Thursday, February 25, 2016

Kissing Spine X-Rays

When my Sports Medicine/Lameness Vet first introduced the idea of Kissing Spines and X-rays to me, I have to admit I was pretty dismayed. To me, Kissing Spines were a game chager and a potential career-ender. The husband and I had a vacation booked, so I took a few weeks to get used to the idea, plus break the husband in to the idea that more vet bills were looming on the horizon. By the time I got back from my trip, I was ready to do the X-rays and hopefully learn for sure exactly what we were dealing with.
 
I want to take a moment to talk about my vet. Dr. C is a lameness and sports medicine specialist that is highly regarded by the local horse community. As such, day in and day out, he sees many horses with high-level careers that are worth $$$TheBigBucks$$$. But he has never once made me feel that me and my little bargain basement horse are anything less than equally important or worthy of his time and expertise. He has been sensitive to my financial picture without compromising the quality of his care. He has given me honest, frank guidance and his services and practice have been much more affordable than the services I received from my former small practice vet. I am so grateful to be in an area of the country that is on the forefront of medicine - both human and animal.
 
I scheduled the X-Rays for Friday, Feb 5th. It just so happened that we got a snowstorm that day that dumped 8-12" of snow on our area. Dr. C was still game to come out, and I was determined to get the X-rays done, come hell or high water.
 
At this point, I had heard the term "Kissing Spines" tossed around in horse forums online, but I really didn't understand what exactly it was. Horses have dorsal spinous processes that extend vertically from their vertebrae. In some horses, these proceeses become too close together and impinge upon each other. The most common area this occurs is with the Thoracic vertebrae - directly under the saddle - but it can also occur in the Lumbar vertebrae as well.
 
 
I have attached a link to an article in the UK publication of Horse&Hound that I found extremely helpful. KS can be hard to diagnose, because the symptoms are largely behavioral and not always specific.
 
Dr. C started the X-rays at Boca's wither. This is an example of a healthy spine. There is good space between the processes and the bone shows a solid density throughout. No light spots or dark spots. The changes at the top of the first two processes I was told are normal.
 
 
 
Further down the thoracic spine and everthing is still looking good. No interference.
 
 
And then we get to the third Xray. And there it is, kids. Impingement of the dorsal spinal processes, AKA Kissing Spines. You don't need a doctorate to see it doesn't look normal.
 
 
 
When we reviewed the X-rays, Dr. C pointed at that spot and said "That is the cause of all your problems". I don't think I've ever heard a vet say anything quite so definitive before.
 
More good news followed. This was not the career-ending scenario I pictured when I first considered Kissing Spine. Dr. C continued on, saying that there were only 2 vertebrae involved. Due to the process we had followed of injections and exercise that had proved to provide short term relief, and the minimal number of vertebrae involved, Dr. C thought Boca was an excellent candidate for surgery. Dr. C went so far as to say that he believed with surgery, Boca 'would be a new horse."
 
Surgery for Kissing Spine is very new, and was only introduced in the US in 2013. Prior to that, Kissing Spine had mostly been managed through injections and physical therapy, with varying degrees of success, based on the individual horse.
 
The surgery is minimally invasive, is performed while the horse is standing and the success rate of the surgery has been reported as 95%. On top of that, a local equine surgeon, Dr. Jose M Garcia-Lopez at Tufts University, has done a number of KS surgeries and is very experienced with this type of surgery.
 
Armed with this information, surgery is the option I decided to go with.







26 comments:

  1. I know someone who had the surgery done last year and her horse is back showing/jumping this year. It's worked so far for them!

    ReplyDelete
    Replies
    1. That is great to hear. I honestly didn't even consider NOT doing the surgery, as at this point Boca is not comfortable pursuing even a low-level career without discomfort.

      Delete
  2. You're so lucky to have a vet like that in your corner. Plus that surgery protocol is promising. I'm not very pro-surgery in horses generally, but that actually sounds like something I'd consider if it came up. :-) Can't wait to hear how it went.

    ReplyDelete
  3. On the one hand I'm sorry to hear about this (especially the vet bills), but on the other I'm so relieved for you that you finally have an answer. It's great that there's a surgical option now. I know of a couple of really nice horses who got this diagnosis a few years ago and are now standing in fields doing nothing. Yay for medical breakthroughs! (Boo for vet bills.)

    ReplyDelete
  4. I'm so glad you've finally got answers, well done to you for following your gut and not giving up on him!

    ReplyDelete
  5. So glad you stuck to your gut and kept at it. And even more glad that you have a diagnosis and a good, solid treatment plan! And I'm VERY glad that you are back blogging - I've missed your blog! :)

    ReplyDelete
    Replies
    1. Thanks! It's great to hear kind words about my blog. I just kind of took a break.

      Delete
  6. Everything sounds so promising! I look forward to hearing how this resolves.

    ReplyDelete
    Replies
    1. Thanks! 95% is a pretty promising statistic!

      Delete
  7. That is super exciting!!! I can't wait to see how he is after surgery.

    ReplyDelete
    Replies
    1. Thanks! Me too. It will be a few months until he is back under saddle.

      Delete
  8. How great you got such a definitive diagnosis and treatment plan!

    ReplyDelete
  9. So glad to hear you have a great plan going forward! Fingers crossed for a successful surgery and easy recovery.

    ReplyDelete
  10. wow i didn't even know surgery was an option for this (granted i know very little about the condition). your vet sounds phenomenal - like he's got a great plan for you and Boca. fingers crossed it all goes well!!

    ReplyDelete
    Replies
    1. I'm so glad I encountered this post-2013 where there is a minimally invasive surgery available!

      Delete
  11. Thanks for sharing the x-rays! It's really interesting to see things so clearly. So sorry he needs surgery, but how awesome that the success rate is so high :)

    ReplyDelete
    Replies
    1. I am fascinated by large animal medicine, so that part was really cool, to be able to see what a normal spine looks like, versus an unhealthy one.

      Delete
  12. A horse at my barn is actually having this surgery today.

    ReplyDelete
    Replies
    1. No way! Kissing Spine twins! Good luck to your fellow boarder's horse. I hope it goes well!

      Delete
  13. Glad to hear you have answers and a positive treatment plan *hugs*

    ReplyDelete