Enigma: Kissing Spines In Horses – Part 4 – Management Considerations

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This article is sponsored by Platinum Performance.  It was originally published here: https://www.platinumperformance.com/articles/kissing-spines.html

Management Considerations For Horses with Kissing Spines

Certain adjustments can potentially improve the horse’s comfort and ability to perform and compete successfully.

  • Warm-ups – Tailor warm-ups to the individual horse’s needs and preferences.
  • Weather – Adjustments may be needed to properly prepare a horse’s muscles for work in cold weather.
  • Tack – Pay close attention to saddle and girth fit, as it can either help or hinder treatment or management.
  • Bodywork – Consider adding equine chiropractic care and acupuncture as part of your management plan.
  • Nutrition – Always vital to a horse’s overall health and wellness, diet can play a critical role in maintaining a healthy weight, laying a strong foundation and supporting a normal, healthy level of inflammation.

Ongoing Management Considerations

Whether or not surgery becomes a viable option for a Kissing Spines case, there are ongoing management considerations that can directly impact the horse’s comfort and ability to perform and compete successfully. “You need a good management plan,” says Dr. Williams emphatically. “It’s crucial for these horses and their ability to do their job and to do it without pain. This includes changing how you manage, ridem and warm up the horse.”

Warm-ups seem like a fairly simple step in preparing a horse for work. In reality, warm-ups should be tailored to the individual horse’s needs and preferences to not only yield the best results but to ensure horses with conditions such as Kissing Spines are able to be ridden comfortably. “You have to adapt it to the individual horse,” confirms Dr. Williams. “For instance, I’ve seen enough horses to know that some just do better warming up at a canter rather than the traditional walk, trot, canter method. You have to be open to what the horse is telling you always.” In addition, making adjustments according to the weather is a vital piece of the equation. “In cold weather, consider putting the horse under a ceramic heat lamp ten to fifteen minutes ahead of riding to warm up the muscles,” he says as one method to prepare a horse’s muscles for the rigors of work.

While saddle fit won’t directly cause Kissing Spines, it can play a role in either helping or hindering treatment and management. “I’ll always look at both saddle and girth fit, as well as the behavior of the horse when it’s being tacked up,” says Dr. Williams of his assessments. “The saddle gets blamed for a lot more than it should, but with that said, it can exacerbate a lot of back issues like spinous process impingement, especially if a horse is changing its back muscling because it’s not using itself properly. If that’s the case, then saddle fit is going to change, and you need to keep up with that.”

Beyond considerations for weather and tack, two vital components to a successful management plan for Kissing Spines cases, and really most cases, is to assemble the right bodywork team and pay due attention to the horse’s nutrition. “I ask my clients about their bodywork team — their chiropractor and their acupuncturist,” says Dr. Williams. “These are specialists that can help these horses be managed in between treatments.” One such expert is Dr. Melinda Story who, aside from being a high-level sport horse veterinarian, is also a licensed and practicing equine acupuncturist and chiropractor. “I believe in a multimodal approach for helping these types of cases,” says Dr. Story of Kissing Spines patients. After breaking the pain spasm cycle, Dr. Story uses acupuncture as one of her first-line therapies and as part of a long-term management plan, along with Platinum Longevity® to support a more normal inflammatory response. “I use acupuncture along with strengthening and mobilization to keep these horses comfortable and, as part of a global approach, use nutrition, integrative pain management, and strengthening.”

In terms of nutrition, veterinarians value both diet and advanced nutritional formulas as playing a critical role in the horse’s overall wellness and ability to heal and maintain muscle. “We examine the horse’s diet as a critical part of that inflammatory process, and we’ll make changes to each individual case as necessary. We may also need to counsel the rider about the necessity for weight loss in the horse,” explains Dr. Allen. “It really does all start with good nutrition,” agrees Dr. Story. “I believe the diet is a very big component when keeping any athlete performing but especially when there is any type of injury or underlying condition. I use Platinum Performance® CJ to support the health of the horse as a whole, as well as all of the synovial structures. Keeping the joints healthy and moving correctly is so important for proper biomechanics. Platinum Longevity® is one of the products that I am very quick to recommend anytime I have a horse with axial skeleton discomfort or dysfunction. I really believe it supports these horses. Lastly, if there is an underlying inflammatory state in the body, getting the horses comfortable and on the road to recovery is very difficult. As a first step, I want to make sure that metabolically the horse is in a healthy place, which usually includes starting them on Platinum if they aren’t already,” she explains of her approach.

At Texas Equine, Dr. Honnas includes nutrition as part of his approach to treating the whole horse, not simply the injury or condition at hand. “When we operate on a horse that has a good nutritional foundation, we find that supports the healing process as well as muscle tone. Good nutrition has a systemic effect,” he explains. Dr. Williams agrees and considers nutrition a passion area in his practice. “I’ve always had a love of nutrition and an appreciation for how much of a role it plays in the health of the whole horse. I’m also a real big evaluator of metabolic issues in horses, and I see a lot of cases that have either borderline or blatant metabolic issues. They carry way too much weight. Weight plays into a lot of problems, but it can directly impact the back.” Aside from recommending a more natural diet based on high-quality forage with limited or low-starch and low-carbohydrate grains and concentrates, Dr. Williams recommends Platinum Performance. “I am a huge believer in Platinum. I’ve used Platinum as either a grain replacement for a lot of the metabolic cases we deal with or I’ll combine it with low-starch or low-carb feeds. For a lot of our other cases, we’ll see what issues we’re dealing with and then add the appropriate Platinum product into our treatment protocol,” he explains. “It’s about helping these horses, and I whole-heartedly believe Platinum does that.”

“I’ve always had a love of nutrition and an appreciation for how much of a role it plays in the health of the whole horse. I’m also a real big evaluator of metabolic issues in horses, and I see a lot of cases that have either borderline or blatant metabolic issues. They carry way too much weight. Weight plays into a lot of problems, but it can directly impact the back.”

— Cooper Williams, VMD, DACVSMR, ISELP, Equine Sports Medicine of Maryland

Looking Ahead

Kissing Spines is a condition once synonymous with frustration and mystery, often involving ambiguous clinical signs without a concrete diagnosis, treatment plan, or road map for successfully returning horses to work pain-free. Today, thanks to the work done by Drs. Honnas, Story, Williams, Allen and their colleagues, Kissing Spines is emerging from the unknown and becoming more widely diagnosed and treated with successful medical and surgical protocols. “I’ll tell you that there have been countless horses for eons of years that have been wasted because nobody knew the back was the issue, and nobody knew how to fix it,” says Dr. Honnas of the mystery cases involving severe undiagnosed behavioral and lameness issues. It’s ironic that veterinary medicine is now at a place where, thanks to advanced diagnostic imaging and better-recognized clinical signs, Kissing Spines has risen exponentially as a diagnosis. “As veterinarians, we can always educate ourselves further, as well as educate owners and riders about what to look for,” says Dr. Allen. “Our diagnostics can improve. I’d like to get to the day where we can draw blood, look at genetics, and determine a horse’s predisposition for Kissing Spines, allowing us to watch for it much more closely before clinical signs ever appear. Treatments still vary widely as well, and veterinarians still may not be focusing like they should on the muscle and its importance in getting these horses moving again. They need to get back to work. They need to not sit in the pasture or on stall rest, that’s not going to be effective. It’s going to cause more muscle loss, and that muscle is hard to get back once you’ve lost it. The rehabilitative process is critical for these horses,” he says with conviction. Dr. Williams agrees of course, as a skilled horseman, former 5-goal professional polo player and a man who has dedicated so much of his professional life to establishing a solid place for veterinary-directed rehabilitation in veterinary medicine. “We need to define a lot of the protocols that we use in rehabilitation of sport horses. One of the things about the college is that we’re really trying to define a certain set of protocols for individual conditions,” he says of the important work of the ACVSMR.

Perhaps one of the reasons Kissing Spines has an element of both challenge and reward for veterinarians is the sometimes difficult road to diagnosis and the extremely individualized course of treatment for each patient. Equine veterinarians quite literally live their profession. It’s rooted in their soul, and it isn’t simply the science and the problem-solving nature of the work that holds their passion. It’s the horses themselves and the people that love them. “I like helping horses compete at their peak and their owners achieve the goals they’ve made for themselves,” says Dr. Honnas. As a born horseman, Dr. Allen shares those feelings of commitment, responsibility, and genuine love of his patients and clients. “Where I am today started with a love of the horse as a young kid and then transformed into loving the science of veterinary medicine,” he remembers. “That evolution happened because I started seeing problems that I couldn’t resolve, then I started wondering why that was. I was lucky enough to have my dad to turn to, who was a prominent horse veterinarian. I kept questioning things and found incredible mentors over the years that helped me learn to work through the conundrums I couldn’t solve until I could.” The back was one of these conundrums. The senior Dr. Allen taught his son to never stop asking questions and not to rely on doing things the way he was taught but rather always to look for a better way. “Luckily no one stopped answering those questions and teaching me that there’s always a better way to do things. We just may not have thought of it yet.” As more questions are asked and answered through emerging research and advancements in clinical practice, perhaps we’ll see evolving clarity and more clearly defined treatments and rehabilitation techniques surrounding Kissing Spines, making it an enigma no more.

 by Jessie Bengoa,

Platinum Performance®

You can check out the other parts of this series here: Part 1, Part 2, & Part 3.

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