Would you nerve a navicular horse?

[Libby2563]

Thankfully I’m not in the position to decide myself, but a close friend’s teenage daughter has a horse that the vet has recommended nerving. Her parents don’t know much about horses so they have asked me for my opinion and I just don’t know much about it.

The rider is 16 years old and bought the horse last year or so for the purpose of lower-level eventing. When she goes to college in a year or two the assumption is that she will no longer have time to ride (I did, and I don’t know why that’s the assumption, but it is) and was always planning to sell the horse then.

The horse is young…I think 7 or 8 at the oldest? He is an OTTB who was raced unsuccessfully then retrained as an eventer. He vetted fine and had clean x-rays when they bought him over a year ago. Since then they’ve had nothing but problems, including lameness that ranges from acute to indistinct. He has now been diagnosed with navicular syndrome in both front feet. They’ve done therapeutic shoeing, injections, daily Previcox, Osphos, etc. and nothing keeps him sound even for flatwork.

The vet has now recommended nerving the horse. He says that way he won’t be in pain and she could enjoy him until she goes to college. I love and trust this vet, but to me it sounds a bit barbaric. Plus I wonder what their chances are of selling a horse that has been nerved. (Although they will have a hard time rehoming a lame horse too.)

What are people’s opinions on nerving a navicular horse? Is it as barbaric as it sounds?

[IPEsq]

I had one who had been nerved before we got him. He was a wonderful horse with a long career and very expensive shoes. Would I choose to do it? I don’t know. Seems really awful, but our boy had a happy life for a long time after he had it done, so I’m torn.

ETA - Navicular disease was confirmed in this horse.

[Marla_100]

I would NEVER consider nerving a horse. Ever. If a horse is lame or sore there is a reason. I’d want to know more than just describing it with the catch-all phrase of navicular syndrome. This term is thrown around when vets cannot pinpoint the exact reason for the problem. Sometimes a change in farrier/trimming/balancing can help this problem. Some vets believe the “syndrome” can be reversed and soundness achieved with proper hoof balance.

IMO, to nerve a young horse just so the child can continue showing is cruel
and unnecessary. There are many other options to explore.

[joiedevie99]

Navicular syndrome is used all too often for nondescript and unlocated pain in the hoof. If the horse had clean x-rays a year ago, I’d bet that navicular isn’t the answer. Rather, I’d suspect a soft tissue injury in the hoof - and recommend they get a MRI of that foot to locate the real source of the pain and determine a treatment plan for that.

[JB]

If everything else had been addressed, including fixing how the foot was trimmed, then I’d consider it for a pasture ornament only - no more work other than maybe the occasional walking trail ride.

You mentioned a bunch of things having been tried: I’ve seen more than one horse where all those things were tried, to no avail, because nobody bothered to notice that the trim itself was the problem.

Have NEW xrays been done?

[Libby2563]

They have done new x-rays as well as MRIs. He was recently on stall rest for several months because the vet first thought it might be a soft tissue injury, but did not improve with rest, goes ballistic in his stall, and is then dangerous when he does get back under saddle.

They have been paying top dollar for a well-reputed farrier and the vet approved of the job he has been doing. (I do think a “good” trim job is pretty subjective.) They have also done some research into barefoot management but haven’t taken any steps. (It seems to be more popular in the UK?) He has pretty fragile TB feet and I think it would take more careful management than their large boarding stable can provide. Plus the barn is way overpopulated and the ground is not in good shape.

I do understand that “navicular syndrome” is sort of a catch-all. I just don’t know what else to advise them to do when they’ve already been taking him to the best lameness specialists in the area, doing all of the therapies they recommend, etc.

Their trainer is now supportive of nerving too but the daughter would rather have a lame horse than subject the horse she loves to that, and I think mom agrees. However, in the long run I don’t think they’re in a position to keep the horse for the rest of his life. Maybe attempting to rehome him is really the best option, but they worry what kind of home a lame high-maintenance horse would end up in.

Sigh…I’m glad I have the luxury of keeping my problem child for life!

[arapaloosa_lady]

Why would your friends rather have a lame horse than do a neurectomy? Have they sat down & talked with the vet about what it actually involves?

I wouldn’t leave the horse in his constant pain, and I’d try the neurectomy before I euthanized him for the pain.

(edited after I read your update)

[JB]

well-reputed farrier that a vet approves of doesn’t give me a warm fuzzy

If it comes down to it, I would put the horse down if I could not afford to keep him for the rest of his potentially long life. A nerved horse is not safe to ride much at all, and there are no guarantees once he leaves that someone won’t think he’s quite sound enough to go back to work :no: If he’s just sort of lame, he could be pasture sound enough to live a comfortable life for another 15+ years, but if he’s got true navicular degeneration, at some point the occasional bute isn’t going to cut it anymore.

Are you saying they are in the UK? I don’t know anything about the best Vets there, but if there’s a chance on getting a consult with some place like New Bolton here in the US, that might be a good idea.

[Libby2563]

I wouldn’t say the horse is in constant pain. That’s what makes it a tougher decision, I think. (Before my horse had experimental shoulder surgery, he was lame at the walk and getting worse. It was either the surgery or eventual euthanasia. That’s an easy decision. And btw he is a GP dressage horse now, but that’s a whole other story.) This horse isn’t there yet. He’s just not sound to ride. Like Marla said, nerving a horse just so someone can keep riding him seems a bit cruel.

They have taken him to a well-known private lameness vet in Virginia as well as Marion duPont Scott in Leesburg, VA. I don’t think they’re lacking for good medical opinions. (The UK point was just that there is a lot of info about barefoot treatment of navicular in the UK but not as many resources here.)

[JB]

Ok, thanks for the clarification. It sounds like this may well be the actual degenerative disease.

He’s an 8yo GP Dressage horse? Not saying it’s not possible, but just questioning it because it would be really uncommon for a horse who had a racing career first, then went Eventing for a bit, before turning to straight Dressage. If he was indeed pushed hard for GP at 8, that might explain some of the issues he’s having.

[meaty_ogre]

I had my TB gelding nerved. We exhausted all other options. He’s a high/low horse (feet angles don’t match) and he has had some shoeing/trim issues over the years, but they weren’t to blame for his chronic lameness. I agree with the others though, they need to be sure that this isn’t severely underrun heels, negative palmar angles, excessively thin soles, etc. that are causing the lameness.

Another thing they need to be sure of is that the navicular bone has not become jagged and demineralized to the point where it is shredding the DDFT. Catastrophic severing of the DDFT can occur in that case, and nerving the horse will accelerate that process. My vet did tell me that catastrophic failure of the DDFT can occur even without that pathology.

Nerve blocks need to be done first to ensure that the denerving will actually address and possibly solve the soundness issue. If a nerve block fails to make the horse sound, the nerving is unlikely to succeed. Nerve blocks are tricky though.

There are many techniques (laser, cryogenic, combination) and some seem to have better outcomes and lesser chance of neuroma formation post-surgery. Just make sure they do their research and choose a vet with a lot of experience and good outcomes.

My horse went from pasture lame in shoes to mostly sound barefoot. He never went back to a high level of work, but was able to work at his previous level, and was much more sound, and able to maintained barefoot after the surgery, so it was worth it for my situation. He was head-bobbing pasture lame when I made the decision to try the neurectomy.

I still have the horse, and had no intentions of selling him, so that also factored into my decision. Basically I was hoping at worst it would make him more comfortable in the pasture without having to continue to be shod since he wasn’t working; it actually allowed him to continue to work for a few more years.

[Marshfield]

I had the surgery done on a then 18 year old SWB after managing the issue for about three prior years. Right foot only. He was then able to return to being a solid third level schoolmaster for me. My only regret was in waiting as long as I did. He was still sound seven years later when he died on my front lawn

[findeight]

[QUOTE=JB;8038155]
Ok, thanks for the clarification. It sounds like this may well be the actual degenerative disease.

He’s an 8yo GP Dressage horse? Not saying it’s not possible, but just questioning it because it would be really uncommon for a horse who had a racing career first, then went Eventing for a bit, before turning to straight Dressage. If he was indeed pushed hard for GP at 8, that might explain some of the issues he’s having.[/QUOTE]

Think poster was referring to her own horse who had xperimental shoulder surgery and is now GP.

I would nerve one but only after enough diagnostic work to be sure it would relive pain. And only for light work on one I keep, not to compete or sell. I know too many who bought undisclosed nerved horses so they can and do get sold on without that information, poor things get worked inappropriately and end up worse.

[SportingSun]

I’m curious as to what he has actually been diagnosed with. Has the source of the problem been pinpointed? Is it soft tissue? Bone? Undetermined?

What kind of corrective shoeing is being done?
Have bursa injections been tried? Previcox? Isoxuprene?

There are many things I would try before nerving the horse. I would have no issue with nerving a horse after all other therapies had been tried. But it would not be so I could have a riding horse back, it would be to give the horse a comfortable retirement and maybe do some light riding if the horse was safe for it.
Nerving a horse to keep jumping or something is like keeping a horse on bute to keep it riding sound or drugging a horse to keep it calm. It’s being done purely for human entertainment and that I cannot agree with.

[2tempe]

Presuming all diagnostics have been done, there aren’t many options.

1. Pasture puff/retirement.
2. Nerve and hope it helps the horse for at least a while.

It will impact any future sales effort, but if they do nothing there is no sale opportunity anyway.
Nerves can and do grow back, so solution may not be permanent.
Sounds barbaric but many horses do well and go back to career.

[Marla_100]

Doesn’t surprise me that the trainer supports nerving as they don’t like their income stream interrupted. I’ve had trainers push to train obviously lame horses so they could continue their fees.

Agree w/ JB- well reputed vets and farriers can be wrong and out of date on their opinions. I’d rather hear the exact diagnoses IF they have one.

BTW, there are many skilled barefoot trimmers in US who advocate pulling shoes, balance the feet properly and give 'em some “Dr. Green and a Tincture of Time” meaning rest and turnout for a period of healing time. If this were my horse and I didn’t have a more definitive diagnosis, I’d do this.

[Foxtrot_s]

My vet even offered to buy my navicular horse and would have nerved him to event him. Sometimes the nerves become exposed to the outside and those can be very sensitive.

Horse ended up retired and as a low level hack-around-the-farm horse with special shoeing.

I’d take professional advice, maybe even a second opinion.

[findeight]

Seriously consider pulling the shoes and turning it out for a year. Not only may it help the horse with " inconclusive" vet results, it does wonders for horse’s temperament and owners wallet. Doesn’t help trainer much though and some don’t act in the best interest of owner let alone horse.

[Nestor]

I’d definitely want more details, but on a 7-8yo horse, I’d seriously consider it, if everything else had been tried already. But one year of lameness probably hasn’t covered all avenues of trying to fix him. I spent 4 years on my navicular horse, trying to keep him riding sound, and considered nerving him, but in the end was glad I didn’t. He was pasture sound, so I let him retire (at 15), and he ruptured his DDFT the next year - who knows how ugly that would’ve been if he couldn’t have felt that.

The biggest concern with nerving them is that if the DDFT is compromised in ANY way before they are nerved (lesions, etc.), and they strain it after they are nerved and can’t feel it, they can rupture it, so instead of a lame horse, you probably have a dead horse. So the good vets require an MRI before they’ll nerve a horse, to see if he’s even a candidate. But then, my horse was a candidate, and he still ruptured his DDFT, so…

I’ve heard lots of positive endings to horses being nerved. But I’ve seen firsthand why it’s dangerous. And there’s no guarantee how long it will last, there are enough cases of the nerves regrowing after 2-3 years that I decided not to do it.

[findthedistance]

Based on the details and being in the area, it isn’t hard to guess which vet is working on this horse. If that lameness specialist is recommending a neurectomy, they are at the point where the options are neurectomy or retirement. Neither answer is wrong, but for a horse of that age I would be tempted to try the neurectomy and see if he can be useful in a low-level job. His feet pretty clearly can’t handle the pounding involved in eventing/jumping.

I have a friend who did a neurectomy on her former eventer. He’s been a happy, sound dressage horse for many years since. Correctly managed it’s not necessarily the end of the world, but the owner needs to be ready to commit to very attentive leg/hoof/footing care for life since the horse won’t be able to feel his heels.

There is no “sale” in this horse’s future. He’s a permanent fixture in their lives, or – best case, if he is one of the ones who responds very well – possibly a very careful giveaway.