Many horses suffer from back pain. Very acute back pain often manifests itself in behavioural changes, some of which may be pretty extreme; rearing, refusal to be tacked up, bucking under saddle. More usually the signs are subtle; a loss of performance, breaking stride when being ridden down slopes or bucking following jumping. Sometimes, pain is evident upon palpation of the horse’s back and muscle tone may be lost along the topline and in long-standing cases problems can occur elsewhere, particularly in the hind legs.
One relatively common cause of low-grade, chronic back pain is a condition called kissing spines.
What are ‘kissing spines’?
Horses with this condition fall into the category of low-grade pain sufferers. The spinous processes; that is the sections of bone attached to the vertebrae, are sited too close together. They rub against each other when the horse moves. You would expect this to cause the horse great pain, but often the condition presents far more subtle symptoms and is therefore not easily diagnosed.
Your vet will observe the horse being worked. He will look at the horse’s general demeanour; is he accepting the bit, working through his back, his posture, even his facial expression. Sometimes the walk and trot is fine but the horse will become disunited in the canter. When his back is groomed or his girth is fastened he may become irritable. Sometimes the vet will use a nerve block – an injection of local anaesthetic between the spinal processes. He will then observe the horse at work again and ask the rider if the horse feels any different.
A definitive diagnosis is usually made using X-rays and ultra-sonograms. In very long-standing cases kissing spines may not be painful at all as ligament fuses the bones together completely. This would show up on X-ray but your vet may elect not to treat the condition as the condition is not painful and the horse would not be in any discomfort.
Could my horse be affected?
Any type of horse can have kissing spines. It is mainly competition and performance horses who are referred for investigation for back pain, probably because of a drop in their performance level during physically demanding work. Horses used for hacking or light work may well have the condition but exhibit no signs.
What’s the treatment?
The usual treatment for kissing spines is surgical. Two small incisions are made along the horse’s back. The supraspinous ligament is then cut. All attachments both ligamentous and muscular are severed along each side of the horse’s spine and approximately half the spinal processes are cut off, removing around three inches of bone. The ligaments and skin and then stitched up.
Following the procedure, a space remains. A blood clot forms within this void and eventually fibrous tissue forms to fill it.
Not every horse is referred for surgery. Each case is reviewed depending upon the degree of severity of the condition, the horse’s lifestyle and his tolerance levels. For a horse in moderate to light work with a minor degree of kissing spines, it may be possible to manage the condition through twice-yearly steroid injections combined with physiotherapy and re-schooling.
Recently, a new keyhole procedure has been developed which involves cutting through the soft tissues that link the spinous processes to sever the nerves which cause the pain.
Recovery time following surgery is usually around three months and most horses are able to return to full work again.
If your horse begins to exhibit odd behaviour and you are worried that his back may be causing him pain, always consult your vet. Your horse may be suffering in silence.
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