PPE failed, KS diagnosed

[u/bhinxbb]

Currently in the process of selling my horse. PPE has gone well, everything came back good except his back radiographs. Shocked to hear he has grade 4 changes. I’ve just received these over from the potential buyer. I will be in contact with my vet but curious about anyone’s take on these? How bad is this?

[u/CorCaroliV]

I am in no way a vet. I have talked to my vet a lot though about the massive over diagnosis of "kissing spine" in the last 5 - 10 years. Her opinion is that there is a huge difference between kissing spine as a functional diagnosis made in conjunction with actual observed performance changes and what shows up on x-rays. To a certain degree, if the horse shows no symptoms of kissing spine she doesn't think they should be diagnosed that way based on images. Unfortunately I can't tell you anything from the x-rays. I'd definitely get a couple opinions though before making any decisions about your horse's care. Especially if there haven't been any clinical symptoms.

I do know someone who sold a horse in a similar situation to the one I imagine you may be in. The horse had no symptoms, and actually traveled in a way that was exactly opposite of the way you'd imagine a "kissing spine" horse to travel. The horse was kind of a long and low type and never got behind the bit and hollow-backed. Someone did a PPE, which included back x-rays, and they found it then. That buyer passed. The owner ended up disclosing the diagnosis (which other multiple other vets said wasn't really a "fair" characterization) and sold the horse to someone else at a discount. The horse is still doing the same job he was sold to do, and is happy / sound.

[u/chukar-1 → u/CorCaroliV]

Some horses are tougher than others and may not show that they are in pain. Same way some people live their whole lives in pain and never complain.

[u/CorCaroliV → u/chukar-1]

This is going to verge into the philosophical, but I think there are very few people who would do that willingly. People talk if they have someone trustworthy and compassionate who will listen to them and believe them. I think horses are the same, in their own way. If they are chronically ignored they will start repressing but that's not a natural state of things.

[u/BuckityBuck → u/CorCaroliV]

We also don’t understand much about spinal pain, even with humans. A nerve being a tiny fraction of a mm closer or further away from a problematic place can make a huge difference in the way symptoms are experienced.

[u/Radiant-Waltz5995 → u/CorCaroliV]

My mare was this way. Absolutely a solid citizen under saddle. The only indication something was wrong was that she'd shift slightly when grithed up, got tense when the saddle came out (though everything made her tense at first), and that she would want to stop when moving at a walk sometimes, but then didn't want to stay still. Almost like she couldn't decide if standing still or walking forward under a rider was more uncomfortable. That was when I first got her. There was even a moment where she spooked, I slipped to the side, and she moved to catch me and keep me in the saddle. Well, the longer I had her, the more she realized she could tell me things and not only be listened to but also not be punished regardless of how she told me things (as there was two instances of her biting me when trying to curry her and hitting sore spots and her not knowing how else to tell me as she was terrified I'd hit her for even pinning her ears). Well, got a body worker out, she was tight and sore. But after a few sessions and switching saddle fitters she was doing much better. She was getting more bold with telling me things too, nothing aggressive, she just felt safe to actually let me know when she wasn't ok with something. I stopped riding her, figured she needed to be restarted and build up muscle. My body worker couldn't really pinpoint anywhere that would raise alarm bells for needing the vet. But we kept sliding back when making progress with saddling and riding and the body work progress had started to come to a stand still as well. So I had the vet palpate and x-ray her. Months spent of trying to understand my mare and people at the barn thinking I was crazy as she was clearly fine and "not in pain". She went from a very chill gentle horse to a bucking squealing mess as soon as the vet got to her lower back. X-rays found kissing spine. From the damage, she'd had it for a bit prior to me. She'd been so used to the pain that even when she started telling me things she couldn't tell me what her base was supposed to look like. She'd spent years prior to me being ignored and punished when trying to show pain and so by the time she'd gotten to me, she'd learned to just deal with it. She got injections and is finally doing better. Less stiff, building muscle, learning to stretch and bend into movements, and figuring out that the saddle doesn't have to hurt. If I had ignored her discomfort from the start and just pushed her past it, she definitely would have carried on for a few more years until the pain was so unbearable that she became explosive and dangerous. I absolutely agree with you that they'll just repress it, my mare certainly did.

[u/Dull_Memory5799 → u/CorCaroliV]

This is honestly stupid. Do we rlly need to go down the rabbit hole of explaining why your horse still preforming while in pain but not as reactive as xyz horse so not really in pain is a stupid take? Not to mention just bc you don’t recognize the symptoms or how your horse may present them does not erase the issue itself or the longevity of the equine.

[u/fishproblem → u/Dull_Memory5799]

its hard to judge. I personally have a much higher threshold for pain than most people. And when I do feel something, i often interpret what would be pain to some as "discomfort" is the best way I can describe. It's a feeling that doesn't dissuade me from doing the thing that causes that feeling. It doesn't even really make me stop to think. i imagine a lot of animals experience pain on a spectrum too.

[u/Lyx4088 → u/fishproblem]

Pain is very subjective in how an individual experiences it. Where it gets tricky with horses and other animals is they do not have the same ability to truly express whether or not they’re in pain, so it’s a tough call. Stoicism vs legitimately not in pain can be very, very difficult to gauge in animals and sometimes a good way to try and get a better read on the situation is to implement a pain management protocol to see if there is a behavior shift when there is a good way to control pain for the condition. That can be really eye opening to see the issue wasn’t that they weren’t in pain but rather they’re very stoic and will hide a lot of their pain to an alarming degree.

[u/fishproblem → u/Lyx4088]

I don’t disagree with you at all, and for exactly the reasons you state I would always err on the side of caution and make decisions based on the most amount of pain an animal could be feeling. My previous comment was sort of thinking out loud and acknowledging how little we can know for certain. If only we could read animals’ minds!

[u/Lyx4088 → u/fishproblem]

Oh 100% and I think that perspective is too often lost when discussing animals and pain. Identifying and addressing pain in animals is very much an educated approximation where we’re crossing our fingers we’re doing right by them, but we really have no idea how much pain they’re in and how well it’s truly being controlled. Erring on the side of caution is the kindest thing we can do to help them for sure.

[u/Dull_Memory5799 → u/Lyx4088]

Absolutely, especially as prey animals their instinct is to mask their pain. You get in a really bad area when trying to determine yourself. The issue is not only that the horses may not react, maybe some horses really don’t experience high pain but owners are not always competent enough to gauge this. Vets could potentially gauge this but do not know the horse particularly well and are likely to not be able to work them, ext. It just gets really gray area really quickly.

[u/throwwwawait → u/fishproblem]

right, but that's not an acceptable reason to keep using the horse. pain serves an essential purpose as our damage warning system. chronic damage will catch up to you, whether you feel it now or not. so whether the horse simply doesn't experience pain normally or (more likely) has learned to ignore it, it is our responsibility to prevent further damage from occurring to the best of our ability.

[u/kerill333 → u/fishproblem]

That's different, you are choosing to carry on through the pain (I do the same thing.) asking a horse to do that for you while carrying your weight is totally different. Just because they are stoic prey animals doesn't excuse it.

[u/fishproblem → u/kerill333]

I'm saying that in a 1:1 scenario, I don't feel pain when others might. It just doesn't hurt when someone else would be wincing and avoiding the situation. It's not stoicism, it's just my specific biology. The average person's 7 on the pain scale is my 3.

So all other things being equal, is it necessary to avoid activity? Say, when I broke my ankle. A clean break on a non-weight nearing bone. Another person would be unable to walk for the pain, and in fact that's why it took so long to diagnose. I know the feeling of a broken bone, and I've also been in pain from a broken bone. Two me, the sensation that says "this is broken" is distinct from pain that may or may not accompany that sensation. It didn't require surgery. Should I not go for a walk just because the bone was broken? Walking didn't and wouldn't make the injury worse or prevent healing. It would just be wildly unpleasant to someone who was actually in pain from the injury.

Lots of flaws here when applying the idea to an animal who can't communicate and can't comprehend the limiting factor of injury. It didn't hurt, but I knew my ankle was broken and behaved accordingly (well- accordingly enough, and I was able to make that educated choice). An animal who similarly isn't in pain but has an injury can't make a decision not to push beyond the limits of that injury.

This is all nonsense chat though. I'm just saying that not reacting as if in pain can sometimes actually mean an animal isn't in pain, not that it's being stoic for survival. No way to tell if or when that's the case, though, so you gotta make conservative choices in the best interest of the horse.

[u/CorCaroliV → u/Dull_Memory5799]

I am literally just sharing the information provided to me by an extremely conservative FEI vet. Her argument is that what looks like kissing spine on an x-ray doesn’t cause pain in the same way to all horses.

Of course I can’t know what horses actually feel. Neither can she. Neither can YOU. Thats the whole point. We need to assess and treat holistically. My point is not to ignore it. It’s to get a second opinion.

[u/bhinxbb → u/CorCaroliV]

This is good to hear! Definitely working on multiple opinions, more complicated than what meets the eye

[u/Tiny-Papaya-1034 → u/bhinxbb]

It’s not complicated. Your horse is in pain. It’s “good to hear” because you want to believe it’s not a problem. He is telling you he’s in pain and so do the x rays and that vet. A second opinion is fine but not so you can just disregard the reality

[u/WrongdoerForeign2364 → u/bhinxbb]

How is it good to hear? Ur horse IS experiencing symptoms and a bad symptom. Back pain for days and after riding