What is Kissing Spine in Horses?
Kissing Spine in horses is a persistent low level of pain. Kissing spines is a condition that develops when the spinous processes of the vertebrae touch each other, pressing or rubbing against each other during movement. Please note that an X-ray is often insufficient to diagnose Kissing Spine disease. Horses with Kissing Spine disease do not always show discomfort. Therefore, it is difficult to detect and insufficient to make a clear diagnosis.
What are the symptoms of horses with Kissing Spine Disease?
Often overlooked, undertreated and poorly understood. Kissing Spine in horses is often associated with bad behavior.Signs of discomfort, weight shifting, bucking, trotting problems, temperament problems, and so on. There is a lot to say about the symptoms of Kissing Spine and how to treat it. We have an entire article dedicated to this for you to read.
What can I do about Kissing Spine myself?
My horse is behaving badly and I can't figure out why. I'm afraid the vet will say it's kissing spine disease, and I don't want to think about surgery. What can I do? Create an action plan to combat this disease.- Alternative methods
- Training and physiotherapy
- Changes in equipment can prevent major vet bills.
- Saddle fitting solutions
- Equine rehabilitation and training
A change in equipment can prevent serious vet bills!
As you know, at ThinLine we are committed to making horses' lives better and happier. After several years of working with veterinarians, trainers and owners, we have put together information about Kissing Spine in horses.
That is why we have drawn up an action plan to combat this disease.
If you suspect that your horse's accident may be related to pain, and generally it is. We have listed the easiest methods for you before you move on to more aggressive treatments.
Alternative Methods for Kissing Spine in Horses?
Alternative methods such as acupuncture, chiropractic adjustments, mesotherapy and/or massage can play a role here. Use them both as a first line of treatment and in a supportive role.
“In my opinion, if we are dealing with a case of significant bone reaction along with kissing spines, the benefits of chiropractic care can minibe timeless and possibly counterproductive;
However, acupuncture or mesotherapy can reduce pain and dysfunction. There are several people in our region who practice equine massage and are often recommended.” (Frank Frantz, Burlington Equine).
Training and Physiotherapy
Physiotherapy should be reconsidered as the essential component for the treatment of this condition. Using exercises that help build core strength and lift the back are the most important concepts.
Frequent lunging with side reins, using a Pessoa system, abdominal lifting exercises are all designed to strengthen the back and pelvic floor muscles.
When we talk about building core strength, we are not referring to the back muscles above the spine, but rather the muscles that lie next to the spine (multifidus muscles). The muscles that run from below the spine to the hips (psoas muscles). And the muscles that run along the abdominal wall (abdominal muscles) that we are trying to strengthen. These are the muscles that work to lift or flex the back, as opposed to the muscles above them that extend the back.
Of course, the physiotherapy part is easier said than done and it can take months before the benefits are fully noticeable. “I find that combining it with some type of therapy that makes the horse more comfortable is the best approach.” (Frank Frantz, Burlington Equine).
And what about the saddle fit?
Hiring a certified saddle fitter in your area should be one of the first things you do with any horse that shows discomfort with tack.
Always check your horse after a good ride and make sure they are not showing any pain.
Gently press your fingers on either side of the spine from withers to rump. Your horse should not react by lowering its back. Some horses are sensitive, so try to establish a baseline after a few days of rest.
Just Google a saddle fitter in your area. Saddle fitters are money well spent on all horses.
Rehabilitation and training for Kissing Spine
Horse and Hound UK
Equine surgeon Bruce Bladen points out that a colleague in Sweden who has operated on many cases of Kissing Spine Disease in horses has recently had excellent results – without surgery – with horses sent to a rider experienced in equine rehabilitation and retraining.
“This makes sense,” says Bruce. “We're talking about the normal flexibility of the spine, which occasionally results in 'cushioning' the edges of the bones. It is easy to imagine how a different rider or saddle, or increased muscle tone due to physiotherapy and a change in work, could prevent this.
“It's also easy to see how the results of training a horse can be so different depending on the psychology of the rider,” adds Bruce. He believes that surgery can have the effect of a placebo in some cases.
“The difference in attitude between a rider who is concerned that his horse is behaving this way because it has an underlying disease, and a rider who knows that his horse has had surgery for this disease and is now 'cured' will be significant - rightly so.
“But it is a major operation and this has limited the use of the procedure – no one wants to do it unless they really think it will be beneficial.
Sometimes just a change in equipment can successfully prevent serious vet bills!
Whether it's saddle fit, less than perfect training, or less than perfect riding, we know for a fact that the comfort of the horse's back needs to be addressed as quickly and as easily as possible. Both horses before and after surgery find relief in the therapeutic saddle pad from ThinLine.
Learn more about Kissing Spine in horses, from a top veterinarian
By Randy Frantz of Burlington Equine Veterinary Services, LLC, Vermont
Dorsal Spinous Process (DSP) impingement or “Kissing Spines” is a condition recognized as a major problem for horses. What constitutes the problem is subject to debate and how to make a definitive diagnosis can be a tricky process.
The following article will discuss the anatomical findings, diagnostic procedure, therapeutic options and prognosis.
To understand the problems behind DSP impingement, you need to understand some anatomical factors. Generally the problem is in the thoracic portion of the spine – the area where the rider sits.
Less commonly, involvement of the lumbar vertebrae behind the saddle area may be the cause of the problem.
The Vertebrae
As you can see in the attached image, the thoracic vertebrae begin at the withers and continue through the saddle area.
The part of the vertebrae we are interested in is the vertical part that projects upward and should be evenly distributed from the adjacent process.
The following image shows two dorsal spinous processes with the correct proportion.
To understand the correct relationship between the vertebrae in the back, an X-ray is the easiest way to see how the bones fit in relation to each other.
The following image is of a combined radiograph of a horse's back with normal space. The left side of the image starts at the withers and moves along the back to the right, showing the lower back.
High vertical DSPs that form the withers are narrow and long, but are not usually involved in Kissing Spine Disease; instead, it is usually the group of vertebrae behind this area – the thoracic vertebrae, in the area where the rider sits.
As you can see, the spacing between the DSPs is even and there is no significant bone reaction.
The next picture is of an abnormal radiograph which clearly depicts kissing spine. As you can see the finger like spinous processes are either touching the adjacent process and in some cases actually overlapping.
DSP entrapment in a horse with significant back pain
Clinical Signs of Kissing Spine in Horses
Horses with this condition can exhibit a range of symptoms, ranging from asymptomatic, that is, showing no abnormal symptoms, to horses that are unrideable, may buck, refuse to be saddled and/or exhibit behavioral problems, even on the ground.
The problem is not so much understanding the more obviously affected horses, but rather the asymptomatic horses. The radiographic changes did not occur overnight.
And there certainly were horses that worked regularly during this time and were able to jump, ride dressage and/or western pleasure, while the x-rays looked abnormal.
Something has to change to make the problem visible, and something has to change again if the problem is to be brought under control.
Behavioral and Training Problems
I have heard a variety of complaints from riders and trainers over the years regarding this condition, the most common of which involve behavioral and training problems.
In general, the horses may not be obviously lame, but rather exhibit avoidance behavior that affects their work, such as: refusing to accept contact with the bit.
They prefer to keep their heads up and their backs down (not rounded), don't want to bend in one direction or the other, don't consistently pick up the right lead, feel disconnected or go into a cross gallop.
Obviously, these symptoms can be associated with various problems such as stomach ulcers, Lyme disease, horse equipment, training, rider, to name a few.
Diagnosis of Horses with Kissing Spine Disease
Making the diagnosis can be a simple process in some cases; in other cases it is a process of exclusion. The history and clinical signs are particularly useful to the veterinarian.
After this, radiographs are the first line of defense. Digital X-rays allow us to take X-rays of a horse's back in minutes and clearly see if any problems are present, as shown in the image below:
Ultrasound
Ultrasound is also sometimes used. Traditionally considered an excellent method for evaluating soft tissues, it is extremely useful when viewing bone surfaces.
While X-rays penetrate bone and show the edges and interior of bones, ultrasound shows many details about the bone surface and the soft tissues attached to it.
What in some cases cannot be appreciated without ultrasound is back pain caused by the ligament that runs over the spine and inserts into these DSPs (dorsal spinal processes), nor the ligaments that are between the bones.
Thermography
Thermography is also used in some cases to evaluate heat release, which may correlate with inflammation. By using a thermal camera you can visualize areas of the back, legs and even saddle fit.
The more intense red or white areas correlate with inflammation. The next two images show a more normal spine on the left compared to the one on the right with more inflammation in the saddle (thoracic) area and over the hips (sacroiliac) areas.
Significant heat release in the saddle area + over the lumbar region (sacroiliac area).
In cases where there are more questions about involvement of the back versus other areas, a nuclear scan may be performed. These procedures are performed in referral clinics.
Advantages, like thermography: They are dynamic studies and show problems in real time, unlike static studies such as x-rays or ultrasound, which show what is there at that moment but do not necessarily correlate with inflammation.
A nuclear scan detects the release of accumulated radioactive material using a camera.
Treatment of Kissing Spine in Horses
As would be expected, treatments can vary. The key concept is that regardless of the treatment, physical therapy is even more important for a successful outcome.
What I mean by this is that the treatments can help manage the pain in the short term and even for longer periods, but without introducing a change in riding, training and/or tack the problem may continue to affect the horse.
Overall, I have found that treating the affected areas with injections of a combination of corticosteroids and Sarapin has been beneficial.
In most cases this will be my first treatment and is often carried out at the same time when the diagnosis has been definitively made.
Shockwave therapy or Laser?
Over the years I have treated countless horses with Shockwave Therapy (SWT) and have also found it to be effective; in fact, for some horses the benefits are comparable to injections.
SWT is also beneficial as a management tool, i.e. treatment periodically and/or shortly before competitions can help to reduce the discomfort associated with this chronic condition.
In some acute cases I have effectively used a laser to treat focal areas of inflammation. Laser treatments can treat inflammation of the bone, soft tissues and nerves.
What is Tildren?
Tildren is the newest drug I would add to my list. Most of the research with this drug has been conducted in Europe and it has proven benefits for horses with Kissing Spine. The essential mechanism is that it reduces the destructive process of bone inflammation and “activates” the bone cells that help repair damaged bone.
What is unique about this drug is that it not only masks pain, but actually improves damaged bone, which interrupts the destructive process and improves long-term comfort.
I currently import it from France with a special permit and have used it successfully in numerous cases. Although it is expensive, the benefits often outweigh the disadvantages.
The horse below with Kissing Spines, which was reluctant to move forward comfortably, refused to jump and could not gather properly, was treated with Tildren. After treatment he improved significantly and the results lasted longer than when local injections alone were used.
Alternative methods
Alternative methods such as acupuncture, chiropractic adjustments, mesotherapy and/or massage can also play a role here. I have used them as a first line therapy, but also in a more supportive role.
In my opinion, the benefits of chiropractic care can minitimes and possibly counterproductive if there is a significant bone reaction along with Kissing Spine; however, acupuncture or mesotherapy can reduce pain and dysfunction.
In our area there are several people who practice equine massage and are often recommended by me.
Physiotherapy for Kissing Spine in Horses?
Once again, physiotherapy should be considered the essential part of the treatment of this condition. Using exercises that help build core strength and exercises that can lift the back are the most important concepts. Frequent lunging with side reins, use of a Pessoa system, abdominal lift exercises are all designed to strengthen the back and pelvic floor muscles.
When we talk about building core strength, we are not referring to the back muscles above the spine, but rather the muscles adjacent to the spine (multifidus muscles). We try to strengthen the muscles that run from below the spine to the hips (psoas muscles) and the muscles that run along the abdominal wall (obliques).
These are the muscles that work to lift or flex the back, as opposed to the muscles on top that stretch the back.
Of course, the physical therapy part of the puzzle is easier than it sounds and can take months before the benefits are fully appreciated. I find that combining it with some type of therapy that makes the horse more comfortable is the best way to go.
Best choice: Use a saddle pad for protection, ThinLine. Saddle pads recommended by veterinarians for Kissing Spine in horses.