a long rein so he can carry his head where he chooses. once a year he has a steroid jab into the worst area and while he is happy we will continue.

If I could turn back time, both myself and our vet agree We would never have had the op done and neither of us would recommend it. We would have stuck with the steroid jabs and all associated risks rather than put him through that.
 
Interesting that your boy's back tilted out sideways after the ligament snip. (And I was thinking about side saddle at one point).

Thanks for your input - much appreciated. Happy hunting!
 
Darkly_Dreaming_Dex said:
I had four vertebrae ligaments snipped on our gelding when he was 10,rehabbed well but started to take the odd wonky step ,would work through it but by the time he was14 we had a mechanically unsound horse, he also had strained his DDFT in his hind .

nerve blocks or bute didn’t make any improvements , further xrays etc showed the back had tilted out side ways so some vertebrae were out of line if you looked from the tail to the ears, we looked at various options including PTS then by chance, discovered he is 99% sound (no drugs) in a wykeham pad (flat felt panel) side saddle and hunts for hours with his ears pricked, in a snaffle, no martingale and a long rein so he can carry his head where he chooses. once a year he has a steroid jab into the worst area and while he is happy we will continue.

If I could turn back time, both myself and our vet agree We would never have had the op done and neither of us would recommend it. We would have stuck with the steroid jabs and all associated risks rather than put him through that.
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This is very useful information, thank you.
 
I would have to be absolutely convinced that KS was the correct - and only - diagnosis for the problem. As others have said, there are often problems elsewhere that have been missed so it is sometimes a sledgehammer to crack the wrong nut. Having gone through every diagnostic test vets could provide I thought I was doing the right thing in putting my horse through the operation - she came through it well and seemed more comfortable. Then we started the physio rehab and it all went wrong as she had explosive reactions to certain movements. Vets were clueless as to the reason. The answer? - a horse communicator who told me exactly where the problem was and how serious it was. She was PTS. So when I say "every diagnostic tool" I always include communicators in that tool box as well.
 
Out of curiosity Trouper, what did the communicator ‘diagnose’? Interested to know whether it is something totally random or one of the usual suspects in KS horses?
 
She wasn't a pure KS case as I had started investigations for a constantly unbalanced pelvis only to be assured by the vets that it was hocks (and possibly fetlocks!). When hock injections made no difference they x-rayed (and bone scanned) and did discover 5 spinous processes which they considered the problem. I accepted their diagnosis and went ahead with the operation with the results I described above. So after exhausting the ideas and services of my regular vet, who concentrated on everywhere but the front, I was recommended to the Osteopathic Vet who quickly identified that the front end was the source of the problem. Unfortunately, he could not treat sufficiently to keep her comfortable. Interestingly, when I looked back, there had been a few incidents of front-end stumbling when out hacking, which we had put down to rough ground, or time for the farrier, but which was probably the first indications of the real problem I had virtually made the decision to PTS but the communicator (Robert Pring) was the last check to ensure I had exhausted every avenue of help for her. When he described what she was feeling -"no amount of Bute will help this level of pain" - it helped me to make that final call. I did not give him her medical history and we communicated via pictures of her face over the phone so I was convinced it was accurate. (He has since helped me with another horse - but again as corroboration of conventional diagnostic services). To me using a communicator gives that last 360 degree view of the situation when you are facing a serious decision. I would never use it in place of qualified medical opinion or examination - but, as I said, these occasions need every tool in the box.
 
My mare was x rayed and some mild KS found. However they went the next step and did a nerve block of the area and it made no difference at all. So they concluded that while the processes were close, they weren't actually a clinical problem.
Further tests and a bone scan eventually found that a section of her spine was fusing on the underside - so was not accessible for any surgery or treatment, and I assume not visible on x ray either. As there was no treatment and my girl was clearly in pain / discomfort even when not in work she was PTS soon after diagnosis.
 
I don’t think this is an easy call there’s lots to think through I think process reshaping ( the kind way of describing sawing them off ) is at the limit of what it’s fair to put a horse through imo
My horse was in considerable discomfort post op and needed heavy duty nursing but he did come through and was great and he was very unlucky to have those tumours so soon after .
I would never do the snip the long term result for it are too poor .

And agree with those who say don’t do the op without a bone scan first and scan of the suspensories .
You do need to know what you are dealing with the whole horse before you take the step .
Oh and factor in the costs ulcer treatment you are almost bound to need to do it .
 
Melody Grey said:
I think too many vets are quick to assume that KS is the whole problem, when the more I learn, it seems that it’s usually the result of the other problems in combination.
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This! The vet found KS, jumped on it and said operation would work. I agreed with their expertise. We never scanned anything else prior to op, I regret that more than ever. After op we found chronic hock arthritis and ulcers, treated those yet still lame as a cat. Vet said she could have suspensory issues, more arthritis but didn't even know where to start. She was so broken and PTS at 9 years old, a year after the op. She was so unhappy.
I would never operate again, unless scanning elsewhere to confirm no other issues.. but with KS usually their always is. I know several friends who horses have had KS, all have had other secondary issues. I still feel awful to this day for putting her through such a major op, such long on box rest and rehab when she had so much else wrong. :(
 
ForbiddenHorse said:
This! The vet found KS, jumped on it and said operation would work. I agreed with their expertise. We never scanned anything else prior to op, I regret that more than ever. After op we found chronic hock arthritis and ulcers, treated those yet still lame as a cat. Vet said she could have suspensory issues, more arthritis but didn't even know where to start. She was so broken and PTS at 9 years old, a year after the op. She was so unhappy.
I would never operate again, unless scanning elsewhere to confirm no other issues.. but with KS usually their always is. I know several friends who horses have had KS, all have had other secondary issues. I still feel awful to this day for putting her through such a major op, such long on box rest and rehab when she had so much else wrong. :(
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So sorry to hear about your experience but by speaking out you will help other horses. Thank you.
 
It is interesting that there are no positive stories adding to this thread. I have actually made the decision not to operate and I will do the right thing. However, I have seen other threads extolling the benefits of the operation, admittedly historic threads. Does this mean they also hit problems further down the line? Much of what is being said here regarding other issues makes sense to me.
 
My horses KS op was an amazing success his tumours where nothing to do it just rotten luck
He felt fantasic often transformed
 
zoregano said:
It is interesting that there are no positive stories adding to this thread. I have actually made the decision not to operate and I will do the right thing. However, I have seen other threads extolling the benefits of the operation, admittedly historic threads. Does this mean they also hit problems further down the line? Much of what is being said here regarding other issues makes sense to me.
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There must be long term success stories, but sadly I don’t know of any. If you’d have asked me 6 months after the surgery, I’d have probably said it was a success as my mare care back really well, until the work was stepped up and then a miriad of other problems became evident and she was PTS aged 7.

My suspicion is that any that have gone back into full work/ competition are probably balancing on a knife-edge of enough of the right kind of work to keep their muscle tone supportive enough to not reveal further problems. That’s eventually going to go wrong in my opinion.
 
Goldenstar said:
My horses KS op was an amazing success his tumours where nothing to do it just rotten luck
He felt fantasic often transformed
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Mine was also transformed, like a complete miracle, until he started smashing his head. I don't think that was related, but knowing what I know now about long term stability issues, I wouldn't do an operation on another horse. I don't think I can offer the right environment to keep the horse in sufficient work to maintain the core strength that I think is probably needed long term.

I suspect some of the most successful rehabs are in competitive sports horses and hard working hunters, provided that there aren't any other issues causing the kissing spines.


.
 
zoregano said:
It is interesting that there are no positive stories adding to this thread. I have actually made the decision not to operate and I will do the right thing. However, I have seen other threads extolling the benefits of the operation, admittedly historic threads. Does this mean they also hit problems further down the line? Much of what is being said here regarding other issues makes sense to me.
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Join the 'Kissing spine' group on Facebook and ask the question. A excellent group which helped me endlessly.
 
ForbiddenHorse said:
This! The vet found KS, jumped on it and said operation would work. I agreed with their expertise. We never scanned anything else prior to op, I regret that more than ever. After op we found chronic hock arthritis and ulcers, treated those yet still lame as a cat. Vet said she could have suspensory issues, more arthritis but didn't even know where to start. She was so broken and PTS at 9 years old, a year after the op. She was so unhappy.
I would never operate again, unless scanning elsewhere to confirm no other issues.. but with KS usually their always is. I know several friends who horses have had KS, all have had other secondary issues. I still feel awful to this day for putting her through such a major op, such long on box rest and rehab when she had so much else wrong. :(
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I am so sorry you are feeling guilty about operating but please cut yourself some slack. You were just doing your very best for her. My story echoes yours but what I feel is angry that we seem to have to do half the vet's work for them in diagnosing the issues!! They are the ones with the training and experience - we are all learning on the job but paying others to do it.:mad::mad::mad:
 
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