Navicular bone cyst? Options? Treatment? Success stories?

[kiwifruit]

I just can’t catch a break with horses! I lost my broodmare to colic two weeks ago and now my 13 event horse after careful rehab of hind suspensory faciotomy for over two years came up lame in left front. Diagnosis via xrays is a bone cyst on the navicular bone. His prepurchase xrays from five years ago show nothing but its pretty evident on the latest films. Sigh. So vet gave me several options: Tildren, an operation on the cyst, nerve him or retire. He feels injections would be a waste of time since we just recently did his coffin joint in the spring and the results lasted a minimum amount of time. Didn’t think bursa injections would help as well and said for the money/age of the horse, a neurectomy on that one foot would be the way to go. We did block him at the heel and he trotted off sound. I’ve been reading up on all three treatment options and they all have their positive/negatives. Anyone have success on the above treatments? Feel free to PM me if you want. I know that nerving is a controversial topic in the horse world but I still would like to hear the good, the bad and the ugly on it.

Thanks

[trafalgar]

I am interested in these questions as well.

[Donkaloosa]

I am NO expert by any means, and I’ve never had to deal with this problem. But I do remember attending a vet seminar years ago where they were talking about nerving a horse for navicular syndrome. The vet said that his daughter’s horse was nerved, and he’d far rather have her riding and jumping a horse who’d been nerved than one who was in pain and might go down or refuse and throw her. Yes, you have to be more careful about foot care. I was surprised by what he said, but it does make sense. Now, that was a while back, and I’m not sure what the current thoughts on nerving are, but it’s probably worth considering.

[AKB]

You could try a regional perfusion of Tildren and see if it helps. Injecting right into the leg is usually a lot cheaper than IV as a smaller dose is used. I guess that would be my first choice as I usually go with cheaper, lower risk treatments first and then move up to the higher risk and more expensive treatments later. We have a navicular horse who has had a lot of treatments over the years (bursa injections, IRAP, Tildren, etc). Now, at age 25, he has a bad suspensory from a splint bone fracture. Neurectomy was going to be on our list of options for his navicular, but the suspensory lesion has made him a pasture pet.

[Remington410]

My mare was “nerved” several years ago due to navicular cysts. It worked ok for a while. At the time I was told that the procedure may have to be repeated if the nerves regenerate? She’s also got chronic arthritis, so she ended up a pasture puff anyway.

[Watermark_Farm]

My gelding was diagnosed with a huge navicular bone cyst at Pioneer Equine hospital years ago and I was advised to euthanize him. He was probably 3/5 lame. Had the rads reviewed by 6 different vets between Pioneer and UC Davis. I was strongly encouraged to put him down because they were concerned that the cyst would cause the navicular bone to fracture suddenly.

I scheduled the euthanasia. Farrier asked if he could make one last ditch effort. He wanted to trim the horse so that he landed flat. Horse toed out and landed lateral side first pretty hard, had always been trimmed in a balanced way and shod by a CJF. I figured there was nothing to lose. Farrier pulled shoes, and trimming consisted of watching the horse walk, then some rasping, then walking, rasping, until horse was landing flat and the trim was decidedly unlevel. Then the shoes went back on. I was NOT a believer. At all. I went along because I respected the farrier and he said that I would only owe him $$ if the horse went sound. How would this help? To this day, I am not sure.

The horse became sound quickly, and stayed sound through the following many months of shoeing, which happened every 3-4 weeks, same watch-walk-rasp process. 18 months later, he was re-radiographed at Pioneer Equine and the navicular cyst had disappeared. The horse stayed sound for another 10+ years until old age took him.

To this day I wonder about the whole thing, from diagnosis to the very unique farrier approach. It did teach me to ‘think outside the box’ and consider concussive forces and anatomy in soundness issues. I wound up owing the farrier a lot of money!

[ToTheNines]

Wow, cool story Watermark Farm.

[kiwifruit]

Interesting you say that Watermark. Vet xrayed with shoe on and it was obvious that foot was unbalanced. Inside of his foot was much higher than the outside. Once we removed the shoe and xrayed again, his foot was level. Now my guy goes in glue ons that are glued directly to the bottom of the foot. Seems like there was too much glue on the inside heel to cause an inbalance. I might have a conversation with my farrier to see if anything more can be done.

[mvp]

[QUOTE=ToTheNines;7135517]
Wow, cool story Watermark Farm.[/QUOTE]

Really cool story. Some parts make sense to me-- or at least I can make up a story that sounds good.

In that explanation for the horse going sound with the right trim, the only relevant part for you, OP, is about

1. Your horse’s foot being unbalanced (still, and in rads) and how it works in motion. For that you need a farrier with a great eye for conformation all the way up the leg and for the horse’s movement.

2. In older horses, I think bone cysts are usually about trauma. The ones on joint margins are about arthritic changes. They suck. But, OP, bone is always being remodeled, so if you fixed the problem that was causing irritation in there via shoeing, you might get the cyst to fill in.

3. Besides Tildren, you could try Platinum Performance’s Osteon. It has bio-available silicon in it and fed for horses healing from fractures who need to get busy laying down new bone. It’s powdery like clay, so it works best if you mix it well into wet grain and own a Vacuum Horse who will eat anything.

Let us know what your gurus advise and what you do.

[rhymeswithfizz]

My eventer was diagnosed with a navicular cyst at age 15. It had probably been there for years, but when it suddenly appeared, it was rubbing the DDFT and he went 3-legged lame. We chose the do the neurectomy and call him retired.

However he lived to the ripe old age of 25, and even though he was technically retired, he became the rockingest trail horse that ever was. He even started fox hunting, slow flight of course. I lost him this spring to colic, but other than being a bit old-horse arthritic, he never regenerated the nerves, and lived a very comfortable last ten years. He is very much missed.

[kiwifruit]

Well after having a lengthy conversation with my farrier and consulting New Bolton’s finest Dean Richardson, I’ve scheduled the neurectomy. Everyone is pretty positive that he will respond to it. If not he can be a pasture puff. Thanks for the information!

[kiwifruit]

Just to update I had the neurectomy on Friday. It went well and less than an hour. Vet was optimistic I should see positive results in about 2 weeks. If anyone is reading this thread who has had experience with neurectomy, what sort of shoeing did you do for the horse? Blacksmith likes a Memphis bar shoe on aluminum but it is hard to make, takes time and cost more $$$. He thought that the area where cyst is should be supported but has no real proof if that is the case. Vet said maybe a standard bar shoe? Depends on how he responds to surgery. Thoughts?

[vxf111]

Another shoeing option to explore are Natural Balance.

[kiwifruit]

I guess I should have added he is in natural balance aluminum with the add bar to the foot that had the neurectomy.

[vxf111]

That’s what I’ve heard Dave Kumpf recommend.

[merrygoround]

Kiwifruit- No experience with that. I guess it’s next.

So sorry it’s come up as fertilizer for the roses, rather than “coming up roses”.

[kiwifruit]

So its been a 1.5 years since the nerving and he is looking pretty good! Just curious for those who have nerved, how long has your horse been “sound”. My vet suggested xraying the foot every year to see what is going on and I plan to do that in the next month. Anything else?