The sacro-iliac area bears an enormous amount of strain in the horse. It is the region where the pelvis connects to the spine (at the sacrum). All the impulsion created by the hind limbs is transferred to the rest of the body through the sacro-iliac joints and ligaments.
Sacro-iliac injuries occur commonly in working horses (especially show jumpers, dressage and eventers). They usually present as a gradually increasing reluctance to work. Affected horses can become disunited behind and exhibit painful responses on palpation of the lower back. If a sacro-iliac injury is suspected, your Vet can infuse local anaesthetic into the area to desensitise the area. Ridden exercise after the desensitisation is performed will be improved if the area is painful and inflamed.
Treatment is centred on a gradually ascending walking out programme from the box with ridden exercise being introduced as soon as possible. Gentle introduction of trotting in a straight line will follow. A potent anti-inflammatory (steroid) can also be injected into the affected area and this can be very effective in some cases. Recovery can take 4 – 5 months in total. Relapse is prevented by the gentle ascending exercise building up the epaxial muscles of the spine so as to best support the sacro-iliac area.
This is an increasingly diagnosed condition. Kissing spine occurs when the spinous processes of the vertebrae come too close together, rub against each other and cause pain.
Two surgical procedures exist for addressing the problem and both are done in the standing animal rather than under general anaesthetic. The most commonly performed procedure is to shave the spines that are rubbing to leave a healthy gap between them. A 3 to 4 month recuperation programme is vital for a full recovery.
Such a programme involves in-hand walking out for a period of weeks followed by lunging exercise to build up fitness and muscle strength. Eventually ridden exercise in straight lines is introduced and finally school work. Such a programme often results in a complete resolution of the problem and a return to full work without the back pain.
Colic surgery involves creating a large wound along the belly. Recovery aims to minimise the likelihood of a re-colic in the weeks immediately post-surgery when it is most likely, and ensuring the abdominal wound heals with no danger of a hernia forming. Box rest on a high roughage diet and in hand walking little and often is the order of the day. The walking out is gradually increased after 2 weeks post-surgery when the skin sutures are removed. Small paddock turnout is often achievable within 2 months of surgery.
Lateral Plantar Neurectomy/Fasciotomy
An operation often performed on cases of hind limb suspensory injuries (see above). The main focus of aftercare is on ensuring the wounds (which tend to be small) heal without complication. After wound healing, there is a period of controlled exercise to minimise scar tissue formation and allow the cut ends of the nerves to settle down. Horses are frequently back in full work within 3 months of the procedure being performed.
Arthroscopy is the surgical exploration of a joint and is most commonly done when there is an injury to the cartilage lining the joint. The surgeon enters the joint using a scope to visualise the damage. He/she will then remove the damaged tissue. This is performed through keyhole surgery so the wounds made in the skin are very small.