Long term prognosis for kissing spines

[sodslaw]

HI

Does anybody here know what the honest long term prognosis for kissing spines (KS) is? Is it a conditions, like arthritis that will get progressively worse? My horse was diagnosed 3yrs ago and we did cortisone injections, accupunture, all the rebuilding groundwork, schooling etc and for a while things went well. We even progressed from Prelim to Novice quite successfully.
Lately things have started going wrong quickly. Eg. suddenly won't travel in the trailer, unless all the partitions are out. (he still loads fine, but it seems to be the movement) Canter and lateral work has been progressively getting sticky. The worst problem is currently: when asked for rein back (with a loose rein) he will go back happily, but when then asked to move forward he will bunch up, kick out and threaten to buck. I've had vet, saddler and chiro out and today my horse's threats are bordering on becoming dangerous. he is a very polite boy who always loved his work, so I kinda take his threats seriously. Please don't lynch me for asking/saying this, but I really don't have any more money to pour into this problem and my horse seems deeply unhappy. Can somebody please tell me honestly how long they could keep their horses going? I've seen all the immediate rehab success stories (can tell my own), but for how many years???
Thanks

 

[soulfull]

so sorry to hear this. and sorry I don't have the answers. I am myself facing a probable ks diagnosis on my horse so I have been doing loads of research.

Sadly I am finding the same, that things seem to go well for a while, and I must say yours is one of the longest so far.
so I honestly don't know the answer

could you just afford to have the injections again as they did last 3 years

If it were me and I thought he was in pain and I couldn't help him I would PTS

my vet thinks my own horse is in pain in the field right now but we are awaiting app for liverpool so at the beginning of it all

 

[Wagtail]

I am in a similar position but I have stopped riding my horse. He will go to Rossdales for further investigations and bone scan. He has very severe kissing spines and injections had no effect. I believe the only solution is an operation, though I suspect he may be beyond that. If it is not too late, the operation seems the only real way forward and has a high success rate. Also, there is another treatment called mesotherapy which has had good success. It is also possible that in some horses, when the spines finally fuse (like the hocks) the pain will be less. Sadly however, I think that without an operation, prognosis for severe cases of KS is poor.

 

[sodslaw]

Hi Soulfull and Wagtail

Fingers crossed Soulfull that it is not KS in your horse, but rather a problem with a simple solution
Thanks for your posts. I still cannot find anybody/anything on the internet who can say anything realistically about the long term prognosis.

I do not have the funds to do the op and my horse is 14yrs old already. With regards to the mesotherapy: I have a vet doing a year in the UK from the continent and he suggested mesotherapy as it seems to be a common treatment on the continent. I asked for a qoute which came to £500. I was also told that the effect of mesotherapy could last as little as 3mnths or as long as a year, but will then have to be repeated.
I had the chiro out on Friday and told to give him a couple of days rest. I got on him yesterday and today for about 20min and his behaviour is much worse. Caught in a bit of a catch 22 here: if I don't work him the muscles supporting the spine starts to deteriorate making the back worse, but if I do work him when he is in pain he will deteriorate anyway. Starting to think I might need more X-rays done to see if there is possible more degeneration of the spine in the last 3 yrs. If there is then I think it might be time to say goodbye. He is even becoming mean(er) to his field companion.
I am so worried about this that I even forgot to make baby's milk last night!!!
Good luck to you both. I really feel that up to now I have given this horse every chance I could.

 

[classicalfan]

Sorry to hear about your boy. He sounds as if he is very uncomfortable. We get KS cases here, mostly post-op but also for physio etc in order to re-train the muscles (and the rider).

Some horses do make a good recovery but they seem to be in the minority. Many can still work but not at the level they were used to. Some never overcome the fear of the pain and remain dangerous - it all depends on the horse's characer.

If he responded well to the injections then he isn't one of the more serious cases. Howerver, as horses get older the supporting structures weaken (mucles, tendons, ligaments, etc) - it's just a normal part of the ageing process so to expect the same level of success again would probably be unrealistic.

Have you considered retiring him? Often when a horse is allowed to stretch and move in a way that suits him the discomfort is lessened, added to which most retired horses probably spend a large amount of their day with their heads down at ground level!

 

[huntley]

One of ours was diagnosed with KS as a 15 year old who had retired from 2* eventing and was just hunting. He had it in six places and it was simply not possible to operate due to the number. We could have tried him on bute, but we made the sad decision to retire him even though he was fit and well in every other way. That was two years ago and he is very happy in his field although I do feel he misses the attention he used to get - he is a bit of a snuggle bunny! Personally, I saw no point trying endless treatments at his age and he owed us nothing, but riding him was becoming increasingly unpleasant. I think you have to decide what is right for you and your horse and how deep your pockets are. I would want a definitive diagnosis though.

 

[pedilia]

Sorry about your boy. My much loved TB was diagnosed last July after similar behaviour, ending up with him bucking me off.

He had the op within a fortnight, months of rehab and I had him back in work, we even started jumping again, he was given the all clear by the vet. Then within a matter of weeks, all the old behaviours started again, although the op had intially looked sucessfull, in the end it wasn't.
I retired him 2 days before his 9the birthday, he got progressively worse and as the pain increased, his behaviour got dangerous.

I made the heart breaking decision to have him PTS last month....That said, there are horses that make it back into full work after the op. if I had my time again I wouldn't put him through the operation.

 

[Wagtail]

I have decided on the operation for my boy. He needs 5 processes removing and it will be done under sedation so he will be awake and standing throughout the procedure. The cost is around £2500 plus vat so if your horse has fewer spinious processes to take out it would be cheaper than that. I was told the success rate is very good but as Classicalfan says, often the horse retains some of the mental attitude that relates to the pain. I am going through with the procedure because my boy is so bad that the vet says he is very uncomfortable even without a rider. She was astounded that I had got this far with him. She says it is down to his genuine and kind nature and the fact that I have had endless patience and time with him. So really, for me, there was no option. I don't have him as a riding horse now, and he would be in pain retired, so I am hoping that at the very least he will be able to be comfortably retired. I am hopeful though for the first time in an age that I may get him back as a riding horse, as the vet thinks there is a very good chance.

 

[Wagtail]

Sorry about your boy. My much loved TB was diagnosed last July after similar behaviour, ending up with him bucking me off.

He had the op within a fortnight, months of rehab and I had him back in work, we even started jumping again, he was given the all clear by the vet. Then within a matter of weeks, all the old behaviours started again, although the op had intially looked sucessfull, in the end it wasn't.
I retired him 2 days before his 9the birthday, he got progressively worse and as the pain increased, his behaviour got dangerous.

I made the heart breaking decision to have him PTS last month....That said, there are horses that make it back into full work after the op. if I had my time again I wouldn't put him through the operation.

I have just read this. How heart breaking for you to have it appear to work and then not. Did you get any explanation as to why that was? Could he have developed KS in the parts of his spine that were not operated on or perhaps sacroilliac problems? I still suspect my horse may have problems further back too as he is reluctant to lick up his hind legs, but there is very little other than steroid injections that they can do to treat problems in that area.

 

[bounce]

My story is sadly similiar to Pedelia's. My horse had the op and had 4 removed. He then got through the rehab quite well and moved incredibly well. He started competing in dressage again and the first time out he was brilliant. The second time out his behaviour started again and then the downward spiral to being retired as too dangerous to ride. I can't even get a surcingle around him without him broncing very severely. He is now a retired field ornament at the grand age of 12 and he seems fine with that. Whether it is to do with a memory of pain or whether the pain returned I shall never know.

If yours has previously responded well to the injections could you try that one more time.

Rather than riding could you try lunging with a pessoa to see if you can get an improvement with that. I have heard that if you don't go for the op then you need to lunge them regularly to keep the back in good shape.

As for long term prognosis I don't think anyone can give you the answer you want as each case is very different.

 

[Wagtail]

My story is sadly similiar to Pedelia's. My horse had the op and had 4 removed. He then got through the rehab quite well and moved incredibly well. He started competing in dressage again and the first time out he was brilliant. The second time out his behaviour started again and then the downward spiral to being retired as too dangerous to ride. I can't even get a surcingle around him without him broncing very severely. He is now a retired field ornament at the grand age of 12 and he seems fine with that. Whether it is to do with a memory of pain or whether the pain returned I shall never know.

If yours has previously responded well to the injections could you try that one more time.

Rather than riding could you try lunging with a pessoa to see if you can get an improvement with that. I have heard that if you don't go for the op then you need to lunge them regularly to keep the back in good shape.

As for long term prognosis I don't think anyone can give you the answer you want as each case is very different.

I can only think it was pain returning because if it was the memory of pain then he would have reacted badly from the start, when you first started riding him again. I have to say these stories are all very depressing!

 

[milz88]

Quick note from my side of things.

My boy was diagnosed with bi-lateral bone spavins in his hocks in April, they were treated and he improved although not as much as I would have liked. 6months later I thought he felt worse again, so back to vets for re-injection of hocks.

My vet thought he had a lot of muscle loss behind the saddle when she saw him again (after 6 months) so x -rayed back, and then he is diagnosed with KS. I think it was 3 touching. Poor boy, so double whammy for him, 16.1 ISH, 12 years old, previously eventing.

Between us, for various reasons we chose not to operate, so medicated back and since then (September) he has been on the pessoa for re-rehabilitation. So I sat on him for the 1st time last weekend, definitely felt much better and looked like he was using him self so much more in the pics!

All I can say is I am hoping we can still do some low level stuff, who knows? I miss competing like crazy, he loved his XC, such a genuine horse! But I realise we have financial limits as to what you can keep throwing at them to try to fight/manage a degenerative disease., in his case 2 of them!

Try injections again, if they worked the 1st time, perhaps they would a 2nd time. Good luck.

 

[Riverboy]

Hi there

My mare has just had the standing surgery under sedation to remove 3 dorsal processes for kissing spines. The success rate I was given for the surgery was very encouraging and I worried that the steriod injections would give us a short period of 'ok' but not remove the problem which would then come back.

We are only 2 weeks into long reining and she had the operation on 8th September so I don't know about long term prognosis but I will keep my fingers crossed for you.

RB x

 

[Wagtail]

Hi there

My mare has just had the standing surgery under sedation to remove 3 dorsal processes for kissing spines. The success rate I was given for the surgery was very encouraging and I worried that the steriod injections would give us a short period of 'ok' but not remove the problem which would then come back.

We are only 2 weeks into long reining and she had the operation on 8th September so I don't know about long term prognosis but I will keep my fingers crossed for you.

RB x

My horse had the steriod injections and they had absolutely no effect whatsoever. The vet at Rossdales said that this did not surprise her as the spinal processes were so close and there was no room for the injection to go.

 

[BethH]

I have a happy story! My horse became so dangerous it was recommended he be operated on or PTS, I was advised he was in discomfort 24/7. He had the op 5 yrs ago (3 processes removed) and is still doing fantastically. He is now 12, jumps (I'm a scaredy cat so 3ft max!) hacks out alone and in company and is capable of a good novice dressage test and can do most lateral moves.

I have helped a lot of people and horses with this issue and I truly believe you have to rehab the mental as well as the physical and not rush your horse back to fitness. It is completely imperative that you take your time to build really good strong core muscles, a lot of slow but correct long and low work, I prefer long reins to encourage correctness and learning to ride in a classical and correct way so that you don't block the horses movement is also key.

My little horse is amazing, vets, physio's and instructors cannot believe he has had this op even tho he spent the first 7 years of his life compensating for not even being able to walk properly.

2 other things helped with his recovery - firstly, I love him to bits so was determined to get him through it and secondly lots of funny herbal supplements like marigold, Rosehips and celery seed powder. He can look a little stiff some days but the supplements work wonders for him and he is a very sound and happy horse now.

Just wanted to post to say it can work long term and you can have a positive outcome.

 

[Wagtail]

Thank you BethH. It is really good to hear a positive story when your horse is going through the op! I am certainly going to take my time with him.

 

[BethH]

Sadly I think that the only cure is to operate otherwise you end up just ticking your horse over as the back continues to deteriorate over time. If you are a superb rider and have the time to keep your horse exericsed and fit you might be ok, but then you feel tremendous guilt if you have a day off or a holiday, the palliative route is exhausting and mostly doesn't work (I did try that first!) much as I've always dreamed of being a superb rider, I'm not and never will be although I try hard!

Take your time but make the work you do with your horse constructive and expect to have the odd bad day or step backwards, it has happened to most of us, but you do get through it! Its a brave choice to operate but probaby the right one if your horse is young and has no other issues like mine. Good luck I hope you have a permanently good outcome.

 

[milz88]

All very good points from Beth.
But unlike her, we chose not to operate, whether or not this is the right decision I don't think I will truly ever know.
Sadly, my horse also had bi-lateral hock spavins, he is 12 and was eventing to BE novice. Given these factors as well as not having enough insurance money left we decided not to have the op.
He responded very well to hock injections and has had his back done, he has now been lunged for 10weeks and thew difference in stride/physique/musculature is amazing.
I rode him today for the 2nd time he did the biggest trot I've ever felt him do he feels fab. I can only hope that use of the injections, continued lunging, and 24/7 turnout will do the trick, I keep my fingers crossed.

Good luck to all, but remember KS and spavins and their treatment should very much be assessed case by case, what works for one may not necessarily work for another.

 

[aregona]

Hi all, I am posting this as it may help some of you.
My tb was diagnosed about 3 months ago. I has 9 spots touching. My vets have developed a new sergery in which no prosess are removed but instead a ligament is cut in between them. The cost is around £750 for the opp and it is done standing. My boy is booked in to have it done in February, they won't do it any sooner as the rehab is crucial. You must be very determined with the rehab to make it work and as I live on a mountain and have every risk of being snowed in the surgeon told me to wait until next year.
Please search the practice online and give the surgeon a call, he is really helpful.

Cotts equine clinic, south Wales.

Good luck!

 

[Wagtail]

Hi all, I am posting this as it may help some of you.
My tb was diagnosed about 3 months ago. I has 9 spots touching. My vets have developed a new sergery in which no prosess are removed but instead a ligament is cut in between them. The cost is around £750 for the opp and it is done standing. My boy is booked in to have it done in February, they won't do it any sooner as the rehab is crucial. You must be very determined with the rehab to make it work and as I live on a mountain and have every risk of being snowed in the surgeon told me to wait until next year.
Please search the practice online and give the surgeon a call, he is really helpful.

Cotts equine clinic, south Wales.

Good luck!

How interesting. I had googled Cotts Equine and thought they shaved a bit off the spines. It makes more sense now that you say that they snip a ligament, thus allowing the spines to separate out. The wounds look much less severe than the traditional method of taking out each alternate spine and the horse is far less sore afterwards and can be returned to ridden work much quicker. Thanks for this. Unfortunately too late for my boy as he has already had the op. Please keep us posted on how you get on when your horse has the procedure done.

 

[aregona]

I have not heard of the opp been done anywhere else so thought I would post so people get to hear of it. My liveries horse had it done earlier this year, he was not stiff, lame or sorry for himself. You would not of know anything had been done other than the tiny marks on his back. He is back in full work and jumping (he had the opp in may or June this year) he looks a picture of health. Now has all his topline back and much happier in his work. Definately worth looking at if your in the same situation as me.

 

[Gracie]

Hi Aregona,

Just had my horse x rayed today and vet suspects kissing spine subject to further diagnosis after a bone scan at Liphook. Wanted to ask how your horse is getting on now it is a few years after the keyhole surgery carried out by Cotts?

Hoping it all went well and would much appreciate your thoughts. Thank you

 

[Goldenstar]

The ligament snip is the way to go if they can do it , if the processes are very close together they can't get in to snip them and the traditional OP has to be done .
One of mine had the injections he did very well but he was very well muscled on his top line and that helped a lot as did regular physio.
His working life was ended by something else at 19 .

 

[Gracie]

Thank you Goldenstar - that's very helpful to hear of your success with the injections. How often did your horse have to have them?

Following the bone scan I think I will get in touch with Cotts Equine clinic for their opinion too. I am slightly wary of going down the injection route and making the problem worse / causing more inflammation to the prosesses that are touching.

On seeing the X-ray's yesterday I was quite devastated, but having read up on this site many people seem to have had positive results so am feeling that there is light at the end of the tunnel.

 

[Holly7]

Hi,

My horse underwent interspinous ligament desmectomy two weeks ago. He had his staples out on Tuesday. I too was devastated as I only bought him in May and he only turned 4 then too !

I am told the prognosis is very good, my question is though (and sorry to hijack the post) are there any unsuccessful stories for this surgery ? My boy has gone off his head! He tries to rear and buck and bronk during his in hand work, goes off on one when is turned out (in his smaller area but with his reliable field companion - 27yr old) and just appears to be getting worse ! His walking has improved greatly but now I'm not sure whether he is just high spirited from being free from pain or whether there is something else wrong / whether it has failed.

After being out all night, I brought him in for his 10 min walk slot and all was OK then at about 5 min he reared then at 7 mins he planted himself and started going backwards. After a firm no etc he then walked like a dope on a rope back to his stable.

 

[frostyfingers]

My TB has the ligament snip 3 summers ago now and is, so far, ok - he's 13 now. The rehab takes a fair amount of effort, but it has been worth it. We had a blip last year when he stopped jumping so he went back to 3 Counties (who were fab) for a check up and they re xrayed and said his back and pelvis were still ok. He's had 2 months off over the summer, his saddle refitted and reflocked and so far seems happy. He has physio every 3 months, his saddle checked every 6 and he lives out at all times so he's always on the move. We live in a hilly area and that helps too. I was told from the outset that there were no guarantees and that they don't know how long he would be pain free but I've had more time than I thought with him after the initial diagnosis so for me it's been worth it. I am somewhat paranoid and very conscious of the slightest stumble and never really relax but to see him galloping about and rolling like a mad thing when he couldn't before the op gives me great pleasure.

 

[Holly7]

Thanks frostyfingers. I no we are on a long road. Its more difficult as I'm not really sure what his real character is (due to evidently always having been in pain from point of purchase).

My vet didn't actually say no guarantee (and that's a bit naïve of me really - but have gone through a hard time loosing my other two (mum - EMS/cushings/laminitis - 18yrs & daughter - KS/SI/navicular - 6 yrs ) earlier this year maybe I was a little shocked, annoyed and upset to have bought a horse (doing everything right as I thought) to be in this position.

I think I will give it over the weekend and if his behaviour doesn't change or gets worse I will be speaking with my vet again. I no its early on in the rehab but I just didn't think this change would have happened. (he is a very loving character and my vet thinks that this is why he had severe KS at 4, as she thinks the people who backed him took the p*** and did far too much due to his nice nature).

 

[BethH]

Holly you've done really well get him operated on so young. Mine is still going 9 yrs after the op, I have not regrets about operating except for wishing I'd done it when I thought there was a problem at 4 rather than waiting with him struggling for 2 yrs until he was 6.

Just for the record my horse was broncing in the stable after the op and split his stitches, I couldn't do the in hand work because he stood up on his back legs and was dangerous to walk out - your safety comes first, he needs time to heal and the behaviour could be relief from niggling pain or a boisterous baby but it could also be panic. Happens a lot, in their heads they worry if you ask them to so something they aren't comfortable with it will hurt. My solution was to put a very large stable sized pen in the field with an elderly mare in the field with him (but not in the pen) 24/7 that calmed him down a lot and then I only hand walked as much as I could do safely. I never lunge, he started long reining in walk at week 5 in a fenced sandschool just for a few minutes a day and gradually built up - he did quite a few handstands in the first couple of week and then settled in to a programme of long reining (long and low) for 6 weeks which really helped to strenth all of his body. When I got back on I was terrified but I got a friend to lead him around with a packet of polos under nose and he was so relaxed I was thrilled.

I guess I'm saying don't panic quite yet, there is plenty of time for things to settle down, make sure he has pain relief and to help any swelling and see if there are any supplements/herbs you can add to the feed like comfrey/marigold etc to help the healing as he will feel quite bruised still. Also make sure if he is out at night he is well rugged as he will feel the cold through the operation site. Mine did have bone removed so was a more major op but your horse has been through a lot, time is a great healer!

 

[Holly7]

Thanks Beth, I needed that :-0))

A different vet came for his staples out (but she was present at the operation) and she said he was fat and should be on restricted grazing or only let him out for an hour in a small paddock !!! but my normal vet had said he wasn't fat he has a dropped popped belly due to being unable to hold his back up due to the KS, so I have gone against the staples out vet and turned him out overnight with his field mate as he was going stir crazy. He actually came out of his stable last night, quite calmly but totally lost his step in the doorway and came straight down heavily on his side on the concrete :-(( He appeared OK and has this morning (another reason for leaving him out last night).

I truthfully think I need to re-back him as I think he is thinking far too much about the pain (that hopefully is no longer there). I have the physio coming week Fri or Mon (awaiting confirmation) so I will check with them whether the proposed rehab plan is right for him or not. I think really I should start with long reining instead of the lunging and if it takes longer then so be it. I'd rather have a happy horse. Am dreading having to ride him at the moment !!!

I'm an emotional rollercoaster at the moment anyhow, as still raw about the girls, and now his problems . . . . . . aarrrgghhh !

 

[BethH]

I accept that I can be a little alternative in my thinking but I would have turned him out too, the fact he is now calmer shows you were right, just manage his environment as much as you can but you are doing just fine in your thinking, when they are young they will find box rest harder than an older horse. I also agree with the initial vet, he can't possibly strengthen his abs if his back can't lift. You will see this change as you start to work him and my advice would be to slowly but surely put on plenty of layers of muscles rather that fixing him into a rigid outline and forcing it on. The long reining is so much better for him, feel free to pm me for ideas, I found that I thoroughly enjoyed it and could teach lots of verbal commands and do exercises that have helped our relationship hugely over the past years.

Looking back, I was quite excited by being able to redefine our relationship, your rehab is a form of re-backing as you are doing lots of groundwork to instil the basics but he will remember also everything he has been taught so far so it won't be as difficult (I hope!). Have you an instructor who can ensure you are long reining correctly ( sorry pet hate of mine, but it isn't lunging with 2 lines!!!! You work the horse from the hip not the shoulder....) and when you get back on, do it on a day that you feel happy doing so not when you are worried. Give him a few weeks to start working consistently with the groundwork first to build both of your confidence. As someone said to me "Take your time but don't waste it!"

Good luck let us know how you are progressing, I hope your roller coaster turns into a merry go round!