# KISSING SPINE - INTERSPINOUS LIGAMENT DESMOTOMY



## nbred (2 November 2012)

Hi,

My horse had kissing spine surgery around 4 weeks ago (the new technique used at Cotts Equine). Has anyone else had this surgery? Would be interested to hear your stories.

thanks


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## Wagtail (2 November 2012)

No, my boy had the more traditional surgery at Rossdales. How is your horse getting on?


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## nbred (2 November 2012)

Wagtail said:



			No, my boy had the more traditional surgery at Rossdales. How is your horse getting on?
		
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Hi, I remember talking to you about it a while back when i was undecided. He seems to be doing really well. Tracking up much better and has lengthened his stride. We are about 4 weeks post op, i am going to get on him in about 5 weeks depending on the physios approval, the vet has already said i can get on him in 2 but i dont want to push it. Would rather get him strong ready. How is yours doing?x


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## Wagtail (2 November 2012)

That sounds fantastic. I will keep my fingers crossed for you. Sadly, although my horse now moves much better, he still has explosive reactions to the saddle or roller and so I have given up, finally. I am emotionally exhausted. He does not settle well to our winter routine here as we only turn out in the all weather for 3 hours a day. That's fine if a horse is laid back or in work, but he gets really excitable and squeals and bucks coming out of the stable and bounces all the way to the turnout. He gets worse as the winter goes on, bless him. I think therefore I will be sending him to the blood bank in the spring. I know it is something he would settle well into as they are turned out in huge herds in massive field in the summer. He would love that as he loves to play. In the winter they are house in huge barns but with space to interact and move about for a leg stretch. He is a vet's ideal horse as he is great with needles and so good to handle in the stable. All the vets love him. Anyway, I think I am going to do that rather than keep prodding and poking and trying over and over to ride him. I will miss him, but I think it's for the best.


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## CBAnglo (5 November 2012)

Mine had the "standard proecure" - the tops of 3 vertebrae removed on the 20th of August and the swelling has mostly gone down; there is still a little bit of residual swelling.  He is on box rest and being walked out twice a day (well the object is to walk, he just bounces and fly bucks around).

He is having his 3 month scan in 3 weeks to see if we can start lunging, however he has added complications as has PSD in hind legs so we are rehabbing two surgeries at the same time.

The new procedure wasnt even mentioned when my boy went to AHT; what exactly does it entail?

Sorry to hear about your boy Wagtail.


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## Flibble (7 November 2012)

Hi my lad had a new procedure at Bushy Equine 3.5 weeks ago. He ha two processes touching and had the point of contact removed. He comes off Boxrest walking in hand a week on Friday then has 6 weeks working in a Pessoa plus turnout.


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## nbred (9 November 2012)

Wagtail said:



			That sounds fantastic. I will keep my fingers crossed for you. Sadly, although my horse now moves much better, he still has explosive reactions to the saddle or roller and so I have given up, finally. I am emotionally exhausted. He does not settle well to our winter routine here as we only turn out in the all weather for 3 hours a day. That's fine if a horse is laid back or in work, but he gets really excitable and squeals and bucks coming out of the stable and bounces all the way to the turnout. He gets worse as the winter goes on, bless him. I think therefore I will be sending him to the blood bank in the spring. I know it is something he would settle well into as they are turned out in huge herds in massive field in the summer. He would love that as he loves to play. In the winter they are house in huge barns but with space to interact and move about for a leg stretch. He is a vet's ideal horse as he is great with needles and so good to handle in the stable. All the vets love him. Anyway, I think I am going to do that rather than keep prodding and poking and trying over and over to ride him. I will miss him, but I think it's for the best.
		
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Oh no, i am so sorry to hear that. Does the vet think its in his head or does he actually think he is in pain? sounds like you are doing the right thing for him x


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## nbred (9 November 2012)

Flibble said:



			Hi my lad had a new procedure at Bushy Equine 3.5 weeks ago. He ha two processes touching and had the point of contact removed. He comes off Boxrest walking in hand a week on Friday then has 6 weeks working in a Pessoa plus turnout.
		
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HI, Did your boy actually have them removed or just the ligament cut? how is he?x


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## nbred (9 November 2012)

CBAnglo said:



			Mine had the "standard proecure" - the tops of 3 vertebrae removed on the 20th of August and the swelling has mostly gone down; there is still a little bit of residual swelling.  He is on box rest and being walked out twice a day (well the object is to walk, he just bounces and fly bucks around).

He is having his 3 month scan in 3 weeks to see if we can start lunging, however he has added complications as has PSD in hind legs so we are rehabbing two surgeries at the same time.

The new procedure wasnt even mentioned when my boy went to AHT; what exactly does it entail?

Sorry to hear about your boy Wagtail.
		
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Hi, my friend had her horse operated on at Rossdales 4 weeks ago and they didnt offer the new surgery either. Basically its a less invasive surgery but they do not remove the vertebraes they cut the ligament over the top which allows the spine to relax and for the spaces to widen, heres a good link http://www.cottsequine.co.uk/wccms-resources/8/0/6/8/81642ebc-4aca-11e1-a685-0050568626ea.pdf


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## Flibble (10 November 2012)

Sorry missed this he didnt have ligament cut he had bone shaved away he is doing really well and we finish boxrest next Friday Whoo Hoo!


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## Tammytoo (10 November 2012)

I was very interested to read your original post about this type of KS op.  Would you mind saying how much the op was?  (PM me if necessary).  I had a mare diagnosed a couple of years ago but ins. company refused to pay for an op.  for various stupid reasons.  She is a beautiful field ornament at the moment, but if there is a chance I could have treatment now I would take it.

Really glad to hear how well your horse is doing.


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## nbred (16 November 2012)

Tammytoo said:



			I was very interested to read your original post about this type of KS op.  Would you mind saying how much the op was?  (PM me if necessary).  I had a mare diagnosed a couple of years ago but ins. company refused to pay for an op.  for various stupid reasons.  She is a beautiful field ornament at the moment, but if there is a chance I could have treatment now I would take it.

Really glad to hear how well your horse is doing.
		
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Hi, sorry its taken me a while to get back to you. The op cost £1,000 which i thought was great seeing as the traditional op was anywhere between 3-5k. Luckily my insurance paid out but it may be worth a go with your mare, the recovery rate is quite high x


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## coffeeandabagel (16 November 2012)

Just got the date for the hoss to go to Rossdales for diagnostics - KS is a possibility. Trouble is its on 11th Dec - 3 more weeks of just waiting and having a grumpy horse to look after.


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## kezimac (27 November 2012)

Nbred how is it horse now? Mine has had gets this morning - I am going to see her this afternoon he has operated on 9 processes - travelling her home tomorrow as 5 hr journey


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## Tammytoo (27 November 2012)

nbred said:



			Hi, sorry its taken me a while to get back to you. The op cost £1,000 which i thought was great seeing as the traditional op was anywhere between 3-5k. Luckily my insurance paid out but it may be worth a go with your mare, the recovery rate is quite high x
		
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Thankyou!

How is your horse doing?


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## Tonks (2 December 2012)

nbred said:



			Hi,

My horse had kissing spine surgery around 4 weeks ago (the new technique used at Cotts Equine). Has anyone else had this surgery? Would be interested to hear your stories.

thanks
		
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nbred.....

I am very interested to hear how your horse is getting on.

My new boy, who was bought to event, is showing some characteristics of back pain and possible kissing spines which I want investigated as I don't think the current approach advocated by the vet has fully addressed what's going on.

If it does turn out he does have kissing spines I am very interested to hear about your experience of the desmotomy.

Certainly the research [carried out by Richard and others and published] is very encouraging as it states that: 

"Horses having ISLD were 24 times more likely to experience long-term resolution of signs of back pain (OR 24; 95%CI: 5-115; P = <.0001). Repeat radiographs in 19 surgical cases indicated that interspinous spaces widened significantly postoperatively (P = <.0001).
CONCLUSIONS: This surgical technique allowed horses with back pain and radiographic ORDSP to return to work without further clinical signs of back pain and to show radiographic evidence of improvement."

Just a quick question......is it worth taking my boy up to Pembrokeshire for a diagnosis - as it may not be KS? Do they have adequate equipment? Langford is right on my doorstep and I am considering taking him there but they obviously don't do this procedure.

Best wishes, Tonks.


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## kezimac (2 December 2012)

my girl had the op 5 days ago, is walking so much more freely already. As long as you can go somewhere local for xrays you can have them sent to Cotts via email if its a long way as was a 5 hr journey for me.


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## Tonks (2 December 2012)

kezimac said:



			my girl had the op 5 days ago, is walking so much more freely already. As long as you can go somewhere local for xrays you can have them sent to Cotts via email if its a long way as was a 5 hr journey for me.
		
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That's very interesting to know.

I have a 3 year old son and a yard full of horses so I would find it extremely difficult to get away.

So, if I can organise some diagnostics here, locally, I can send all info to Cotts and they organise the procedure?

How long is the horse stabled with them after the procedure? Am I looking at an overnight stay?

I don't as yet know that my horse has KS - but he is showing some characteristics (disunited in left canter at liberty and under saddle, some bucking, mild bronxing, back soreness - his behaviour is mild and is not throwing himself to the floor etc, but he is a bit grumpy when the saddle is done up) enough for me to want to investigate with a set of back radiographs, etc.

Thank you.


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## kezimac (2 December 2012)

Tonks said:



			That's very interesting to know.

I have a 3 year old son and a yard full of horses so I would find it extremely difficult to get away.

So, if I can organise some diagnostics here, locally, I can send all info to Cotts and they organise the procedure?

How long is the horse stabled with them after the procedure? Am I looking at an overnight stay?

I don't as yet know that my horse has KS - but he is showing some characteristics (disunited in left canter at liberty and under saddle, some bucking, mild bronxing, back soreness - his behaviour is mild and is not throwing himself to the floor etc, but he is a bit grumpy when the saddle is done up) enough for me to want to investigate with a set of back radiographs, etc.

Thank you.
		
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well mine has 9 impinging processes - never once bucked, never went disunited, never reared, just sore over back and grumpy to tack up. I just had a feeling and wasnt expecting 9 !!!!  

Due to the distance we went the night before and travelled back the day after. If within 2 hrs you can go and leave same day! its done under standing sedation. rehab afterwards is box rest 2-3 weeks, with 30 mins twice a day hand walking, then after 3 weeks introduce pessoa when walking, and turnout then lunging and back on in 6-8 weeks.


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## kezimac (3 December 2012)

for those who want to know what it looks like after the operation (this was done last tues and bandage fell off today - stitches due out on fri)







she had 9 processes cut


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## Tonks (4 December 2012)

Looks to be healing really nicely.

What does Richard say about prognosis?

Is prognosis dependent upon how many spinal processes were affected?

Does he argue that his procedure is more effective than more traditional surgery routes?

Would be very interested to know.

I will take my boy along to Langford as they have a suite of diagnostic equipment and then if it does turn out to be KS I will take him up to Cotts.

It's a real hike for me [as it is everyone else, I guess] but it certainly sounds like the best option - minimally invasive with a better outcome!!

Best of luck, and PLEASE keep me posted as to your horse's progress.

Best wishes,


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## Tammytoo (4 December 2012)

kezimac said:



			for those who want to know what it looks like after the operation (this was done last tues and bandage fell off today - stitches due out on fri)







she had 9 processes cut
		
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Looking good! 

PLEASE keep us updated.


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## kezimac (4 December 2012)

Tonks said:



			Looks to be healing really nicely.

What does Richard say about prognosis?

Is prognosis dependent upon how many spinal processes were affected?

Does he argue that his procedure is more effective than more traditional surgery routes?

Would be very interested to know.

I will take my boy along to Langford as they have a suite of diagnostic equipment and then if it does turn out to be KS I will take him up to Cotts.

It's a real hike for me [as it is everyone else, I guess] but it certainly sounds like the best option - minimally invasive with a better outcome!!

Best of luck, and PLEASE keep me posted as to your horse's progress.

Best wishes,
		
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yes wound looks fab, there is low risk of infection with this op. 
I dont think it matters how many affected - I would prob say more likely to get other problems if you had less affected (my horse is also sore over SI joint and richard did say before he operated that in 6-8 weeks we should see how the Sacroilliac is and if needed it should have a steroid injection - the soreness may have been caused by so many processes being affected OR it could have been the original problem  - will only find out once done the rehab bit)

he says that the cutting of the nerve is what takes the pain away and by cutting the ligament and opening the space up in between does the job just as good without taking away bone. I would not have had the traditional route as its usually done under GA and then 3 months box rest which mine certainly would not have put up with. 
And i like the fact that its a keyhole procedure with alot less risks, but all the benefits.

Yes it is far to travel - I actually went to Svend Kold to have mine diagnosed, but didnt want him to do traditional surgery so got her referred to cotts.

Its well worth the travel in my opinion and you can always leave them there longer if you wanted to go home and come back to pick up (I stayed in bed and breakfast for two nights)


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## kezimac (4 December 2012)

She is walking out very well at the moment and already looks really free when walking.


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## Nemo (4 December 2012)

Long time lurker here 

My horse had this surgery at the start of September, so is now at the stage of being ridden. The difference in his back is amazing. His muscled are actually soft! before they were so tight and hard. He is also much happier in himself.

He was re X-rayed before we started ridden work and the amount his processes had sprung was incredible. 

He is much better ridden now and I am building him up slowly. He still has moments where he gets very tense when being ridden but I think he still has a lot of negative feelings/memories of being ridden as it would have been sore for a while before it was diagnosed.

Looking at his back you can't tell he has had anything done and can only feel a little bit of scarring where he had the incisions.

Hope this is of some help to people going through the same thing.


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## coffeeandabagel (4 December 2012)

So pleased to be seeing positive things about KS surgery. My horse 's xrays came out clear, he has arthritis in is neck instead, but I was turned inside out worrying about it. Seems there are some good solutions for you guys


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## CBAnglo (4 December 2012)

Seeing everyone else's photos, makes me really wish that this option had been presented to me.  My boy was seen by Sue Dyson who I trust 100% and she has been my lameness vet for years but I so wish this thread had been started before August.

Its not the time off work or the boxrest its just the pain that I had to put him through - my boy's back was severely swollen (I mean, his withers were twice the normal length) and he was in a lot of pain for a long period of time which he might have been spared if we had gone down this route.

ETA: mine had his KS surgery on 20th August and it will be another 3 months before we even get a saddle on him, let alone ridden work.  So that will be 6 months off post surgery.


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## Nemo (4 December 2012)

I'm sorry to hear that about your horse CBAnglo. I know a lot of horses who have had the 'traditonal' surgery who are now back in work, but it does seem so much more invasive which is what appealed about this surgery.

I guess it is still very early days to see the long term results/effects but hopefully they are positive so it is option that is available instead of the more invasive route.


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## Bubbles (5 December 2012)

Following this thread with much interest as my horse had the traditional surgery 3 weeks ago. I've been extremely lucky, little swelling, no infection, no GA as done under standing sedation. Even better only two weeks solid box rest. Would love to hear how the desmotomy horses are getting on though their rehab compared to my horse...


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## Slightlyconfused (8 December 2012)

Thank you for pointing the way to this thread. 

I hope everyone's horses recover well. In waiting to hear back from  my vet who is sending mares X-rays off to Ian wright at Newmarket. She has four dorsal fused vertebrae and four that are going to fuse/kiss soon. 

Worried about the time she would spend on box rest as althought she is a fab little mare she likes her turnout and can get stressy if left in on her own.


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## Tonks (17 December 2012)

Kezimac and all others who have recently had the desmotomy - how are all your horses getting on??

Mine will be having his radiographs and bone scans hopefully just before or after Xmas.

Has the desmotomy worked?????

Best of luck.


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## kezimac (17 December 2012)

I  going to do a proper update - mine had stitches out last week - and now starting turnout, the wounds have healed well but a little raised and so can't put Pessoa on yet - she seems to be walking really freely and looks more comfy - so looks good so far


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## Tonks (17 December 2012)

Sorry don't know what you did with your [mare?] before but are you expecting her to return to full work after a period of rehabilitation? 

What does Richard at Cotts said about prognosis?

Fingers crossed for you XXXXX


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## kezimac (17 December 2012)

We did dressage - no jumping and also did hacking out - Richard thinks prognosis good for back - cant guarantee me I won't uncover a problem in her sacroiliac as he felt she was sore over the joint (I know it's not ligament as had that scanned a few months ago as she was sore and ligament was fine )  and the SI joint  may need medication end of jan depending on whether the soreness still there then - it may be she has guarded the back and injured the SI joint or it could have always been there and the back is secondary,  he does say sometimes you sort the back and find out other stuff after. I am hoping to return to at least hacking and dressage schooling- whether we compete I don't know -with one thing and another its now been 18 months since last competition(she also had surgery last yr to remove an ovary as a Tumor  on it!!!!!!)


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## nbred (4 January 2013)

hi everyone,
quick update on my boy,  so we are about 12weeks post op and i have been back on board for about 4 weeks, although this has been literally sitting on him for a few minutes lunge session and he feels great, stride length has increased massively and he is much softer through his neck and in the contact. Although it has uncovered a very cheeky and lively pony! ! he feels good which is fab!  he has had physio treatments and she is very pleased with him so this week has been increased to 10mins ridden work after the lunge. he is going in for xrays at the end of jan to see if the spaces have widened, so glad everyones horses seem to being doing well x


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## Tammytoo (4 January 2013)

Great news and thanks for the update.

Please keep us posted as I am considering this for my mare.


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## CLB (31 March 2013)

excellent news nbred, my mare is having the new surgery on Thursday after the steriods and shock waves showed a remarkable difference, albeit short term.  

With the new less invasive surgery can you tell me what the after care and rehab plan is, i have heard you start it very quickly after the operation.  

I am very nervouse and am hoping this is a postive outcome for everyone and my girl.


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## LittleGreyMare (31 March 2013)

We have had two horses operated on. The first an older horse was knocked out to be operated on an the lounged and brought back into work as suggested. Sadly he never came back right and within a year he was not safe to ride. Sadly he was PTS this year as was a danger to us and himself. In hindsight at his age (13) we would not have had the op done and dropped him to intro.

The second a seven year old was operated on last june whilst still standing, we followed the box rest the lounged him and very briefly rode him. We then turned him away over the winter and just starting to lounge him again. From the first weeks lounging he is a different horse and we are really looking forward to getting him going again.

Two very different experiences with (hopefully) two different outcomes. I do really believe that turning the second horse away after his initial rehab has worked really well.


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## Wagtail (1 April 2013)

Unbelievably, I am back riding my boy after giving up on him last year. He had the traditional surgery of having five processes taken out under standing sedation. The op went really well and his movement was noticably better almost immediately. His rehab went well (was operated on in November 2011), and I was back riding him, but had issues with him head tossing, and the freaking out after being girthed, was worse than ever. Last summer I tried one more time, but even lungeing him was a disaster as he kept having panic attacks at the lunge roller and pessoa. So I gave up last Autumn. 

In one last ditch attempt to address his panic issue, I decided to treat him for ulcers. After only four days on abprazole I tried him in the saddle and he was fine, even with a tight girth. A week later, I got on him and he didn't batt an eyelid. I have been lunging him in the equiami and he's going well so far.


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## annunziata (2 April 2013)

nbred said:



			Hi,

My horse had kissing spine surgery around 4 weeks ago (the new technique used at Cotts Equine). Has anyone else had this surgery? Would be interested to hear your stories.

thanks
		
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Come and join our Facebook page horses with kissing spine there are lots of people who had the same surgery as your horse on there x


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## Caballito (7 April 2013)

Great to hear everyone's positive experiences of this - particularly the new interspinous ligament desmotomy surgery as this is a potential option for my boy. He's being investigated next week for KS and the ISLD would definitely be my surgery of choice (if he needed surgery)

Is there anyone here whose horse had the new surgery when it was in its infancy a few years ago? I'm interested to hear some longer term outcomes.


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## charlie76 (7 April 2013)

Our horse had this op in January.  Unfortunaly ours has so far not been great.  We were originally going to have the traditional op,  we were two days off of the insurance running out, we were recommend


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## charlie76 (7 April 2013)

Ed the new op and had to make a decision in a hurry. Took vets advice and went with the new op.  
When peforming the op the surgeon caught the top of one of the vertebrae with the scapal chipping the bone.  It is now April and he still has a lump where the saddle goes and cringes when you touch it,  there is no way we can put a saddle on.  
We took him back to the vet who x  rayed and scanned him twice,  they just put him on anti biotics ( even though there is no sign of infection.) And basically told us to wait and see what happens.  This was two months ago and its no better.  The horse is in more pain than before the op! 
We don't know what to do now as we feel the operation was messed up,  we are left with a horse we can't ride and have been abandoned.  We can't re op as we are no longer insured.


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## Caballito (7 April 2013)

Oh no Charlie76, I'm so sorry to hear that. I really hope he comes right eventually. Did the surgeon actually admit to chipping the bone? 
Fingers crossed for a recovery x


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## charlie76 (8 April 2013)

Yes, he did. We also have before and after x rays with no chip on one and a def chip on the other


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