Navicular & Rider's Depression

[HAPPYREDROAN]

Meet my downhill conformation-ed, post-hocked, long backed, lovely 15 hh 16 yr old AQHA mare!

Her history includes: showmanship, barrel racing, western pleasure
Her future with me: (aiming towards) lower level dressage (don’t laugh…i know)

Problem Pony Issue #1: cyst in navicular bursae
Problem Pony Issue #2: navicular bone degeneration
Problem Pony Issue #3: thin hoof walls with flat soles (no matter what I/vet/farrier do)

3/5 Lameness FR - inconsistent with head-bobbing lameness (but sometimes worked out of it)

What has been done to date with little-no success chronologically:

1. egg bar shoes w/wedge pads and a squared toe - little change
2. bute trials - resulting in ulcers
3. previcox trials - no change
4. bursae & coffin joint injections & drainage of fluid along coffin joint- 95% sound for two weeks
5. bute trials - came off lame
6. severe stone bruising both front hooves - treated w/hoof hardener, epsom salt soaks, magic cushion hoof packs, and hoof boots)

farrier scheduled for Oct 25th for re-eval
vet to come mid-november

via vet, upon failure of injections, further recommendations include:

1. double previcox
2. corrective shoeing, starting with a ‘backwards shoe’
3. nerving

Being a college student, who works full time just to pay for her $600 board, taking on a rescue was just a ginormous mess that I honestly should not have involved myself in. I have heard enough horror stories about navicular issues that just make me want to crawl under the covers and cry daily, and it seems like this sweet mare that I love so is slowly becoming one of my worst nightmares.

Has anyone had success with any of these options? Or something else? My gut is telling me just to nerve her (even though it remains my last-resort, and is no way a long-term promise).

I have heard that Previcox/Equinnox lead to renal failure (and because a single dose didn’t touch her, why should I risk her other bodily health) and that long-term (she’d be on it for the rest of her life) would be a bad idea.
And I know that I cannot afford $400+ corrective shoeing every 4-6 weeks.

Help? Friendly advice? Comfort? Local lameness/navicular specialist recommendations (CT/MA/NY/RI)?
Slowly reaching my wits end here and I have no one else to turn to…

[alibi_18]

I would put her to sleep.

Sorry.

[Eventer13]

Does the corrective shoeing have to cost $400? You can start with something simple, like a backwards shoe or a wedge. Just on front, it shouldn’t cost that much (although maybe your area is very expensive).

Previcox can cause kidney injury. As can bute and banamine, and all other NSAIDs. Usually this is only a risk if they are on high doses for long periods, or if they are not drinking properly. I would try it, if you think it would help, and you can afford it long-term.

I don’t think you should put yourself into debt, either. If the shoeing, previcox, etc is going to be very hard on your budget, I say try the neurectomy, assuming you understand the risks and think you can manage her appropriately.

[CrowneDragon]

I would get an ultrasound or MRI of her feet and see if there is a soft tissue component to her lameness. If she has a DDFT tear or impar tear or an adhesion somewhere etc etc all of the shoeing and bute in the world won’t fix it. The navicular changes may be causative or incidental. The boon to these things is that there is often something you can do to repair them. I personally wouldn’t nerve a horse without knowing that I wasn’t covering up an injury that could/would be compromised without appropriate treatment. I have a feeling that some of the DDFT ruptures seen after neurectomies are because the horse had a DDFT tear causing the lameness in the first place.

Good luck!

[Eventer13]

While I think an MRI is a great idea for navicular horses, she’s a college student and I imagine the horse isn’t insured. Add in the cost of treatment for a soft tissue injury, and you are looking at a few thousand dollars, easily.

[CrowneDragon]

[QUOTE=Eventer13;7803283]
While I think an MRI is a great idea for navicular horses, she’s a college student and I imagine the horse isn’t insured. Add in the cost of treatment for a soft tissue injury, and you are looking at a few thousand dollars, easily.[/QUOTE]
The cost of treatment for most soft tissue injuries is $0, because it’s mostly just stall rest. MRIs are expensive, yes, especially if the horse needs to go under general anesthesia.

OP, I have no idea where you are, but if you are anywhere near Aiken, SC, Carol Gillis is a fantastic ultrasonographer for feet, and it would cost less than you are paying for shoeing. If you aren’t near her, it wouldn’t hurt to shoot her an e-mail and ask if she could suggest anyone near you. http://www.equineultrasound.com/

If cost is a concern, I would try to find another boarding arrangement. $600 is a hefty chunk of change. If you are in a bigger city, perhaps you could move her out a ways, especially while she isn’t rideable and you don’t need fancier facilities.

[HAPPYREDROAN]

unfortunately, corrective shoeing (from the farriers that I know) all START at around $200-400++, as well as boarding starting at $500-$1500+. I have moved through three different barns in the past year because of board rate increases that I couldn’t afford. I did self-care for the past 10 months of having her, only now finding a place that I could afford enough to have daily care done so that I could pick up extra shifts at work. CT is not the place to live with a horse if you’re not filthy rich!

If I did have the money for an MRI, she would be up at Tufts tomorrow!
Not sure if there are any good ultrasounders in my area, but I will send an email inquiry out!

It just seems that for every inch forward that we get, we then leap two strides backwards.

[CrowneDragon]

Good luck. I know how frustrating these issues can be. I went through this with my own mare and years (!) of trying to make her sound with a diagnosis of “navicular”/“caudal heel pain” and pedal osteitis based on radiographs. This was a while ago and soft tissue injuries in the feet weren’t really a big consideration. MRI didn’t exist in any meaningful way for horses yet. It wasn’t until Dr. Gillis worked on her and found an adhesion between her navicular bursa and her DDFT and a torn impar ligament that we finally made progress and I got to ride again, after months of rest and rehab. Of course shortly thereafter she developed ringbone in the other leg, but that’s another story! There aren’t a lot of good ultrasonographers out there who work on feet, but they do exist. U/S is not as complete a view of the foot as MRI, but it’s a lot less expensive, more practical for re-checking, and eliminates the risk of general anesthesia.

I found this article regarding hoof ultrasound that you might like to read: http://www.thehorse.com/articles/26793/foot-pain-in-horses-diagnosing-soft-tissue-problems-aaep-2010

I hope you are able to make some progress and get your girl more confortable.

[alibi_18]

And for the cost of the MRI (+1500$) + anesthesia (+300$) , she could put her horse down and buy similar one that would be more suitable and sound.
EquineNow website has about 200 Aqha mares between 12-16 yrs old between 15 - 15’3 in that price range

I wouldn’t put a lame 16yrs old thru anesthesia. I wouldn’t nerve that horse either.
I wouldn’t invest in a full year of stall rest for this horse.

I’m sorry to be that harsh but really, they are so many horses out there, sound and sane, and this one just needs to be put out of its misery. Yes it is truly sad.

OP, as a college student, I would suggest you don’t buy another horse. Take lessons, find a friend who could lend you their horse, half lease/board, become a working student… there are so many possibilities that could let you finish school in peace and then, you’ll be able to afford the horse of your dream.

Good luck .

[chestnuthunter]

You could always promise your first born to your vet to cut costs.

All joking aside, best of luck to you OP. Sounds like you are in a really tough spot but handling it beautifully. Jingles for your horse, and chin up.

[eruss]

From what you are describing, the last thing I do with feet like these is set the shoe back. With a horseshoe, the wall is what is taking all of the weight. If the walls are thin, setting the shoe back (squaring toe, reverse shoe) adds excess pressure behind the toe.

I generally start with fitting the toe and building breakover into the shoe back to about the tip of the coffin bone. Plus add equipak.

[AKB]

If she is 3/5 lame, I am skeptical that shoeing can make her 100% sound. It may help, but won’t cure. Our big grey horse did well with equipak and short toes. He also got some benefit from regional perfusions of Tildren, which are far less expensive than systemic IV Tildren.

I think you are on the slippery slope with this horse. Once they no longer benefit from the usual treatments, it is hard or impossible to fix them. Often, you can improve them, but it is hard.

See if there is a reputable racetrack vet who does cheap injections, including the regional perfusions of Tildren. I used to drive the big grey guy to West Virginia. The racetrack vet did great lameness work and was dirt cheap. They injected so many horses per day that they could keep prices low. We got joint injections, IRAP, Adequan and other treatments. Now, the big grey guy is age 26 and lame. He is still happy, but I don’t know how much longer I can keep him happy.

Good luck. This is a hard road. Do what you can, but don’t be afraid to put her down if she isn’t happy.

[Pocket_Pony]

Personally, I would not do further diagnostics on this horse, nor would I nerve it or do any other sort of serious treatment. She’s had her career, put forth her effort, and her body is showing the result and she is paying the price. Unfortunately for you, she’s not rideable. If you are dead set on riding her, it is going to cost you money it sounds like you don’t have. She’s already broken - how much more broken does she have to get before she enjoys the life of retirement or is put out of her misery? When does it get to be about her and not what people want from her?

Sorry, I just think you’re going down a rabbit hole and looking for a magic pill. Perhaps just accept that she can’t do what you want and let her live in peace.

[LDavis104]

Where exactly are you located? I am also in CT and there are farms out there for less than that amount, but maybe you are in a particular expensive area. I have a wonderful farrier who travels out of NH for me but she isn’t taking additional clients outside of NH. If you were willing to trailer to NH though, I would say it is worth a shot to work with her at least once.

I have been through all of this with my gelding. He actually fractured both front navicular bones before I knew he had navicular disease. He was insured so thankfully the majority of the costs to diagnose (MRI at Tufts), treat (along with the rest/rehab for the fx’s - shockwave, tildren, coffin joint injections, isoxuprine, previcox) - shoeing didn’t make him sound even after getting the angles in his feet correct. After about a year of trying to get him sound I opted for a neurectomy (also done at Tufts). I did know however that there was no DDFT involvement in his navicular lameness. After the neurectomy though my horse injured his knee twice… 2 separate incidences of chip fractures, and had to go BACK up to Tufts for knee surgery. So sometimes the saga seems to never end.

Knock on wood my guy is doing beautifully now and we are able to flat arond now no problem. I know the nerves will eventually grow back (but sometimes they don’t from what I have heard), but it has given me some more time with my horse.

If I had to do it all over again my head would tell me not to, but every time we were deciding his fate he just looked so darn cute and reminded me why I love him so… darn horses. Having him insured was a HUGE factor in doing all that I did though. So I would say without insurance see if you can find someone who can ultrasound the entire DDFT. I think you can’t see it all (i.e. what is in the hoof) but have heard of some who can ultrasound through the frog? This would then at least give you an answer as to whether you have soft tissue to rehab or whether a neurectomy is an option.

Though something my farrier said recently (she is also my friend so at liberty to say these things) hit home though… she said sometimes you have to consider whether you are at a point where you are doing this for the HORSE or for YOURSELF. If you are hanging on putting your horse through all of this, is it really the best thing for them or is it for yourself. I don’t regret my decisions to do all that I did for my horse, but just something to think about. No one would blame you if you decided to give your horse a peaceful goodbye.

It’s a really tough decision - I feel for you PM me if you want to chat more.

[Snowflake]

Oh… This sounds just like my trials with my big mare. It’s a heartache for sure. I’ve done the wedged eggbars (2 degree wedge) with no real change. Right now, we set her in a pair of KN Navicular eggbar shoes with a leather pad packed with magic cushion and this seems to be doing the trick.

My mare has a spur on her navicular that hooks into her DDFT. It’s ugly so she’s not a candidate for neurectomy. She also can’t do stall rest due to other arthritic issues.

Honestly, if it got to the point where I couldn’t afford to do what was necessary to keep her comfortable, I would put her down without question. Navicular is a very painful and progressive disease. You don’t have the option of just not treating it and it can get very, very expensive to diagnose and treat. I’ve spent thousands of dollars on this mare in the past two years of aggressively trying to get her sound. And it’s been a roller coaster.

If you’re not on for the ride I wouldn’t blame you at all. It’s not for the faint of heart or the budget conscious.

[joiedevie99]

If you want a second opinion, I’d highly recommend my vets: Dr. Harmon and Dr. Mitchell at Fairfield Equine. They have a standing MRI and are great with the portable ultrasound too if you want to go that route.

Personally, I would not expect this horse to be rideable again. I’d give her some time, and see if you can get her comfortable enough to have some nice retirement time.

[beau159]

Obviously, you know some of the options to get better information about your horse (like an MRI). And you also know what the limits are of your pocketbook.

Two years ago, I put down my 14-year-old horse who I had owned since he was 6 months old. It was a very hard decision. But I couldn’t keep him comfortable anymore, and I couldn’t afford to continue to keep him as a pasture pet because I couldn’t keep him sound. I miss him dearly, but it was the right decision for me.

That is an option for you and your horse that only you can decide. No one would shame you for putting down a horse with health issues that you can’t afford to take care of.

Of course, you can also “make do” with what you can financially afford. I do caution you, however, with how you USE your horse based on how lame or how not lame she is. Keep the horse’s comfort in mind as well.

@HAPPYREDROAN;7803256

4. bursae & coffin joint injections & drainage of fluid along coffin joint- 95% sound for two weeks

Can you elaborate on this?

Did your horse get injections from the front only? Or did the vet also (or) inject from the back, directly through the bursae?

For your horse’s sake, I sure pray he didn’t inject from the back.

I took my horse to a lameness specialist (one of the best ones in my geographical region) and he informed me that they used to do injections like that all the time, where they went in from the back, through the tendon, and directly into the bursae. Until they found out by doing that, you’ve got approximately 1 1/2 years left on your horse until their feet are ruined. Period.

He didn’t know the exact mechanism, but injecting from the back will eventually make your horse go permanently lame. Hence … they don’t do that anymore.

My particular horse is an excellent candidate to be nerved, if the injections (from the front!!!) ever stop working for him. If you are looking into that option, just make sure you are well-educated about it. Many people are mis-informed when it comes to de-nerving a horse.

[CrowneDragon]

[QUOTE=beau159;7804399]

Can you elaborate on this?

Did your horse get injections from the front only? Or did the vet also (or) inject from the back, directly through the bursae?

For your horse’s sake, I sure pray he didn’t inject from the back.

I took my horse to a lameness specialist (one of the best ones in my geographical region) and he informed me that they used to do injections like that all the time, where they went in from the back, through the tendon, and directly into the bursae. Until they found out by doing that, you’ve got approximately 1 1/2 years left on your horse until their feet are ruined. Period.

He didn’t know the exact mechanism, but injecting from the back will eventually make your horse go permanently lame. Hence … they don’t do that anymore.

My particular horse is an excellent candidate to be nerved, if the injections (from the front!!!) ever stop working for him. If you are looking into that option, just make sure you are well-educated about it. Many people are mis-informed when it comes to de-nerving a horse.[/QUOTE]

This is incorrect. There is no definitive limit on injecting a horse’s navicular bursa causing irreversible damage. Lots of people have had repeated injections done with no long term ill effects, myself included. Repeated injections of any joint is not optimal. When you have to puncture a tendon to do so it’s even less optimal, but sometimes that’s what you have to do to keep the horse comfortable.
You cannot inject the bursa “from the front”. I think you may be thinking of the coffin joint. There are ways to inject the bursa from the side of the leg without going through the DDFT, but it is more difficult and much less commonly done.

[FineAlready]

I am not a person that routinely advises euthanasia. Check my posting history if you want to be sure. That said, I would let this mare go peacefully. Navicular is very painful and degenerative. A good friend of mine was in a similar situation with a horse that I knew and absolutely loved. I gave her the same advice, which she took. At some point, you have already done really all that can be done. I think you are at that point.

I have another friend that nerved her navicular horse twice (the nerves can regenerate), and the horse ultimately ended up down and unable to rise - basically the worst possible situation for a horse - before she put him down. She loved him and tried to do all that she could to save him. I do think he would have been better off being euthanized earlier in the process.

I’m so sorry. Navicular is a terrible thing.

[rockfordbuckeye]

I have had decent luck managing navicular but the initial presentation did include a ligament tear and we had to get through rehab of that first before working on the navicular. All the corrective shoeing and bursa injections in the world would have left me with a still dead lame horse due to the ligament injury which was underlying.

I would worry that there is the potential for your horse to have underlying ligament/tendon damage and that is why you are struggling for soundness with all the “usual” navicular stuff. My horses ligament damage was NOT easily detected by ultrasound and was only picked up by MRI. THe same with her navicular issue - xrays and ultrasound did not show it. Only MRI showed it though obviously clinically I had a horse that was 3-4/5 lame. So we knew something was wrong. That is the thing…without MRI you will never know for sure and my guess is there are some rare cases where even with an MRI you may not be able to get a full grip on the extent of the issue.

If the MRI is done at an academic center, you may be able to finance with CareCredit that will give you low interest (or no interest) to pay off the MRI bill over 6-12 months. I think the MRI would give you a lot of answers and help you to decide whether to continue to pursue management or go the euthanasia route. It is a lot of money to pay up front though and I suppose if the answer you get is to go towards euthanasia you may look back and think - why did I spend $2k or whatever bucks just to find out I needed to stop? Well the truth is that guilt and love make you do crazy things. I know for me, I couldn’t sleep at night thinking I put down a good horse that just needed more time etc. But for everyone that is an extremely personal choice that has to take into account many factors about your life, your horse, finances, etc. and only you can decide what is right for you.