Cyst in navicular bone?

[BackHomeFarm]

I have a 12 year old Thoroughbred who just came up lame in the left front. He’s sound at the walk and trotting to the right, but definitely lame in the left front. I had the vet out, he did x rays and found a cyst in his navicular bone. He recommended starting with 40 days of Equioxx and putting him in a natural balance shoe (which was done yesterday). If he doesn’t come sound, we can inject with Osphos, which will cause the cyst to calcify and should bring him sound. However, he will forever be limited to flat work as jumping could put too much strain on the already weakened bone.

Has anyone dealt with this before? I haven’t been able to find much information on bone cysts in the navicular bone.

[Feathered_Feet]

Probably not super helpful, but I had a horse with a cyst right by the coffin bone (~ 10 years ago, so therapeutic approach has probably changed a lot since). We did several rounds of Tildren and then steroid injections directly into the joint. We did dressage so jumping was never an issue, but he was sound with the joint injections. We were doing them every 6 months or so.

[BoyleHeightsKid]

I would be curious to see pictures of these feet. Natural balance shoes are only great and will only help if they are applied correctly to a correctly balanced foot.

Do you have an MRI? In these cases there is almost always soft tissue damage before the boney changes occur. Does he land toe first/heel first/flat? Is the back of the foot healthy?

Many horses have xrays that look a mess but are sound because the caudal foot is healthy.

I would not necessarily say he’s limited to flatwork only. There is much you can do to help with him with the right diet, trim and therapeutic shoeing.

[rhymeswithfizz]

I once had an eventer who developed a cyst in his navicular bone. One day he was running Training level, and two days later he was virtually three legged lame. This was 20+ years ago and before the days of Osphos or Equioxx, so those were never options for us. The only option we had was to do a neurectomy (cut the nerves to the back third of the hoof) and retire him. It takes away the pain, but of course the cyst remains. Heartbreaking. But happily, he was then sound enough to pack around little kids and be a kick ass trail horse for 10 more years, even hilltopping at the local foxhunt. He died of colic (likely caused by melanoma, he was a grey) at the ripe old age of 24 and the nerves never regenerated.

[mroades]

I had a 3’6" horse with a huge cyst. He was never lame from it.

[BlueDrifter]

Mine had the same story beginning Jan 2019. On/off lameness RF, got a new farrier with new balance AL shoes, saw immediate improvement, but still lameness flared up. Xrays showed a cyst. Did Osphos, didn’t notice improvement, did Prostride, didn’t notice improvement. He got some time off, didn’t notice any improvement. Finally did MRI. MRI didn’t see anything out of ordinary for 13 yo horse. Didn’t see the cyst either. Vet said the “cyst” on xray was just an artifact. Vet said he has niggling issues, but none that should cause lameness.

Brought him home, this time he got more time off because I was injured, but finally by December, I gave Equioxx and said “if he doesn’t get better by spring, retirement.” Since January he is a changed man. Prior too he was balky with attitude. Now he is happily in regular training. No more girthiness, no more fussy about bridle, seems like a miracle.

So, was it the Equioxx, or did the Osphos work and cyst disappeared by the time I did the MRI (6 mo later), or was it time off? Who knows. My gut feel is that it is equioxx and was a soft tissue issue from prior incompatible shoeing that never got to heal properly. But between me trying everything he didn’t get ridden much in 2019.

My fingers are crossed, but I will keep him on Equioxx.

[joiedevie99]

I would get a consult with a good clinic. Cysts can go undetected for a whole lifetime when they don’t cause issues, but when they do they can be difficult. The existence of the cyst, though, isn’t thought to be the primary cause of lameness - or at least it wasn’t last I spoke to my vet about this. It was either the development of the cyst (in yearlings), a fracture of the weakened bone (adults), or osteoarthritis caused by the cyst (adults). Also on the table unless you’ve had an MRI - a soft tissue injury in the area of the weakened bone. What you do depends on where the pain is coming from. Rest alone sometimes works in yearlings. In adults, Osphos/Tildren are options, direct injection into the cyst is an option, and surgery is an option in some cases.