Kissing Spine Files

Part 3

Surgery & Rehabilitation

So he has Kissing Spine, Now What?

 

Although massage, chiropractic, injections, and other therapeutic options can provided some relief, treatments seemed unsustainable after spending thousands of dollars over the course of 2 years without any lasting results (and a lot of frustration!). I couldn’t get Moose back to his previous training level

Once we took x-rays, we were able to get a clear picture of what was causing this change in my horse's behaviour.  Moose had 4 vertebrae touching and 1 starting to hook, so he qualified for an Interspinous ligament desmotomy (ISLD).

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The decision to try rest before surgery

Over the course of treatments, Moose developed muscles to help him cope. His pectoral muscle development was a big concern for me. How would his movement be affected after surgery? I didn’t believe he would develop the long-term benefits if his body was built to withstand the pain he was feeling. I believed his rehabilitation would be impeded.

 

I couldn’t snap my fingers and make those muscles disappear, so I retired him to allow them to weaken. Since rest was another known solution to kissing spine, it was also the least expensive option before surgery. I wanted to start from a point where he could develop good muscle and tone without pain or discomfort. He stayed on rest a little longer than I planned, but life got in the way.

Once we were ready to commit to surgery and rehab, we had the vet out to take x-rays again. We were trying to decide if he would qualify for the ligament snip surgery (which wasn’t widely available in my area when he was originally diagnosed).

 

X-Rays can be a bit controversial. Taken on the slightest of angles, your horse could look like they have kissing spine. But, the x-rays taken after resting came back with a few spots of interest and Moose was booked for the ISLD once mud season ended. Since I was in no rush, and I wanted to give him the best chance at recovery, I chose the dates of the surgery to coincide with the best weather in Ontario, Canada.

Surgery 

 

Surgery marks the beginning of a lot of work for owners. It’s imperative to know what you are getting into and decide whether you can commit to the rehabilitation. Since my horse was living at a retirement barn, I was going to be committing to going out there to look after him twice a day for at least a month. Moose would come home from surgery without kissing spine. Pretty good odds I’d say! The catch? It’s only as successful as the rehabilitation.  

 

When the ligaments are snipped, the horse loses feeling in those places. In order to carry himself, and the weight of a rider, he must build up his muscles to basically ‘hold himself together’. So, the success of it all was up to me, and me alone.

 

I liked those odds, after sending horses to surgery for other issues in the past and having to hope you were in the 60% success rate group. Putting the success of the surgery on my shoulders was a breath of fresh air.

 

Because of Covid restrictions, my horse would be in and out of the hospital in one day. I was a little nervous about the trailer ride home and the stress, but the whole ordeal was like ripping off a bandage. It was quick. Once at the hospital, they took more x-rays and found 5 spots where the vertebrae were touching. The surgery went well, and he came home that afternoon.

 

Home from surgery

Your horse will most likely come home with a long wide bandage which spans the length of his back where the incisions are. The recommendation was to keep the bandage on for 3-4 days. Moose had 5 small incisions measuring less than 2 cm each. The fifth incision, which showed the most post-surgery inflammation, became problematic.

Trying to keep the bandage in place is like trying to keep an unbuckled blanket on your horse. Every time I came into the barn, it would be shifted or bunched up. I ended up using long strips of duct tape, about 1 inch wide and running double the length of the bandage. This trick worked best to keep them in place, and after the 4 days, I created a little teepee on his back to keep flies from landing on the incisions.

 

Once they started healing, my horse got very itchy. He was on Sulphatrim to protect him from infection for the first 10 days, but his urge to scratch the incisions was enough to break one open, and an infection ensued. We put him on another dose of Sulphatrim and I became the back scratcher, using my fingernails to scratch in-between the incisions.

 

He spent 14 days of stall rest followed by hand walking and turn out in a small paddock. Depending on how your horse handles stall rest, you will be able to determine the right care choices. My horse is a dream at stall rest, so that worked well for me.

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first day home.... he would not let me near it with the camera....

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In this photo, the pieces of duct tape I was using were too short to keep the bandage in place. I ended up doubling their length. 

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What the incisions looked like after 14 days. The largest one at the back opened up and became infected. 

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getting some relief from itching

Hand walking your horse twice daily for 30 minutes might be very easy for you or could pose a problem. My horse was a wound up, explosive, firecracker. Walking him was dangerous for his recovery and for me! I drove over to the vet’s office after he almost got away from me on the driveway, and picked up some mild sedatives to help ease the process so we could smoothly begin the rehabilitation.

 

Sedatives would promote relaxation. Tense muscles weren’t going to help him heal properly, so a dose of Ace and some quiet were just what the rehab ordered. The sedatives helped him take bigger steps when on our walks, stretch and generally keep his head lower.

Once we were ready to start the lunging work, I pulled out the training system that was recommended in Moose’s aftercare. Because he had been retired before surgery, and those muscles he had developed during the pre-diagnosis were gone (good and bad), I knew this area of the rehabilitation was going need patience and time, so we started with 5 minutes of walking and moved our way up from there.  The lunging system itself was recommended on his recovery papers from the vet hospital. I purchased something similar to the Pessoa System which is a little like long lining on a lunge line and spent 2 months lunging and building the muscles he needed to start carrying a rider.

He started getting some shape, and we turned him out with his buddies once the infection cleared and the incisions were healed. He was one happy horse. Reuniting with his girlfriend was on his top 5 things to do, but the rolling and scratching continued for some time.

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lunging rehab... this will become part of our exercise regime for as long as Moose continues to be ridden.

Saddle Up

Once we got to the point of putting a saddle on him again, I pulled out my beautiful French saddle, which had been custom fit to him. When I swung it up over his back, it looked like it was made for a completely different horse. I assumed the saddle fitter would come out to adjust the padding, but it looked like the tree size had even changed. The cantle of my saddle hovered about 2 inches above his back with a zero percent chance of being 'adjusted'. This was a huge surprise to me. I didn’t think I would be having to fork out money for a new saddle, but horses with kissing spine issues must have a properly fitted saddle and my horses’ back changed more than I had imagined it could. (PS, my saddle fit without any half pads or shims prior to surgery).

Once the saddle fitter arrived, we determined that the best fitting tree for Moose would have an open plate at the pommel with a longer tree point than a French keyhole system. Since the saddle would need adjustments every three months, we also opted for a wool flocked saddle (instead of foam), so adjustments could be made wherever needed. Foam filled saddles tend to leave little room for a truly custom fit. If you can imagine, a pre-cut piece of foam inside your saddle cannot be adjusted as easily as loose flocking. This complete saddle change came as a bit of a surprise for me, and I shed a tear as I said goodbye to the french cut saddle and hopped into my new choice of a Kentaur Saddle.

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The cantle no longer follows the shape of his back, and the shoulder is pinching.

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more padding on the cantle and more space for comfort with a wider channel

Join me in the final leg of the series next week when I talk about getting back in the saddle and the struggles we’ve faced.

Great reference explaining everything we tried prior to surgery here: 

https://news.vet.tufts.edu/2019/09/surgical-management-of-impinging-or-overriding-dorsal-spinous-processes/

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