symptoms of SI, kissing spines?

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MeganMarie

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Hey everyone,
this is a long one, so bare with please...

i’m at my wits end with my boy, he’s being so vague with his problems!!!! :(
Basically he’s been lacking hind impulsion, worse on corners and circles (feels worse to me than he looks), doesn’t want to go forward in canter (or ends up complying but he’s stroppy about it), struggles to pick up right lead canter (runs in trot instead etc.)
Had physio out, she watched him lunge, said he wasn’t right, i REALLY had to chase him on the lunge (don’t normally), she thought he was slightly short on LH. Had the vet out, he watched him lunge, and again he was REALLY lazy (unlike him). He thought he may have suspensory damage to LH as he did palpate a bit sore there.
Flash forward to a week (he only went on the walker and was handgrazed). Vet out to scan & x-ray. Scan showed minimal wear and tear to suspensory but nothing that he could say is the actual problem. X-rays of hocks and fetlocks - hocks are good, slight changes on fetlocks but again nothin that he could say is the problem/would cause symptoms. He is 13 so there is expected changes etc. all horses would, just like people.
He’s recommended sending him to Newmarket for a few days for lameness exams, nerve blocks etc.
But i’m losing the plot because i’ve been riding him since the scans to see if he’s ‘miraculously’ recovered himself & he is a little better, still not right, but one of the staff also pointed out that he looks a tad short on his LH also, but she REALLY had to look. But anyway we’re not sure whether his little improvement is only related to the fact he’s had some time off, not done anything or been in the field and so he’s just happy, rather than the problem being gone etc.
I would hate to send him to Newmarket spend ££££ waste their time, for them to not find anything - but obviously i want my horse happy and pain free!!!!
I’m thinking perhaps it’s higher up? Sacroiliac, kissing spines maybe? What sort of symptoms are there for these? Wish he’d stop being so vague :(
thanks
 
Why on earth did your vet scan and x-ray where he did without the concrete proof of nerve blocking that that was where the problem lay??

Unless you are local to Newmarket I would find a good experienced equine vet that will do a thorough work up and go from there. This may involve the horse being hospitalised over night if the issue is multi-factorial.

I have also found that it is useful to get a vet that rides if at all possible. My horse showed spinal impingement T14/15 on X-ray and would have been medicated by most vets, however mine blocked it and then rode him and declared there was no difference. A lot of horses will show impingement on X-ray but that does not necessarily mean that that is the issue to which they are reacting.

Yes, the symptoms displayed could be SI, could be kissing spine, could be both or could be something totally different. It is pointless making wild guesses in the dark; spend your money on good diagnostics by an experienced professional. If it is a competition horse, make sure that the vet is used to dealing with subtle lamenesses.
 
Your vet has done exactly what two local practices would do with an uninsured horse, x-ray the most obvious/likely culprits and scan where pain response is present on palpation. One doesn't even x ray, they will go straight for hock injections without them.

If I was you, I'd now get spine x rays done before sending to Newmarket, unless you are insured in which case you might as well just go the whole hog straight away.
 
Sounds a bit like what I've been dealing with for the last 18 months OP! Same symptoms as yours but RH worse. So far we have found ulcers which were recurring so pointed to another issue, so went and had a bone scan and found hot spots on the hocks, xrayed and found mild changes so medicated, bought back into work slowly but deteriorated when asked to do more. Old vet couldn't find any lameness so recommended continuing full work until lameness showed which it eventually did a few months ago when he refused to canter on the lunge and ridden. Got a fresh set of eyes from a new vet and went in for a workup inc nerve blocks and blocked to the suspensory and vet also suspects SI issues but chicken and egg situation so have opted for surgery on the suspensories and then we'll look at him again in a couple of months or when he's coming back into work. I had also mentioned spinal xrays for KS to the vets but he doesn't palpate or show any symptoms at all as and Gunner said, a lot of horses might have impingement but not be reactive at all so have decided not to go down that route at the moment. Sorry this doesn't help but I have been there and I feel your frustration!
 
When I bought Old Cob he had a terrific buck, into canter. There were no signs of a back problem on palpitation by the vet. He then went slightly lame (2 or 3/10) behind. He was sent for a bone scan which showed up problems in his spine and sacrum. The veterinary hospital recommended injecting nearly every vertebrae but my own vet restricted this to the sacrum and three vertebrae. He also had a Tildren infusion. This did not solve his lameness issue - this turned out to be a stifle issue - damaged cartilage which was removed by arthroscopy. After all this he had nearly 10 years of good ridden work before I retired him in his late 20s.

In a similar situation I would go straight for spinal x-rays as a reasonably cheap option and then take things from there. My cob's back looked fairly horrific on bone scan and x-ray but after treatment he improved massively - and is still agile and moving well aged 30+. Others may appear to have less of an issue but be much more uncomfortable/in pain. However, at least with x-rays you might have a starting point and can rule skeletal issues in or out before looking more at tendons/ligaments etc.
 
Hi,
Im sorry to hear youre having such bad luck. Usually SI problems are secondary to something else going on. If its occurring with both His (even if one is worse than the other) then its more likely to be hock related or suspensory +/- SI changes. But kissing spines is also a possibility. Lots of these cases are a combo of if one thing goes other things start to fail. The way forward is definitely blocking! If you can feel that something is wrong, most likely a vet will see it clearly as they're more sensitive with their eyes to lameness, so blocking it and seeing a difference and feeling one ridden is important, that way you can isolate the problem and go from there! Also, I was told hock X-rays are good but sometimes the changes on an X-ray arent always respective to the degree of lameness, i.e. lots of changes dont always mean a v. lame horse and vice versa.

Good luck!

P.S. sending it to Newmarket for a potentially simple lameness work up seems excessive, do you used mixed vets or pure equine?
 
Usually SI problems are secondary to something else going on.
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I'm not sure this is true? SI strains all on their own are quite common. Mine did his by slipping in the road and sitting down, and that's a common field injury too.
 
You're right you can get some that are primary, but they are usually affecting the one side only and are of limited significance in the long term other than the aesthetics. They are also affecting a different area of the SI periarticular structures. True bilateral SI problems are commonly secondary to PSD or TMT +/- DIT OA. But again, only my experience.
 
Fluffyponies said:
You're right you can get some that are primary, but they are usually affecting the one side only and are of limited significance in the long term other than the aesthetics. They are also affecting a different area of the SI periarticular structures. True bilateral SI problems are commonly secondary to PSD or TMT +/- DIT OA. But again, only my experience.
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That's interesting. Mine was indeed one-sided, and recovered without a recurrence but always looked lop-sided.
 
So maybe on this rare occasion I could be right :'). Interesting what you said though, you made a point that I hadn't explained very clearly! You can go down the root of blocking SIs to confirm. If you block one side it can be done on the yard. But both sides MUST be done in a clinic with a knock down box, anyone trying to do otherwise is dangerous. There is a risk if you block both SI joints at the same time that the horse may fall down, no long problems from it! Just an annoyance for the vets more than anything!
 
I’d be a bit annoyed with my vet that they’ve come, spent a fair bit of money which hadn’t achieved anything, and probably wasn’t likely to at the start. Newmarket practises are horrendously expensive. Depending on where you are, and how much money you have, I’d be getting a thermal imaging scan done first to see if it picks up any problem areas, and then look at going into a local vet hospital for nerve blocks and X-ray of spine (if felt needed), then go from there
 
fredflop said:
I’d be a bit annoyed with my vet that they’ve come, spent a fair bit of money which hadn’t achieved anything, and probably wasn’t likely to at the start. Newmarket practises are horrendously expensive. Depending on where you are, and how much money you have, I’d be getting a thermal imaging scan done first to see if it picks up any problem areas, and then look at going into a local vet hospital for nerve blocks and X-ray of spine (if felt needed), then go from there
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I think there is some sense with the above, just ensure if you go down the thermal imaging route you get someone who is qualified and that the results are interpreted by someone qualified (e.g. sync will get their team of vets to interpret, so its of better quality and reasonable interpretation).
 
Hi there, my horse was diagnosed with Kissing Spine and SI issues last July. He was 110% sound as a pound, he had a full poor performance work up as I knew something wasn't right. Same as you, his symptoms were vague, and very easily misread as poor schooling or bad behavouir.

He struggled with right canter, often struck off on the wrong lead. Struggled to collect, found cantering out in the open OK (i.e going XC) but really struggled in an arena (i.e SJing!). Rushing over fences, he did eventually start stopping periodically Show Jumping which I believe to be if we got wrong to a fence he couldn't collect to put himself right, he would usually go then stop normally resulting in us landing in the fence - In my opinion he didn't WANT to stop, he was just finding it hard. He did develop soreness in his lumbar, where we always struggled to put on muscle, but he didn't become sore until well into the event season.

After we narrowed it down to that he was then ridden, nerve blocked, then ridden again and it made a clear difference so I knew we were right to go down the op route. Hope you get to the bottom of it OP!
 
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