Emily Goldstein with dark bay Thoroughbred dressage horse

Kissing Spine is “Not a Death Sentence”: One Owner’s Journey to Recovery

Emily Goldstein with dark bay Thoroughbred dressage horse
Emily Goldstein and Mo

Our Guest on Horses, Hope, and Healing: Emily Goldstein, entrepreneur and equestrian, talks about her healing journey

The topic for today is the management of the condition known as Kissing Spine. ((See previous post My Aching Back, here.)) More and more horses are diagnosed with this condition. For some, it is asymptomatic or can be managed. For others, it can become a crippling or career-ending problem. There are a variety of treatment options, including various types of surgery. In this post we are going to explore one owner’s experience with Kissing Spine, her decision to pursue a surgical option, and how she and her horse navigated through the process.

Since we are not veterinarians, this post is going to focus on the condition from the owner’s point of view, in other words, how she made treatment decisions, endured the recovery process, and approached reconditioning afterwards. It is not meant to give medical advice, but rather to instill hope to those facing a kissing spine diagnosis to help owners make their own best decisions for their horses.

Welcome Emily! First, tell us about your riding experience. What discipline of riding do you do, level, highlights of show experiences. Before the KS diagnosis, what were your hopes for your horse and riding goals? 

I have been riding for about 20 years. I began in hunter/jumper land as a kid, then evented through my teenage years before making the transition to dressage. I have competitively shown through 4th level on my self made ottb, achieving my bronze medal and have trained him through PSG. My short term goal is to finish up my silver medal with my ottb but some medical issues have postponed that goal for now. My long term goal is to eventually ride at the GP level but mostly to just keep improving and display good horsemanship. 

Let’s hear more about your horse as a partner: his name, age, breed, how long you’ve been together, funny quirks about him or a fun fact…By the way, the pictures of you two are great! 

My horse’s name is Siouxperlucky, aka Mo. He is a 2006, 16 hand off track thoroughbred born and bred in West Virginia. I bought Mo in March of 2013, green as grass, after he was sort of a tough resale project for a friend. We did some lower level eventing and eventually transitioned to dressage which is where my skill set is. We then traveled up and down the coast together over the past almost 10 years for working student positions  jobs, and horse shows. Mo has been the one constant in my life and has been everywhere with me, you could say I’m pretty obsessed with him haha. He has the sweetest personality on the ground complete with a lot of talking (nickering and calling) and loves to have mutual grooming sessions with any person who will provide neck scratches. I call him a social butterfly. Mo is also a hard worker. He has done every job I have ever asked of him, and done it well, from eventing to trails to dressage.  He has always held his own against other professionals and their horses, and surpassed my original expectations and stereotypes for thoroughbreds doing dressage. He helped me earn my bronze medal, and half of my silver so far, and was instrumental in helping me receive a training grant from The Dressage Foundation in 2021. I still hope that we are able to make it to PSG together but that has been delayed due to Mo’s injuries and medical issues (surgery for then ligament, suspensory lesion, kissing spine, etc.)  If he can’t come back to the level I need, then I will give him an easier job, possibly teaching my students. He will always have a home with me. He’s such a sweet, special horse.

He does sound like a really special guy.  So, when did you suspect something was amiss with Mo? What were his symptoms and how was KS diagnosed? How did you react to the news? I know I read everything I can when I get a diagnosis on my horse. 

Mo has always been a little fussy under saddle, hiding from rein contact, difficult to get truly through over his back, etc. but I never thought too far into it. Fast forward to November of 2019 Mo became lame in his left hind leg. It turned out to be a torn manica flexoria ligament, something I didn’t even know existed until then. I was told he would need surgery to be sound again and so we took him to Leesburg to be operated on. Rehabbing that surgery was hell. Mo was miserable, had bandage rubs, multiple infections, issues healing, you name it…not fun! When it came time time to get back on, I noticed he became extremely back sore and seemed unhappy and stressed about work. Eventually we took a look at his back via x-ray and it was revealed that he had been dealing with pretty severe kissing spine along his lumbar spine (T12-T18) and an ultrasound revealed arthritis in his SI. The assumption is that when he had to stall rest after his surgery his toppline atrophied and then his back did not have the level of support that it did when he was fit, so the kissing spine became much more irritated and painful. I wasn’t shocked but it did explain things about how he feels under saddle. Knowing now what he has been dealing with, I give him even more credit for being such a good boy and doing his job for me despite a level of chronic pain. When we got the original kissing spine diagnosis, I went online and read a lot and also joined a few kissing spine Facebook groups to get more info from the “hive mind”.

If you feel comfortable, please share the severity of his condition, what options your vet presented or you considered before making the decision for surgery? What considerations should an owner look at in your opinion while trying to make the decision for surgery…price, age of horse, etc? Other thoughts? We know there are different types/ levels of KS surgery, so if you can, would you share how involved your horse’s surgery was?

Mo had about 6 vertebra affected by kissing spine (T12-T18 with some arthritic changes). My vet suggested trying injections first to get rid of some inflammation and then to slowly bring him back to work. So we injected his back and gave it a try. A few months in, we also injected his SI and that injection actually seemed to make a bigger difference than his back injections. We also found a good balance of turnout.  So for most of 2020 and 2021 we had a very careful work routine that included lunging with side reins (which he loves) and lots of stretching and deep and round work, slowly reintroducing more work and injected his back and SI as needed. I also used a heating pad on his back regularly, implemented stretches and belly lifts, and made sure he had regular body work. 
For most of 2021 Mo was actually beginning to feel pretty good. We used our training grant and I was even thinking about getting back to the show ring. However, fall of 2021, when the temperatures began to drop, there was an immediate difference in how he was feeling. I’m not entirely sure why, as I have never noticed a change in cold weather before, but I suddenly went from schooling 3rd/4th level movements to hardly being able to ride. He hid from the contact, dropped his back, and even developed a strange head throwing behavior in his left lead canter. I also noticed him having a hard time raising his head after grazing or eating, and if he was fed from a ground pan it was really hard for him to get his head down there.
At this point we had been trying to rehab and avoid surgery for nearly two years and were at an all time low. My sports med vet (Cooper Williams) started to push kissing spine surgery as our best next step, since we really exhausted most of our options by that point. At the time, Mo was approaching 16 so I wasn’t sure how many years of work he has left, and wasn’t sure if he would ever come back to the level of work I needed. Also, after his previous surgery and other medical bills, I had accrued quite a large amount of debt.
I had to ask myself if I felt like giving up the fight, or trying one more time. I am so tired of the never ending rehab and vet bills that became my life over the past few years, so I wasn’t sure I had another surgery in me. But in the end I decided to go for it, one last shot to try to make him feel better. At least I would be able to say I tried everything and have a clear conscience that I was getting rid of his chronic pain and hopefully providing a better quality of life. My boyfriend and a close friend created a Go Fund Me for Mo’s surgery, I was shocked when people donated. Between the Go Fund Me, and private donations we did raise the money needed to cover his surgery. The surgery cost came in at just under $2,000. I will always be so grateful that people cared enough to help. Without those donations, I’m not sure I would have been able to make it happen. On December 15th, we brought Mo to Unionville Equine Associates, in PA for his surgery with Dr. Norris Adams. Mo’s surgery was an osteotomy, the most invasive of the kissing since surgeries where they remove the tops of the affected processes. In addition, they also did a bone shave in a few places as well. Mo had 6 spaces done. 
Xray of horse spine
Mo’s before and after spinal X-rays

Looking back, what one thing (if there was one) that made you decide to do the surgery? 

The one thing that pushed me to follow through with the surgery was giving Mo a happier quality of life. Once he seemed to be having issues eating and moving his head/neck up and down I decided that no matter the level of work he returns to, he deserves to live pain free, chances are he has many years ahead of him and I don’t want him to spend them in pain.

Talk about the recovery process. People are always concerned about a horse being confined to the stall. How long was each stage? How did your horse handle it? How did YOU handle it not riding for so long? Did you have to do a lot to treat the surgical site? Did you worry about shipping him home after the operation and what safeguards did you need to put in place for transport? Any extra needs in his stall? Did you have the vet out for a series of check ups or did you have to ship him back to the hospital? Looking back, how hard was it on him versus on you? 

Our kissing spine surgery was by far an easier recovery than the surgery on his leg. He stayed at the hospital the night of his surgery and then we picked him up the next day. The ride home from the hospital definitely jostled him and his back around so when we arrived home I immediately sedated him and gave pain meds to get him through the first night. I was able to recognize his behavior when he is in a lot of pain from his prior surgery on his leg, so I had a good idea of when to intervene with mediation and sedation to keep him from hurting himself, rolling, or throwing himself around. He was very sore for the first 4 days, and then he got a little better each day. A few days in, we had to take off his bandage which was stapled to his back. That was an adventure I wasn’t quite prepared for. We ended up using needle nose pliers (after speaking to the hospital) and were able to remove the staples (just from the bandage) but I highly recommend getting a staple remover and being more prepared haha. 
Mo spent the first month on stall rest and began hand walking after 2 weeks. At around the 2 week mark, I had my vet out to remove his staples. I didn’t have to do much to the incision site. I just made sure it looked ok, no discharge or unusual swelling and besides that, just kept it clean, which was easy since it was winter so it was always covered with a blanket. Sometimes I did apply a little of Neosporin, or silver cream and would gently apply lotion onto his shaved skin so it wouldn’t become too dry. We had no difficulties with stall rest, Mo was an absolute champ and did not require any sedation, past the first day when I just needed to keep him calm dealing with pain from the drive home. Month 2 he started turnout. Small paddock, individual turnout is recommended. Month 3 we were able to start lunging with side reins and a surcingle. I was really ok with not riding for a while. It took the pressure off and I just got to hang out and enjoy my horse on a personal level. I also continued to ride client horses during this time.
post surgery incision site on horse
Post-surgery incision

Share with us your experience the first time you sat on him again after the surgery. How did you feel? Looking over your journey, is there anything you would have done differently?  What advice would you give owners who are grappling with a KS diagnosis? 

I sat on Mo for the first time (post-surgery) on March 11th. I am happy to be back on him, but I know we still have a long way to go. And just because he had surgery, doesn’t mean he will feel like an entirely new horse. We still have a lot of physical and mental healing to do from the chronic pain Mo has dealt with up til now. I still feel very worn out about rehab but will keep trucking along and doing my best for him. 
Looking back, I think if I could do it again, I would have done surgery back in 2020 when his KS was diagnosed. I would have saved myself so much time, money, hard work, frustration, etc.  
To people grappling with their horse’s KS diagnosis I would say that kissings spine is not a death sentence, it is actually a lot more common than most people realize, most horses just do not exhibit clinical symptoms and they go their entire lives without anyone knowing. There are so many options for treatment and every horse is different. Once you find the right treatment for your horse go with it, think outside the box. Horses don’t know what is classically correct, they only know how they feel. 

Very wise advice. So now that the surgery is behind you, what are your hopes and dreams for your partnership and are they any different from before? Has this experience changed you or changed your relationship with your horse? 

I am still hoping to get Mo back to PSG to finish my silver, however there really isn’t any pressure. We are taking things very slow and day by day. If anything, this experience has brought me closer to my horse. We spent so much time together in the stall, grooming and playing. We have a really nice relationship and I am trying to preserve this as Mo comes back into work. On his days off, I still come to the barn to groom him and play with him so he doesn’t think that all we do is work. We have more than a transactional relationship. He’s my buddy! 
Thank you so much for your time, insights, and for sharing your personal feelings about your experiences. 
In addition to being a kind and generous horse owner, Emily also trains horses and can order you a pair of amazing riding boots if you ask (I’ve got a pair that fit like a glove and are gorgeous!). If you want to know more about Emily, her businesses, and her horse’s recover, check out her biography and contact links, below:
Biography and Social Media Contacts
Emily Goldstein is a life long equestrian that grew up in Mt. Airy, Maryland. She currently resides in Frederick, MD and splits her time between her training business Emily Goldstein Dressage, and her position as a rep for The Distinguished Rider, selling custom Kingsley riding boots and fashion footwear. She has a soft spot for off track thoroughbreds and enjoys promoting the breed in dressage and breaking stereotypes while pursuing her training career. 
Contact links:
Instagram @siouxperluckygirl
Facebook: Emily Goldstein/Emily Goldstein Dressage
woman riding dressage horse
Emily and Mo
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