Sandy the Bear - Kissing Spine Surgery 101

I can't believe we are already a month in 2019! To say I am excited about this year is an understatement. I have three of the best horses sitting in my barn and their future is looking very bright. I am in the process of expanding my business (more to come on that, I can't reveal all the secrets yet!) and have a wonderful group of students and sponsors and I am looking forward to helping make their own year just as amazing. While I could go on and on about my plans and goals, I really wanted to share the journey of the last few months with everyone regarding Gem. For anyone who follows me on social media, I have been posting regularly about her kissing spine surgery rehab. Its been an interesting couple of months but I wanted to share what happened and how we got to where we are. 

2018 was a great year for this very special mare. She moved up the from novice to modified with fantastic results ultimately being named top placed Maryland Bred OTTB for eventing. After my wedding I took her to the Maryland starter trial to run her first preliminary and this is where things started to get a little interesting. Gem has never said no, but as I got to about fence 10 coming out of the water downhill to a trakehner she started to back off and quit about 5 strides away. In the moment I figured it was due to the ground being quite muddy and her not feeling confident leaving the ground. We called it a day and when most of the division had issues there, I knew we weren't alone. We went back to the drawing board and did some cross country schooling, changed her shoeing and after a very successful outing at Marlborough finishing on our dressage score I thought we were good to go.  But unfortunately at the training championships we had a couple issues resulting in an elimination and then I really knew someone wasn't right. 

Since we had addressed her feet, the obvious answer was ulcers! Don't all performance horses have ulcers? Gem was scoped and the gastroscopy relieved nothing more then a little bit of stomach irritation. We decided to treat her for a few weeks and see if we got any behavioral improvement. Off we went to Maryland again and Gem jumped around the training winning the event. Again, must be good to go! 

But what happened over the next week was very telling. Gem refused to work. Over the next week I wasn't even able to trot without her trying to rear. I called it quits knowing there was something seriously wrong and back to the vet we went. 

Now, I knew Gem had a spot in her back (T-16&17) that had some severe remodeling. But she had always been so willing to work and she showed no discomfort in palpating her back.  I had made an investment in partnering with Equipe saddles with there carbon fiber trees to support her as much as possible. I had seem a huge improvement in the way she moved and swing in her back, I though that there must be something else bothering her. We ran may tests revealing nothing. She had limited range in her neck so we took X-rays wondering if that could be the root cause but those also looked great. This really left us with one option, her back.  We decided to take new pictures and the changes in the spinal processes were very apparent from 18 months ago. As you can see from the pictures, the bones are touching and remodeling. If you look at the right side of the picture, you will see what a dorsal spine is suppose to look like, ample spacing between the vertebrae. We were 99% sure that this was the issue. 

There were a couple options for treatment including shockwave, injections or surgery. My previous FEI horse, Chance of Flurries, also is a victim of kissing spine. I had been through the shockwave therapy routine, tildren, etc with mixed results. Since Gem was only seven, I decided to consult with Dr. Adams at Marion Dupont Equine hospital on the surgical option.

There are two types of surgery that they are doing for kissing spine patients. Now bear with me, I am not a vet, not a science nerd, and only understand this in 3rd grade english. The first option is to go in and cut a ligament that runs alone the vertebrae to release the pressure and hopefully allow more movement in the back. Due to the severity of her case, it was recommended to do a bit more invasive procedure which involved going in and "cutting" a piece of the bone to create more space and ultimately help them not touch. The procedure can be done standing up but did require Gem to stay in the hospital for a few days to be monitored. Below is a picture of the incision. It is about 6 inches long right on top of her spine and cause a lot of swelling and a small "hump" on her back. 

The rehab plan is as follows: 
4 weeks stall rest, at 2 weeks she could start hand walking 10 minutes a day. 
8 weeks in a small paddock, continue hand walking 
At week 9 Start back into a rehab program with the first four weeks working in the pessoa rig or longlinning. 
At week 12 re-check and gradually add rider to fitness routine. 

We are approaching the point where Gem can start light work in the pessoa rig and I will outline a more detailed rehab fitness routine to help others bringing horses back into work after a surgery or extended period of time off. 

There are a few other things that I've also been using to help the healing process. First I used a laser on the area during the first few weeks to help reduce inflammation and swelling. I also have been using a benefab smartscrim at night to help increase blood flow through ceramic and magnetic therapy. Lastly, Gem has a large patch of skin on her back shaved and had quite a bit of irritation and scruff so I have been using coat defense preventative powered to help with the irritation. It's been wonderful and I highly recommend! 

Lastly thank you to Dr. Adams, Dr. Johns, Dr. Allen, and all the vets at Marion Dupont who took such wonderful care of Gem. Also to my coach Lynn Symansky and my farrier Stephen Fulton to helping me try to find the route of the problem during the fall and putting up with my stressing. Gem still has a long road to recovery, but I know we are doing everything possible to get her back to feeling 110%.