Equine Spine & Joint Care

12/03/2024

09/22/2024

Kissing Spines, or Overriding of the Dorsal Spinous Processes, is a commonly diagnosed problem affecting athletic horses in disciplines varying from barrel racing to racing thoroughbreds to dressage and jumpers. Radiographs are most commonly used to find dorsal spinous processes that are touching, and causing pain. From there, a plan to address the pain caused by these touching DSPs is formulated.

Many times, surgery to create space between the DSPs is recommended. This involves removing some part of the DSPs that are in contact. This is a faulty way to approach Kissing Spines.

Kissing Spines is not a primary disease, it is a symptom caused by lack of stability and support in the thoracolumbar spine. This lack of support leads to a "hollowed out" posture. (See picture showing various postures of the thoracolumbar spine)

There are multiple reasons that stability and support may be lacking. Some of these reasons include:
-Lack of hind end collection due to inadequate muscular development
-Injury to the muscles supporting the spine. This can result from slip and fall type accidents.
-Osteoarthritis of articular facets in the thoracolumbar spine
-OCD lesions in the thoracolumbar spine
-Pelvic injuries that make hind end collection painful
-Injury to the psoas muscle

Any time a horse is diagnosed with Kissing Spines, further diagnosis is required to find the primary cause responsible for the loss of stability and support for the spine. Once the primary cause is found, an appropriate plan can be implemented to address the real issue.

Addressing the primary cause of thoracolumbar instability leads to a much better outcome with less risk of causing further harm to the horse's back.

08/04/2024

Kissing Spines is NOT a disease!
It is a SYMPTOM of spinal instability.

08/02/2024

A commonly overlooked cause of lameness, reduced range of motion in the hind end, and decreased performance in athletic horses is osteoarthritis of the hip, or coxofemoral joints. Pain in this region is commonly attributed to the stifles. In cases of hip arthritis, stifle injections do not seem to help much, if at all.

Osteoarthritis, also known as degenerative joint disease, is a common hip disorder in horses that can lead to permanent lameness. It's caused by a loss of cartilage in the joints, which can be due to aging, trauma, or excessive use. Coxitis, an inflammation of the hip, can also lead to osteoarthritis.

Signs of hip arthritis in horses include:
Lameness: This can be intermittent, sudden, or slowly progressive, and may affect both the supporting and swinging leg.
Reduced range of motion: This can worsen over time.
Pain: The horse may be painful when the joint is manipulated, or may experience pain in the hips, buttocks, or groin that worsens during activity.
Stiffness: The horse may be stiff when first coming out of its stall or starting work, but may feel more comfortable after warming up.

Diagnosis of hip arthritis in the field can be made using ultrasound.

There is no cure for osteoarthritis, but it's usually possible to slow its progression with proper management. Treatments can include:
Anti-inflammatories such as NSAIDs or intra-articular corticosteroids, these can help relieve pain.
Biologic therapies such as platelet-rich plasma can help slow or stop the progression of the disease.

If you have a nagging lameness or change in your horse's gait that has been difficult to diagnose and treat, Dr. Taraba may be able to help. With over 22 years of experience diagnosing and helping some of the top equine athletes in multiple disciplines, Dr. Taraba has the specialized knowledge to accurately locate all types of musculoskeletal problems.

10/25/2023

Kissing spines is not a disease. It is a symptom of disease causing instability or decreased support for the thoracolumbar spine. Any spine disease that causes instability can lead to kissing spines as a symptom.

Because kissing spines is not a primary disease, surgery for kissing spines is rarely a good idea. Removing part of the dorsal spinous process(es) does absolutely nothing to address the spinal problem that led to kissing spines. Instead, medical therapy, such as injections or shockwave, to temporarily reduce pain combined with proper physical therapy and exercises can provide long-term relief.

09/20/2023

I've seen these images posted multiple times today, and I just want to make something clear. The images do have a good angle to them, but the hoof is too long. It should be trimmed up to the yellow line that I've added. Trimming this way moves the solar surface back and would center it under the coffin bone. Backing the solar surface up will also correct the underrun heels that are evident in the first image.

08/23/2023

It looks like they are trying to make the claim that their supplement will increase bone density. However, the only things that changed in the 2 navicular radiographs are: 1) a shoe was removed, 2) the technique (power of the xray tube) was turned down. There are no evident physical changes to the bone. The appearance is different because less power was used in taking the second radiograph.

When companies resort to this type of trick, it generally means that their product is pretty useless.

08/21/2023

The biggest problem with their statistics is that the horses that were held back and did not race as 2 year olds were mostly held back due to injury. So, when they are finally raced as 3 or 4 year olds, they are already set up for further injury.

If they were jogged 1 to 2 miles 4 to 5 days per week until October of their 2 year old year. Then, if galloping started that October with works at race speed beginning around December of 2 year old year or January of 3 year old year, catastrophic breakdowns would lessen.

Also, if the equine veterinary profession would revamp the methods used in musculoskeletal diagnosis, these injuries could be detected much earlier, thus reducing catastrophic injuries. Palpation of the musculoskeletal system with accurate interpretation of the results would, without a doubt, improve the diagnostic ability of Equine veterinarians.

You may ask, "How can you be so certain?"

I know this because I've been diagnosing musculoskeletal injuries in racehorses for 20 years. Most of the usable information from my lameness exam comes from palpation and range of motion exams. I've taught other veterinarians how to do this type of exam and how to interpret their findings. Bottom line, it works infinitely better than jogging and blocking.

Before most horse racing jurisdictions shut down across the country and threw the economic balance of the sport into question, the industry's biggest problem was its need to reduce racing and training fatalities. Veterinarians and scientists are still learning about the causes of catastrophic injuri...

02/16/2023

Dr. Nicoletta nailed it!

📣 Kissing Spine in Horses 📣

What is “kissing spine”?

The name refers to arched flexion of the dorsal spinous processes (that look like “fins” on top of the vertebrae). When the spine is “arched”, like in the hollow back example, the processes can hit each other. Or come close to touching. The scientific names are “impingement of dorsal spinous processes” or ”overriding dorsal spinous processes”. Those moments of bone-on-bone contact cause inflammation which is very painful.

It can be the cause of a well broke horse starting to buck or crow hop or develop a “cold back”. Some horses will start refusing jumps, or have difficulty standing for the farrier, or may blow off a barrel, or maybe they just start getting cinchy and you drop some coin on omeprazole but no real change…

How does it happen?

At the root cause, it’s a posture problem. The horse is letting his belly hang out there.
Now *why* he has a posture problem is another topic. Something has caused the horse to stop engaging his core (abdomen) to lift his spine. Then, his epaxial muscles along his top line become weaker at the same time they are forced to carry more of the workload.

What can be done about it?

There are medical and surgical options;

1. There are two surgical methods being done right now; one is chunking out pieces of bone from each of the affected processes or cutting off an entire “fin”, and the other technique is cutting the big ligament (aka interspinous ligament) that runs between each vertebrae and helps hold the spine together.

Both surgeries usually give at least a short term pain reduction, probably from the collateral action of cutting the pain fibers in the region—a neurectomy.

It should go without saying, that when you remove large pieces of things that the horse’s body hangs from in suspension, disastrous consequences can occur down the road. As in, the spine can collapse completely, beyond the hollowed out back at bottom of picture. There’s nothing to be done to salvage that.

📣Spoiler alert: I have yet to recommend surgery as the first line therapy.

2. Medical options—

📣Rehab and physical therapy! You must correct your horse’s posture.

(But you must correct his posture even after surgery too! So how do we know that surgery is actually improving the situation, or is it the physical therapy program the surgeon should be sending home?)

To get the horse through the intial 2-3 weeks of rehab work, we often give injections of strong anti-inflammatories (like cortisone). We’ll place these medicines in between the processes to relieve the pain while physical therapy has time to take effect at home.

Mesotherapy is *extremely* beneficial for breaking the negative feedback pain cycle during the rehab phase. Most horses benefit from treatment once per week.

Shockwave also will help the body heal by sending high dose ultrasound signals to the cells, like shaking them awake.

Class IV infrared laser is helpful for reducing inflammation and stimulating the body to heal via increased blood flow and release of molecular ATP.

PEMF is another great modality to reduce pain, helping the horse get through the rehab program.

🚩 This diagnosis would *not* benefit from swimming. Full body swimming could make it worse. You want to avoid any excercise or movement with the head elevated. 🚩

Keep in mind, all of those are *adjuncts* to physical therapy, not a replacement! If you want to avoid an extremely costly (and frankly, largely unnecessary surgery) you have to be willing to commit to the work at home. It’s not hard. But it takes consistency.

You also need to have a good exam done fo find any other sources of pain or problems in your horse; including but not limited to joints, soft tissue, neurologic pain, and imbalanced feet.

My takeaway;

Surgery is an expensive but quick fix with potential long term career-ending consequences; medical management is easier on the pocketbook and the horse, but requires the human to be committed.
Rarely, some horses do in fact need surgery. But I would estimate it to be less than 2-3% in my hands.

Recommending rehab does not make as much money as surgery, but in my experience is better for the horse long term. There’s no magic bullet. Pick your poison.

If you would like discuss your horse, please call or text Dr. Nicoletta at 719-660-7498