Advances in Navicular ?

[ihatework]

My horse has been investigated for lameness over the last 6 weeks, today I had the upsetting news that the most likely cause will be navicular. It appears to be degenerating fairly rapidly unfortunately.

I discussed with the vet the option of having an MRI to pinpoint the exact cause but we are both of the opinion that this will be money down the drain given the horses response to various diagnostic procedures we have done over the last few weeks.

So we are going to throw every possible treatment at him in the hope he can have a purpose before making the difficult alternative decision.

He is having shoeing (egg bars, rolled toes, gel inserts), adequan & steroid injections into the navicular bursar, tildren and shockwave therapy. My vet is also going to speak to one of the counties leading orthopedic vets to see if there is anything else that could be done.

Was just wondering if anyone who has researched navicular knows of anything else that could be done?

We have ruled out neurectomy, for me that is not an option. He is also a horse that would not cope barefoot.

Many thanks for your help

 

[Patches]

I can't offer any advice in his treatment B_and_J but I wanted to let you know how sorry I am you've had this diagnosis and I wish you all the good luck and vibes in the world that you are able to find something to help him.

 

[FAYEFUDGE]

Hi, sorry to hear about your horse.
As an alternative to conventional metal shoes you could try the OLLOV rubber coated horse shoes. Apparently they are the next best thing to barefoot. They work by cutting down concussion to the hoof and joints. I am using them on my horse who has joint problems and they are great. They also are useful to navicular cases. If you just put the word OLLOV into google it will bring up loads of articles on them. If you have any problems please PM me and I will help you as much as I can. I know how awful navicular can be, having owned 2 horses with it in the past. Good Luck. xx

 

[seabiscuit]

I am so so sorry to hear this about poor Jack.I dont know much about Navicular but I will definately keep my eyes peeled and ears open for any latest research or people with other recent experiences in dealing with this.There is absolutely loads there that he is getting treated with which really should help him a lot temporarily, although I am very sceptical about the effects of shockwave therapy but others seem to rave about it.Sending lots and lots of postive healing vibes to Jack to get better soon XXX

 

[seabiscuit]

Edited to say that should have read eyes opened and ears peeled! God am dyslexic!

 

[brightmount]

Having had a horse recover from navicular, I had to comment although the answer isn't what you want - she went barefoot.

This is effective for navicular syndrome, though if you are dealing with navicular disease it's not quite so straightforward as that is degenerative.

In fact my horse had been lame for so long without improvement she was about to be PTS, and we had the MRI scan on the insurance just to confirm in our minds that we were doing the right thing. Without insurance we wouldn't have paid for it (£1000+) and would have gone ahead with euthanasia. The MRI scan showed that while she had a long list of issues, they were not terminal, and related to some extent to poor foot balance. Hence the barefoot route. She is now back in full work and totally comfortable.

If you are sure your neddy can't cope with barefoot (mine is TB, so don't write it off) then I wish you every success with your choice of treatment. (((((Good luck)))))

 

[ihatework]

Thanks everyone,
I will definitely investigate those ollov shoes further.
Lynwood, I wish I could try barefoot with him, and I am really glad it has made a difference to yours, J has had 3 sets of xrays over the last year and all have shown very good foot balance to the point where the vet said not to change anything!! He sustained a different injury back in January and was turned away for 9 months barefoot, coped okay on the soft but became so foot sore this summer we had to put fronts back on, unfortunately he has a naturally very thin sole.
So, fingers crossed, something of the above works. Thanks for your kind words.

 

[Doublethyme]

Firstly sorry to hear you have had this news.

I have read that Egg Bars cause long term more problems than they resolve. Crush the heels over time. If shoeing is your option of choice, I would ask you vet/farrier about more Natural Balance shoeing systems which are much better, ie the EDSS.

Steroid injections too give short term relief, but apparently can cause increased bone changes long term.

Sorry I know you say your horse can't cope unshod, but the barefoot option in my opinion is the best one for the possibility of a long term future. Not a cure all, but better than the other options.

A friend's horse has advanced navicular changes and changes to his coffin joints too. He had remedial shoeing as a 4 year old, had 6 years of OK soundness, although with hindsight, probably the last two of those he wasn't 100% OK (ie often got "some unlevel strides" in a dressage test/hated any sort of unlevel ground/started stopping at jumps etc), then crashed again. Has spent the last year in the cycle of steroid injections(which gave him a few months soundness then crashed and new x-rays revealed increased bone changes

, plus remedial shoeing (by top Nat Balance farrier), all to no avail, made him more comfortable, but no where near sound. Decision was made to give him a year out (read permanent retirement, which is what we all thought).

My friend was adamant and so were the vets and farriers that this horse could never cope without shoes - needed the support, was always very very footy if lost a shoe, blah blah blah.

Well events overtook - said horse had a completely separate accident and ended up on length 3/4 months box rest for a laceration to his extensor tendon.

In that time, the remedial farrier was still against taking his shoes off, but because he was so sore on his injury, my friend decided it was the best thing to do - take the shoes off while he was in his box only. She fully intended to remedially shoe him again once the injury healed.

Well, the horse is now back on turnout (has been for about 2 months now). Have his shoes gone back on - no. Why - because this horse is walking normally, even over lumpy stony ground - in fact in my friend's words "he has never walked as good ever - even when he was "sound" in shoes in his younger days. Ever since I have known him (since he was 4), he has hated uneven ground, hated turning on uneven ground. Now he strides out completely unconcerned.

Yes he isn't in work yet, but he is sounder than he has ever been - this horse wasn't sound even on a school surface. We are now all really hopeful that he will come back into school work and be able to hack out with the aid of hoof boots.

That is surely better than retirement in remedial shoes at the age of 12 and even with retirement, the vets weren't optimistic about how long he would stay comfortable.

I was also a "horses need shoes to work" person, but the last 12 months of taking my own mare barefoot have really opened my eyes, however, I still never thought that my friend's horse would cope as well as he is doing without shoes and certainly never dreamt he could well come back into work. I'm not a barefoot zealot who thinks that all shoes are wicked and do think that they have their place, but for navicular horses, the most successful long term treatment really does seem to be barefoot (the info is out there, just not by the normal routes).

It really is something to consider. Even if it is just to allow your horse's foot to repair itself and then re-shoe sometime in the future. I am afraid the facts are out there that shoeing will only patch over the problem and sometime in the future those problems will get worse.

Having said all that, I can completely understand how you feel, I really do, and that when all the vets and specialists are telling you to do one thing, it is very hard to do something a bit "out there". My friend felt the same, but now she feels that it has been an expensive learning curve and why couldn't one of the professionals have suggested taking his shoes off in the first place!

Anyway, best of luck with whatever treatment you decide to take, hope everything improves for you soon.

 

[Doublethyme]

Oops took so long writing my essay, that OP you have posted your reasons for not trying barefoot in the meantime.

Very understandable reasons too, although whilst I may get slapped down for saying it, for many of these cases, there really is a difference in the advice and trim you will get from a trimmer like an EP, than a farrier. So if all your avenues of treatment fail you in the future, please keep this in mind and try it, you may just be surprised.

Very best of luck.

 

[RobinHood]

Sorry I don't have any personal experience but this article makes interesting reading:

http://www.hoofrehab.com/end_of_white_line_disease.htm#Navicular

Good luck I hope you find something that works for your boy xx

 

[brightmount]

[ QUOTE ]
there really is a difference in the advice and trim you will get from a trimmer like an EP, than a farrier.

[/ QUOTE ]

I will second that.

I note that you tried your horse barefoot for 9 months and he was OK until summer. I admit even mine took a few backward steps in August of this year - the ground was very hard, but as soon as it rained and the ground softened up again, she was back onwards and upwards.

At this point I also started using Pernamax which is a natural anti-inflammatory.

As we are about 8 months away from the next spell of hard ground, maybe barefoot could still be worth considering for the immediate future?

Thin soles also become less of an issue as you continue down the barefoot route. My horse now has a strong rim of wall and increasing concavity that lifts the sole from direct contact with the ground.

 

[BBs]

[ QUOTE ]
have read that Egg Bars cause long term more problems than they resolve. Crush the heels over time. If shoeing is your option of choice, I would ask you vet/farrier about more Natural Balance shoeing systems which are much better, ie the EDSS.


[/ QUOTE ]

They do indeed! I used them (egg bars) sucessfully for around 3 or 4 years until they cause deep seated brusing to my fellas heels.
My vet (bob) said to try aluminum shoes after the brusing went he was sound for many more years. Although he is crippled with arthritis now, he has no problems with his navicular!

Sorry to hear Jacks is in a bad way.

 

[annie02]

I have one horse that has navicular problems.

My first question is what did the xrays show? I ask this because "navicular" problems can be due to a number of things. My mare has calcification on either side of the navicular bone as well as degeneration of the bone its self (on the xrays the bone resembles swiss cheese, with small dark circles in the middle of the navicular bone).

In her case both the vet and farrier agreed on al. new balance shoes, they help keep her break over point and allow her to wear off her toes, keeping them shorter and well rounded between trims/resets.

She is also on a drug called ixosoprine, it basically increases circulation in the feet to help keep heat and inflamation out of her feet. In most cases it is the inflamtion from the "navicular" area that causes the pain and lamness.

Which is also why bute and banamine help to control lameness. For horses that are really sore and all other methods have failed sometimes low doses of bute, say 1/2 - 1 gram of bute daily will control the pain and inflamation. However it isnt ideal to have a horse on bute forever, if you end up at that point probiotics should be given daily to help restore the gut flora.

Simple things like not working on hard ground, maintain strick trim/reset dates, and controlling the inflamation when it happens will allow you to ride for a long time. My girl also had injections into the coffin joint every 3-4 months which made a big difference.

Hope this helps

 

[ihatework]

Thanks everyone.

BB's were Berties aluminium shoes just regular ones like race plates or were they aluminium egg bars?
I think in the short term I will opt for egg bars to try and get things stabilised, but both my farrier and vet have mentioned that they aren't always a long term solution, my farrier in particular has said that I would be best to alternate their use.
If I get another 3-4 years from him I reckon I'll have done pretty darn well!

Annie02 - I'm sure you know that navicular disease/syndrome is so vague to diagnose, we would need an MRI to really pinpoint things as xray isn't the best diagnostic tool but insurance only covers half and combined with the fact the horse also has issues with PSD behind we have decided not to MRI.
But basically a few weeks ago we did a work up, lame NF 1/10th on straight, 3/10 on a circle. Coffin block in NF bought him sound. Following week did some xrays, we were expecting to see some sort of DJD in coffin joint, Xrays clean as a whistle around that joint but showed roughening of the lower surface of NF navicular bone, and not apparent in OF. Had a steroid injection into NF coffin joint as part of diagnostic process. Reexamined this week, injection has made no difference, horse now 6/10 lame NF on circle. performed a navicular bursar block and went about 6/10 lame on OF (hadn't at previous work up), blocked OF navicular region and came almost sound.

I've just got to put my trust in the vet's follow their advice, if I can get J soundish and happy then great, if not I'll have to consider the alternative. But I'd definitely try him on bute if it would give him a good quality of life for a short while.

 

[brightmount]

[ QUOTE ]
we would need an MRI to really pinpoint things as xray isn't the best diagnostic tool but insurance only covers half

[/ QUOTE ]

Not that this helps, but for the record, NFU only cover half of an MRI scan because, in their words "we don't want you to use up all your cover on MRI scans" (hmmm?).

Petplan cover the total cost of an MRI scan.

 

[annie02]

Sounds like he got pretty lame in a hurry...going from a 3/10 to a 6/10.

You're right to follow the vets advice. That is what I did. You start to see what is working and what isnt, we always made sure to let our vet know and she was good to give suggestions or changes to our program accordingly.

Maybe you should talk to your vet about using bute daily for the short term to see if you can get the pain and inflamation under control. You may be doing things to help but if he is that sore you may not see a difference. Just a thought.

 

[KINGLIAM]

so sorry for you and your horse a mate of mine had the same problem with he tb she does not have him shod she uses old mack boots he is now 21 years old and is doing fine

 

[monstermunch]

I am so sory to hear about your boy. It's never easy when something goes wrong as we all have to rely on various professional opinions and people's reccomendations all of which can be conflicting. Follow your heart as much as anything as you know your horse better than anyone.

With that said I have to say that in my experience steroid injections can do more harm than good and I personally don't see them as a log or short term solution. this applies with human injuries as well.

In terms of long term use of bute this is something that I also struggle to get my head round. I do believe that there are situations where yes this is possibly the only option. However I kjnow a number of people who are in the same situation as you or in similar situations where there horses had been on long term use of bute. They decided to try a different route and use a very high strength therapy grade joint supplement. 6 of those horses came completely sound for the first time in years and are now not having to use bute. Both them and their vets are thrilled.
So there are sometimes alternative options to try. I feel that non invasive methods and non drug methods are always the best to exhaust first.

I also know of many people who have had great success with corrective shoeing and some who have not. So again it seems to vary from person to person.

What I would say though is that navicular isn't necessarily the end of the line for your horse. There is a lot that can be done and I have seen many horses brought back to full and even competitive workloads.

I wish you the best of luck with your horse and hope you can find the right solution for your boy

 

[mrussell]

OK I am going to be very controversial here - only because I found the last resort for my boy and it continues to work.

Cytek shoeing.

Similar in concept to NB but supports more sole, relieving hoof wall and heel pressure.

Vets hate them as to traditional farriers. But the proof is in the pudding.

They dont work for all horses but they have and still do for mine.

Good luck.

Cala

 

[SusanFlynn]

My friend went all the routes you are going to do. Sadly all the vets knew and suggested failed. That was 4 years ago. She found out about Cytek shoeing and went that route. It was a good result till this summer when it all came rearings its head again.The vets again came back with remedial shoeing. and similar ideas But she was adiment it didnt work last time and if the condition is now worse it wont work this time.
So she investigated BF and all the information she could find and spoke to a number of respected people in the field and even read papers written on its success. Till then she was certain her horse would never handle BF as the typical TB and her environment was not suitable. She has her own place with a school but no tarmac or flat concrete for conditioning. 5 months ago this was. The shoes were removed and her trimming has only been carried out by a KC trained EP. Xrays have been taken and examined as referance for the future. But she was very lame even out in the field on 2 bute a day. It was hard for her as an owner so she was put into pads inside of boots to help her. Gradually she has come through improved. Now she is sound and not in boots and checked by the vet as sound, on no medication, and even on circles in the school. She is being ridden and hacked out ( in boots on fronts as it is very very rocky and stony in the lanes till she gets to grass.)
5 months is what it has taken to get there. Much sooner then any of our expectations of even some improvement let alone sound.

I am not saying this is cure for all but it has to be a consideration. A lot of navicular is man made through ill balanced shoeing allowing the foot out the front door and collapsed heels and the balance out. There can be a solution. The Cytek did help for a long time but we know now it is not a long term answer.
I am not promoting Cytek either here only explaining what was done.
BF is not a man made product or an application, it is simply balancing the foot and supporting it wih help through conditioning to heal itself. The foot has that ability to do it if it is given a chance.
Her case isnt isolated by any means.
Its another route to be aware of either today or someday in thefuture.
If you want to visit the Enlighten Equitation forum and go to the BareFoot section you will be able to search more for yourself.
I know my friend is very happy for her mare and her vet is very pleased it has worked out , exceeding all expectations.

I hope this might be of come help to you,

 

[sally2008]

I echo what others have said about egg-bars not being the best option. I'd be interested to hear your vets theory on what benefit he thinks they would provide. I suspect it might be a "we've always done it that way" kind of answer as there are much better options available now to take the strain off the tendons and release the pressure on the navicular bone.

I've seen good results with NB (often combined with graduated pads) and EDSS, which has to be the most sophisticated and adjustable system I've seen.

Either way, I hope you find a solution to make him more comfortable in the longterm.

 

[Mahali]

Oral Gallium Nitrate Restores Soundness in Horses with Navicular Disease
http://www.der-huf.de/aktuelles/Gapodo.htm

Might be interesting...

 

[puddicat]

Sorry to hear about your horse, that's very unfortunate.

Nothing new in navicular research that would be of any benefit unfortunately. At BEVA Congress this year there was a session on caudal foot pain (a strategically more generic term to refer to the symptoms typically associated with navicular disease). Rachel Murray from the AHT presented a review of their MRI cases. The punchline was that there are lots of related changes to anatomical structures in foot in cases labeled as 'navicular'. The significance of these changes is not known but (1) it reenforces the idea that navicular is a syndrome, ie a set of symptoms that ma have several causes and variations (2) it provides some explanation for why navicular cases can progress in different ways. Apart from that Alan Wilson from the RVC presented a model for how navicular disease progresses which amounts to "when horses alter their posture to relieve pain, they create a situation inside teh foot which could increase the rate of degeneration" or in other words positive feedback.

Because there is so much variation in progression and progression rate it might be worth taking some time to see if you can find a solution for your horse that makies him comfortable. Farriery might work, either trimming or taking out concussion with a rubber shoe (you would probably know whether this is likely to work just by trotting on relatively soft ground such as turf. There is a class of drugs called bisphosphonates which 'may' help prevent further bone loss (this is working on the assumption that the bone loss in the navicular is important in some way either functionally or by causing pain). They are patented for use in horses but I'm not sure whether there is a drug available yet - vet would know.

Don't give up hope though, there's nothing to say that you won't find a solution that's workable for your horse. Reserve judgement on the rate of degeneration. What you really know is that the onset of pain was fairly rapid and when you looked you found degeneration. The degeneration could have been there for ages at almost the same level but some small change exposed a nerve ending. Although it seems large scale improvements in the bone don't occur, it's not impossible that small scale improvements might occur and alleviate the pain.

 

[MissDeMeena]

Sorry, i can't offer any real advice!!
But i evented a 14yr old TB for someone this year, who 2yrs ago was diacnosed with Navicular!
This season, she started BE eventing for the first time, and qualified for a PN 3day, and completed said PN 3day, trotting up sound on the third day!
Along with her normal feed, she is fed that strawberry powder (or any flavour) used to make jelly! (as in jelly and ice cream) the owner said she'd had her on various expensive foot suplements, none of which worked, but this jelly powder does (found in any supermarket)

So not really an advice post.. but just to say chin-up, and that a horse that owner was told to shot a year ago, has just trotted up sound on the 3rd day of a 3day event... and also, to try that jello powder stuff!

 

[Santa_Claus]

well my lad was diagnosed with Navicular Disease in July time. He was treated with Tildren primarily for his bone spavins but also as apparent the Navicular. Steroids injections had made only minimal temporary effects on the spavins and so the Tildren was a bit of a last chance effort but thankfully the results have been brilliant. He also now has pads which raise his heel. Soundness wise he is more sound than he has been in years and his actual movement has dramatically improved as well, and he is only 12years old. (rising 13!).

IT has been about 5 months now since he is treated and they say if the tildren works it will take up to 6 months to see the full benefit because of the time it takes for the bone to regenerate.

The only downside is it doesn't work on all horses but those it does it seems to do wonderful things. One friend's horse no longer has xray bone changes and so has been effectively cured. Another for bone spavins passed vetting easily whereas previously it would never have passed.