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Navicular, Share your opinions and stories!

Horse Care
#1

Okay, I don’t post here often at all. I have a 10 year old quarter horse that was diagnosed with navicular disease last week. (He is huge, 16.1hh and almost 1,200lbs) We have been battling soundness issues off and on for the past year and finally after fresh x rays and thorough lameness exam my vet has come to the conclusion that he has navicular. Last May, we took base line x rays and determined that he had some mild changes in his right front, and it has gotten to the point where the lameness has gone from intermittent to all of the time lame at the walk.

We are working with a farrier and he is currently in a “Trac Me” shoe with a 3 degree wedge with no improvement in soundness. He also gets 2 grams of bute a day and it is not touching his lameness, I would say he is a 3/5. The vet is recommending we bring his toe back even farther and put him in a bar shoe with a 6 degree lift to the heal and pour in pads. He has also mentioned that because he is still so lame on the bute he is not sure that even with isox or Osphos would he show improvement and he thinks that my money may be better spent having him nerved. Because of his age both the vet and my self are hesitant to make that drastic of a decision though. ( I should also mention that he does block sound)

I have a 3 year old son, farm, feed and turn out at the barn where I board my horse in the evenings (30 horses) and am a teacher so while before my son was born I rode 6 days a week and showed a couple of times a month. Now I am lucky to get on my horse once a month to go for a trail ride, partially due to the fact that I do not know if he will be sound or not and also the fact that I am so darn busy. I know that I am at a different place in life right how with my horse than I was 4 years ago. I am just trying to get options that are both financially sound as well as going to be best for my horse.

Have any of you been in my shoes or can offer advice as to treatments you have tried, that have worked? I am at a loss here and seeing this guy in such pain is disheartening…

Thanks so much!

#2

I was in your exact situation about 2 years ago. My QH was diagnosed at 9 he is now coming 17. I didn’t have an issue with him ever being unsound until he was about 13 and he blocked sound, 2 grams of bute a day, Very hard to watch your baby walk like that. When he was 15 I moved him to Texas with me found an exceptional lameness vet and farrier combo. When they x-rayed he was 3 degrees negative! so we put him in a wedge pour in pad and aluminum shoes. I also started him on a combo of platinum performance hoof and Delta hoof power. I also wanted him to go back to work. he would be trail sound just with the shoeing changes and farriers formula. After 6 months of the corrective shoeing and radiographs he came to a positive angle and now is almost completely where he needs to be. I would consider him trail sound but I’d like to continue doing lower level dressage work with him and ride 4-5 days a week. Those dang quarter horse legs are hard to deal with especially as they get older. It’s really up to you after hearing your vet and farriers take on it but i would consider a corrective farrier to at least get him sound at the walk. He is also now on Previcox instead of bute and his feet grow like crazy so there is a lot of hoof for the farrier to work with.

Keep us updated on your guys preogress! Jingles to him

#3

Man, I hope he has a navicular! It’s kind of an important bone :wink:

It’s navicular syndrome :slight_smile:

Have you considered, or would you consider, an MRI? We’re finding that so many of these “navicular syndrome” horses actually have soft tissue damage in the foot. Unfortunately, the only way to really SEE in there is with an MRI. Treatment and prognosis can vary depending on what, exactly, is going on.

2 Likes
#4

Thanks for the support! I will keep you updated! I would just love for him to be sound walking at this point, poor guy! He has always had great quality feet, but has always been on a 5 week shoeing cycle because of how fast they grow! Combine that with corrective shoes and ouch, that puts a hurting on the check book!

#5

Navicular syndrome, and navicular disease, are 2 different things, so you need to know which one you’re dealing with.

NS is almost always caused by poor long-term trimming, causing the heels to contract and make the whole back of the foot sore. Provided the trimming hasn’t caused permanent damage, this can almost always be resolved by getting proper trimming going forward.

ND is a disease which deforms or degrades the quality of the navicular bone, which makes the back of the foot sore (so same symptoms), and can start to involve surrounding tissue which just exacerbates things.

So, so many vets and farriers don’t know the difference, and just put it all in the same category and go right to “corrective shoeing” without ever fixing the cause when the cause is the trimming in the first place.

Can you post the xrays?

You do need to know, for sure, whether the changes seen on them are (likely) caused by poor trimming. If they are, and you just go on with wedges and such, things will just continue to get worse.

You won’t likely be able to undo the changes, but if they are trim-induced, then fixing the trim will at least prevent progression, and more recent issues may resolve to some degree.

1 Like
#6

I have never heard of them being two different things, syndrome and disease are used interchangeably from my experience.

ex: http://www.equinehorsevet.com/pdf/Navicular%20Disease%20in%20Horses.pdf

My retired 19-year old gelding was diagnosed in fall 2016. He is currently sound with 2° wedges and Previcox. He is my only personal experience with navicular disease, but he has been pretty easy so far.
I imagine if I had a horse that unsound with wedge shoes and bute, I would consider blocking.

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#7

There is definitely degeneration of the Navicular bone, he has been blocked and has come sound with the block. X rays show a definite change of the shape of the bone. He has always been shod by the best farriers in SC Pa.

#8

My then 6 year old QH rescue was on and off lame and we took x-rays and blocked and he became sound. He had a very small cyst on the navicular bone but became increasingly and more consistently uncomfortable. I was unable to do an MRI and I always figured he was more bothered by something soft tissue, swelling at the bursa maybe, in there due to his level of discomfort.

We tried every possible shoe available with no success and the farrier finally threw up his arms and asked if we could try him barefoot and he has been that way since. He is 21 this year. At the beginning we tried Navicon etc and none of it worked so I got desperate and put him on Gallium Nitrate. It took 3 months but it was really magic. His x-rays have not gotten any worse and he is happy. He would not have lived this long without the gallium. He is pasture sound and living the good life. He deserves it.

Good luck! It really is trial and error a lot of the time unfortunately. Especially if you are not able to get an MRI done for whatever reason. I keep wishing I could win the lottery and get some more diagnostics done for him just for my own curiosity.

1 Like
#9

I agree they are often used as the same thing, but IMHO, and in the opinion of many farriers I know, incorrectly. YMMV :slight_smile:

NS would encompass ND, as it’s just generically “caudal heel pain” but without any underlying diagnosis, other than, too often, the vet (or farrier) hoof testing and find the heels sore. Not helpful - that’s a symptom. That heel pain might not even involve the navicular bone at all.

ND is much more specific - diseased/degenerating navicular bone, possibly pulling other structures into its misery.

Horses with heel pain due to contracted heels due to poor trimming don’t have ND, unless that deformity has existed long enough to force remodeling of the navicular bone.

#10

Is it 1 or both feet?

I do get that there are changes to the NB. I’m just curious if it’s possible they are now diseased due to a history of poor trimming, or more likely to be genetic.

16.1 and 1200lb isn’t really all that big, but maybe that’s because I’m used to 16.2+ and upwards of 1500lb lol The weight for that height is pretty appropriate. Does he have small feet for his weight? That’s a bigger factor.

#11

[QUOTE=JB;n9698356]

Is it 1 or both feet?

I do get that there are changes to the NB. I’m just curious if it’s possible they are now diseased due to a history of poor trimming, or more likely to be genetic.

16.1 and 1200lb isn’t really all that big, but maybe that’s because I’m used to 16.2+ and upwards of 1500lb lol The weight for that height is pretty appropriate. Does he have small feet for his weight? That’s a bigger factor.
[/QUOTE

It is just his right front. I should have said that he is “halter bred” so I suspect it is a genetic issue. Everyone that see’s him said he is built like a brick poop house! Believe me when I say that he has always been handled with care when it comes to his feet due to him being so large. He has shown very successfully in the hunter world for years until I had my son, where he was leased but stayed with the same farrier, and barn.

#12

What’s a Trac Me shoe? Is he in any kind of pad? My experience with navicular…and no, don’t know which, NS or ND, 2 were leased and 1 owned. Do suspect ND in one lease horse for sure. Pretty sure the owned one was NS, never saw any x rays on either leased horse.but the one I owned had x rays showing nothing remarkable about the NB.

Anyway, IME, if the shoeing really helps, they are better right away, never had lingering soreness after the shoeing job. Had better luck with wedges and rim pads then full pads, even pour ins. Sometimes they put more pressure on the heel rather then reducing it. Bar shoes a must, Bell boots and supervised turn out to avoid yanking them off. It’s manageable but I never bought or leased another with it after the last one. It’s pricey and it can disappoint you flaring up at inconvenient times. Never goes completely away either.

#13

Simkie is correct. @Pink Cadillac does not say exactly what was on the xrays that lead to the diagnosis. And there are NOT just 2 options, navicular syndrome or navicular disease. With the horses that block sound and no findings on xrays, they are being diagnosed with “caudal heel pain of unknown origin.” And its not necessarily caused by poor hoof care.

My blacksmith has been using this shoe with success:
http://www.grandcircuitinc.com/products/grand-circuit-egg-3-degree-wedge-frog-relief

Along with giving the horse a lot of time off (a year), and bringing it back into work slowly. But fair warning that with shoeing, some horses respond to some shoes and some to others, it can be very horse specific.

2 Likes
#14

It’s still NS after you’ve ruled out actual ND, but have not yet figured out if there are other structures that are causing the issue. I mentioned earlier that “heel pain might not even involve the navicular bone at all”. NS really just means “caudal heel pain” which is just as vague as “colic” LOL It might be as a direct result changes to the NB (which then makes it ND), or it may have nothing to do with hard tissue. It might be an under-developed, sickly digital cushion, for example.

But fair warning that with shoeing, some horses respond to some shoes and some to others, it can be very horse specific.

Agree, and you also have to figure out the exact trim that makes the horse comfortable. Lots of variables, from trim tweaks, to the material of the shoe, to even shoes or not, to the shape of the shoe, etc. Trial and error.

#15

I have a now 20yr old 17h TB gelding that was diagnosed with Navicular Disease when he was 16 years old ( I had dealt with lameness issues for almost 5 years before we found a vet that could give a diagnosis)

Though it wasn’t cheap up front, we chose to do Stem Cell Therapy on him.
He had moderate damage to his navicular bone and I was lucky to ride him once a month to every few months.

We had tried every shoe I can think of and bute/other pain killers just weren’t helping.
Long story short, it was a month of stall rest and then confinement to a smaller (50x50) paddock for another month maybe. We switched farriers and we are very careful to keep his toes back and heels up. When originally changing his feet, we used boots when riding. Those are no longer necessary and he has been barefoot for over 4 years now.

He is 100% sound on a day to day basis…every once in a while if we do too much or the ground is frozen for long periods, he may be sore for 2-3 days, but that is the extent of it. This happens maybe 2-3 times a year.

I can do all manners of flat work as often as I want…and even small jumps here and there. I try to never put him in a stall as I feel tight turns and standing around are not good for him. Due to his size, if I had larger stalls, it probably wouldn’t be that big of a deal.

The stem cells were injected directly into the foot (he was the worst on the LF but was affected in the RF as well) and left overs were done IV. Before and after x-rays showed significant improvement to the navicular bone. I would post them but my last laptop was destroyed and I am still attempting to retrieve all of my files from the hard drive. Stem Cell Therapy was a one day procedure in clinic and I have not had to do any treatments sense.

This is obviously not the way to go for everyone, but it gave my guy a second chance after years of lameness. We were close to euthanizing

#16

No, not at all. Most vets are moving away from NS if the xrays are not conclusive. Hence the use of “caudal” instead of “navicular.”

http://www.thehorse.com/articles/35426/caudal-heel-pain-or-navicular-whats-the-right-term
"Caudal heel pain is typically used to describe pain from the heel or back of the foot. A horse with caudal heal pain would respond positively to a palmar digital nerve block. The navicular structures are often included, but the horse could also have pain associated with other structures.

Navicular disease is usually used to describe disease that has caused radiographic changes to the navicular bone.

Navicular syndrome is more encompassing to describe lesions associated with the navicular soft-tissue structures and may not have radiographic abnormalities."

1 Like
#17

I have a 19yo warmblood with changes in navicular bone/soft tissue in both fronts. She started out as on/off lame RF>LF in spring 2013 but her x-rays of her navicular were not that bad, but she had very thin soles and was not balanced medial to lateral. With previcox, light work, and a straight bar shoe she was pretty sound until November 2013, then very acutely lame RF again. X-rays did not show that much change from spring to correlate with how lame she was so we injected coffin and bursa, that didn’t help so suspected some kind of soft tissue in the foot. I couldn’t do an MRI at that point, so did 3 months of stall rest + 7 months of turnout, farrier put 3 degree wedges on her and the swelling in her distal limb that had been there for months went down the next day, and she was somewhat better but still a 2/5 on her one foot. Opened up a credit card and did the MRI in October 2014 (just a standing one which is not ideal, but was the nearest one that would not have made shipping prohibitive for me) and the end result was a boatload of edema and changes to basically all the bone and soft tissue in her foot.

Did a RLP of Tildren in both fronts November 2014, started her on isoxsuprine, shoeing looked pretty good as far as balance, and after a couple months started her back up with light flatwork. She is not show horse sound, but she is serviceably sound in that she’s fairly even in front under saddle (still has a head bob on the lunge/running around inverted in the pasture). She’s gotten osphos about every 6 months after the tildren-- I don’t feel like that made as much of a dramatic difference in her RF lameness as the tildren did, but it has helped her back and hocks to the point she is able to work better behind to get off her front feet some, and anyways I don’t let it go to the point where I’m like “omg she looks bad” so there isn’t as much of a before/after, but she hasn’t progressed as fast as she is aging on the calendar-- so whereas it was devastating when she was as lame as she was as a 15yo, as a 19yo it’s a little more “well she’s probably going to have something at that age.”

She has stayed on the previcox and isox and joint supp-- not sure how much the latter two do anything, but they’re cheap enough I’m happy to do it to make me feel better :wink: She gets coffin injections as needed and they do help her. She has good days and bad days, and if she overdoes it running around she might be a little extra sore that night/the next day, but she is a horse who NEEDS a job otherwise she is a pill to handle and runs herself (and her pasture mates) around. She last got her coffin injected in November and next week we’re going to try pro-stride in her bursa. I haven’t blocked out her RF (the baddie) to see how lame she goes on the LF in a few years, but at this point I’m doing pretty much everything I can afford treatment wise…could also do shockwave but that would tip the budget. The biggest things for her have been staying on top of maintenance, and keeping her in steady light work-- when I had the MRI done I asked if it would help to keep her in for a few months in case any of the soft tissue stuff could heal up further, but it’s all old enough at this point that there’s not much to do and he wanted her to keep moving so the ligaments don’t contract standing around.

It still blows, but she’s been a trouper through it all and as horses go she’s pretty happy doing her thing. If at all possible for you, I would really recommend getting the MRI if you can, so you know exactly what structures you are dealing with. If you are looking at nerving, I would be surprised if the surgeon would do that without an MRI first. Feel free to PM me if you want to see any of her xray/MRI reports, videos of her moving after various treatments, or have any other questions. Sorry you are dealing with this with your guy, but it is a lot more manageable than I thought it would be at first!

#18

IMHO, the shoes work within the first week if they are going to do anything. Also IMHO, 3/5 lame on 2 grams of bute per day is a serious problem, not something maintainable long term.

If it were my horse, I’d do two things:

  1. I’d give Osphos or Tildren - either full body or regional limb perfusion (a bit cheaper) to target the bony changes you are seeing.

  2. I’d get the horse in for a standing MRI of that foot. So many of these in-the-field navicular diagnoses are in fact serious soft tissue injuries inside the hoof capsule that never get diagnosed or treated.

3 Likes
#19

You might see an improvement with different shoes in the first week, but the horse might not necessarily come sound that fast (I’m not sure what you mean by “work”). If there is inflammation and damage in there, the horse needs time to heal (pun intended). The shoe provides relief for that area and then mama nature does her thing. It may take months and months and months for the horse to come sound.

#20

My trimmer has an excellent series of articles on NS on his web site. He is also giving a seminar on it at the Ohio Equine Affaire if you are near enough to go.

http://enlightenedequine.com/category/navicular-disease/

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