Equine Spine & Joint Care

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...

02/15/2023

Overriding of dorsal spinous processes, or kissing spines, is the result of incorrect posture in the thoracolumbar spine. The "hollow back" posture shown in the image is less stable as far as supporting weight, is responsible for development of osteoarthritis within the spine, and causes significant pain.

Surgical vs. Nonsurgical treatment

Surgical treatment of kissing spines generally involves removal of bone (either from the edges of or entirely removing one or more dorsal spinous processes). These procedures create space between dorsal spinous processes that have been touching. Sensory nerves that had been carrying the pain signal from the kissing spines are also cut during the procedure. The up side of the procedure is that the pain resulting from dorsal spinous processes touching is removed. The downside is that nothing has been done to correct the root of the problem, thoracolumbar posture.

Because surgery and, in most cases, rehabilitation after surgery does not address the posture of the spine, thoracolumbar instability and osteoarthritis continue to be problems. Also, because the normal anatomy of the dorsal spine has been disrupted by the procedure, the spine is less stable than prior to surgery.

Nonsurgical management of kissing spines, when done correctly, alters the posture of the spine and brings the horse into a "neutral back" posture. This is achieved with specific exercises performed daily over the course of 2 to 4 months. In many cases, osteoarthritis pain needs to be addressed before a horse is comfortable enough to properly perform the exercise routine.

While physical therapy for kissing spines is very labor intensive and requires a real time commitment from the owner, it does lead to a superior result with far fewer complications compared to surgical intervention.

For more information, please contact Dr. Keith Taraba.
903.855.3179

02/09/2023

"But he hasn't done anything yet. How can he have a back injury?"

This type of fall, when a horse is playing in pasture, can lead to muscle, joint capsule, and ligament tears in the thoracolumbar spine.

01/22/2023

🏇Spinal pain is a very real and serious cause of performance decline or difficulty in horses. 🏇

Dr. Nicoletta is pictured here performing ultrasound-guided lumbar facet injections.

The first step in treating any horse is getting a list of accurate diagnoses, and the basis of that is our unique approach to physical exam.

We do not find “diagnostic” nerve blocks helpful, and instead rely on our decades of palpation and flexion techniques, combined with detailed observation of the horse’s responses to find the areas of pain.

Many times, complex lameness cases are managed in a step-wise manner. This case is a coming-4 year old QH mare in reined Cowhorse training, that we have previously addressed proximal suspensory inflammation, and typical mild hock inflammation. Yesterday’s exam revealed her hocks and PSL are within normal limits. However she had significant-for-her reaction to palpation of several facet joints in her spine.

Ultrasound imaging revealed the subtle (and sometimes not-so-subtle!) pathology around the joint capsules that traditional radiographs often have a difficult time capturing.

Using ultrasound, we are able to place anti-inflammatory steroids directly in those spinal joint capsules to relieve chronic inflammation and keep her feeling her best going down the fence.

Call or message if you’d like to discuss your horse.

Dr. Romy Troy Nicoletta’s cell is (719) 660-7498

Texts often go through sooner due to mountainous locations. We look forward to hearing from you and discussing how we can best help your horse!

12/17/2022

2022 is coming to an end. Rodeo series have come to an end. Now is a great time to evaluate and fine-tune your horses for 2023!

Noltrex, with superior lubricating and unique ability to adhere to damaged cartilage, can be a big part of a successful campaign.

Talk with Dr. Taraba to see if your equine athlete might benefit from joint injection with Noltrex.

https://vimeo.com/644053857

11/24/2022

Dr. Taraba will be bringing his two decades of experience diagnosing and managing lameness in equine athletes to the Rose Palace in San Antonio this Friday, Saturday, and Sunday for the Go Fast Races Thanksgiving Classic.

Come by and see us, or call/message to book your appointment.
903.855.3179

08/02/2022

I'd like to talk about a common misconception among equine veterinarians and horse owners. It seems that many people (both veterinarians and clients) assume that all neurologic issues in horses are caused by EPM (Equine Protazoal Myeloencephalitis). While EPM is not an uncommon cause of neurologic symptoms, it is far from the only possible cause.

Possible causes of neurologic issues in horses include:
Infection by certain viruses (equine herpes, West Nile, eastern and western equine encephalitis, etc)
Head trauma
Cervical spinal malformation (wobblers)
Spinal OCD lesions
Spinal trauma
EPM
Neuron degenerative disease
Brain tumors

This list, while not absolute, contains the most common causes of neurologic dysfunction in the horse.

My point in saying this is to promote an understanding that if appropriate therapy for EPM has already been attempted in a horse with neurologic symptoms and the symptoms are still present, then it is probably safe to say that EPM is not the cause. That means another problem is much more likely causing the issue, and a more complete exam needs to be done.

07/20/2022

04/01/2022

This article, while it appears to support the vast majority of equine veterinarians' viewpoints, is not very helpful to the profession in my opinion. Sacroiliac and lumbosacral pain in horses is relatively simple to diagnose with a good musculoskeletal exam and a good understanding of biomechanics. This article makes it sound like nuclear scintigraphy is needed in order for one to be confident in the diagnosis of sacroiliac pain.

I would love to teach veterinarians who have difficulty with their current methods in identifying this type of problem and are open to tweaking how they approach lameness.

03/23/2022

If your horse can do this, we have a problem. 🤣

03/14/2022

01/25/2022

Some very significant causes of neck pain in horses are extremely easy to find with a simple ultrasound examination. Arthritis, subluxation, and even fractures of the neck can be seen quite well with ultrasonography.

Horses with injuries in the neck may show decreased willingness to bend one or both directions, pain to pressure on part of the neck, unusual front limb lameness, and/or an uncoordinated gait. At times, these horses appear to have EPM that doesn't respond to treatment.

An effective treatment plan begins with an accurate diagnosis.

12/31/2021

With the coming cold weather this weekend, be sure to add a couple tablespoons salt to your horse's feed every feeding (in addition to whatever electrolytes they normally get). This increases thirst and can help them keep drinking as the temperature drops. Decreased water intake, even for a day, can lead to colic.

12/25/2021

Wishing a Merry Christmas to all of our clients and friends!

11/24/2021

Dr. Taraba will be bringing his two decades of experience diagnosing and managing lameness in equine athletes to Arizona December 7, 8, and 9.

Call or message to book your appointment.
903.855.3179

11/21/2021

Osteoarthritis in the thoracolumbar spine is a common cause of back pain and decreased cranial phase of the stride in the hindlimbs of horses.

The photos show the most commonly affected locations for significant osteoarthritis in the lumbar area of horses. Since most (over 70%) of the lateral flexion of a horse's thoracolumbar spine (bending) occurs between T-18 and L-2, the articular facets between T-18 and L-1 as well as L-1 to L-2 are most commonly affected.

The photo of the spine shows what significant bony change in T-18 to L-2 actually looks like when compared to a normal articular facet between L-3 and L-4. The ultrasound picture shows the irregular bony margin of an arthritic facet (red circle) versus a normal smooth bony margin (green circle).

Various therapeutic modalities can be used to alleviate pain caused by osteoarthritis in the spine, however accurate diagnosis is required before a proper treatment plan can be made.

Dr. Taraba is well versed in both diagnosing and treating spine problems in horses. If your horse has back pain, or an abnormal gait behind that has not responded to attempted treatments, call to schedule an appointment today.
(903) 855-3179

Dr. Taraba is based in College Station, TX, and travels throughout Texas and Arizona.

11/10/2021

A common cause of pain that is localized to the hock region is chronic proximal suspensory desmitis, or long-standing inflammation of the high suspensory. This issue can cause varying degrees of lameness from a mild and intermittent problem to a full blown limp.

Attempts to block the lameness can, in many cases, lead one to believe that the problem is coming from the distal hock joints. Often, the hocks are injected at this point, and the horse is placed back into work. Hock injections may temporarily relieve some of the pain and inflammation in the area due to diffusion of the corticosteroid locally. However, the root cause of the suspensory problem is not addressed, and the pain returns...usually in a matter of weeks.

Radiographs of the hock in these cases may not be very remarkable, however if sclerosis (a pathologic increase in bone density) is seen in the medullary cavity of the cannon bone...as pictured in the photo...the proximal suspensory should be evaluated.

Ultrasound of these chronically inflamed ligaments may not show any visible tearing, but enlargement in the hind limb high suspensory is very significant. Because of the anatomy in the area, and a strong fibrous band of fascia that covers the high suspensory there, swelling has no place to go, and the result is moderate to severe pain. In addition, sclerotic changes in the bone at the origin of the suspensory cause deep bone pain.

These horses need treatment aimed at reducing the swelling of the high suspensory, and some amount of rest to allow whatever damage that caused the swelling to heal completely.

09/12/2021

September 25-27, Dr. Taraba is bringing his 2 decades of experience in diagnosing and managing equine lameness back to southern Arizona. Call or message now to schedule an appointment. 903.855.3179

Dr. Taraba takes a unique approach to locating sources of pain. His advanced knowledge of biomechanics and functional anatomy leads to accurate diagnosis and treatment plans that make sense.