Opinions on Egg Bars and Osphos?

[tipzythegreat]

My horse is an 18 year old OTTB who I’ve owned for 9 years. Throughout that time we’ve struggled with hind end lameness… but about 2 months ago he came up lame in his front left. In October I had a lameness evaluation and the vet injected his coffins and he felt good up front. In fact, I didn’t know he was having issues until he flexed positive. When we injected his coffins again 3 weeks ago DUE to actual lameness, she confirmed he could have navicular but hopefully we’d be able to manage it with coffin steroid injections. He improved for a week but quickly went back to being lame and instead we had a shifting and inconsistent lameness. So we did navicular x-rays.

The major things are his RF is NPA and he has some narrow spaces near the coffin on one side oif the bone but in both feet (which are uneven because the outside of his hooves are visibly higher on both LF and RF.) He does also have a notch in his LF which may be an old injury or actually affecting his DDFT, but the vet said we really can’t know the severity of it based on images. Overall his changes are pretty mild. I’ve never x-rayed him before. He did have some minor front end lameness in the winter of 2023 – but I thought he was getting mud under his pads and it resolved with a few days of rest.

She recommended a 2 degree wedge on his RF. A flat pad on his LF. And egg bar shoes. We also did oshpos. He was already wearing 4 shoes – but I took the pads off some time ago so he was just wearing plain steel up front.

He’s just gotten all set up today with everything so I’m not sure how he will ride… but I’m reading a lot of negative information about BOTH osphos and egg bar shoes! I know everyone has an opinion but I’m wondering if the COTH community thinks this is the right thing to do? My end goal is to keep him comfortable and happy working as long as possible. He’s already 18 and had hind PSD surgery, but honestly we mostly just WTC with some lateral and pole work. He’s happy to work and a saint to ride, but I want to keep him riding for as many years as possible.

Happy to post films if there’s interest! Thanks everyone!

[LazyA1]

I hope people smarter than me chime in but Egg bars in front? he is going to pull those off, and they gravitate the center of balance back.

Be sure she doesn’t mean heart bars, and if, ask her about frog support pads instead.

[Baybaybay765]

So a big sign of navicular is heel pain. You can see this by watching how your horse walks. (A slowmo video at ground level can show this better) They should be pulling the front foot out, doing a little toe flick, and landing heel first. Navicular horses often don’t do the toe flick and will land on the middle of the foot or on the toe first. They walk this way to take pressure off the sore part of the foot (the heel).

Egg bars are essentially just putting metal on your horses heels and having them walk on those all day. It’s not going to help the heel pain. Osphos is an okay temporary bandaid but it’s been shown to cause bone degeneration and it’s not going to change the way your horse walks. My navicular mare did not respond to osphos.

You will find everyone giving you their advice on how they prefer to shoe a navicular horse. Wedging and pads will help take pressure off the DDFT, but is really just another bandaid and you have to be careful with wedging long term as it can crush the heel further.

I’ve had good results on keeping my navicular mare comfortable with Duplos, or a similar shoe that is flexible but supports the heel.

You can also check out The Humble Hoof, who recommends rehabbing navicular with a diet change, track system and barefoot. She will often start her rehab horses in cloud boots or something padded to help them feel more comfortable at the heel, so they can start walking correctly, which will fix a lot of the issues.

Good luck! It can be a rabbit hole and navicular is so tough

[tipzythegreat]

I DID ask about heart bar and she said it can cause frogs to collapse so she didn’t recommend it.

I DID also ask about him pulling those shoes off – and she was like make sure he wears bell boots!

[RedHorses]

I can’t speak to the combination of egg bars and Osphos, but I got Osphos (off label for general arthritis) for my then 26 year old senior last August and he was feeling good all fall and into winter. I had it done again early in April and he’s doing really well with it.

Obviously at this age, long term side effects are not a significant concern. We are very firmly in the “do what makes him comfortable now and deal with anything that might come up when/if it does” stage of life. He’s never going to be 100% again, but he’s quite comfortable going on WT hacks for an hour and a half, and has even been willing to do a bit of canter (I think the last canter was 16 seconds ).

[tipzythegreat]

I will try and get a video and slow it down to watch. I know my horse sometimes sort of paddles his front right out/flicks it outwards. I assume he’s had it for a long time and has just figured out how to compensate some what when it’s bothering him. I can’t FEEL it when I ride and I never see anyone else ride my horse so I don’t know exactly what it looks like. Just what my trainer has said.

I asked how osphos worked to relieve pain and my vet was like, “we don’t know… but it works!” But I figured at 18, I can do a shot or two to get him working until 20. But it is very scary how it can damage bone long term!

I will look into Duplos shoes, thank you.

I also did see a thread about rehabbing navicular with doing the barefoot thing and a diet change. He’s a few months into being 18 and has feet that are too small for his body. If I can keep him working for another couple years via wedges and pads, I think it would be interesting to pull his shoes and watch his feet when he retires. BUT the problem is, due to his age, that a month off will set him back really far. My vet always says he’ll fall apart when he’s out of work. And he was out of work for 2 months completely a year ago… and it took me 6 months to bring him back. So now, a year later… if I pull his shoes and let him struggle for 6 months, I have no confidence he’d be sound in his many other ailments. And I do mean MANY. I used to joke he had one good leg… and now it has navicular LOL.

Thanks for the insights!

[tipzythegreat]

Was the Osphos for arthritis in a particular spot? This makes me feel better – because yes, I just want to keep him comfortable and working while understanding he’s far from a spring chicken. I really hope I can keep my boy comfortable at 26 to do WT hacks! And that’s so cute on the canter! He was feeling froggy!

[RedHorses]

My senior has enough arthritis in his left knee to reduce the range of motion (that toe often smacks the ground as he swings the foot forward in the walk) with uninteresting xrays. My vet felt that the Osphos would benefit all his joints as well as the knee, making him overall more comfortable. He still hits the toe sometimes when he’s getting tired or generally being sluggish when walking, but he’s very obviously much more comfortable once the Osphos takes effect.

[outside_leg]

My navicular retiree benefited greatly from Osphos. He was walking lame last summer to the point that we were at the point of euthanizing if we couldn’t get him for comfortable quickly. Osphos, bursa injections, and coffin injections have made a significant difference and he’s now happily pasture sound.

We did try egg bars, but those did not help (he’s always had one under run heel up front). The setup that seems to be working for him is a mild wedge. But he also had a DDFT injury several years ago, so we balance keeping his tendons comfortable with keeping his feet comfortable.

My experience is that navicular horses can be quite tricky, and what works for one may not work for others.

[atr]

My 18-year-old dressage schoolmaster has navicular issues. Osphos has been a miracle drug for us. In fact we did some new x-rays a few weeks ago just to see what was going on, and my vet was quite pleased. It looks like there has been some reversal of bone loss, and the edges are fairly smooth. We do it every 6 months, religiously, not waiting for signs of pain. I’m with Redhorses. We do what we need to in order to keep him happy, which means for him and his brain, keeping him in work. He’s been on it for at least 3 if not 4 years now.

My farrier has never felt the need for bar shoes. I trust his judgement. He’s shod every 6 weeks and we are very careful about the balance and level of his feet and keeping his toes short. I’d prefer every 5 weeks, but my farrier can’t work on that schedule, and I’d rather keep using him!

Other things we do… work him only in very good footing, and the occasional coffin joint injection if the ground in turnout has been particularly unfriendly (lumpy frozen or summer rock hard.)

I can tell it’s time for something if he starts to get tight through his shoulders and isn’t moving as freely in front.

[tipzythegreat]

Thanks @RedHorses – I appreciate your experience!

@outside_leg I wasn’t sure if you could do Bursa and coffin injections. I’m wondering if that gives me ONE more option. How often are you doing Osphos and the injections? What kind of shoes does he go in now?

REALLY @atr ! This is very promising. At this age, every working year is a blessing. Does he wear standard shoes up front? Pads or wedges? I am also particular about footing – my horse has a PSD injury so I’m very cautious Thanks for the encouraging feedback!

[outside_leg]

I did Osphos last year and haven’t needed a repeat yet. His last bursa and coffin injections were in the fall, around October. I thought we’d need to do them again this summer, but so far he’s maintaining his soundness. The bursa injections in particular were a game changer for keeping him comfortable.

He’s currently in a wedge shoe with a pad up front. It took us a few cycles to find the right setup for him, but again, it seems to be working.

[Bonnie2]

Ok, free advice - worth what you paid for it if you’re lucky!
Diagnosis - It would be unusual for what is usually called navicular to show up for the first time at 18. Certainly possible he had some trauma that caused discomfort in the navicular region. If the lameness doesn’t resolve, my first step would be to review the diagnosis / get a second opinion and or MRI.
Osphos - At 18 there are fewer downsides and osphos can be near miraculous in a horse that hasn’t had it before. Personal observation is each subsequent treatment has less effect. But it could give you several more years.
Egg bars - These are seldom applied in the most beneficial way. This is something that vets who haven’t ever shod a horse recommend. Ideally, the widest part of the shoe would fully support the heels. In the real world, few farriers will put on a big enough shoe or set it far enough back because they know it won’t stay on. Bell boots will not keep it on. Pulled shoes don’t help sore feet. I had luck with a classically navicular horse (horrible xrays at 4) in straight bar shoes with the toes brought well back. Didn’t maximize his movement but helped keep him comfortable.
Injections - Prostride can be amazingly helpful, depending on what exactly is wrong. Worth asking your vet about.
The good news is that there are so many helpful therapies today. Hope you find one that works for you!

[atr]

He wears standard shoes all round, no pads or wedges. Anything we can keep simple, we do! His front feet are an unmatched pair, so trimming him perfectly is quite the art, but the recent set of x-rays show that it’s being done right and he has also excellent sole depth. I love my farrier. When I got him, he had been wildly over-trimmed by a “barefoot expert” (my vet muttered something about “bloody stumps”) sore and miserable, but that’s a long story.

My vet tends to shy away from bursa injections for some reason. I think they are more complicated and invasive?

[LazyA1]

I had an 18 year old with heel pain (corns). He was most comfortable barefoot. His job was as a very low (2’3") hunter with very minimal jumping at all.

Bursa injections helped him a lot. But my vet was very conservative with them. They have to go through a ligament/tendon or something like that, and it is detrimental to that. I can’t remember exactly why. She would not do them more frequently than every six months.

[tipzythegreat]

Thank you @outside_leg ! I did also do coffin injections last october so you’re definitely getting a better shelf life from them. I appreciate your insight!

@Bonnie2 You’re absolutely right – but I think he’s always had navicular, honestly. In retrospect, of course! He’s a huge tripper (even at the walk) and I’ve worked with different farriers for years to help that. He’s worn pads off and on up front, but he’s always wearing rolled toes and trimmed with short toes on a 5 week schedule. I think it’s just finally to the point where it’s not enough to just do that. IN HINDSIGHT… He’s always been off and on stiff in his neck and has down right refused to walk downhill. 2 years ago, at 16, he started flicking his toe weirdly. That winter he was NQR and a bit lame randomly in his RF. I had some farrier changes and he would be lame here and there and fine after a few days of rest. I assumed it was mud under the pad or an abscess. At 17 he first had his coffins injected and navicular didn’t really occur to me at that time.

I will ask my farrier about the straight bar shoes. Overall it seems the consensus is yes Oshpos NO egg bars!

I used to use IRAP in his hocks and stifles before I ended up switching to steroids. I wonder if prostride would be useful… but if steroids lasted 3 days I’m not sure prostride would help.

@atr really on the Bursa injections! Well, mine didn’t offer it at all… but I’ll ask. I always email her follow up questions so thanks for the suggestion!

@LazyA1 Perhaps this is why @atr 's vet doesn’t want to do them. I think with a traditional steroid, you don’t want to do more than every 6 months. But I don’t know. I’ll ask and find out more!

Thanks everyone – really. Y’all made me feel a bit better about deciding to try Oshpos… and to not do the egg bars next trim cycle. I appreciate it!

[Peggy]

Two quick thoughts.

Given the NPR and the tripping, I would make sure his toes are kept short. Some farriers really don’t want to keep the toe back.

Tripping plus stiff neck could be something NQR with the neck–impingement or transient impingement. And a bad neck can lead to navicular syndrome (as opposed to navicular disease).

[tipzythegreat]

That’s actually a really good point and something ive never thought of. I assume neck issues are diagnosed with xrays?

[IPEsq]

Neck might be able to be seen on Xray if he’s developing some arthritis.

Osphos would help if there is bone pain and bone loss. If this is DDFT irritation or injury or something else, then it’s not going to help. You’d need an MRI to really see what’s going on in there.

There are some other techniques for supporting the caudal foot other than egg bars.

Back to the neck …if his feet are really that different from each other, that’s a common sign of a neck issue of some sort. Arthritis, nerve irritation, cervical malformation, and resulting muscle asymmetries. Because they don’t load the feet the same and may also just stand around unevenly loaded. This can cause one foot to be more upright, one more flat, and lateral imbalances. Correcting the entire posture and thoracic sling can trickle down to helping get the feet looking more normal, along with thoughtful trimming management. It’s not enough just to do this when the horse is working, but he has to learn to adopt better habits on his own. If there’s an issue of neck pain or foot pain, or both, you have to address the pain component first before you can create new posture habits.

[kaya842]

Osphos might help with bone pain. N = 1 but my experience was it was one of those things I couldn’t tell any difference. It could have been that my horse’s issues were “too far gone” though.

I did have good success with egg bar shoes with that same horse, though. They were applied for a few cycles at two different times in her life by two different farriers. First time? I don’t remember any or much improvement. Second time? HUGE turn around. She stayed in them for a few cycles and then transitioned to a rim pad and regular shoe IIRC.