The Cutting Edge Veterinary Podcast

STUDENTS: Codi Ashbacher and Ashley Sauve

FACULTY MENTOR: Dr. Mike Scott

PODCAST EPISODE DESCRIPTION
Is your horse’s back pain really “kissing spine”? In this episode, we unpack the myths and dive into evidence-based diagnostics for overriding dorsal spinous processes. Learn why radiographs alone aren’t enough, how to combine imaging with clinical exams, and why a systematic approach matters for accurate diagnosis and better outcomes.

ABSTRACT
Overriding dorsal spinous processes (ODSP), commonly known as “kissing spine,” is a frequent yet often misunderstood cause of equine back pain. This episode explores the diagnostic challenges surrounding ODSP, emphasizing the importance of distinguishing true pathology from incidental findings. Clinical signs are typically subtle—ranging from poor performance and stiffness to behavioral changes—complicating diagnosis. Radiographs, while widely used, offer limited sensitivity and may reveal abnormalities in asymptomatic horses, increasing the risk of misdiagnosis. Nuclear scintigraphy provides high sensitivity but lacks specificity, and diagnostic analgesia remains critical for confirming primary back pain. A systematic approach combining thorough physical and lameness examinations with targeted imaging and analgesia is essential to avoid unnecessary interventions. The discussion also addresses the growing controversy of including thoracolumbar radiographs in pre-purchase exams, given the weak correlation between radiographic changes and clinical signs. Veterinarians are urged to prioritize evidence-based protocols over client-driven speculation to prevent inappropriate treatments and career-ending decisions. By adopting a structured diagnostic algorithm, practitioners can improve accuracy, reduce overdiagnosis, and guide effective management strategies for equine back pain.